Salmon Essays (1909 words) - Salmon, Oncorhynchus, Thamnophis

Salmon What species would travel over 2000 miles just to have young and then die? It has been said that anyone who has not seen a wild salmon has not seen what a fish should be. Salmon was the common name applied to fish characterized by an elongated body covered with small, rounded scales and a fleshy fin between the dorsal fin and tail. In this paper I will be discussing history of studying salmon, the life cycle, spawning and mating behaviors; which has much to do with the total reproduction of salmon. Salmon were studied earlier than some may think. Experiments were done by men that date back to the mid-1600s. These experiments involved catching salmon in fresh water, tagging them, and then catching them again when they return to the same place, around six months later. These experiments were doubtful and it was not until the beginning of the 1900's that proof was available that the salmon returned home. (Shearer) Although usually drab in color before the breeding season, which varies with the species, members of the salmon family develop bright hues at spawning time. The male, during this mating season, usually develops a hooked snout and a humped back. In many diverse taxa, males of the same species often exhibit multiple mating strategies. One well-documented alternative male reproductive pattern is 'female mimicry,' whereby males assume a female-like morphology or mimic female behavior patterns. In some species males mimic both female morphology and behavior. We report here female mimicry in a reptile, the red-sided garter snake (Thamnophis sirtalis parietalis). This form of mimicry is unique in that it is expressed as a physiological feminization. Courting male red-sided garter snakes detect a female-specific pheromone and normally avoid courting other males. However, a small proportion of males release a pheromone that attracts other males, as though they were females. In the field, mati ng aggregations of 5-17 males were observed formed around these individual attractive males, which we have termed 'she-males.' In competitive mating trials, she-males mated with females significantly more often than did normal males, demonstrating not only reproductive competence but also a possible selective advantage to males with this female-like pheromone. In the competitive mating trials, the she-males were successful in 29 out of 42 trials. The normal males won out in only 13! The authors ask the question: Why aren't all males she-males given such an advantage? (Mason, Robert T., and Crews, David; Female Mimicry in Garter Snakes, Nature, 316:59, 1985.) Comment. Among the fishes, bluegills and salmon (and probably many others) have female-appearing males competing with normal males. Abstract: The influence of sperm competition and individual mating behaviour in an externally fertilizing species of fish, the Atlantic salmon (Salmo salar), is estimated from video observations of multiple-male spawnings and subsequent paternity analyses. One male dominated the paternity during polygamous spawnings, fathering more than 80% of the progeny in a single nest. Behavioural analyses of the spawnings showed that the first-mating male had sperm precedence in 6 out of 10 cases. In three of the other spawnings, sperm limitation likely influenced individual success, as the first-mating male had participated in a large number of spawnings. In the final, nearly simultaneous spawning, male size was more important than the 0.6-s difference in spawning times. Thus, male fertilization success can be influenced by a variety of factors, including sperm precedence, male size, and spawning history. Back to Table of Contents Before mating, one parent excavates a nest for the eggs; after the eggs are deposited and fertilized, the female stirs up the stream bottom so that earth and stones cover the eggs and protect them. The eggs hatch in two weeks to six months, depending on the species and the water temperature. During the migrations and nest-building activity that precede mating, neither the females nor the males consume food. In the life cycle of the pacific salmon, nature recycles the parents to feed the babies. Mature salmon leave the Pacific Ocean as saltwater fish, never again to eat as they battle their way up the Columbia River to spawn in the home stream where they were born. Those born in the upper reaches of the Columbia River's tributary stream, the Snake River, travel more than

communication in virtual teams Essay Example

