Aging with Spirituality: A Review of the Literatu Essay

Aging with Spirituality: A Review of the Literature Sherry A. Tattersall South University Tampa Abstract The intention of this subject is to spread awareness of the impact that religion and spirituality play in the aging process, specifically those over the age of eighty-five. It is becoming more and more acceptable to incorporate a person’s faith in their care, both at home and in a clinical setting. The impact of spirituality and/or religion in terms of how much better a person will age physically, mentally and emotionally is overwhelmingly positive. This wisdom and love of God that is not only gained through years of experiences, good and bad, but also through a deep-rooted faith, is often overlooked and even sadly ignored. The elderly have so much to offer anyone that will take the time to listen, as they have a precious ability to embrace the end of life and a love for the Creator that goes beyond the understanding of most young people. It is only recently that spirituality and the neurobiological effects that it has on the aging in relation to mental and physical health, as well as attitudes about death and dying, have been taken seriously enough to study and implement into care. Faith in God seems to be the key to doing what our mothers always told us to do†¦age gracefully. In this day and age, it is acceptable to consider age 85+ years old as elderly, and upon accomplishing the age of 100 years, we win the prestigious title of Centenarian. Due to the baby birth explosion Post WWII, hence the ‘Baby Boomers’, born between the years 1946 and 1964 (U.S. Census Bureau), along with healthier lifestyle, eating habits and advances in science and medicine, more people are living longer. Research has shown that the effects of religious faith and personal spirituality in the elderly are extremely beneficial in understanding the meaning behind death and illness, as well as coping and healing. It makes sense that as we age, we also develop our spiritual capacities, drifting away from the hustle and bustle  of work and raising children, making it easier to explore spirituality and participate in religious activities.After all, there is within each one of us, a strong desire to connect with the Holy. Atchley (2008) defines spirituality as, ‘an in ner, subjective region of life that revolves around individual experiences of being, transcending the personal self, and connecting with the sacred.’ With the loss, disability, illness, and general physical breakdown of the body in the aging process, it becomes increasingly valuable for us to understand our spirituality, ultimately connecting with our Creator as this is truly where all peace and understanding originate. Spirituality is a way of making sense out of what is happening in the aging process and gives the elderly a sense of peace while grappling with serious issues. Even coping with dementia seems to become a more peaceful experience for the older caretaker. The Duke Longitudinal Study of Aging found that, although religious satisfaction and attitudes do not change much with aging, the feelings of being useful and happy, as well as personal adjustment, tend to increase. Tornstam (1997) coined the term, ‘gerotranscendence’, referring to how the older, mature adult experiences conception of time, an awareness of death and mortality, which may result in an increased desire to explore individual spirituality. Tornstam reports the following comments made by an 86-year old woman in relation to this philosophy: â€Å"You go back to childhood almost daily. It comes without reflection. I talked to a good friend about this. We both go back to the town where we grew up (in our thoughts). Childhood means much more than one thinks; I go back to it all the time.† Ironically, the older adult’s childhood may seem nearer at age eighty-five than at age forty-five. Throughout life, we store away life experiences through language and perception as memory in the brain. Some of these experiences could be ‘spiritual’ depending on the individual’s actual capacity to be enchanted in wonder. For example, looking at Niagara Falls or the Grand Canyon could be a spiritual experience if the individual has developed the capacity to perceive the absolute beauty of nature. The wonder or enchantment is not inherent in the falls or the canyon, but in each of us as human beings. Throughout life, spirituality is developed spontaneously, subconsciously, and even purposely as we get into our later years and really begin to accept  our mortality. We do this by nurturing our spiritual being with reading spiritual material, attending church, listening to and watching spiritual programs, spending more time in prayer, and desiring to be around spiritual or religious people. The elderly generally develop a â€Å"let be† attitude about life’s journey, and know that developing spiritually cannot be forced. It is enjoyable and educational to listen to the wisdom expressed by the elderly when they speak or write about their spiritual journey. They teach us that wisdom and spirituality is a living process. Aging successfully through spirituality really sparked interest in the 1990’s by the McArthur Research Network. Their studies showed that religious participation in the elderly is just as beneficial as diet, exercise, mental stimulation and being connected socially. A better quality of life in spiritually-connected elderly can also be linked to the decreased use of tobacco products, abuse of drugs and alcohol, longer marriages and of course their supportive networks that all bring about a sense of peace and tranquility. There are many large-scale community studies that assess religion and spirituality as it coincides with the health and well-being of elderly men and women. The Established Populations for Epidemiological Studies of the Elderly (Lavretsky, 2010) did a study on approximately 20,000 U. S. adults, revealing that involvement in religion can prolong a life by seven years on the average. In another study, Comstock’s and Partridge’s analysis of 91,000 peo ple in Maryland that attended church showed a decrease in the prevalence of cirrhosis, heart disease, and suicide.A great number of studies reveal a direct correlation in commitment to one’s spiritual self with lower rates of hypertension, cancer pain and stroke. Studies also prove that religion or spirituality is also associated with decreased anxiety, stress, strong relationships and better overall mental, physical and emotional health. All of these types of studies have proven similar results in all parts of the world and in all races, cultures and religions. The benefits of spirituality for the aging adult may be a fairly new concept in that it has really only been studied in the past twenty to thirty years, however, it is being taken seriously in geriatric care by practitioners everywhere. In many clinics, religion and spirituality are now taken seriously as a part of an individual’s history when it comes to  assisting elderly or seriously ill patients in order to help them cope, and even heal. Of course, the subject of religion may be a touchy one for some; therefore practitioners know that they must approach this area cautiously. One way to do this is by asking open-ended questions, such as, ‘is faith (religion, spirituality) important to you in this illness’; ‘has faith been important to you at other times in your life’; ‘do you have someone to talk to about religious m atters’; and ‘would you like to discuss religious matters with someone?’ The sense of well-being through spirituality and religion equally runs through White, Mexican, and African-Americans as studies have demonstrated, because inherently, people of faith, no matter what the race or culture, internalize peace and tranquility about aging and illness, leading to better self-esteem, attitudes and lower rates of depression and anxiety. â€Å"Evidence suggests that meditation, prayer, and other religious and spiritual practices may have significant effects on the aging brain – positive effects that may help improve memory and cognition, mood, and overall mental health† (Newberg, 2011). Gerascophobia, the fear of aging, is common in people that have a difficult time experiencing birthdays, and that do everything within their power to ‘stop the clock’. We see as people age that they experience disengagement and loss like never before, such as losing professional identities, incomes, and seeing friends and/or family die or move away. This is a ‘time for working out a philosophy, and then working that philosophy in to a way of life; a time for transcending the senses to find, and dwell with, the reality that underlies this natural world’ (Smith, 1991). As Pope Benedict said to the residents of a nursing home in Rome, Italy in 2012, â€Å"It is beautiful to be elderly!†¦We must never let ourselves be imprisoned by sadness! We received the gift of long life. On our face there must always be the joy of feeling ourselves loved by God, never sadness.†

