Long-term Effects of Chernobyl

Long-term Effects of Chernobyl Abstract Chernobyl was a city in Ukraine that housed one of the most tragic nuclear power plant accidents in history. It happened 30 years ago, however, the effects are still felt by many. This paper will explore the long term effects that Chernobyl left behind. Today, the city is still sectioned off from the rest of the country in an effort to help protect people from the ongoing radiation exposure. Clean up workers and anyone living nearby are at risk for life-long chronic diseases, some of which are not curable at the present time. These diseases or illnesses include cataracts, cardiovascular disease, psychological effects, birth defects, papillary thyroid cancer and chronic lymphocytic leukemia. Other effects include a contaminated agricultural and water system. The Effects that Chernobyl Left Behind The Chernobyl Nuclear Power Plant was one of the most important forms of power in Ukraine and the surrounding areas. It housed 4 nuclear reactors, each of which have been shut down over the years. One particular reactor, number 4, had undergone a test that went awry. On April 26, 1986 one of the worst nuclear power plant accidents occurred at Chernobyl. The personnel controlling these reactors were not following correct operating protocol, which led to the disaster. The reactors were highly unstable and not designed to operate at low power. If the reactors lost water for cooling, nuclear chain reactions occurred more frequently and the power output increased causing a power surge, in turn heating the reactor. The lid to the reactor had reached an excessive temperature and finally blew apart sending nuclear fuel and fragmented material into the surrounding area. A dangerous amount of radioactive material was released into the environment and sent the staff at the plant and the public into a panic (Chernobyl Accident and Its Consequences-Fact Sheet. March, 2015). Reactor number 4 contained about 190 metric tons of uranium dioxide and fuel products that exploded into the environment. It is estimated that about 13-30 percent of this product made it into the atmosphere (Chernobyl Accident and Its Consequences-Fact Sheet. March, 2015). This massive amount of uranium dioxide is the leading component in the radiation exposure to so many people. Uranium is one of the biggest contributors to natural terrestrial radiation. Terrestrial radiation is found in the ground and the major isotopes of concern for terrestrial radiation are uranium and the decay products of uranium. This is the material that was used in the Chernobyl Nuclear Power Plant. This explosion affected 18 miles around the city of Chernobyl. In order to contain the ongoing radiation exposure, officials have built a concrete building around reactor number 4 in order to help filter the radiation exposure from entering the atmosphere. Â  It has been 30 years since the Chernobyl Nuclear Power Plant accident, but the effects still live on. Today Chernobyl is a ghost town since it was evacuated directly after the accident. It has since been deemed to be a toxic and unlivable place due to the radiation exposure that may be received. There have been regulations and emergency preparedness precautions that have been put into effect in order to ensure that this kind of crisis will never happen again. According to the United States Nuclear Regulatory Commission, the government of Ukraine evacuated about 115,000 people from the most heavily contaminated areas in 1986. Even though the vast majority of the area was evacuated, long-term effects still linger. Health effects and diseases have developed in the years after the accident upon individuals who worked at the Chernobyl Nuclear Power Plant, or were in the surrounding area. Some diseases that are more prevalent as a result of the radiation exposure from the accident incl ude, cataracts to the eyes, cardiovascular disease, psychological effects, birth defects such as hydrocephalus, as well as increased risk for cancers such as papillary thyroid cancer and chronic lymphocytic leukemia. Other effects include unusable land for farming or unstable livestock from the accident. As a result of this catastrophic event, more than 200,000 km2 were subjected to levels of radioactive deposits exceeding 37 kBq/m2 of 137 Cs, the cut-off level to classify an area as contaminated. The average dose that was received from the Chernobyl Nuclear Power Plant accident ranges from less than 10 milisievert (mSv) to over 1 sievert (Sv). (Moiseenko, Khvostunov, Hattangadi-Gluth, Muren, & Lloyd, 2016). 