communication in virtual teams Essay Example communication in virtual teams Essay communication in virtual teams Essay communication in virtual teams BY Anna160283 Communication and leadership in Virtual Teams Communication is fundamental for personal and organizational socialization. Generally, communication is the process of transferring information, meaning, and understanding between two or more parties, and there is a huge literature on how this process can be made more efficient and effective. Communication plays the central role in the virtual team success. Communication process for face-to-face interaction is different from virtual communication. Virtual teams typically use computer-mediated asynchronous communication. Computer-mediated synchronous communication typically allows for multiple threads or concurrent themes of conversation to occur from multiple contributors all at the same time, instead of being restricted to turn-taking (with communication blocking) as is common with synchronous face-to-face communication. (Berry, 2006). Virtual team members can express their ideas without any interruption from others. Computer- mediated communication has fewer social, political, or power context cues as found in face-to-face communication. Another specific characteristic for virtual communication is absence of verbal cues such as intonation, facial expression, estures, and contextual cues that enable listeners to read (or misread) the speakers intent and this can aid (or hinder) understanding. (Sproull Kiesler, 1991; Vroman Kovachich, 2002). Also researchers point out that in virtual communication informal or unintentional information is less likely to be shared between team members. This can result with work interactions being more task focused than on face-to-face teams (Hiltz, Johnson, Turoff, 1986; Maynard, 2006). Computer-mediated asynchronous communication is largely unrestricted by location or time zone (Harasim, 1990). This means that virtual communication provides a constant opportunity to discuss problems, share perspectives, get feedback, and answer questions that arise among team members without waiting for scheduled meetings. Hinds Weisband, 2003). In another hand, the absence of physical presence is considered to be the major drawback of virtual teams (Cohen Gibson, 2003). Some virtual team members may be less productive or satisfied because they feel isolated and detached from both the work and the other team members. Create social relationships in virtual teams is very difficult and takes a lot of time and effort but ack of social interactions may lead to superior task outcomes. Although virtual team members may miss the normal face-to-face int eractions of the workplace or classroom, they also typically acknowledge that these more traditional social interactions are not necessary to complete their assignments. (Berry, 2006). The success of failure of virtual team is depends on proper communication and leadership. In the articles on communication process various features of competent communication practices have been presented, ranging from information seeking and networking skills to negotiating ability. Motivating team members and offering support are vital skills when leading a virtual team. The team members of virtual guidelines for their proper use is critical for the virtual team in order to get daily computer-mediated communication to function effectively as well as set clear goals for the future (Sivunen Anu). Other authors suggest that leaders directly manipulated technology, task, and people structures. Leaders must learn to recognize the triggers, shift their focus to improving team interaction, and effectively take action, so that team productivity can be maximized. (Thomas Dominic). Christine Grosse add that the managers use a number of communication strategies to help them get their message across successfully with virtual teams: communicate continuously; use active listening; keep communication simple and clear; use different technologies to advantage; build relationships and trust (Christine Grosse). Authors of the article Global virtual teams refer that team leaders should be mindful of cultural differences, communication, and language barriers, and discrepancies in technological proficiency among team participants and how these make a difference in team effectiveness (Dube Line). Other researchers identify six leadership practices of effective leaders of virtual teams: 1) establish and maintain trust through the use of communication technology; 2) ensure that distributed diversity is understood and appreciated; 3) manage virtual work-life cycle (meetings); 4) monitor team progress using technology; 5) enhance visibility of virtual members within the team and outside in the organization; and 6) enable individual members of the virtual team to benefit from the team. All these practices will help leaders of virtual teams to build a strong and effective virtual team (Malhotra Arvind).