Difference in Lymphatic Function in Health and Disease State Essay

ABSTRACT High Performance Liquid Chromatography has been used to evolve an analytical procedure for the evaluation of the content of paracetamol in the bulk, dosage forms and in urine, a body fluid. Separation and resolution have been achieved with a combination of methanol and 2.5% acetic acid (15:85) on a reversed-phase column at ambient temperature. Elution was isocratic with UV detection at 257nm. Internal standard calibration method was used for quantitation with caffeine as the internal standard. Mean retention times for paracetamol and caffeine were respectively 2.61  ± 0.13 min and 11.98  ± 0.72 min . The calibration curve was linear over the range 0.1-5.0ÃŽ ¼g/ml. The method was also suitable for the assay of paracetamol-codeine combination drug as well as estimation of the amount of constituents in urine when the wavelength of UV detection was 245 nm with acetanilide as the internal standard. Keywords: Chromatography, isocratic, internal standard, in vivo and in vitro INTRODUCTION Paracetamol (N-(4-hydroxyphenyl) acetamide) tablets are listed among the essential drugs selected for the health care delivery system in Ghana. OH NHCOCH3 Figure 1: Chemical Structure of Paracetamol Paracetamol is very much used for antipyresis and analgesia without prescription. The drug is useful in mild to moderate pain such as headache, myalgia and postpartum pain. It is a very good alternative for mild to moderate pain in patients who cannot take aspirin because of allergy,  haemophilia, history of peptic ulcer and asthma. (Katzung, 1989). As a result of the Ghana government’s policy of generic prescribing, the liberalization of trade and import laws, and the ever-increasing number of pharmaceutical industries, a wide range of paracetamol products appear on the Ghanaian market. According to the Ghana National Drugs Policy, only drugs conforming to nationally accepted and/or internationally recognized quality standards shall be permitted to be procured and distributed in the country (Ghana National Drugs Policy, 1999). Any study therefore designed to monitor and improve the quality evaluation of pharmaceutical products both at the time of registration and post-market is very essential in the policy and technical guidelines of drug regulatory authorities such as the Food and Drugs Board. Such a study also benefits the Ghana Health Service in the sense that procurement staff, prescribers, dispensers and patients have access to high-quality and efficacious drug products. Pharmaceutical industries may also have simpl e analytical procedures for both in-process and finished product evaluations. The HPLC has been used to determine paracetamol in tablets. Franeta et al (2002) used the HPLC for the  19 simultaneous determination of acetylsalicylic acid, paracetamol, caffeine and phenobarbital in tablets on a reversed-phase column using a mixture of acetonitrile and water (25:75 v/v) adjusted to pH 2.5 with phosphoric acid. The Bio Rad 1801 UV-Vis detector was used (207 nm). Ramos-Martos et al (2001) also described a rapid reversed-phase HPLC method with UV detection for the simultaneous determination of acetylsalicylic acid, caffeine, codeine, paracetamol, pyridoxine and thiamine in pharmaceutical preparations using two successive eluants of water for 5 minutes and acetonitrile-water (75: 25 v/v) for 9 minutes, both eluants adjusted to pH 2.1 with phosphoric acid. Codeine was determined at 240 nm whilst the rest were detected at 285 nm. Okine et al (2003) used a mixture of methanol and 0.05M NaH2PO4 (17:83), pH  2.0 with UV detection (273 nm) for eluting ascorbic acid, paracetamol and caffeine combined in a tablet. Apart from the high cost of acetonitrile for routine analysis, the systems were not selective for unchanged paracetamol in urine. It therefore becomes imperative to evolve a system that is cost effective and selective for paracetamol in the bulk powder, dosage forms and biological fluids s uch as blood and urine for easier routine in vitro and in vivo monitoring of drug samples. EXPERIMENTAL Components of the Liquid Chromatograph Pump: Spectra System P100 (Spectra Physics) Detector: Spectra 100 Variable Wavelength Detector (Spectra Physics) Integrator: CR501 Chromatopac (Schimadzu) Sample Injector: Syringe loading sample injector fitted with an external 20 µl loop (Model no. 8125-095) Stationary phase: Spherisorb HPLC column, S10 ODS2 (10cm, 4.6mm) Materials  Pure paracetamol powder (Chemcon GmbH, Germany), Paracetamol tablets (Phyto-Riker Ltd., Ghana), Paracetamol tablets ( PZ Co Ltd., Ghana), Paracetamol tablets (Tylenol Forte, Cilag Ltd., Switzerland), Paracetamol-codeine combination product (Paracod, Phyto-Riker Ltd., Ghana), Paracetamol-codeine combination product (Co-codamol, Alpharma, UK), blank urine sample, deionised water, urine samples with unchanged drug and drug metabolites, methanol (BDH), acetic acid (BDH), potassium dihydrogen phosphate (BDH), caffeine (BDH), salbutamol sulphate (Shubhmets, Mumbai, India), citric acid (Acid India) and phenyl ethanolamine (Blue Bird, Mumbai, India) Method Design Considerations Information on the physico-chemical properties of paracetamol and the other chemicals above were searched. Details considered include solubility properties, chemical structures, acid dissociation constants (pka), level of purity, stability in solution and ultraviolet light absorption pattern in acidic, basic and neutral media with their respective wavelengths of maximum absorption (Moffat, 1986; British Pharmacopoeia, 2000). The substances were found moderately polar. Based on their polarity, reversed-phase HPLC was  considered more applicable because in this mode, a nonpolar stationary phase and a polar mobile phase were utilised so that more polar substances were eluted before the relatively nonpolar. The differences in the physico-chemical properties of paracetamol and the other chemicals aided in selecting an internal standard for the study since they all interacted differently with a chosen combination of mobile phase to give a chromatogram of different separations, resolution s and retention times. Various combinations of methanol/phosphate buffer and methanol/water (pH and ionic strength modified with acetic acid) were tried in order to optimise column capacity factor for separation and resolution. Each concentration of phosphate buffer or water (various pH) was combined with methanol in various proportions, starting with a 50:50 combination and gradually increasing and decreasing the aqueous content while monitoring their respective effects on separation and resolution. All the mobile phase combinations tried could elute both paracetamol in the bulk powder and tablet matrix with reasonable retention, but not all the other chemicals being considered for an internal standard (caffeine, salbutamol, citric acid and phenyl ethanolamine). Some had poor resolution and tailing peaks while others had poor resolution and unduly long retention times. Some of the mobile phase combinations that could conveniently separate and resolve paracetamol in vitro could not separate and resolve blank urine (urine from a healthy person before drug was administered) spiked with a standard solution of paracetamol. Further altering the combination ratio, ionic strength and pH of the mobile phase produced the optimum system that could satisfactorily resolve paracetamol in the bulk powder, tablet matrix, spiked blank urine and unchanged paracetamol and other paracetamol metabolites  excreted in urine. Among the list of chemicals for an internal standard, caffeine was found the best under the optimum chromatographic conditions of the study. The best mobile phase combination was methanol/2.5 % acetic acid (15:85). Elution was isocratic because a single mobile phase combination was used. After other investigations, the best wavelength of maximum absorption for UV detection was 257 nm, absorption unit fraction scale (aufs) for  quantitative detect ion of the analyte at very small concentrations , 0.5, flow rate of mobile phase, 1.5 ml/min and chart recorder speed, 5 mm/min. Preparation of mobile phase The volume of mixtures do not usually equal the sum of the separate volumes making up the mixture as a result of differences in density and other physical factors such as volume expansion and contraction. The mobile phase was therefore prepared by measuring separately the volume of each component and mixing them together. All mobile phases prepared were filtered through a membrane filter before use. Validation of Analytical Method Various parameters can be evaluated for validating any newly developed analytical system. These include linearity, precision, accuracy, sensitivity and comparison to other standard methods. Comparison of new method with standard spectrophotometric method, (BP, 2000) The method was applied to paracetamol products from three pharmaceutical companies. Twenty tablets of each of the experimental paracetamol products were weighed together and finely powdered. A quantity of the powder containing 0.15g of paracetamol (0.1692g of Phyto-Riker Paracetamol, 0.1578g of PZ Paracetamol and 0.2001g of Tylenol Forte) was weighed and quantitatively transferred into a 200ml volumetric flask with 50ml of 0.1M NaOH and then diluted with 100ml of distilled water and shaken mechanically for 15 minutes. Sufficient distilled water was then added to produce 200ml. After filtration, further dilutions were made with distilled water such that the final concentration of paracetamol in solution was 0.00075 %w/v an d the NaOH, 0.01 M. The absorbance of the resulting solution was then taken in triplicate with the Cecil 7020 double beam UV spectrophotometer at a wavelength of 257nm with quartz cuvette of path length 1 cm using 0.01 M NaOH as the blank solvent. New Method For each of the experimental brands, sample preparation was done by crushing 20 tablets. A quantity of the powder equivalent to 0.1g of paracetamol (0.1128g of Phyto-Riker Paracetamol, 0.1052g of PZ Paracetamol and 0.1333g of Tylenol Forte) was weighed and quantitatively transferred into a clean 100ml volumetric flask with 20ml of methanol. It was then mechanically  shaken for 10 minutes. It was diluted to the 100ml mark with deionised water. Insoluble excipients were filtered off through a medium porosity sintered glass filter. A 0.1%w/v aqueous solution of caffeine was also prepared as a stock internal standard solution. A final solution containing 0.00025% paracetamol and 0.001 %w/v caffeine was prepared for the HPLC analysis. Triplicate