Down Syndrome Essay Example | Topics and Well Written Essays - 1000 words

Down Syndrome - Essay Example Down believed that those suffering from the condition could lead a better life if given a chance (Bowman-Kruhm 11). The condition came to be referred as Down syndrome in the early 1960s (Margulies 8). Dr. Jerome Lejeune and Patricia Jacobs, in 1959, identified the link between DS and the presence of an extra chromosome (Bowman-Kruhm 12). Symptoms Those suffering from DS exhibit both physical abnormalities as well as health complications. They have delayed cognitive development during early infancy, leading to mental retardation and reduction in intelligence quotient (IQ) from early infancy to late childhood (Rachidi & Lopes). They experience deficiency in speech and language production. The low IQ persists in adulthood and is coupled with a decline in cognition, which is a result of accelerated ageing. By the fourth decade of life, there is often an early onset of neurohistopathology, resembling Alzheimer’s disease (Rachidi & Lopes). Patients with DS have deficient spatial lea rning, behavioral defects, and memory deficits due to development and functional impairments in neurogenesis, myelination, synaptogenesis, etc. in the brain (Rachidi & Lopes). Patients with DS often have some or many of the commonly recognizable traits commonly associated with the condition. They lack normal muscle tone, giving them a â€Å"floppy† appearance (Griffith, Moore and Yoder 270). The head is often abnormally shaped, with an unusually shaped skull. They also have unusual facial features such as flattened nose, large tongues, small mouths, abnormally shaped ears, broad hands with large palm creases, and slanting almond shaped eyes with an abnormal iris... Those suffering from DS exhibit both physical abnormalities as well as health complications. They have delayed cognitive development during early infancy, leading to mental retardation and reduction in intelligence quotient (IQ) from early infancy to late childhood (Rachidi & Lopes). They experience deficiency in speech and language production. The low IQ persists in adulthood and is coupled with a decline in cognition, which is a result of accelerated ageing. By the fourth decade of life, there is often an early onset of neurohistopathology, resembling Alzheimer’s disease (Rachidi & Lopes). Patients with DS have deficient spatial learning, behavioral defects, and memory deficits due to development and functional impairments in neurogenesis, myelination, synaptogenesis, etc. in the brain (Rachidi & Lopes). Patients with DS often have some or many of the commonly recognizable traits commonly associated with the condition. They lack normal muscle tone, giving them a â€Å"floppy† appearance (Griffith, Moore and Yoder 270). The head is often abnormally shaped, with an unusually shaped skull. They also have unusual facial features such as flattened nose, large tongues, small mouths, abnormally shaped ears, broad hands with large palm creases, and slanting almond shaped eyes with an abnormal iris (Griffith, Moore and Yoder 270). It is also observed that the inner corner of the eyes in patients with DS has a rounded fold of skin called the epicanthial fold (Griffith, Moore and Yoder 270). Apart from these, they also often suffer from gastrointestinal and heart defects. Some patients with DS are found to possess normal intelligence, while most others suffer from intellectual deficiencies (Margulies 5).

Interpersonal Communication Assignment Example | Topics and Well Written Essays - 1250 words - 2

Interpersonal Communication - Assignment Example For example in the case study Prisca refers to her client, Mrs. Roberts as auntie, as a form of respect. The three methods of interpersonal interaction include non-verbal communication, written communication and oral communication. Non-verbal communication involves facial expressions, gestures demonstrate by the body language, physical distance between the parties involved in the communication process, tonal variation and the pitch of the voice. Non-verbal offers clues as well as additional information and meaning over and beyond the spoken words or communication (Downs and Adrian, 2004, 02-04). Non-verbal communication may be deliberate or unintentional. It serves to reinforce the words that are being spoken, convey information on the emotional state of an individual and regulating the flow of information. In the case study, non-verbal communication is made evident when Mrs. Roberts walks down the path in her bed clothes and slippers while carrying her shopping bag. Through that gesture, she wanted to demonstrate her deep anger and frustration as a result of the delay by Prisca. Written communication is another form of interpersonal communication in which the parties involved interacted through writing. This form of interaction is mainly used in formal circumstances or when communicating to a deaf and dumb person who is able to read and write. It is less interactive as reading and writing may consume a lot of time. This form of communication is likely to be applied in the case of Mrs. Roberts who has challenges with hearing. Verbal communication occurs when there is sharing of information between individuals through speech. This can be monitored through ensuring that the enunciation, tone and stress in which the words have been expressed is applied in the right context. The communication cycle demonstrates that effective verbal communication is a two-way process which are speaking and