Mark Twain's use of Irony The Nortorius Jumping Frog Essay

Mark Twain's use of Irony The Nortorius Jumping Frog - Essay Example He was a keen observer of human beings and did not like much of what he saw. He believed that people were often very foolish or cruel and the literature he wrote in response to this plainly brings people to task for being this way. However, to simply state this proposition is not an effective means of communicating it. It becomes a much more powerful idea when Swift uses rhetorical devices like satire and irony. We believe the story until the end. We become invested in the story of the gambling on frogs. Only at the end do we realize it is a joke. This is one of the first indications that we are dealing with a satire or parody. In a satire, a narrator appears to be endorsing something he is actually mocking. This is done by using irony. Irony can be a very effective rhetorical method, pouring contempt on an idea or principle much more harshly than a straightforward attack. Irony sneaks up behind you and ambushes you. It is a good way to rhetorically attack problems and situations that are right in front of you and that many people might want to defend. With irony you can attack but others will not realize you are attacking until it is to late (Horn 76). This is what Twain has done in The Notorious Frog. For ma ny who picked it up, it would take some time to realize it was all a joke. When they did realize it was a joke, they would be shocked and begin to really think about what Twain meant. This is an especially militant form of irony—something Twain truly excelled at. People will always take advantage of one another. Gullibility is omnipresent. A lesser writer might have been tempted at the end of the story to reveal the whole thing to be a joke. But Twain is a rhetorical master. He realizes that consistency is everything in rhetoric: if you shift out of the voice you appear disjunctive and lose the full effect. That is what makes the final paragraph of the story so powerful: even at the end, Twain and his narrator claim he is

Marketing on Women Essay Example | Topics and Well Written Essays - 500 words

Marketing on Women - Essay Example Today, women are well educated, travel, and live alone in new cities, and they form a mobile workforce. Women are active in almost all sectors, such as engineering, manufacturing, construction, hospitality, healthcare, entertainment and TV, and many other sectors. Thus, the earning power of women has increased, and they do not have to depend on their husbands, fathers, brothers, or partners to buy products2. Statistics: In USA, high net worth women make up 39 percent of the top earners while 2.5 million women have assets of $ 4.2 trillion. About 43 percent of women in USA have assets of more than $ 500,000. Estimates until 2020 indicate that women will control and manage about two thirds of the national wealth and control about $ 40 trillion. Generally, women make 95 percent of the decisions to buy a large number of products, while in groceries; they make 99 percent of the decisions. Estimates indicate that women are the decision makers for 85 percent of all consumer goods, 91% of new homes, 92 percent for vacations, 65 percent for new cars and 93 percent for pharmaceuticals, beauty products and personal hygiene items. Women also participate in online buying and 22 percent shop online almost daily, and they post reviews about their purchase, post messages in social media and write to marketing firms about their pleasure or displeasure3. Loyalty: Studies indicate that womens loyalty is less for some types of products such as consumer goods, groceries and toiletries. They look at a number of factors such as product quality and price and they would be willing to try new products that are recommended by friends or that cost less, but the products must meet the expected quality requirement. Celebrity endorsements have limited appeal, unless women like the products. Women also tend to be more loyal to the service provider such as the waiter,

The Family in the UK today is in crisis Essay Example | Topics and Well Written Essays - 1000 words

The Family in the UK today is in crisis - Essay Example absence of fathers in the lives of their children.2 Aside from the after effect of the feminist movement on traditional family lifestyle, Burgess (1926) states that industrialization and modernization also creates a signifincant impact over the continuously changing functions on nuclear family in our society.3 With regards to the increasing rate of divorce in UK, the essence of a child personally knowing and growing up with his/ her biological parents is highly affected. As a result, a lot of social consequences are becoming significant in the lives of the local citizens. In order to determine whether the family in UK today is in crisis, the researcher will examine the trend related to divorce rate, crime rate, employment rate, early abortion rate and the decline in the UK population as well as its corresponding consequences in our society. One of the main causes of crime is due to poor parenting which is often associated with broken family.4 Many times, children who grew up with a broken family either causes an aggressive behavior or inferiority complex among the children.5 Eventually, these young individuals may end up searching for other alternative ways such as joining a gangster or end up using drugs and alcohol in order to divert their attention from their family issues.6 In line with this matter, Slapper (1997a, 1997b) suggest that parents who practice poor parenting should be controlled by imposing them a penalty.7 Social and economic resources of each family could affect the parents’ capacity to regulate their children’s behaviour.8 In a traditional nuclear family structure, in case the father could not provide sufficient monetary income for the needs of the family, the wife has no choice but to go out of the house to work. Based on the report that was released by the Office for National Statistics in 2006, divorce rate in England and Wales fell by 7% as compared to 2005.9 Eventhough divorce rate in UK dropped from 13.1 to 12.2 persons