injections onto the column were successively done for each of the experimental brands. Average peak area ratios (test sample/internal standard) for the various samples were calculated from their chromatograms. The actual concentration of paracetamol in each of the samples analysed was interpolated from a calibration curve using the average peak area ratios. The student’s t-test was used to compare the means of the two methods while the variances were compared with the f-test. Calibration Graph The range of concentrations used was 0.000005%-0.001%w/v. The new HPLC method was used for the determinations. Injections were done in triplicate for each of the concentrations in the above range. A graph of average peak area ratio was plotted against concentration. All the concentrations used gave signals but not all the signals were proportional to concentration. Concentrations that were not detected proportionally defined the limits of detector linearity under the given set of experimental conditions. Before preparing the solutions for the calibration curve, the paracetamol reference powder was identified and characterised according to BP 2000. Determination of inter-day variation of  analytical method The inter-day variation was investigated to assess the likely variations in results from day to day when the new method is used. This involved the HPLC assay of paracetamol of approximately the same concentrations on two different days under same conditions. The results for the two different days were paired and the f-test applied to determine likely significant difference in their variances. Determination of intra-day variation of the analytical method Several assays of paracetamol were done within the same day to determine the repeatability of the new method. Seven sets of solutions of approximately the same concentration (0.0001 %w/v) from the same homogenous stock were prepared and successively analysed with the HPLC. Each set was run three times and the average peak area ratio taken to represent that set. Actual concentrations of solutions were interpolated from the calibration graph. The relative standard deviation of results was calculated to determine the level of repeatability. The concentration of paracetamol solution was so chosen to ensure that readings were taken within the linear region of the calibration curve. Application of analytical procedure to urine, a body fluid After following all pharmacokinetic protocols (Shargel and Andrew, 1993) six healthy male volunteers between the ages of 26 and 32 years were each given 1.0g of paracetamol tablets and had their urine samples collected at specific time intervals for 24 hours. All subjects had the same time points of urine collection after administration of the tablets and these were: 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0, 6.0, 9.0, 12.0, 18.0 and 24.0 hours. The entire volume of urine voided during each sampling interval was pooled together and recorded and the analysis done immediately. Where urine samples had to be kept overnight, quantities were kept tight in sample tubes and frozen. Other applications The new HPLC method was also applied to a combination product containing paracetamol and codeine both for assay and determination of unchanged forms of the two constituents in urine. RESULTS AND DISCUSSION Since paracetamol is a compound of moderate polarity as shown by its chemical structure in Figure 1, a reversed-phase column with a polar mobile phase was used. The mobile phase was methanol/2.5% acetic acid (15:85). In reversed-phase separation, compounds were separated based on their hydrophobicity. Retention increased as the solutes decreased in polarity; thus, polar species were eluted first. Hence, eluting time increased by increasing the polarity (water content) of the eluent. The pH of the eluent  as well as the pka of the drug being separated affected the elution profile. Figures 2 (a-c) therefore show different elution profiles and retention times because of the differences in the physicochemical properties of the analytes under review. The retention time of caffeine (11.98  ± 0.72 min) was greater than paracetamol (2.61  ± 0.13 min) because it was greatly retained on the column as evidenced by the tailing nature of the caffeine peak because of its relatively greater h ydrophobicity. The components of the blank urine though poorly resolved, had shorter retention times (< 2.5 min) than paracetamol because they were relatively more polar and interacted better with the polar mobile phase, resulting in decreased retention. The presence of aromatic rings together with auxochromes in the chemical structures of paracetamol and caffeine made UV absorption possible for monitoring the column effluent. As regards the intra-day precision of the new method, the relative standard deviation (RSD) of repeated assay of separate identical samples of concentration 1 µg/ml was 2.17% (Table 1 and 2). According to Dong (2000), only HPLC analysis with modern auto samplers yields RSD of less than 2.0%. Manual sample injections with RSD of 2.17 can therefore not be said to have a poor potential to give reproducible data under the same experimental conditions. Random errors from analysts might as well have contributed to the RSD value being greater than 2.0%. The degree of agreement among the individual observations was indicated by the value of the absolute precision (0.02). This appears small and suggests a good level of agreement between test results. The inter-day precision from Table 3 and 4 was high as there was no statistical difference between the variances of the set of analytical data generated for two different days at a confidence level of 95%. The method therefore was reproducible and could produce data for peer analysis. There was a positive correlation between peak area ratios and the concentrations of analyte (Figure 3). Correlation coefficient (r2) of 0.9998 implies that the scatter presented in Figure 3 was accurate enough for predictable purposes within limits of detector linearity. From Table 5, the range of detector linearity was established as 0.1-5.0  µg/ml. Under the set of experimental conditions, the lowest concentration of paracetamol that was detected but did not necessarily produce a signal that was proportional to concentration was 0.05  µg/ml. However, signal for 0.2  µg/ml paracetamol solution was approximately twice that of 0.1  µg/ml. Since the minimum concentration of paracetamol that started varying proportionally with peak area ratio was 0.1  µg/ml, it was chosen as the limit of quantitation of the method. This observation was in good agreement with what has been reported that in many cases, the limit of quantitation is approximately twice the limit of detection (Seth i, 1993; Olaniyi, 2000). The upper limit of quantitation was also set at 5.0 µg/ml because there was no proportional increase in peak area on increasing paracetamol concentration from 5 to 10  µg/ml. Evidence of correlation between the new method and that of British Pharmacopoeia (2000) for the assay of paracetamol tablets was positive. The F-test at 95% confidence level, showed no significant difference between the variances of both the HPLC and UV methods (Table 6). This means that within certain limits, both methods have comparable precisions. However, the absolute precision of the two methods at the same confidence level indicates that the HPLC method has a better precision. The absolute precision values were respectively 1.90 and 2.12 (Table 7). As regards accuracy, even though the results of both methods complied with BP (2000) limits for content of paracetamol in tablets (Table 8), a significant difference was observed between the means of the two methods when the student’s t-test was applied (Table 6). Assessing the absolute error of the mean for the two methods, the HPLC results (2.3%) was found to be more accurate than the UV (4.3%) (Table 7). Moffat (1986) reported that when a dose of paracetamol tablets is administered orally, close to 5% is excreted unchanged in urine. As found in this study, only a small fraction of the absorbed dose was excreted unchanged for all the paracetamol products. These were 5.3 ±0.9%, 5.3 ±1.2% and 5.0 ±0.7% respectively for Paracetamol CoA, Paracetamol CoB and Paracetamol CoC (Table 9). These values are closely in agreement with what has already been reported, making the new method suitable for the detection and quantitation of paracetamol in urine. CONCLUSIONS Paracetamol in the bulk, dosage form and urine has been analysed accurately and precisely by HPLC with Methanol / 2.5% acetic acid (15: 85) in the reversed-phase mode at a wavelength of 257 nm using caffeine as the internal standard. The method has also been used for the detection and quantitation of codeine and paracetamol in urine as well as codeine-paracetamol combination tablet. The wavelength of detection in this case was 245 nm with acetanilide as the internal standard. REFERENCES British Pharmacopoeia (BP) (2000). Volumes I &II, CD-ROM, The British Pharmacopoeial Commission. Dong, W. M. (2000). Precision in HPLC. In Today’s Chemist at Work (2000), 9 (8): 28-32. Franeta, J. T., Agbaba, D., Eric, S., Pavkov, S., Aleksi, M. and Vladimirov, S. (2002). HPLC assay of acetylsalicylic acid, paracetamol, caffeine and phenobarbital in tablets, Farmaco Sep; 57 (9): 709-13 Ghana National Drugs Policy (1999). Ministry of Health, Ghana. pp 4, 7, 12 and 19 Katzung, G. B. (1989). Basic and Clinical Pharmacology, 4th edition, Appleton and Lange, Norwalk, CT. p 444 Moffat, A. C. (1986). Clarke’s Isolation and Identification of Drugs, 2nd edition, the Pharmaceutical Press, London. pp 420-421, 849-850 Okine, N.N.A., Asiedu, K.S. and Acheampong, J. (2003). RP-LC determination of ascorbic acid, paracetamol and caffeine in multicomponent anti-cold preparation, Journal of Science and Technology, 23 (1): 55 Olaniyi, A. A. (2000). Principles of Drug Quality Assurance and Pharmaceutical Analysis, Monsuro Publishers, Ibadan, Nigeria. Ramos-Martos, N., Aguirre-Gomez, F., Molina-Diaz, A., Capitan-Valley, L. F. (2001). Application of liquid chromatography to the simultaneous determination of acetylsalicylic acid, caffeine, codeine, paracetamol, pyridoxine and thiamine in pharmaceutical preparations. J.A.O.C. Int. May-Jun; 84 (3): 676-83 Sethi, P. D. (1993). Quantitative Analysis of Drugs in Pharmaceutical Formulations, 2nd edition, C.B.S Publishers and Distributors, New Delhi. pp 33-37 Shargel, L., Andrew, B. C. Y. (1993). Applied Biopharmaceutics and Pharmacokinetics, 3rd edition, Appleton and Lange, Norwalk, CT. pp 205-209