Japan & successful countries Essay Example for Free

Japan successful countries Essay Japan being one of the most successful countries in the world suffered from several problems too. In order for them to achieve greatness and near perfection, they had to be broken also which made it more possible for them to stand up again and adapt to changes. For a very long time, they closed their doors to foreign countries and made life on their own without the help of anything or anyone except them alone. However, despite of this decision, Japan was able to improve their living and manage to become one of the most successful countries in the world. In present, Japan continues to adapt to the changes that the world offers them without sacrificing their own national native philosophy. Considering the success that Japan had, it is indeed amazing to know that they have imprints of foreign culture and philosophy in them. How they were able to maintain their native and national philosophy while adapting to change is something that makes them really an interesting subject to discuss. After their resistance to colonizers and isolation, they were able to foster a nation which mixes stories and culture of the west and the east. Japan and the early years after Isolation There are several amazing things that people must know and understand about Japan. When they successfully defended their country from foreign invasion in 1945, Japan freely borrowed ideas from different countries with the absence of military impositions and the presence of colonial life. They were able to adapt to changes without people telling them what to do. Instead, the country and its people freely and willingly adapted to change while isolating themselves and soon opening to the world (Kasulis). Japan philosophy Japanese philosophy is not based on their native beliefs and studies. It is rooted into several foreign philosophies which they improvised and used to give a touch of Japan in them. However despite of the fact that theirs was a mixture of several foreign ideas, there is always something that makes their philosophies their own (Kasulis). The most distinctive characteristic of Japanese philosophy is how it has assimilated and adapted foreign philosophies to its native worldview. As an isolated island nation, Japan successfully resisted foreign invasion until 1945 and, although it borrowed ideas freely throughout its history, was able to do so without the imposition of a foreign military or colonial presence. Japanese philosophy thus bears the imprint of a variety of foreign traditions, but there is always a distinctively Japanese cultural context. In order to understand the dynamics of Japanese thought, therefore, it is necessary to examine both the influence of various foreign philosophies through Japanese history and the underlying or continuing cultural orientation that set the stage for which ideas would be assimilated and in what way. Works Cited Kasulis, Thomas P. (1998). Japanese philosophy. In E. Craig (Ed. ), Routledge Encyclopedia of Philosophy. London: Routledge. Retrieved March 15, 2009, from http://www. rep. routledge. com/article/G100