Ethical Issues with HIV Positive Clients

Ethical Issues with HIV Positive Clients Introduction HIV and infectious diseases is a sensitive issue that has prompted the introduction of additional laws to protect the psychological and emotional needs of the clients. Ethical values basically guide ethical behavior and conduct. Various moral concerns have been identified since the emergence of HIV. Ethical Principles Basic principles that guide medical behavior include respect for persons, justice and beneficence (Angel, 1998). Fundamentally, these are achieved through keeping promises, upholding respect and maintaining confidentiality (Wolf, 2001).Other ethical principles include utilitarian perspective and the ethic of caring (Wolf, 2001). Ethical Issues Confidentiality. Generally, all medical information and records are expected to be kept confidential. Gostin et al (1997) shows that the sensitive nature of information related to HIV and other infections have prompted creation of additional laws to protect the affected clients. There are exceptions however that allow the healthcare personnel to report cases to healthcare authorities (Gostin et al, 1997); the need to disclose the status to the persons at risk (Gostin Webber, 1998); the case relating to infected healthcare personnel that rested in the formation of a panel of experts that restrict the activities of the infected workers or inform the patients of their status (Kass, et al, 1996; Lurie Wolfe, 1999; Singer et al, 2006; Varmus Satcher, 1999); prenatal testing that has introduced routine testing to all expectant mothers (Connor et al, 2004, Levine 1998 ; Sargent, 2000) End of life issues. Ferriman (2001) ascertains that this existed during the initial times of the emergence of HIV when it had the capacity to develop in to a terminal disease in a short period of time. Availability of effective ARVs has changed the situation (Lurie Wolfe, 1999). However, it still affects populations with limited resources. Palliative care is essential. Vaccine Research. Wolf and Berkey (2000) indicate that the minority are employed in trials. Wolf (2001) notes that the populations have false hopes about the possibility of being cured. Vaccines have adverse impacts on the immunity of the participants. Participants may be denied travel rights due to the health implications of the vaccine. There eligibility of taking up certain jobs is affected. Gostin and Webber (1998 show that at times the participants are labeled very vulnerable to infection. This has far reaching implications n their behavior. Confidentiality is often breeched by the researchers. Research ethics. Feriman (2001) points out that the participants are not given vital information prior to research. In other instances, their consent is not sought. Healthcare providers contribute to the misconceptions (Gostin, 2000). Patients are not informed about the implications of the research. Loyalty by patients makes them to avoid informing themselves of the necessary procedures. Patients at times provide information in return for better services from the healthcare in future. Healthcare providers undertaking research place greater emphasis on financial benefits rather than the interests of the patients. Summary It is clear that the ethical principles of respect for people, justice and beneficence provide essential guidance in health care. In addition, the utilitarian perspective and the ethic of caring also provide vital guidance to medical behavior. Notably, these enable the clinicians to interact with HIV positive patients and those with infectious diseases in a sustainable manner. Ethical concerns such as confidentiality, end of life, informed consent, vaccine research, research design and conflict of interest characterize the interaction between patients with infectious illnesses such as HIV and clinicians. Recommendations Patients need to be informed of their legal rights prior to testing. Pretest procedures and counseling need to be upheld. With regard to HIV vaccine research, it is important that the trials be carried out on a population that is globally representative. Finally, it would be important for the researchers carrying out medical research about infectious diseases to be guided by fundamental clinical ethics References Introduction The sensitivity that is associated with HIV positive clients, infectious diseases and relative information requires the clinicians to uphold a high degree of morality when interacting with the patients at different levels. Since the emergence of the epidemic, various ethical concerns have been identified in different instances. In order to ensure that the wellbeing of the patients and healthcare providers is protected, measures have been undertaken to address the concerns accordingly. Indeed, it is worth acknowledging that the psychological wellbeing of the HIV positive patients plays a critical role in their holistic wellbeing. Physical wellbeing can be achieved if the patients are handled with the greatest level of care. It is against this background that this paper explores the ethical issues concerning HIV positive clients and other infectious diseases controlled by the health department guidelines. In order to enhance a harmonic consideration, the paper starts by underscoring the basic ethical principles