Mission Statement writting assigment Assignment Example | Topics and Well Written Essays - 250 words

Mission Statement writting assigment - Assignment Example To ensure that they nurture the human spirit, they maintain going for the best coffee available in the market around the world. For "one person, one cup and a neighborhood at a time," Starbucks has its own way of developing loyal customers and contributes to the environment even as it makes its profits (Diane, Raven, & Al-Mutair, 1998). In another article on "Wake up and smell the coffee," by Anonymous author, it is stated that during when Starbucks is roasting its coffee, there is a production of smoke that when released to the environment just that way, it causes environmental pollution (Anonymous, 2006). This would show how Starbucks engages in an activity that is considered unethical or illegal. However, the company tries so much to reduce this issue by completing the oxidation process of the material into CO2 and water, which are, therefore, safe to release to the

Team building within a generational diverse team Research Paper

Team building within a generational diverse team - Research Paper Example It follows that this essay examines generational characteristics in terms of their articulation within the workplace environment, specifically considering the ways that a generationally diverse team can be accomplished. Generational Gap in Today’s Workforce There are a number of pros and cons in regards to the generational gap in today’s workforce. One of the most beneficial aspects of generational diversity in the workforce is the ability for individuals within this frame of context to engage in collaborative activities that mesh a variety of world perspectives and experiences together in a way that produces higher levels of company results. Conversely, the values that underline the generational differences can oftentimes result in conflicts of opinion or perception that hinder company progress and can derail workplace cooperation. Another factor that is a problem in regards to generational diversity in the workplace is the consideration of the workplace hierarchy in r egards to generational factors. ... Boomer generation’s retirement approaching they place increased emphasis on the importance of benefits; when this emphasis is compared with that of the Generation Xers who are more predominantly concerned with subsistence and building wealth than enhancing retirement portfolios. Team Building In considering the ways that team building can be accomplished within the workforce one of the most central questions is understanding the characteristics that define each generation and then analyzing how they can be intermingled and implemented in as productive a means possible. In these regards, it’s the values that underline the generations that are the most important factors to consider when building a generationally diverse team. It was earlier noted that one of the challenges facing the overarching corporate benefit structure in terms of generational diversity was attuning conflicting desires in term of compensation needs. For instance, in order to build a more functional te am environment, the business or corporate structure must development retirement and compensation packages that take into consideration the competing values of the generations in the work environment. In properly melding these competing desires into a package that appeals to both generations, factors related to motivation can be harnessed as a means of bringing employees together under a shared goal. In these regards, Notter (2009) writes that, â€Å"Knowing in advance how each generation can be triggered, either positively or negatively, can help organizations develop balanced policies and can help individual managers and employees structure their work interactions in ways that benefit all types of people.† Here Notter raises the interesting point that team building with generational diversity is not

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Fashion - Research Paper Example She also proclaimed and advised that the society ought not to underplay the repercussions of the situation, with regard to the message that most personalities had sent earlier (Breward, 2002). Furthermore, in accordance with a magazine that communicates issues regarding and surrounding the fashion confines, it was devastating that approximately 80% of young ladies in the fifth grades via twelve had been under influence of such fashion magazines, with regard to the images displayed (Davis, 2005). They confessed that most of these advances within the fashion magazines contained material that would probably alter their feeding habits and intake of various substances. Moreover, in the pro-anorexia programmes, posters communicating the notion of participation in television fashion shows and purportedly combing their magazines for ‘thinspiration’. However a bit intricate intelligence exists regarding whether the ubiquity of the excessively thin models results into persons outs ide the fields to innovate disordered feeding or fully blown food consumption chaos. Generally, Dr. Broft confessed that in the course of their working with their patients, this notion of the thinning always arises. Additionally, the psychiatrist within the foodstuff consumption program in the Columbia psychiatry explicated additionally that feeding disorders are extremely intricate based on their aetiology. Additionally, it is reasonable to proclaim that disclosure may be a truth in the innovation of feeding disorders and that an unfussy connection had not been conventional. In addition, the national affiliation of health prospects that the lifetime pervasiveness of anorexia is approximately 1.5% of the adult populace in the U.S.A. However, between the age gap of twelve to eighteen year olds is around 2.5%. Additionally, there immense risk prospects inclusive of their femininity and age among others as influences and the past (Breward, 2002). In accordance with a psychologist at th e Cleveland clinic, disclosure to skinny models could probably take a role. Moreover, though skinny models are not the reason behind feeding disorders, they may trigger or elicit a prospect in up keeping a feeding anomaly (Furze, 2011). Additionally, she proclaimed that if a lady has an establishment for a feeding anomaly and takes most of their time browsing via fashion papers can be one of the prospects that elicit a negative feeling of their body, which initiates them into feeding disorders, like excessive eating. Moreover, consummate research has introduced a relation of the two purporting that there has not existed any single descriptive scientific explication. Furthermore, specialists proclaim that her explication is one of the most fascinating on how the general media can implicate on bodily issues and image regards too. Becker’s exertion has concentrated on Fiji, where she discovered the entry of television coincided with, among other things, an augmentation in disord ered feeding, inclusive of throwing up to lose or take critical control of weight. Additionally, a following up research discovered that peer disclosure was specifically strong, with allies deliberating and internalizing the general media images (Davis, 2005). Though Becker warned against projection of such results to the American, she proclaimed

Leading a Team in Crisis Situations Essay Example | Topics and Well Written Essays - 2500 words

Leading a Team in Crisis Situations - Essay Example I chose this topic because of its importance, significance, and relevance in the contemporary age. Everything has changed over the time, and this has had a great impact on the way organizations function. As a leader, the responsibility of adopting the right strategy in these times of change fundamentally rests upon the shoulders of the leader. Change in leadership is inevitable. A leader is frequently exposed to circumstances that generate the need for change. A leader must be intelligent and proactive enough to adapt to these changes and make the wisest decision considering the needs of the changed circumstances. The experiences I have shared in this paper discuss what strategies I have employed to deal with the challenges arising as a consequence of changes that took place, and how those strategies helped me achieve my objectives. Each experience that I have shared demonstrates a different kind of change and accordingly, a different strategy I adopted to lead my team to success. Qu estions that I intend to answer by discussing my personal experiences of change and leadership include but are not limited to; A leader is needed in every organization of any volume, from large corporations to task forces designed to achieve petty tasks. Subordinates look forward to the leader for the establishment of goals and milestones, as well as support, resources, and motivation for their achievement. The behavior of a leader plays a decisive role in the leader’s success. â€Å"The behavior of the leader and the behavior of the group members are inextricably interwoven, and the behavior of both is determined to a great degree by formal requirements imposed by the institution of which the group is a part† (Halpin, n.d., p. 172). There are several conclusions that I can draw from the experience I have shared in the Case I. Firstly, focusing upon making positive advances instead of stopping behaviors is a more effective and useful approach for a leader. Secondly, it is easier for the team to commence actions that accord with their preferred traits. â€Å"Research once again has confirmed wh at we’ve always suspected - your boss can cause you stress, induce depression and anxiety or even trigger the onset of serious illness. It is not just bad managers who can negatively affect employee health, but it is also the lackadaisical and mediocre who can put employees on the sick list† (Williams, 2011). Thirdly, the desired results can be achieved by using different preferred traits in different situations. Behavioral solutions can be customized for different personalities as per their individualistic preferences.

Free writing journal Essay Example | Topics and Well Written Essays - 250 words - 6

Free writing journal - Essay Example Everyone has the tendency to doubt and to question things. We are not perfect beings. That’s the reason why we see goodness in men and why it’s easy for us to doubt. Since we are imperfect beings, we know that there is always a tendency to turn to evil. But we expect each one of us not to. Why? Because we have the church to make sure that we are well-guided. But church teachings sometimes are not enough. When our expectations are not met, our frustrations lead us to the other side of the road. This happened to Goodman Brown. He expected the priests and other religious men and women that serve the church to stay true to the church. But when he found them at a cult gathering, he began to question and to doubt them. Since he believed that evil cannot turn the people he believed to be pure and good, his experience in the forest greatly disappointed and frustrated him. The story also emphasizes that we, as humans, can make our own decisions. And because of this, we tend to firmly stand for what we believe in. The problem is when you encounter an event that can shake this belief, that we are in control. Then, we will find a problem for everything. Why? Because humans tend to reason out. And we fail or do something out of our control, we look for reasons and

Animal Experimentation Research Paper Example | Topics and Well Written Essays - 750 words

Animal Experimentation - Research Paper Example As a result, The use of animals in scientific experiments increased dramatically especially after the discovery of anesthetics in mid-nineteenth century; the number of non-human animals used in scientific investigations in UK alone increased from one million per year in early nineteenth century to exceed five millions per year in the 1970s. This huge increase in the use of animals for research purposes was paralleled with an increase in the resistance and oppositions to animal testing. The animal testing controversy involves three sides; a group that is in favor of using animals for medical research debating that human superiority to animals justifies the use of animals in experiments. On the other hand, there is group of people who opposes the use of animals in experiments for ethical concerns. Obviously, both of these two sides are extreme; we cannot allow animals to suffer just based on the proponent’s claim nor can we stop animal tests due to the fact that it would stop hu mans from advancing in medical fields. This controversy resulted in new laws and regulations such as, the Animal Welfare Act (AWA) that limits the number of animals that should be tested and the level of pain an animal can endure. Although, of course, experimenting on animals should be regulated, discontinuing this practice must never happen since it would negatively impact the advancement in the medical fields which will affect both humans’ race and non-human animals. The anti- animal testing movement argues that animals have the same rights as humans and therefore we should not be carrying out experiments on them. Tom Regan, a professor at the North Carolina University, argues that animals have similar emotions to our emotional beings, and considering them inferior species is similar to racism. According to Charles Darwin, best known as the father of evolution, humans are different from other species in â€Å"degree† not in â€Å"kind†. Thus Regan believes tha t â€Å"speciesism† which points to the view that the specie that we belong to is superior to other species is the same as racism and sexism. Furthermore, the response that we would get if we ask ourselves what gives us the right to carry experiments on animal for our benefits would be that we humans are more intelligent than other animals. But what about the case of infants or some mentally disabled patients, wouldn’t there be some animals that are more intelligent in comparison to these two examples? So, animals that are less intelligent than humans shall not be tested for human benefits unless we are ready to scarify some of our specie members. Similar to the philosophy of human rights which state that all people should be treated equally, animal rights as well demand that all animals should be equally treated, which prevent the harm of individuals to benefits other(). Humans as well as other animals experience life, and their rights to live and treated equally shou ld not be ignored. Why should animals be the victims of enduring harmful and procedural experiments that would yield benefits that are mostly useful for humans? The answer to this question is the fact there is not many alternative, and only animals are qualified for carrying out medical experiments. The limitation of sources to gain essential information is the reason why animals are used in experiments; there are no computers