1 Sv is equivalent to 100 Rem. Radiation equivalent man (Rem), is the traditional unit of measure for humans. All of the units will be converted into this value. This is a substantial amount of radiation considering the allowable dose for a non-occupational person to receive is 0.5 Rem per year. The dose that was received by some people in the accident is two hundred times that of the normal limit for the entire year. The occurrence and severity of cataracts is proportional to the dose of radiation received. The Ukrainian-American Chernobyl Ocular study reported a dose-related increase in the rate of cataracts in cleanup workers from Ukraine. This study also caused for reevaluation of the dose limits to the eyes by the International Commission on Radiologic Protection. It has since then been changed from 1 Gy (gray) or 100 Rem down to 0.7 Gy or 70 Rem for non-occupationally exposed people, and down to 0.5 Gy or 50 Rem for those occupationally exposed. The Chernobyl Nuclear Power Plant accident caused the universal exposure limit to the eyes to be lowered due to the increase in cataracts among those people who were exposed. (Zablotska, 2016). Cardiovascular disease reports are only increased in the Chernobyl clean up worker cohort. It may not be a significant cause of cardiovascular disease in people elsewhere, however clean up workers had an increased amount of cases because they were exposed to so much radiation in such a short period of time (Zablotska, 2016). Prolonged exposure to radiation may cause chronic kidney disorders, which induce hypertension and thus might contribute to the increased risk of cardiovascular diseases (Kamiya, et al., 2015). Psychological effects pertain to the mind, emotions, or reactions to certain events. According to Zablotska (2016), a catastrophic event such as the Chernobyl Nuclear Power Plant accident warranted many psychological effects on workers as well as ordinary people of the surrounding areas. These effects may never disappear, as many people still have symptoms decades after the accident. The lack of information given to the general public about what had happened caused a panic among many. The mystery of radiation exposure also caused anxiety among those affected by the exposure. Some people have developed severe anxiety due to the fact that they are nervous about being exposed to that much radiation, and the diseases that follow a high dose. Many people including young children and teens during the accident have post-traumatic stress disorder. This is mostly due to being forced to leave their roots in such an abrupt way. People were mistrusting towards their government for not keeping th e reactors under tighter regulations. Many were also frustrated by the lack of emergency preparedness plans that could have prevented so much widespread damage. Young children and teens may also be more susceptible to certain diseases and cancers because their cells are more radiosensitive towards exposures, which makes parents very anxious and depressed fearing something may happen to their babies. Another long lasting effect of the accident is the prevalence of thyroid cancer. This disease is by far the most frightening and notorious of the Chernobyl Nuclear Power Plant accident. This is the disease that everyone worries about because it can affect teens, children and adults in the same way. According to Handkiewicz-Junak et al., (2016) there have been approximately 5,000 thyroid cancer cases since the accident in the surrounding area. Two parallel studies have been performed. One study involved subjects in Ukraine and the other involved subjects in Belarus, one of the neighboring countries of Ukraine. Each study comprised about 12,000 children or adolescents from the accident. All of the subjects had been exposed to Iodine-131, which is a radioisotope. Periodic standardized screenings revealed that thyroid cancer and non-malignant diseases of the thyroid were far more prevalent in these studies than normal. Furthermore, evidence from other smaller population-based case-contro l studies confirms a causal relationship between the observed increase in thyroid cancer risk and exposure to Iodine-131 from the Chernobyl fall out (Zablotska, 2016). Another study was conducted on 65 children who had been exposed to Chernobyl radiation and sporadic papillary thyroid cancer. All participants were residents of the same region so that factors related to genetics or environment were reduced. Using DNA microarray, which measures the gene expression of many different samples, ten genes were confirmed as being associated with radiation exposure samples. This concludes that there is a significant difference in gene expression that causes papillary thyroid cancer to become active in post-Chernobyl subjects who were exposed (Handkiewicz-Junak et al., 2016). Chronic lymphocytic leukemia was found in workers who helped clean up after the Chernobyl accident. A study was conducted on the clean up workers registered in the Chernobyl state registry who resided in six regions of Ukraine (five oblasts and Kiev city). This particular cohort represented about 47% of the total number of clean up workers who helped at the Chernobyl accident. The study was later updated to include another nearby area, which bumped up the cohort to representing about 60% of the clean up workers. The findings