underpinning healthcare and relative research. Then, it exhaustively reviews several ethical concerns and comes up with recommendations that would effectively address the ethical issues. Ethical Principles Clinical work and related research is governed by various ethical and moral principles that guide professional behavior and conduct. When dealing with persons that are HIV positive or those with other infectious diseases, it is imperative to observe these principles as they make the patients feel appreciated and cared for. Of great importance is the moral worth that these values enhance. In particular, Angell (1998) indicates that respect for people, justice and beneficence are fundamental values that govern any form of clinical interaction. The value of respect for persons demands that the decisions and autonomy of other individuals be upheld. In addition, this principle postulates that persons that lack autonomy and those that are unable to make independent decisions be protected. Justice requires that all persons irrespective of their status be treated in a fair manner. The ideal state of justice is characterized by equal distribution of the burdens and benefits within the society. Finally, beneficence imposes upon the clinicians a responsibility to act in the interests of the patients. In order to achieve this Wolf (2000) asserts that the ability to keep promises, uphold respect and maintain a high degree of confidentiality is essential. Other ethical principles that can be used to guide the conduct of clinicians in this field include the utilitarian perspective and the ethic of caring (Wolf, 2001). The former places emphasis on the consequences of the activities and postulates that clinical behavior can only be morally acceptable if its consequences are desirable and enhance the greatest good for the majority of the population. The latter on the other hand judges the activities based on the effect that they have on relationships. However, Wolf (2000) indicates that some of these principles conflict and therefore can not be applied jointly. In addition, it is notable that some principles can not be applied in some situations. The clinicians should therefore weigh the relevance of a principle to a situation before applying it. This is important to avoid conflicts that are likely to stem from application of multiple principles. Of great importance however is to ensure that the greatest degree of good for the greatest m ajority is always upheld. Ethical Issues Over time, various ethical concerns have arisen from the interaction between HIV positive patients and clinicians. Confidentiality is one such issue that has been considered to be very important in this regard. Generally, the law provides that all medical information be treated with a high degree of confidentiality. However, Gostin et al (1997) shows that the sensitive nature of information related to HIV and other infectious diseases has prompted various states to adopt relevant laws that offer additional protection to the same. These laws prevent disclosure of information related to HIV without prior authorization. However, as indicated earlier, there are different contexts that might require that such information be disclosed without the knowledge and/ or authorization of the patients. Basically, such steps are considered ethical as they seek to enhance the greatest good for the greatest percentage of a population. To begin with, the law allows the healthcare personnel to report HIV infections to relevant public heath authorities. Gostin (2000) contends that the advantages of this reporting basically outweigh the risk discrimination of the infected individual. Usually, the name of the individual is not provided during reporting. However, epidemiological studies show that in order for intervention measures to yield optimal results, there is need to encourage provision of name based information during reporting. Nonetheless, it has been argued that this has the capacity to increase the risk of discrimination and therefore should be avoided. This position is also held by the Centers of Disease Control and Prevention that ensure that testing of HIV is made anonymous. Another scenario that breeches confidentiality but is not punishable by law is when the healthcare providers disclose the status of a patient to persons that may be at risk of infection. In this regard, Gostin and Webber (1998) ascertain that the right of a patient to be accorded confidentiality is often in conflict with the right of the partner to be notified accordingly. Despite the fact that confidentiality is instrumental in avoiding discrimination, it needs to be appreciated that the implications of failing to inform a non suspecting partner can be far reaching. In order to avoid conflicts, the patients are usually advised during counseling to reveal their status to their sex partners. Another exception with regard to confidentiality of information that is HIV related concerns the healthcare workers that are infected with the disease. This particularly affects the workers who perform exposure prone procedures. In this respect, Singer et al (2006) cites the US law that demands that the status of these workers be reviewed by the expert panel. This then makes a decision regarding whether to prevent the infected workers from performing such procedures or to inform the patients about their infection. The equivalency policy that demands that the healthcare workers disclose their status has been increasingly adopted by various states. From an ethical perspective, disclosure of HIV status by the health workers and enforcement of some form of restrictions is in line with the best interests of the patients. However, various studies of whom Lurie and