Analysis Report Grading Rubric Essay Example | Topics and Well Written Essays - 750 words

Analysis Report Grading Rubric - Essay Example The need to advance in the human resource management is a main driver for undertaking this course. Today, the course is important to ensure my survival at the competitive job market in the human resource field. Furthermore, the motive to undertake she course comes from the urge to raise the efficiency and my standards of performance in targeted organizations. However, there exist a number of deficiencies during the study of the course. Lack of intensive resources to conduct the research related to Human resource is less than was expected. On the other hand, the available resources are restricted to databases that require rental procedures that will pose a problem in trying to access in-depth information on the course. Additionally, there may be an existence of delay in response from the instructor following that a number of students looks upon the professor for answers to course related questions. Effective and efficient instructions form the basis of comprehension of classwork infor mation on the course. Comprehensive content for instructions initiative include reflection and reinforcement of the approach within the broader human resource strategy that is capable of linking other strategies such as reward and focusing the engagement of every student in the classroom (Morrison 32). The instructional strategies that I prefer includes discussion groups activities, talks by specialized human resource managers, case studies, simulation of facts related to the classwork, application of computer teaching, observational exercises that involve inspection and report techniques, briefs by senior professors, and interactive learning. Remarkably, the timeline of the program depends mostly on the instructor’s plan and procedures. However, on an individual view, prefer a timeline that is takes into consideration other social activities outside the classroom. Furthermore, the timeline should be in correlation with the content that the course entails to avoid over or und erworking for students as well as the instructor. Audience The course compromise of high school learners where I am one of the students to undertake the course. I possess a number of characteristics that enhance my learning capability and collaboration with both the instructor and other students. I am a good listener, which ensures me to capture most from lecture and talks. Additionally, I actively participate in classroom proceedings by answering and asking course related questions. Remarkably, sitting in front of the classroom has been my trend throughout my education system. I do not require any pedagogical or anagogical considerations. The type of learning that needs to occur for the course should be focused on providing the student with practical skills on the course related information. It should demonstrate a good student-teacher relationship. Furthermore, the learning should be associative and inclusive. Inclusive learning ensures that all students regardless of disabilities have equal opportunities to succeed academically, behaviorally, and socially (Evans, Alvin & Edna 25). Spatial learning would also benefit the program because it involves the learning of relations among many stimuli regarding the course. Goals and Objectives Behavioral characteristic in an education environment play a main role in facilitating discipline and smooth flow. Non-natives behaviors in the classroom of restrained class

Homeland Security Research Products Paper Example | Topics and Well Written Essays - 1000 words - 1

Homeland Security Products - Research Paper Example Understanding the radicalization process is crucial in developing effective counter-strategies. This is because potential terrorists begin and progress through radicalization processes. Successful counter strategies can only be achieved if the security structures identify the point where radicalization begins. The second report is that of the Department of Homeland Security titled Right-wing Extremism: Current economic and political climate fueling resurgence in radicalization and recruitment (U.S Department of Homeland Security, 2009). The report provides an assessment of the threat posed by homegrown extremism from right-wing groups. The report is an intelligence assessment that helps in facilitating a better understanding of the emergence of violent radicalization in the United States. The report lacks credible evidence that the right-wing terrorists are planning any acts of violence. However, it bases its argument on the speculation that the extremists may be training more recruits owing to the fear related to several emergent issues i.e. the economic downturn and the election of the first African American president. To address the research question in detail, the report has focused on discussing issues such as the prevailing political and economic environment, exploitation of the econ omic downturn, the presidential election, illegal immigration, and the legislative initial drivers among others. This report addresses the homegrown threat that terrorism activities pose in developed nations, for example, the United States. The study discusses the radicalization factor that promotes terrorism activities. The research is successful in the use of case studies to explain the formation and advancement of the intentions that lead to terrorism. Use of case studies amounts to qualitative research. The case studies provided existing data and information on terrorism for the report.  

Proxy Server Essay Example for Free

Proxy Server Essay Annotations: This research paper is an extract from an about 100 pages enfolding diploma thesis of Martin Eisermann, student at the Fachhochschule Rosenheim (University of Applied Sciences), Germany. It contains the results of performance tests, accomplished with MS Proxy Server 2.0, MS ISA Server and Linux Squid Proxy. This work reflects the personal impressions and test results of the author, made with web performance testing software, described later in this document. The paper is a translation from German into the English language, so it might not be written with the best phraseology. Microsoft, Windows, Windows NT, Windows XP, Internet Information Server (IIS), Web Application Stress Tool, Internet Security and Acceleration (ISA) Server, Proxy 2.0 are either registered trademarks or trademarks of Microsoft Corporation in the United States and other countries/regions. Other products and Company names mentioned herein may be trademarks of the respective owners. 1. Executive Summary This technical research paper contains the results of a performance test scenario with the Microsoft Internet Security and Acceleration (ISA) server, which should make clear, how good proxy servers can improve the speed of a web server. At the beginning, it describes the structure of the test scenario, with aspects of hardware and software. Then, a product will be chosen from a variety of different test tools, which compete with each other. The benefits and drawbacks of every product will be elucidated. The next chapter explains, which products will be compared with the MS ISA server and why they were selected. The following test results are representing the biggest section in this research paper. Finally, there is a short summary of the newly gained cognitions. 2. Test scenario To get an impression, how proxy servers can improve the performance of a network or of a single web server, the following scenario was build: 100 Mbit 100 Mbit Webserver (IIS 5.0) Proxy Server Workstations ill. 1 The workstations shown in illustration 1 are simulating the internal LAN (local area network) clients, which are among themselves connected with a fast Ethernet switch (100 Mbit). The web server, which is also connected with 100 Mbit, simulates the Internet. However, this network capacity is mostly not found in small and/ or middle enterprises, but for compensation, the web server is an outdated machine. The technical data of all components used for the tests is described in table 1. Technical data: System web server proxy server Workstations CPU Pentium AMD Duron Pentium II MHz RAM 200 800 400 96 MB 512 MB 256 MB OS Win XP Prof., IIS 5.0 variable Win NT 4.0 Prof. Tab. 1 3. Test tool selection In the Internet, it is not difficult to find programs, which can execute diverse performance tests for web servers. Many of them, especially if they are build for Linux, are free of charge, but if one likes to have graphical analysis it gets more difficult. Often one has to decide using a Microsoft Windows 32-bit application, which, in general, costs a lot of money. Another problem is the possibility to integrate a proxy server to the web testing tools. Most tools dont support that. Of course, this is comprehensible: which operator, who wants to test his web server performance, likes the results be influenced by a proxy? But in this scenario, it is absolutely necessary. Regarding this two product selection preconditions, there arent left a lot tools. Three remaining products are the WebPolygrah Benchmark Tool from Measurement Factory, Microsofts Web Application Stress Tool and the Web Performance TrainerTM from Web Performance Inc. On a first look, they all three seem to offer the wished functionality. a) WebPolygraph Benchmark Tool: The WebPolygraph Benchmark Tool is freely availably at http://www.webpolygraph.org. The tool was originally developed for Linux based systems, but in between there are also MS Windows 32-bit binaries downloadable. The actually available documentation in the Internet is not sufficient to set up a test environment quickly and without intensive knowledge of the product. More examples and more detailed descriptions would help a lot. A graphical user interface is not implemented, too. b) Microsoft Web Application Stress Tool Also freely available is Microsofts web testing utility, the Web Application Stress Tool. It is downloadable at http://www.microsoft.com. The documentation, which can be found in the Internet, is clearly structured and useful. The handling of the product is intuitive for experienced Windows users. The missing integration of a proxy server in its configuration setup, makes the tool nearly useless, but Microsoft offers a solution: one have to install the Microsoft Proxy Client (or the Microsoft ISA Firewall Client) on the machine, which is used to perform the web tests, then the tests are working suitable. There is only one more problem left, which will get clearer in the next few minutes: There is no proxy client or firewall client available for Linux! And because there is a Linux product in the test environment, the Stress Tool is not useful at last. c) Web Performance TrainerTM 2.4 Finally, the software product from Web Performance Inc. (http://www.webperformanceinc.com) fulfilled all preconditions: graphical user interface, proxy configuration, easy understandable, Internet based documentation. All installation problems and handling questions where answered fast and competent. The product handling is similar to the Web Application Stress Tool, but there are versions for both, Linux and Windows operating systems. The demo version only supports an amount of 25 users, but Web Performance Inc. offered a time limited 3000 user version, for the tests. At this point many thanks for that again. 4. Test specification The web content for the tests is completely static, that means pictures and html-files, No dynamic pages like asp or php were inherited. Reason: these pages are normally not cached in a proxy server. The amount of data used is about 4.8 MB. The test run time is determined to 30 minutes. Significant performance differences should be visible within this time. The Web Performance trainer v2.4 can increase the number of concurrent users by 25 every minute. So, at the end of the test, a maximum number of 750 users can poll the web server. 5. Choosing the proxy products If someone tests the speed of a web or proxy server, he would not now, if his results are good or bad, if he doesnt make a comparison with other products. For this reason, beside the ISA server, the Microsoft Proxy 2.0 and a Linux Squid proxy were other test candidates. The decision for MS Proxy 2.0 is easy to explain. It is the original product, Microsoft build the ISA server on. It also runs on Windows 32bit operating systems and Microsoft propagates, that the ISA server runs about 10 times faster. The Linux squid proxy is in the test field, because it has the same functionality like the MS proxy versions, but runs on a completely different platform. Another reason is, that Linux and squid are both freeware products and thats a big advantage. 6. The test results The most important results, if one tests the performance of web or proxy servers, are described with the data: Total Hits, Errors, Hits/sec and Bytes/sec. In all following diagrams, the colors are defined as follows: Total Hits Errors red Hits/sec Bytes/sec black yellow (with factor: 0,001 kB/sec) green 6.1 Web server (standalone) For a first view, the next two illustrations are showing the test results of the web server, without a proxy: Ill. 2 Ill. 3 While the 30 minutes test duration there were only 111.451 hits and 298.778 errors recognized by the Web Performance TrainerTM and only 470 users could by simulated at all. In the first minutes of the test, the amount of kilobytes per second is relatively high (~ 550) but from minute 11:00, they decrease to an average number of 165 kb/s. A stable result of only 50 hits per second can be metered. Already explained before in this paper, the used web server is an old computer, so these bad results are nothing to wonder. How good the results could get with proxy servers in front of it, will be shown in the next chapter. 6.2 MS Proxy 2.0 vs. MS ISA-Server In a first step, the two Microsoft products will be compared with each other. Already their total hits within this 30 minutes, differ a lot. The ISA-Server has about four times better results than it’s predecessor, while the total number of errors is just about three times higher. MS Proxy 2.0 – Total Hits: 206.953 – Errors: 74.572 Ill. 4 Ill. 5 MS ISA-Server – Total Hits: 781.851 – Errors: 232.879 So, the superiority of the new product is verified. Surprisingly, the count of errors of the MS Proxy 2.0 loose their nearly parallel growth with the total hits line in the 8th minute, and increase much slower in the next 22 test minutes. For this effect couldn’t be found a reason. MS Proxy 2.0 – Hits/Sec – kB/s Ill. 6 MS ISA-Server – Hits/Sec – kB/s Ill. 7 The comparison of the hits/s, shows that the MS Proxy 2.0 cannot exceed the previous peak values of the web server a lot, but holds them constantly (~ 550 kB/s at ~120 hits/s). Whereas the ISA server lies with it’s ~500 hits/s explicit over the MS Proxy 2.0. A ten times higher rate, shown in the small illustration 8 (submitted by Microsoft), cannot be proven. Ill. 7 6.3 Linux Squid vs. MS ISA server The second test candidate is the squid proxy server, based on the operating system RedHat Linux version 7.2. The software products can be downloaded freely from the Internet (http://www.redhat.com; http://www.squid-cache.org). The squid version, used for the test, is release 2.4 stable 1-5. Linux Squid – Total Hits: 1.335.949 – Errors: 303.204 Ill. 9 MS ISA-Server – Total Hits: 781.851 – Errors: 232.879 Ill. 10 This comparing test shows significantly, the higher performance of the squid proxy in opposite to the MS ISA server: it is nearly doubled. The amount of not completed requests is irrelevant higher. Further results like hits per second and kilobytes per second are making this even clearer. Linux Squid – Hits/Sec – kB/s Ill. 11 MS ISA-Server – Hits/Sec – kB/s Ill. 12 In the first six minutes, ISA and squid are competing with each other and are reaching values of 2.600 kb/sec. But then, the performance of the ISA server slackens and even decreases to an average value of 2.200 kb/s. Whereas the performance of the squid proxy reaches its limit not before the maximum possible network throughput rate (at 100 Mbit) of about 4450 kb/sec in the 9th test minute. Then the average value also decreases a little until circa 4300 kbytes per second. 7. Summary The squid proxy, running on a freeware product, is apparently the fastest proxy server within the three test candidates. Its normal implementation is not hard, if the corresponding administrator has little knowledge about Linux. On the other hand, which corporation is in the need of this high caching rates? Who has 750 users that make 1.35 million web requests in 30 minutes? So, if there is already a Windows based network, which perhaps already implemented a MS Proxy 2.0 server, there is no real need to change to a Linux proxy variant instead of updating to an ISA server. On further reason, to prefer the MS ISA server instead of the squid proxy in an existing Windows based network, might be, that all already implemented user groups can be left and later used in the ISA server configuration after an update. Implementing the authorization structure of a Windows 2000 or NT domain on a Linux computer is certainly possible, but probably not easy for a typical Windows Administrator. And implementing the users on two security