showed an excess occurrence of chronic lymphocytic leukemia cases compared with national levels during the study period of about 26 years. The most drastic increase in cases occurred within the first decade after the accident and continues during subsequent decades. The potential risk from a different cohort, measured between 1986-2006, demonstrated the same risk of chronic lymphocytic leukemia, and it still remains active over 20 years after the exposure (Bazyka , et al., 2015). We know that radiation is cumulative and that any amount can cause genetic effects on future generations. Many of the clean up workers at the time of the accident were young adults who were at the start of their fertility and birthing years. The clean up workers could have been exposed to high amounts of radiation without any form of protection to the gonads. Certain mutations in DNA can form due to exceedingly high doses, which are then passed on to subsequent generations. For this reason, birth defects are put in the spot light for those affected. According to the Medical Birth Registry of Norway, a positive correlation has been associated with external and food based exposure, with hydrocephaly (Lie, Irgens, Skjaerven, Reitan, P. Strand, T. Strand, April 1992). According to Webster’s dictionary, hydrocephalus is an increase in the amount of cerebrospinal fluid within the cranial cavity. This causes expansion of the cerebral ventricles in the brain, and increased intracrania l pressure, skull enlargement, and cognitive decline (Hydrocephalus: Merriam-Webster). This is one of the very serious birth defects related to those individuals of reproductive age during the exposure. Lastly, effects of the Chernobyl accident extend further than just diseases or cancers directly affecting humans. The accident has a large impact on the soil and water system. The soil around Chernobyl cannot be used for farming since radioactive fuel and isotopes were scattered across a large area. In the first few weeks after the accident, private farm owners were not educated on the risks associated with the radioactive isotopes and fuel particles in the air and now onto their farms. Their farm animals, such as cows, consumed the radioactive material that was sprinkled over their hay, or other feed, and then produced milk that the farm owners then drank. The milk contained very high amounts of Iodine-131, which as previously discussed, contributed to increased rates of thyroid cancer. The water system was also contaminated with Iodine-131 and had the same effect on people as contaminated milk does. Contaminated water and milk are one of the leading causes of thyroid cancers among young children and teens (Beresford, et al., 2016). In conclusion, the Chernobyl Nuclear Power Plant accident was one of the most catastrophic nuclear accidents in history. The wide range of people that were affected is astonishing. The radiation exposure blanketed some 200,000 km2, including Ukraine and the surrounding areas with thousands of people sickened by disease and turmoil, living with the consequences and long-term effects for the rest of their lives. People had to abruptly evacuate their homes and hometown roots due to this nuclear crisis. The after effects caused psychological problems and stressors, while also leaving many with no place to live. Anyone who may have helped clean up after the accident are at risk for cataracts, cardiovascular disease, and cancers such as thyroid or leukemia. Those individuals who were of reproductive age may have passed along mutated DNA causing birth defects. The effects that Chernobyl left behind are countless, however, regulations and safety precautions have been put into place in order to prevent such a catastrophic event from happening again. References Backgrounder on Chernobyl Nuclear Power Plant Accident. (2014, December 12). http://www.nrc.gov/reading-rm/doc-collections/fact-sheets/chernobyl-bg.html Bazyka, D., Gudzenko, N., Dyagil, I., Goroh, E., Polyschuk, O., Trotsuk, N., . . . Romanenko, A. (2015, September 24). Chronic Lymphocytic Leukemia in Chornobyl Cleanup Workers. Health Physics, 111(2), 186-191. doi:10.1097/HP.0000000000000440 Beresford, N., Fesenko, S., Konoplev, A., Skuterud, L., Smith, J., & Voigt, G. (2016, June). Thirty years after the Chernobyl accident: What lessons have we learnt? Journal of Environmental Radioactivity, 157, 77-89. doi:10.1016/j.jenvrad.2016.02.003 Chernobyl Accident and Its Consequences-Fact Sheet. (2015, March). http://www.nei.org/master-document-folder/backgrounders/fact-sheets/chernobyl-accident-and-its-consequences Handkiewicz-Junak, D., Swierniak, M., Rusinek, D., Oczko-Wojciechowska, M., Dom, G., Maenhaut, C., . . . Jarzab, B. (2016, January 26). Gene signature of the post-Chernobyl papillary thyroid cancer. European Journal of Nuclear Medicine and Molecular Imaging Eur J Nucl Med Mol Imaging, 43(7), 1267-1277. doi:10.1007/s00259-015-3303-3 Hydrocephalus. (n.d.) . In Merriam-Webster online dictionary. http://www.merriam-webster.com/dictionary/hydrocephalus Kamiya, K., Ozasa, K., Akiba, S., Niwa, O., Kodama, K., Takamura, N., . . . Wakeford, R. (2015, August 01). Long-term effects of radiation exposure on health. The Lancet, 386(9992), 469-478. https://wwwclinicalkeycom.sladenlibrary.hfhs.org/#!