Wolfe (1999) are represented argue that this contravenes the privacy of health workers and enhances discrimination especially when the patients are informed. However, it should be appreciated that the benefit of the uninfected patient outweighs the risk of discrimination of a heath worker by the same. To address these concerns, a more viable approach would be for the council of experts to place restrictions but avoid informing the patient, unless under special conditions. Another ethical issue regarding HIV positive patients and those with infectious diseases is informed consent before testing. Basically, various clinical tests that involve testing of the blood samples of the patients do not require consent. However, the realization that testing for HIV had various negative implications led to the need for informed consent. The specific psychosocial risks that are presented by HIV testing include restriction of lack of access to insurance, healthcare or housing, possibility of rejection by family, friends and/ or close relatives and discrimination during employment. Thus special procedures that seek the consent of the patient such as pretest counseling and need for specific informed consent from the patient are a prerequisite. These measures ensure that the patient is psychologically and emotionally prepared to deal with the implications of the results. Essentially, the information that needs to be availed to the patient prior to testing include the benefits and risks of testing, risky behaviors, measures undertaken to prevent transmission, the nature of the test and confidentiality of the test. These are always coupled with an informed consent from the patient. In their review, Varmus and Satcher (1999) indicate that most states require that the patient provide a written consent. However this provision has various exceptions. In some instances, prisoners are persons that are accused of sexual crimes are often tested without consent. In addition, some states have made the testing mandatory for new born babies. In his study, Kass et al (1996) indicates that this also reveals the status of the mother. Notably, prenatal testing is also undertaken without consent from the mother. Fundamentally, early detection is instrumental in preventing mother to child transmission. Initially, prenatal testing was undertaken after a pretest counseling and informed consent. However, changes were proposed and currently, all pregnant mothers undergo a routine prenatal HIV testing. However, the revised edition of this law by the US Public Health Service presented a need for informed consent, although it is not clarify whether this needs to be verbal or written. Connor et al (2004) ascertains that the proposals that seek to make HIV testing mandatory for pregnant mothers are compounded by different complexities. To begin with, the provision does not ascertain whether it would be accepted by all the mothers or not. In this regard, it should be appreciated that some mothers may not be willing to undergo the test. It was posited that once this provision is made a routine requirement, it would become difficult for the pregnant mothers to determine whether they have a right to decline the test or not. Notably, this undermines the principles of autonomy as this critical decision would be beyond the ability of the affected mothers. Further, Sargent (2000) indicates that the care provides are likely to forget that HIV testing has various psychological implications that are likely to compromise the wellbeing of the mothers. In this respect it is recommended that precautionary protective measures be undertaken prior to testing. Further, foregoing the pretest procedures has the capacity to undermine preventive efforts. Connor et al (2004) indicates that in this regard, the mothers would not be informed about these important measures and they would fail to take necessary measures to prevent themselves from contracting new infections. Generally, it is agued that the proposed routine testing may compromise the adherence to vital pretest procedures. The possible spill over effects to the rest of the population can adversely affect the wellbeing of the general population. Further, Levine (1998) points out that pregnant mothers who are HIV positive are usually expected to make various choices regarding their health and pregnancy. In this regard, these women should not be forced to either undergo sterilization or abortion. In addition, the pregnant mothers should be counseled accordingly in order to enable them make viable decisions to either continue carrying the pregnancy or terminate it. Another ethical issue regarding HIV positive patients includes end of life issues. In this regard, Ferriman (2001) appreciates that before the development of antiretroviral therapy, HIV usually progressed very quickly to a terminal disease. However, this concern has in the recent past been less prominent due to the availability of antiretroviral therapy. However, it should be acknowledged that some segments of the global population lack vital resources to cater for these concerns. In such incidences, palliative care that seeks to reduce suffering is essential. In instances where resources are not available, care is fundamentally limited to psychological support that basically helps the patients plan for issues such as child custody and burial. Nevertheless, Lurie and Wolfe (1999) indicate that this scenario is probably changing as measures are being undertaken to increase the provision of anti retroviral drugs to the affected population. Practical measures in this respect include pre ssuring the relevant pharmaceutical companies to provide the drugs at affordable prices, providing resources for purchase of the drugs and allowing