Modern Version of Romeo and Juliet Movie with Leonard Di Caprio Essay Example for Free

Modern Version of Romeo and Juliet Movie with Leonard Di Caprio Essay Old stories get forgotten unless they are rejuvenated for the young. In the media world of today, books are forgotten and so is classical love. Romeo and Juliet with Leonardo de caprio was a fabulous attempt at bringing literature and drama back to life and into the hearts of the youth today. The first aspect of modernization is to portray the families as rich business tycoons of today’s world: Montagues and Capulets. The styling of the men especially, the chic haircuts and clothes are not only modern but in fact futuristic. This is most apparent in the guns, the shining metal and flash of silver cannot be forgotten. The fights between the two gangs take place at common place venues of today, that is gas stations. The cars are also futuristic. The letter that Romeo does not respond to is a by a well known courier service. â€Å"There are times when the rapid cuts and raging soundtrack might cause understandable confusion between the movie and a rock video. Indeed, with all the camera tricks, special effects (such as a roiling storm), and riotous splashes of color, its easy to lose the story in the style† (Berardinelli, 1996). The flush-cut editing and fast-moving scenes and actions contribute further to giving the movie a futuristic feel removing it far from the classic ballad it is. Much of the decor, for example, the aquarium wall, through which Romeo and Juliet first eye each other, is very modern in its architecture and idea. Such interiors never existed in the days of Shakespeare and neither is there any mention in the script. What makes the movie striking is the juxtaposition of old English style, rendered flawlessly and emotionally by the actors, with this modern, futuristic treatment, This juxtaposition is what makes Shakespeare’s work speak to the modern teenager, which was the main objectivce of the movie. References Berardinelli, J. Fil Review, Retrieved on 2nd June 2010 from http://www. reelviews. net/movies/r/romeo_juliet. html

Chronic Obstructive Pulmonary Disease (COPD) Management

Chronic Obstructive Pulmonary Disease (COPD) Management Chronic obstructive pulmonary disease (COPD) is a multi-system disorder, resulting in multiple comorbidities and being the fourth common cause of mortality worldwide (1). Cardiovascular disease (CVD) is one of the leading cause of morbidity and mortality in COPD, through manifestations such as ischemic heart disease, heart failure, arrhythmias, stroke and sudden cardiac death (2,3). Moreover, in the last years, a tendency to paradigm shift occured, the chronic respiratory disease itself being defined as a modifiable cardiovascular risk factor (4,5). This interaction between COPD and cardiovascular disease could be explained either by shared risk factors (aging, smoking, exposure to air pollution and passive smoke, underprescribing of key cardiovascular medication, such as ÃŽ ²-blockers) or mechanisms of increased risk that are incompletely understood, beyond the conventional risk factors (4,6). There is increasing evidence that COPD negatively affect the cardiovascular and autonomic nervous system, leading to sympathovagal imbalance, with increased sympathetic tone, loss of parasympathetic tone and altered baroreceptor sensitivity, which are essential components of cardiovascular risk (7-9). Recurrent episodes of hypoxemia and/or hypercapnea, intrathoracic pressure swings resulting from airway obstruction and hyperinflation, systemic inflammation, oxidative stress, increased respiratory effort and physical inactivity can all be involved in autonomic dysfunction observed in COPD (8-10). Patients with COPD and functional alterations of cardiac autonomic modulation tend to have an elevated resting heart rate (11-13), reduced heart rate variability (HRV) (14), altered blood pressure variability (BPV) (15), an increase in muscle sympathetic nerve activity (16), reduced baroreflex sensitivity (17) and increased plasma norepinephrine level (9). Other clincal findings related to sympathetic overdrive in COPD could be arterial stiffness, altered PWV and arterial compliance, as well as left ventricular hypertrophy and diastolic dysfunction which may occur through direct effect of tone, modulation of baroreceptor sensitivity or activation of the renin-angiotensin system (4, 18-22). Hypoxemia, hypercapnia, pulmonary hyperinflation and activity avoidance are involved in developping cardiac autonomic dysfunction but on the other hand, these mechanisms are also responsible for exertional dyspnea and skeletal muscle deconditioning, including respiratory muscle dysfunction, in COPD patients (23,24). Thus develops a vicious spiral of physical deconditioning, impaired quality of life and early development of cardiovascular comorbidities, leading eventually to increased hospitalization and mortality (25). The golden standard in COPD management is pulmonary rehabilitation, based on its main benefits, as resulted from clinical trials: improved exercise capacity and health-related quality of life, reduced symptoms and recovery after hospitalization, decreased anxiety and depression, shortening the number of hospitalizations and days in the hospital (1, 26-28). The impact of cardiovascular comorbidities on clinical outcomes of pulmonary rehabilitation and vice versa is only partially investigated and understood. It seems that patients with metabolic and heart diseases might achieve lower degrees of improvement in exercise capacity or quality of life, but conflicting results from clinical trials have been published (29). Moreover, it is still unclear if pulmonary rehabilitation programs address cardiovascular risk factors in COPD patients, but there are encouraging results (30). Inspiratory muscle training (IMT) is a particular component of pulmonary rehabilitation, arising from the finding that inspiratory muscle dysfunction is an extrapulmonary manifestation of the disease which is often present in COPD patients. Inspiratory muscle weakness is defined as a maximal inspiratory mouth pressure (PI,max) of less than 60 cmH2O (31) and can be measured with handheld, electronic portable devices, providing automatically processed information on external inspiratory work, power and breathing pattern during loaded breathing tasks in patients with COPD. A recent study concluded that these information are valid estimation of physical units of energy during loaded breathing tasks, enabling healthcare providers to measure PI,max, peak inspiratory flow and quantify the load on inspiratory muscles in daily clinical practice (32). Also, it has been developed various pressure threshold loading medical devices, for standardized training, according to current recommendations although there is no established guideline yet (33). The impact of IMT was extensively studied in recent years. Results from randomised controlled trials in patients with COPD show that IMT as a stand-alone therapy improves strength and endurance of inspiratory muscles, improves symptoms (dyspnea) and exercise capacity (31,34). In a meta-analysis including 32 randomised controlled trials (31), IMT and its effects in patients with COPD were analysed and improved inspiratory muscle strength (+ 13 cmH2O; 95% CI 0.54-0.82; p