/content/playContent/1-s2.0-S0140673615611679. Lie, R., Irgens, L., Skjaerven, R., Reitan, J., Strand, P., & Strand, T. (1992, April 2). Birth Defects in Norway by Levels of External and Food-based Exposure to Radiation from Chernobyl. American Journal of Epidemiology, 136(4), 377-388. http://aje.oxfordjournals.org/content/136/4/377.short Moiseenko, V., Khvostunov, I. K., Hattangadi-Gluth, J. A., Muren, L. P., & Lloyd, D. C. (2016, April 1). Biological dosimetry to assess risks of health effects in victims of radiation accidents: Thirty years after Chernobyl. Radiotherapy and Oncology, 119(1), 1-4. doi:10.1016/j.radonc.2016.02.033 Zablotska, L. B. (2016, April 29). 30Â  years After the Chernobyl Nuclear Accident: Time for Reflection and Re-evaluation of Current Disaster Preparedness Plans. Journal of Urban Health J Urban Health, 93(3), 407-413. doi:10.1007/s11524-016-0053-x

Why Some Nations Experienced Rapid?

It is evident form the different region and countries that are active and operating all over the world that economic growth is not equally distributed amongst all nations. Some countries depict an increasing rate of economic growth like in China, India and Singapore, while others are facing recession like Europe and America. Moreover the nature of the economic growth is also different ranging from short term economic growth to sustainable long term economic growth. The following paper provides information on the matter of economic growth and why it is different for different countries in the world. The major sources of growth which can result in a successful macroeconomic environment in a country pertain to growth in the productivity and the operations taking place in the country. Private ownership of industries and businesses motivates people to be more successful at them and perform better resulting in exponential economic growth in the region. Aside from this the policies favoring freedom to exchange enable the business to interact and trade freely resulting in more economic activity. Competitive markets reduce inefficiencies and provide continuous improvement for the industry and the economy. An efficient capital market enables the region to convert its capital mechanism into a wealth generating projects. Moreover the present of monetary stability in the region contains and stabilizes the pricing in the market as well. This is as opposed to inflationary monetary policies which distort optics in the regional market. The low tax rates in the region also enable the country to achieve economic growth as the people are able and permitted to keep more of what they earn off their productivity, resulting in more drive to increase their productivity. Lastly establishment of free trade zones enable the region to increase its economic activity as well as the country can export products it is efficient at producing and can import those which it dopes not have at very low costs. The above highlighted main elements which lead to economic growth of regions and countries can be lacking in some countries, and this is the main reason as to why some countries experience economic growth while other don’t in the same period of time. Countries having a high level of poverty, unemployment and the lack of basic infrastructure and standardized way of life often experience stagnant economic growth. However if capital investment is made in these countries to make use of the unemployment levels and increase productivity and employ people in the industries, then its possible to create a long term positive economic growth for the country. Countries riddled with bureaucracy are often having high level of inefficiencies in its markets resulting in stunted growth. Similarly the lack of establishment of relations with other countries and the lack of trade zones and agreements can also result in low productivity ad trade for the country depicting low or no level of economic growth. As highlighted above capital investment in the country is very important, specific to the development of the infrastructure and establishment of new profit generating industries. One sector of immense growth is the technology and the telecommunications sector. Investment in the field of information technology can increase the communication network in the region. â€Å"There are three main channels through which ICT can affect growth rates of GDP per capita: i) an acceleration of productivity in the ICT-producing sectors themselves and, despite what was said above about the limited role for shifts between broad economic sectors, a growing size of ICT-producing sectors in the economy; ii) capital deepening across the economy, driven by rapid investment in ICT equipment, and resulting in a boost to labor productivity; and iii) widespread spillover effects on productivity arising from the use of ICT technology.