production of generic drugs. Further, it is argued that the HIV vaccine research has also been fraught with numerous ethical complications. To begin with, Wolf and Berkeley (2000) indicate that the minority of the population has increasingly been employed in research. In this respect, it is posited that population samples for trials are often picked from developing countries. Furthermore, Wolf (2001) notes that the population involved in research often has positive hope because of the belief that it is actually a cure. As such, participants tend to involve themselves in risky behaviors. This implies that the nature and function of the trial is not often communicated to them in an effective manner. In addition, it shows that the researchers place more emphasis on the results of the research rather than the protection of the participants. In this regard, it would be imperative for the researchers to protect their participants too. This will not only enable them to get high quality research but also save the lives of the vulnerable population. The HIV vaccine trials have also been identified to pose various risks to the participants. In this regard, it is indicated that the participants are often refrained from participating in future researches. In addition, the implications of the trials to the immunity of the participants are still unknown. Further, Levine (1998) asserts that the participants may be frustrated in the long run due to the fact that the vaccine may not be effective. Also, it is argued that the participants often react differently to specific antibody tests that characterize the trial. As a result, they may be prevented from traveling to other countries. In addition, these effects are likely to undermine their eligibility for some government jobs such as the military. This may happen irrespective of the fact that their seroconversion may not be a representation of an infection. Furthermore, the participants are likely to face some form of stigmatization as a result of disclosure to friends and relatives. In their review, Gostin and Webber (1998) ascertain that certain phases of the trial often identify some of the participants to have a high risk of contracting the infection. This has various implications and may pose difficulties to the particular person. Finally, consistent research indicates that confidentiality of the status of the participants has increasingly been breached in the past. Recent surveys affirm that this often happens, irrespective of the fact that the researchers are charged with the responsibility of keeping the status of the participants confidential. Further, ethical issues have increasingly been raised with regard to conducting research about infectious diseases and HIV. To begin with Ferriman (2001) indicates that the participants need to be informed prior to the research and their consent sought. Often, the expectations of the participants tend to undermine the quality of the research. In this regard it is worth acknowledging that most of the participants consent to participate in research, not because of the need to help the researcher to obtain vital results but of the expectations to attain personal benefits. The widespread misconceptions about the importance of the research often make some patients to misinterpret the information availed to them. In the long run, the quality of the research is greatly undermined. Health care providers have been cited by Gostin (2000) to contribute significantly to these misconceptions. In this regard, it is noteworthy that the health personnel undertaking a certain research often have an upper hand with regard to the knowledge about the research. In some cases, they fail to inform the patients about the importance of the research. In other instances, they provide wrong advice to the participants and since they have the authority over the patients, the participating patients are inclined to follow their misguided advice. Further, Kass (19996) argues that some patients participate in researches because of the need to please the healthcare staff. In such instances, the participants believe that they would get quality healthcare in return. Moreover, emergent research indicates that the trust that the patients have in the medical institutions often makes them participate in the researches without reviewing the relevant conditions. In such cases, the healthcare providers undertaking the research over estimate the benefits of the same and fail to inform the participants of relevant procedures. Conflict of interests in the area of research and especially that pertaining to infectious diseases also raise various ethical considerations. In this respect, Angell (1998) indicates that these are attributable to the benefits that healthcare researchers get from positive results of their research. In particular, they usually get grants, prestige and promotions fro their research and other published work. As a result, they always aim at recruiting and retaining particular participants in their researches. In some instances, this interest conflicts with the basic interests of the participants. However, the conflicts that are financially oriented often influence the quality of the researches as the decisions made are not objective. In addition, financial conflicts some cases make the researchers to halt the research irrespective of the fact that it is likely to benefit very many individuals. Summary To sum up, it is clear that the ethical principles of respect for people, justice and beneficence provide essential guidance in health care. In addition, the utilitarian perspective and the ethic of caring also provide vital guidance to medical behavior. Notably, these enable the clinicians to interact with HIV