Valedictorian Speech :: essays research papers

First of all I would like to congratulate my fellow classmates Hello my name is Sarah and I am very proud to say I am valedictorian of this program. When I first started classes at this college I was afraid I wasn’t even going to pass let alone be standing here today. It had been a long time since I sat in a class room. I thought I was too old to go back to school. But I was wrong. Coming to this school has been one of the most fulfilling decisions I have made in my life. When I am at home watching tv and a commercial for this college comes on my 4 year old will start yelling that my momma’s college with a big smile on his face it makes me feel proud to be a part of this class. These past eight months have been tough. Especially for those of us with children who know its not easy to do our homework when our kids are trying to color in our text books. Or study for a test when the baby is crying. at first I felt a guilty, not having any time to spend my son. But I just kept remembering the banner we have over the stair case on our campus. It says sacrifice is temporary but I will be a college graduate forever. As I stand up here today and all my hard work has paid of I know my children and my family are so proud of me. As I am sure all of you are as proud of all your graduates standing up here today. I would like to thank you all for giving us the ext ra help, support and understanding we have needed to succeed these past eight months. I would like to thank my teacher Mr. S, for making my learning experience at this school a fun and exciting one. Even thought at times it seamed like he thought we were marines instead of student, Never the less he is just a great teacher I would like to take the time to thank my in-laws for letting me use their car to get to class when mine broke down.My other half for being so helpful with the kids when I had homework or a test to study for.

Marriage and Family Therapy Essay -- Counseling

Marriage and Family Counseling: An Overview History and Development The field of marriage and family therapy is the youngest of all the fields of science. Physical science is the oldest, then the social sciences and then the fields of marital and family therapy (Olson, 1970). David Olson (1970) describes marital and family therapy as fraternal twins, with marital therapy being just slightly older than family therapy. Clinicians began showing an interest in the relationships between husbands and wives in the early 1930’s. Some of the main catalysts to the growth and development of family therapy was the establishment of training programs such as the Marriage Consultation Center in New York (1929), the Marriage Council of Philadelphia in 1932 and the founding of the American Institute of Family Relations in 1939 (Olson, 1970). In 1942, the American Association of Marriage Counselors (AAMC) was organized to help facilitate the development of this growing profession of marital therapy (Olson, 1970). The fields of marriage and family therapy were born around the same time and developed along similar lines but were developed because of different needs. Marital therapy began because of the need to help improve the relationship between husbands and wives. Family therapy came along later as therapist began to realize that treating the family as a system was more effective than focusing on one individual in the family unit (Olson, 1970). In 1970, the AAMC changed their name to the American Association of Marriage and Family Counselors (AAMFC) to include family therapist (Olson, 1970). Although, marriage and family therapy is considered a young discipline, it is recognized as one of the five core mental health professions (AAMFT, 201... ...ilies, 16(3), 258-260. International Association of Marriage and Family Counselors (2011). IAMFC ethical codes. Retrieved May 7, 2012, from http://www.iamfconline.com/PDFs/Ethical%20Codes.pdf Jencius, M., & Duba, J. D. (2002). Creating a multicultural family practice. The Family Journal: Counseling and Therapy for Couples and Families, 10(4), 410-414. Murdock, N. L. (2009). Theories of counseling and psychotherapy: A case approach (2nd ed.). Olson, D. H. (1970). Marital and family therapy: Integrative review and critique. Journal of Marriage and the Family, 32(4), 501-538. Smith, R. L., & Stevens-Smith, P. (1992). Basic techniques in marriage and family counseling and therapy. Retrieved May 7, 2012 from ERIC (ED350526). Sporakowski, M. J. (1995). Assessment and diagnosis in marriage and family counseling. Journal of Counseling Development, 74(1), 60-64. Marriage and Family Therapy Essay -- Counseling Marriage and Family Counseling: An Overview History and Development The field of marriage and family therapy is the youngest of all the fields of science. Physical science is the oldest, then the social sciences and then the fields of marital and family therapy (Olson, 1970). David Olson (1970) describes marital and family therapy as fraternal twins, with marital therapy being just slightly older than family therapy. Clinicians began showing an interest in the relationships between husbands and wives in the early 1930’s. Some of the main catalysts to the growth and development of family therapy was the establishment of training programs such as the Marriage Consultation Center in New York (1929), the Marriage Council of Philadelphia in 1932 and the founding of the American Institute of Family Relations in 1939 (Olson, 1970). In 1942, the American Association of Marriage Counselors (AAMC) was organized to help facilitate the development of this growing profession of marital therapy (Olson, 1970). The fields of marriage and family therapy were born around the same time and developed along similar lines but were developed because of different needs. Marital therapy began because of the need to help improve the relationship between husbands and wives. Family therapy came along later as therapist began to realize that treating the family as a system was more effective than focusing on one individual in the family unit (Olson, 1970). In 1970, the AAMC changed their name to the American Association of Marriage and Family Counselors (AAMFC) to include family therapist (Olson, 1970). Although, marriage and family therapy is considered a young discipline, it is recognized as one of the five core mental health professions (AAMFT, 201... ...ilies, 16(3), 258-260. International Association of Marriage and Family Counselors (2011). IAMFC ethical codes. Retrieved May 7, 2012, from http://www.iamfconline.com/PDFs/Ethical%20Codes.pdf Jencius, M., & Duba, J. D. (2002). Creating a multicultural family practice. The Family Journal: Counseling and Therapy for Couples and Families, 10(4), 410-414. Murdock, N. L. (2009). Theories of counseling and psychotherapy: A case approach (2nd ed.). Olson, D. H. (1970). Marital and family therapy: Integrative review and critique. Journal of Marriage and the Family, 32(4), 501-538. Smith, R. L., & Stevens-Smith, P. (1992). Basic techniques in marriage and family counseling and therapy. Retrieved May 7, 2012 from ERIC (ED350526). Sporakowski, M. J. (1995). Assessment and diagnosis in marriage and family counseling. Journal of Counseling Development, 74(1), 60-64.

Love Vs. Passion In Madame Bovary by Gustave Bovary Essay -- essays re

In an ideal world, like the one Emma Bovary yearns for in the book Madame Bovary, romantic relationships are based on the principle that the two participants are madly in love with each other. But in the world Gustave Flaubert paints in his book, as in the real world, passion and personal gain are the only reasons people enter into a relationship.   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Before meeting Emma, Charles Bovary weds a much older woman. He “had seen in marriage the advent of an easier life, thinking he would be more free to do as he liked with himself and his money.';(p. 7) But he also laments that “his wife was master; he had to say this and not say that in company, to fast every Friday, dress as she liked, harass at her bidding those patients who did not pay.';(p. 7) These are clearly not the signs of a loving relationship; indeed, Charles and Madame Dubuc treat marriage as a chore or formality, and not a pleasure.   Ã‚  Ã‚  Ã‚  Ã‚  When Charles takes his second wife, Emma, love is, once again, not involved. He muses that her father, “old Rouault was rich, and she!-so beautiful!';(p.15) He knows he will be marrying into a wealthy family, and he will be obtaining a “trophy wife.'; As for Emma’s part in the marriage, she has no say whatsoever. She is given to Charles by her father in exchange for a dowry. So, before she is even married, she is already treated like chattel by the me...