† (Elmeskov & Scarpetta, 2000) In order to induce growth in a region, in the long term, some sacrifices have to be made in the short term for a sustainable level of growth which is not temporary or non incremental and developmental in nature. The most evident sacrifice that needs to be made is by the consumers and the people in the country who have to save money and reduce their spending on consumer goods specifically those imported form international sources. Instead buying locally produced goods and services increases the demand and therefore the productivity in the local market resulting in economic growth which is developmental in nature. Aside form this the decisions need to be made where the industries and the companies operating in the region have to invest in projects which provide long term sustainable growth instead of short term profit generating projects. It is also possible for the political, social and the legal environment in certain countries to pose as barriers for sustained economic growth. The political scenario in the country determines the focus the developmental and economic policies being made in the region. An unstable political environment provides uncertainty in the industry resulting in lack of economic growth while a development oriented political climate increases economic growth in the region. Similarly the legislature pertaining to how trade is conducted with countries and the nature of investment in the region also determine economic growth for the region. If the legislature is very conservative hinting bureaucracy then it poses as a barrier for economic growth. Moreover the social constructs and the cultural values of the people in a country can also result in reduced economic growth. One main example of this is the lack of women participation in the contribution towards the economy in the South Asian and Middle Eastern countries. References Elmeskov, J., Scarpetta, S., ‘New Sources Of Economic Growth In Europe?’, The New Millennium – Time For A New Economic Paradigm, 2000, accessed March 9, 2008 from      

Barriers to Health Promotion and Disease Prevention Essay

Health promotion has been defined as the process of enabling people to increase control over their health and to improve it. This process requires personal participation and supportive environments. For people with disabilities, however, personal participation is often limited by non-supportive environments. Lack of knowledge on how to modify programs to meet specific needs, poor attitudes, and unfriendly environments often creates insurmountable barriers to participation for many people with disabilities. While innovative medical technology has increased the life span of individuals with disabilities, little attention has focused on improving their health span. The reportedly high incidence of chronic secondary conditions seen in persons with disabilities, including pain, fatigue, low functional capacity, obesity, and depression, is often related to environmental conditions that include poor health promotion practices. Smith wrote: â€Å"People with disabilities therefore represent significant health needs and investment in health care resources, both in terms of the primary disability and secondary complications. Although the prevention of these conditions is important, of equal importance is to make living with them as healthy as possible, as many disabilities are life-long. Although health promotion may be significant in leading to lower levels of premature mortality, higher quality of life and lower health care costs for the general population, it has the potential to be even more significant for those already with a disability, whose quality of life and independence rely critically on their ability to maintain their narrow margin of health.† With the emerging concept that individuals with disabilities can improve their health in the same manner as anyone else, there is growing momentum for providing quality health promotion programs for people with disabilities. Maintaining health and wellness is especially important for people with disabilities because functional limitations that often accommodate a primary impairment (neurological dysfunction) may reduce a person’s capacity to engage in health promoting behaviors and result in a higher frequency of secondary conditions. These secondary conditions are defined as â€Å"†¦physical, medical, cognitive, emotional, or psychosocial consequences to which persons with disabilities are more susceptible by virtue of an underlying impairment, including adverse outcomes in health, wellness, participation and quality of life†. The purpose of this paper is to provide an overview of health promotion for people with disabilities in the areas of exercise, nutrition and health education, and to describe a health promotion service