positive patients and those with infectious diseases in a sustainable manner. Ethical concerns such as confidentiality, end of life, informed consent, vaccine research, research design and conflict of interest characterize the interaction between patients with infectious illnesses such as HIV and clinicians Recommendations From the analysis, it is certain that ethical issues pertaining to infectious diseases like HIV and Aids are wide and varied. In order to uphold the relevant ethical principles that govern the interaction of patients and clinicians in this regard, it is imperative to put in to consideration various factors. These would ensure that the overall wellbeing of the patients and the clinicians is achieved. To begin with, it is important for the psychologists and other clinicians to inform the patients of their legal rights before assuming any form of treatment or tests. Knowledge about their rights would enable the patients to make objective decisions regarding their status. Particular areas of concern in his regard would be to inform the patients about various exceptions to confidentiality. This would ensure that the patients make informed decisions and in a timely manner. Wolf (2000) proposes that before informing the persons at risk about the status of the patient, psychologists need to inform the patients about their intentions. This would be instrumental in avoiding conflicts at a family level. Furthermore, the importance of pretest procedures and especially counseling should not be understated. Basically, these seek to psychologically prepare the patients to deal with the implications of testing with ease. In particular, the importance of positive living needs to be emphasized. This procedures needs to be extended to prenatal testing. Pregnant mothers have a right to make their decisions and should be allowed to do so through counseling. Much as it is important to protect the life of the unborn, it is worth noting that routine testing that deprives the mother of relevant pretest counseling. With regard to HIV vaccine research, it is important that the trials be carried out on a population that is globally representative. The participants should be well informed about the implications of the trials and their consent sought before the onset of the same. Relevant information should be all inclusive and should entail the emotional, psychological, social and legal implications of the trials. Most importantly, the researchers need to uphold a high level of confidentiality about the status of the patients. Finally, it would be important for the researchers carrying out medical research about infectious diseases to be guided by fundamental clinical ethics. Of great reference in this respect would be their ability to put the interests of the patients before their own. In this regard, they need to inform the participants about the procedures of the research and ensure that they get their consent before beginning the research. In addition, they need to uphold a high level of objectivity when undertaking the research.

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1. Guided bone regeneration (GBR) The concept of GBR was described first in 1959 when cell-occlusive membranes were employed for spinal fusions 105.The terms ‘‘guided bone regeneration’’ and ‘‘guided tissue regeneration’’ (GTR) often are used synonymously and rather inappropriately. GTR deals with the regeneration of the supporting periodontal apparatus, including cementum, periodontal ligament, and alveolar bone, whereas GBR refers to the promotion of bone formation alone. GBR and GTR are based on the same principles that use barrier membranes for space maintenance over a defect, promoting the ingrowth of osteogenic cells and preventing migration of undesired cells from the overlying soft tissues into the wound. Protection of a blood clot in the defect and exclusion of gingival connective tissue and provision of a secluded space into which osteogenic cell from the bone can migrate are essential for a successful outcome. The sequence of bone healing is not only affe cted by invasion of non-osteogenic tissue, but more so by the defect size and morphology. A predictable intraoral GBR approach was developed in the late 1980s and early 1990s; 108-110 (bone augmentation techniques 2007) The survival rates of implants placed in augmented sites with GBR are reported in many publications, survival rates range from 91.7 to 100%. However, there are few data about the success rate of dental implants placed in those areas, according to universally established criteria. This may represent a limit in evaluating the reliability of the GBR technique, because a high implant survival rate may not correspond to a high GBR success rate bearing in mind that an implant can remain stable and osseointegrated even if the total amount of regenerated tissue ... ...nd limitations must also be being considered. Some authors have reported partial relapse of the gained bone. More studies are needed to assess the implant survival in the bone gained by DO versus other augmentation methods, including new bone substitutes and augmentation factors. (Alveolar ridge augmentation for implant fixation: status review zakhary 2012). Determination of what technique should be used, is largely surgeon preference and on the extent of the defect and specific procedures to be performed for the implant reconstruction. It is most appropriate to use an evidenced-based approach when a treatment plan is being developed for bone augmentation cases. (Bone augmentation techniques. 2007)(Clinical outcomes of vertical bone augmentation to enable dental implant placement: a systematic review.2008) (Bone Grafting the Mandible Patrick J. Louis, DDS, MD 2011)