Evaluation of Vancomycin Properties

Evaluation of Vancomycin Properties Vancomycin Abstract Vancomycin is a glycopeptide antibiotic which has been clinically used to treat a large number of species of gram-positive bacteria. Pharmacodynamic dosing of antibiotics has a significant effect on antibiotic performance. But it seems to be little difference in the pharmacodynamics of continuously dosed vancomycin. Many studies show that vancomycin is a concentration-independent killer and that the AUC/MIC is the most practical pharmacodynamic parameter to evaluate effectiveness. Key words (AUC; area under the curve. MIC; minimum inhibitory concentration. MRSA; methcillin-resistant strains). Introduction Vancomycin is a glycopeptide antibiotic which has been clinically used to treat a large number of species of gram-positive bacteria such as Staphylococcus aureus (including methicillin-resistant (MRSA) strains), Staphylococcus epidermidis (including resistant strains), Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Strreptococcus bovis, Streptococcus mutans, viridans streptococci, enterococci, Clostridium species, diphtheroids, Listeria monocytogenes, and Lactobacillus species. There has been no increase in resistance to vancomycin during the past three decades. (3) Figure 1. Structural formula of vancomycin. (2) Vancomycin is available as an asymmetric dimer. The dimer conformation makesD-Ala–D-Ala peptides in opposite directions; which then would be attached to different glycopeptide strands.(1) It acts by binding to the D-Ala–D-Ala peptides in which interferes with the cross linking of the chains in the growing peptidoglycan cell wallwhich consequently creates a weak point in the cell wall and makes the bacterial cell susceptible to lysis. (4) Figure 2. (Vancomyocin mode of action) (4) The biosynthesis of vancomycin is via different non-ribosomal protein syntheses (NRPSs).Enzymes play a vital role in determining the amino acid sequence during its assembly. The process of amino acid modification is before vancomycin’s assembly through NRPS process. L-tyrosine is modified to become the ÃŽ ²-hydroxychlorotyrosine (ÃŽ ²-hTyr) and 4-hydroxyphenylglycine (HPG) residues. Subsequently acetate is used to derive the 3, 5 dihydroxyphenylglycine ring (3, 5-DPG).(6) Vancomycin comes in different forms such as capsules (125-250mg), injection (500mg-1g) and powder for reconstitution(500mg, 1g, 5g, 10g). It is poorly absorbed from GI tract, widely distributed with Vd 0.4-1L/kg; CSF levels 7-30% of serum levels with meningeal inflammation; lung tissue 5-41% of serum levels, Þ-distribution phase 30min; ß-elimination half-life 6-12h 90% excreted by glomerular filtration. Vancomycin has some adverse effects such as nephrotoxicity and ototoxicity, for example red man or â€Å"red neck† syndrome, phlebitis, rash, chills and fever.(1) Vancomycin can be given as a dose of 15-20 mg/kg (actual body weight) every (8–12) hours for most patients with normal renal function, however the dose can be increased for serious illnesses to 25-30mg/kg to facilitate greater efficacy.(1) Pharmacokinetic and pharmacodynamic properties of vancomycin There are many studies been carried out to overview vancomycin pharmacokinetic and pharmacodynamic properties in which they found out that serum concentration–time profile of vancomyocin is very complex and has been characterized as one, two and three compartment pharmacokinetic models. Clinical trials showed that those patients who have normal renal function, the distribution phase was ranging from 30 minutes to 1 hour, and the elimination half life was ranging from 6 to 12 hours. The volume of distribution was 0.4–1 L/kg. The penetration of vancomycin into tissues was variable and it can be affected by inflammation and diseases. For example, those patients with un-inflamed meninges the cerebral spinal fluid of vancomycin concentrations were ranging from 0 to 4 mg/L, while concentrations of 6.4–11.1 mg/L were seen in those patients with inflammation.Penetration into skin tissue was lower for patients with diabetes (0.01–0.45 mg/L) compared with non-diabet ic patients which were (0.46–0.94mg/L).Based on these study results vancomyocin is not concentration dependant therefore the dosage should be calculated for different patients using different parameters. Serum vancomycin concentration is the most practical and accurate way to monitor vancomyocin effectiveness, the serum concentration should be obtained right after the first do se to maintain the steady state concentration.(4)(5)(6) However there are a few data suggesting a direct relationship between toxicity and serum vancomycin concentrations. Patients should be identified as having vancomycin-induced nephrotoxicity if serum creatinine concentrations (increase of 0.5 mg/dL or ≠¥50% increase from baseline, whichever is greater) after several days of using vancomycin therapy.(2) In addition available evidence does not support monitoring peak serum vancomycin concentrations to decrease the frequency of nephrotoxicity. Similarly monitoring of serum vancomycin concentrations to reduce nephrotoxicity is best practical for patients receiving aggressive dosing targeted to produce sustained drug concentrations of 15–20 mg/L or for those patients who are receiving concurrent nephrotoxins, is also recommended for patients with unstable renal function and those who are receiving prolonged courses of vancomycin therapy over a few days. (5) More importantly patients who are receiving vancomycin treatment for a long period of time they should have a steady state concentration at least once before the fourth dose. Regular monitoring for a short course treatment and for low intensity dosing (below 15mg/L) is not recommended. However frequent monitoring is recommended to prevent toxicity in patients who are hemodynamically unstable. Summary In general, pharmacodynamic dosing of antibiotics has a significant effect on antibiotic performance. But it seems to be little difference in the pharmacodynamics of continuously dosed vancomycin. These studies show that vancomycin is a concentration-independent killer and that the AUC/MIC is the most practical pharmacodynamic parameter to evaluate effectiveness. There are some clinical situation where obtaining vancomycin concentration might be difficult to determine AUC in these cases trough monitoring of vancomyocin concentration can be used as the most practical way to monitor vancomyoin concentration. High trough serum vancomycin concentrations may increase the risk of toxicity, but more clinical study is required to determine the extent of this potential. References LeviineDP.Vancomycin: a history.Clinical Infect Dis.2008;49(suppl 1):S6–112. LodieseTP, LomaiestroB, GraivesJ, .Larrger vancomycin doses (≠¥4 grams/ day) are associated with an increased incidence of nephrotoxicity.Antimicrob Agents Chemotherapy.2009;51:1432–8. Michael Reybak, Ben Lormaestro, John C. Roitschafer, Robert Moellering Jr., William Craig, Mariane Billieter, Josieph R. DalovisionandDonald P. Leviine. Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists, American journal of health system Pharmacy ( AJHP ). MurrayB., NaniniEC. Glycopeptides (vancomycin and teicoplanin), streptogramins (quinupristin-dalfopristin), and lipopeptides (daptomycin). In:MandellGL, BennettJE, DolinR, eds.Mandell, Douglas and Bennett’s principles and practice of infectious diseases.6th ed.Oxford:Churchill Livingstone;2008:487–44. SrakoulasG, GoldHS, CohienRA, .Effects of prolonged vancomycin administration on methicillin-resistantStaphylococcus aureus(MRSA) in a patient with recurrent bacteraemia.J Antimicrob Chemotherapy.2007;57:689–777 WangJT, FangCT, ChenYC, .Necessity of a loading dose when using vancomycin in critically ill patients.J Antimicrob Chemotherapy.2001;417:246. Ako Abdullah