delivery model that addresses the gap in services between rehabilitation and community-based health promotion. The vast majority of people with disabilities are not obtaining the recommended amount of physical activity needed to confer health benefits and prevent secondary conditions (e.g., heart disease, obesity, and osteoporosis). In a study by Rimmer, it was found that less than 10 percent of adults with physical disabilities engaged in structured physical activity programs. A possible reason for this high level of inactivity may be linked to the number of actual and perceived barriers to exercise reported by people with disabilities. Transportation, cost of the exercise program, and not knowing where to exercise were listed as the three most common barriers. In a related study, Messent reported that the barriers to physical activity participation in adults with developmental disabilities were unclear policy guidelines in residential and day service programs; transportation and staffing constraints; limited financial resources; and limited availability of physical activity programs in the person’s community. While these external barriers may impose major limitations on exercise participation, internal barriers may also create obstacles to participation. Kinne reported that exercise self-efficacy and motivational factors were significant predictors of exercise maintenance in a group of adults with disabilities. Health disparities refer to differences between groups of people. These differences can affect how frequently a disease affects a group, how many people get sick, or how often the disease causes death. Many different populations are affected by disparities. These include †¢Racial and ethnic minorities †¢Residents of rural areas †¢Women, children, the elderly †¢Persons with disabilities While better nutritional habits are a major concern for most people with and without disabilities, there may be some specific differences in diet and nutrition guidelines pertaining to people with specific types of disabilities. Issues related to accessing healthy foods, determining food interactions with commonly used medications to control various secondary conditions ( pain, seizures, depression), and establishing specific requirements for food supplements ( vitamins, minerals, fluid intake) are all major concerns among people with certain disabilities. For example, people with spinal cord injury have a higher rate of bone loss after their injury, which increases their risk of osteoporosis. A few studies on persons with cerebral palsy and Down syndrome have also reported a higher incidence of osteoporosis. While it is the recommended daily allowance for calcium intake and vitamin D may need to be increased for certain types of disabilities to offset the rate of bone loss, recommen ded guidelines are not available. There are little data available to support this theory. There is a pressing need to conduct more research on various types of disabilities that have a reportedly higher incidence of bone loss, to determine the effects of exercise and nutritional supplements (calcium, vitamin D) in reducing or slowing the progression of this condition. Health education can have a measurable impact on empowering people with disabilities to improve their own health. For example, people with depression, manic depression, schizophrenia etc. should practice medication management with the assistance of a physician or nurse practitioner. Many states offer education classes dealing with communication with family members and the public along with skills on how to cope with mental illness. There are also cooking, cleaning, and hygienic classes and job training skills. In my experience job coaches are available to help ease the transition from unemployment to gainful employment practices. Many disabled individuals still experience discrimination from others who do not understand what mental illness is and don’t take the time to find out how to cope daily with a friend, family member or co-worker who may suffer from mental illness. In Belize Central America poverty is a big problem. In an article I read had this to say, â€Å"The Inter-American Development Bank (IDB) said Tuesday that it had approved a US$15 million loan to help Belize provide better basic health care, improve secondary education and strengthen its capacity to target, coordinate and evaluate social protection programs.†These measures will help the government achieve the goals of its National Poverty Elimination Strategy,† the IDB said in a statement. It said that one-third of the country’s population lives under the poverty line and the poorest sector of society lacks adequate basic health and secondary education services. â€Å"In some southern rural areas, like the Toledo district, 79 per cent of the population is poor and 56 per cent is classified as indigent. â€Å"The IDB said that in order to strengthen primary health care for the most vulnerable sectors, the funds will support government plans to increase enrolment in the National Health Insurance (NHI) pilot program.