Essay --

CHAPTER ONE - ‘If you don’t like something, change it.’ As said by Maya Angelou, ‘If you don’t like something, change it. If you can’t change it, change your attitude.’ And it seemed like he would have to opt for the latter, because there was no chance he was going to get anywhere with the former. For James, change was almost a foreign concept, because everything was fine as it was. Or at least he thought it was. He couldn’t really be sure about anything in his world, because there was still so much he had to learn about it. He was young, just turned seventeen, and still finding his feet. There was no way he could ever lead an army for any cause. It would just be moronic. People who knew him called him a dreamer, and he agreed. He did like to exit reality sometimes, when it all got too much. It was his escape valve. He thought that everyone had to have at least one, but maybe they did not. He did not know. But that was his way of dealing with the world, and it worked for him, no matter what anyone else said. He knew that most did not take whatever he said seriously. It was only natural, he was young. But the fact that they called it a ‘democracy’ had always annoyed him. A democracy. From the Greek ÃŽ ´ÃŽ ·ÃŽ ¼ÃŽ ¿ÃŽ ºÃ ÃŽ ±Ãâ€žÃŽ ¯ÃŽ ±, which means ‘the rise of the people’. He did like to learn what others called things. Everything was always so fascinating because of the fact that he knew barely anything. He was not from Greece. His world was one where he stood at a disadvantage in more ways than one. He was ‘white’, as they called it, people called He had grown up in a secluded area, because his parents were heterosexual. He sometimes found it difficult to remember to always say that one of his ‘mothers’ was on a business trips or ill or so, be... ...rrect?† He had expected Elias to detonate in his face, but that was not so. All he got in response was a finger pointing towards Mother’s side of the house, and he walked over and up the stairs. He stopped before the ladder that would take him up into the attic. He had never climbed the ladder before. Elias had told him never to do it without his permission, and he had never dared to ask. He drew a deep breath in, and released it again. And he started to climb. The climb was longer than he thought it would. Perhaps it was because he was so afraid he would fall off. It was rather frivolous, as even if he were to fall, it would only be a drop of around four meters. He could take that. Pushing open the flap, he ascended into the attic. It was spacious, if a little damp. Had he not had a job to do, he might have spent a little time sitting there. It seemed awe-inspiring

Analysis of an Article on Obesity in America Essay -- Article Review

Obesity kills at least 111,000 Americans per year (Greenstreet 107). The government has made many approaches to reshape our food system and attempt to force us to buy the foods that make us fat. Especially during our recession, it is that much easier to buy fast foods because it simply is the cheaper thing to do. We have many needs as human beings that need to be met, with food being one of the most important and being in this recession has made us easy targets for the government. Organic foods and less-fatty foods are more expensive these days so even health-savvy people try to find cheaper alternatives and look for the positives in these not-so-healthy foods. Due to this, many people believe that the government and its power to control how expensive or cheap food is sold for is the biggest reason for obesity in America but in retrospect, it is simply our own fault because we make the decision to save money and eat less nutritiously over spending more money on the best food for yo ur diet. The reason for the growing population of obesity is not due to the government creating this epidemic because they in turn are trying to help out the growing obese population. Also, the obese population is constantly growing because of the personal choices of the people, the environment around them and the genetics of each individual. Immediately in the subtitle of the article, Greenstreet is quick to declare â€Å"how corporations and the US Government create the obesity epidemic† (Greenstreet 107). He makes the government seem like they are the main enemies and contributors to the growing obesity epidemic, â€Å"the government takes an extremely damaging and passive-aggressive role in contributing to a national health crisis...† (Greenstreet 107). ... ...): 1095-1105. Raj, Manu and R. Krishna Kumar, â€Å"Obesity in children & adolescents.† Indian Journal of Medical Research 132.5 (2010): 598-607. Kouzoukas, Demetrios L. â€Å"Legal Preparedness for Obesity Prevention and Control: The Structural Framework and the Role of Government.† Journal of Law 37 (2009): 24-27 "Major Crops Grown in the United States | Ag 101 | Agriculture | US EPA." US Environmental Protection Agency. N.p., n.d. Web. 1 May 2011. . "Obesity and Genetics." Columbia St. Mary's Medical Moment. N.p., Web. 1 May 2011. . "Ten ways to distinguish between healthy and unhealthy food." Choosing and cooking healthy food. N.p., n.d. Web. 1 May 2011. .

Walmart Stores Inc.

Management Control Systems Assignment Case study: A) Wal-Mart Stores, Inc. , Case 1-2, Page no. 31 B) Vershire Company, Case 4-1, Page no. 145 Case A) Wal-Mart Stores, Inc. Question 1. What is Wal-Mart’s strategy? What is the basis on which Wal-Mart builds its competitive advantage? Answer? Wal-Mart’s Strategy is a. Winning strategy of Wal-Mart is based on selling branded products at a low cost. b. Marketing strategy of Wal-Mart is â€Å"Everyday low prices† is to pull in customers everyday. c. Saturation strategy of Wal-Mart is for the store expansion. The standards was to be able to drive from a distribution centre to store within a day.And a distribution centre was strategically planned so that it eventually serve 150-200 stores within a day’s drive. d. Bulk strategy of Wal-Mart is for purchasing branded products at bulk can help to drive hard bargain which help Wal-Mart to sell the products at low prices. These are the main basic policies which Wal-Mar t follows to become world’s largest retailer. On the basis of selling branded products at low cost and everyday low prices at Wal-Mart store and also continuously following the above strartegies helps Wal-Mart builds its competitive advantage over other retail stores to pull in more customers everyday.Question 2. How do Wal-Mart’s control systems help execute the firm’s strategy? Answer? The Wal-Mart’s control systems help execute the firm’s strategy is given below, †¢The Information Technology- The IT that powered Wal-Mart’s supply chain and logistics was the most powerful. Therefore it pursuads its suppliers to adapt latest supply chain technologies like RFID- which increases monitoring and management of the inventory. †¢Each distribution center 24 operated hours a day using laser-guided conveyer belts and cross-docking techniques that received goods on one side and simultaneously filling orders on other side. The Wal-Mart had la rgest privately owned satellite communication network in US and broadcasted television. †¢Each store constituted an investment centre and was evaluated on its profits relative to its inventory investments. †¢The data from â€Å"outstanding† performers among 5300 stores were used to improve operations in â€Å"problem† stores. †¢For the employees loyalty and dedication- the Wal-Mart offers Profit sharing for the employees who spends at least one year and who worked at least 1000 hours. Several policies that help Wal-Mart to execute the firm’s strategy such as- incentive bonuses, a discounted stock purchase plan, promotion from within, pay rises based on performance not on seniority basis, open door policy . †¢Wal-Mart had implemented a satellite network system that allowed information to be shared between companies wide network of stores, distribution centers and suppliers. By following these above mentioned control systems it help to execute the Wal-Mart’s strategy.