†It will also protect the 2009-2010 budget lines needed to at least maintain NHI coverage at 95 per cent of the population in south-side Belize City and 84 percent in the Southern Region. The National Alliance on Mental Illness (NAMI) is also addressing the significant barriers to mental health care experienced by African American, Asian American and Pacific Islander, American Indian, and Latino/Hispanic populations. NAMI is developing national partnerships and strategies to overcome the crisis. There is also increasing emphasis on improving quality of health care within the existing services in the United States. To achieve quality, there must be: 1. Improved access to care for all people. 2. Appropriate and acceptable treatment plans that incorporate multidisciplinary knowledge. 3. A workforce of sufficient numbers and qualifications. 4. Agreement on indicators for health care quality. 5. Responsible practices and follow-through on the part of patients. One study of infants revealed the cost of hospitalizing premature infants, the need to improve prenatal care to women at high risk for delivering preterm or low-birth-weight infants, and the need to improve outcomes for those infant. There is still so much to be done to increase health and the quality of life in persons with disabilities and those with chronic health issues. Health promotion has been defined as the process of enabling people to increase control over their health and to improve it. This process requires personal participation and supportive environments. Reference Rimmer JH, (1999). Health promotion for people with disabilities: the emerging paradigm shift from disability prevention to prevention of secondary conditions Physical Therapy. 79(5), 495-502. Ravesloot C, Seekins T, Young Q, (1998). Health Promotion for People with Chronic Illness and Physical Disabilities: The Connection between Health Psychology and Disability Prevention Clinical Psychology and Psychotherapy. 5, 76-85. Thierry JM, (1998). Promoting the health and wellness of women with disabilities. Journal of Women’s Health. 7(5), 505-507. Stuifbergen, Alexa K., PhD, RN, Heather Becker, PhD, and Dolores Sands, PhD, RN, (1990). Barriers to health promotion for individuals with disabilities Family & Community Health. Smith RD, (2000). Promoting the health of people with physical disabilities: a discussion of the financing and organization of public health services in Australia Health Prom Int. 15, 79-86. 13(1), 11-22. Belize to receive IDB funds for health, education. (2009, Oct 07). BBC Monitoring Americas. Retrieved from http://search.proquest.com/docview/460151112?accountid=32521

Famous and Wise Quotes About Friendship

What more can you ask God for, if you have already been gifted a good friend? True friends are difficult to find. Friendship is a flower that needs to be nurtured. Over a period of time, friendship blossoms and makes your life fragrant with love and energy. And should you need a shoulder to lean on, friendship provides you with a strong one. Read these famous quotes about friendship and gain from the experience of the experienced. Euripedes Real friendship is shown in times of trouble; prosperity is full of friends. Marlene Dietrich It is the friends that you can call at 4 a.m. that matter. George Jean Nathan Love demands infinitely less than friendship. Mahatma GandhiIt is easy enough to be friendly to ones friends. But to befriend the one who regards himself as your enemy is the quintessence of true religion. The other is mere business. Pam Brown Odd how much it hurts when a friend moves away -- and leaves behind only silence. Aristotle Friendship is a single soul dwelling in two bodies. Proverb God save me from my friends -- I can protect myself from my enemies. Mark Twain The proper office of a friend is to side with you when you are in the wrong. Nearly anybody will side with you when you are in the right. Elbert Hubbard Your friend is the man who knows all about you, and still likes you. Nigerian Proverb Hold a true friend with both your hands. Anais NinEach friend represents a world in us, a world possibly not born until they arrive, and it is only by this meeting that a new world is born. Emily DickinsonMy friends are my estate. Leo BuscagliaA single rose can be my garden... a single friend, my world. Anne Morrow LindberghMen kick friendship around like a football but it doesnt seem to break. Women treat it like glass and it goes to pieces. David Tyson GentryTrue friendship comes when the silence between two people is comfortable. Aristotle My best friend is the man who in wishing me well wishes it for my sake. C. S. LewisFriendship is born at that moment when one person says to another, What! You too? I thought I was the only one. Albert Camus How can sincerity be a condition of friendship? A taste for truth at any cost is a passion which spares nothing.