Migration Stories Essay Family Story Essay

This paper will take a key interest in the migration story of my parents Barbara Heinemann and Kirby Clark and their story in relation to identify the factors that shaped the migration and resettlement of migrants in the 1980’s and the Australian government’s policies and desires. How the processes of alienation and assimilation affected migrants who came from a western culture and how acceptance and ‘mateship’ was difficult to find in Australians. I will do this while comparing the similarities that other migrants in Australia and around the globe faced and different migration trends in the 1980’s. The paper will also discuss migration and what set voluntary migrants apart from other people and particularly the predisposition for migrant children to become migrants themselves. During the early 1980’s like much of the world Canada was experiencing a recession. Many people were in fear of losing their jobs in the current environment. â€Å"I was very nervous about cut backs at PWC (PricewaterhouseCoopers). From what I knew at the time, Australia wasn’t affected nearly as much as Canada was so I decided I’d try my luck in Australia on a 2 year working/holiday. † (). Many such companies were being encouraged by the Australian government to bring immigrants with â€Å"particular Professional skills, business experience† (). Many of the people that decided to take up the opportunity provided by organisations like PricewaterhouseCoopers never intended on staying in Australia. â€Å" When I first arrived I thought I’d always be going home, like most of the people I worked with were expats they all thought they were going to go home after their visa was up†(). By the mid 1980’s Canada had pulled out of the wor st of the recession. â€Å" By the time I left Canada the recessions was pretty much over. I was in a rut, I wanted something new and a 2 year working/holiday in Australia was my way out, but when I arrived I saw that the recession wasn’t over in Australia† (). Australia’s ‘clever country’ policies made it easy for skilled migrants to obtain permanent residence. â€Å"Almost all of the people we worked with at PwC, who where expats decided to stay, we were practically handed permanent residency† ().In the 1980’s the government’s desire to develop the financial sectors and technological sectors saw an increase in demand for workers and an increase in income to those who worked in them. â€Å"migration policies refocused on highly skilled workers, whether  permanent or temporary† (). Skilled workers were in high demand all over the world and Australia being so isolated could only have decreased the desire for people to move there but the Austr alian government may have had one of the best immigrant ‘recruitment’ policies due to the huge percentage of skilled workers that it took in comparison to some other countries. Australia became home to any new migrant families in the late 1980’s and early 1990’s, many of the temporary workers applied and received permanent residency. â€Å"Almost all of the expats at PwC stayed in Australia, and most of them married each other or an Australian.† (). Australia has become one of the world’s most diverse countries if not number one or two. 24 percent of Australia’s population was born overseas and another 26 percent have one or bother parents born overseas. This number will only increase with children from the migrants that arrived in the 1980’s and 1990’s becoming old enough to be part of the statistics. At most schools it seems to be a higher percentage than 26 that have parents from overseas and around the same as 24 that were born overseas. In the 1980’s migrants decided to stay in Australia and to make it their home as no one was from the same place their lives together were in Australia â€Å" Me being Canadian and my wife being English we didn’t have a shared home other than Australia. We both love it here why would we think of moving to either of the others?† (nkob). â€Å" I’m from Toronto in Canada and Barbara is from Vancouver, we didn’t have a shared history in Canada, we came to Australia at different times but we’d made ourselves a home here, we’d gotten married in 1988, bought a house in 1989 and had a son in 1991† (). After about 5-10 years many migrants who arrived in the 1980’s realised that they probably wouldn’t be going back home to live. For many it would have been an hard concept to deal with. â€Å"I know that after about 3 years I thought I probably wouldn’t be going back to Canada but it didn’t really hit me till I was here for the 7th year† (). â€Å"I always thought I’d be going home until my son was about 5, I decided that this is our home now. I’ll probably go home more when my parents get older and are unable to take care of themselves† (). Many of the skilled temporary workers thought they’d be going back to their homeland but most didn’t, about 75 percent of the staff at PricewaterhouseCoopers that came from overseas went home after their 2 years. â€Å"I only remember about four people going back to  their home countries.† () All migrants face some Alienation when they arrive in a new country. Even people who come from ‘western’ countries feel some sort of alienation. It may not have been culturally that they had problems. Socially the migrants that were seen as temporary were not accepted their Australian co-workers didn’t see the point of getting to know them if they were here temporarily. â€Å"The expats stayed together most of the time. The Australians weren’t rude but they just didn’t care it took years to get to know an Australian from work, I was only temporary in their eyes. The Australians were also into buying a house and setting up their families. Most of the expats were here to party, it was called a working/holiday for a reason, we’d go out together most nights of the week† (). The new migrants didn’t know where to go or what to do in Australia. â€Å"I’m sure I would of figured life out by myself but all newcomers were taken und er an others wing shown where to go and which places were the cheapest and the best† (). Some of the migrants are still feel alienated today. They’re not from a different ethnic background from many Australians. The difference is there isn’t a Canadian or an Irish or an English community. â€Å"In some ways it may have been easier to come here from a country where many of people have come earlier. I have been living in Australia for 23 years and I still get asked how long I’m visiting for, or where in the states I’m from† (). They may not be discriminated against but as soon as they open their mouths many of the migrants get labelled as temporary. Assimilation was also something that these migrants had to overcome, most Australians at the time that were the same age as most skilled migrants were starting to settle down, buy houses and starting families. â€Å"we didn’t really have much contact with Australians our age they were either younger or older at either ends of their professional carriers.† (). Many kept part of the culture from their homeland with them or their previous routine. â€Å"In Canada I played Ice hockey at a high level and for the first 6 or 7 years I was in Australia I continued to play, becoming all Australian a few times. I remember Paul played rugby at a high level in Ireland and continued that here as well.† Being considered Australian is a hard thing for a lot of migrants to deal with psychologically â€Å"I don’t have a home country, I’m more of a global citizen, I’m a Canadian citizen, a  permanent resident in Australia but I wouldn’t call either my home. I’m a Canadian in Australia and an Australian in Canada.† ()Assimilation in Australia is hard to define with there being so much diversity it maybe not be a big issue with people having to assimilate with Australian culture if they already come from a ‘western’ cultured country. During the 1980’s migrants were migrating in the search for jobs and to escape from prosecution. Canada, America and Australia had a huge influx of Asian people predominantly from Hong Kong and Taiwan ,â€Å"about 50 percent of peopled the immigrated to Australia in the 1980’s were from Asia†(). In the 1980’s and 1990’s a large number of immigrants that arrived in Australia came from Asian, Middle Eastern countries and India. â€Å"When I first arrived I didn’t see that many migrants that were from Asia, particularly Indian people in comparison to the number in Canada but over the next 6 or so years I saw a huge increase of Asian, Indian and Middle Eastern people around the city† (). Australia was being ‘Asianised’ not as in a invasion but that instead of most migrants being from Europe many more where coming from Asia and the government was being more accepting to non Anglophone people. â€Å"When I first arrived Australia wasn’t a multicultural country in comparison to what id experienced in Canada, but as time went on it became very diverse very quickly. It became the Australia they had been promoting.† In the financial sector most of the immigrants were from Europe or North America but in the Information technology sectors the Asian and Indian people were the majority. â€Å"Most of the people that came to PwC where I was working were from the UK/Ireland, Germany or North America but in the Tech department I don’t think there was a person that wasn’t Chinese or Indian† (). The reason why countries were looking for skilled migrants, migrants with capital and entrepreneurial migrants was that these migrants usually such migrants would find a niche for themselves, perhaps as initiators of the new industries (). Migrants are people willing to change their lives in an instant. Someone who’s willing to leave their homeland and go out into the world, move half way around the world and try their hand at something is someone to be admired. Migrant families also tend to not stay in one spot for long or usually someone in the family makes a similar decision as one of their forefathers to try something else. â€Å"migrants are different from everyone else I think, they’re willing to take a chance, to risk everything, they are looking for an adventure. Although my grandparents moved to Canada from England, I never knew them but from a young age I had a desire to see the world, may have been from the stories from Bob our next door neighbour, none of my brothers or sisters moved away from home.† () Is being a migrant hereditary? It seems that people whose parents have migrated or family members have migrated before are predisposed to do so themselves. â€Å" Do I think it’s genetically inherited no I think it’s a frame of mind and previous experiences. My parents moved from Germany to Canada after World War II, the fact that they were migrants didn’t persuade me to go in anyway but the face that I’d travelled a lot when I was younger did have an effect on me I always entertained the thought that I might not be a Canadian forever.† () It may also be the fact that people that are 1st generation citizens of their country don’t actually identify themselves with that country. â€Å"I was born in Canada but because both my parents are German, I considered myself more German then Canadian which makes it much more confusing for me now living in Australia whether I am Australian, Canadian or German.† () â€Å"Both my parents are Canadian when I talk about home I talk about Canada despite the fact that I never lived there and I was born in Australia, at school I was always considered Canadian. I don’t think I’ll be in Australia much longer, there’s so much more out there to experience!†() This essay has explored what factors shaped the migration and resettlement of my family and skilled migrants in the 1980’s. It also discussed the processes of alienation and assimilation that skilled migrants faced in the 1980’s placing particular emphasis on temporary workers. Whilst comparing both of these with other migrants in Australia and worldwide and other migration trends. Finally I will explore how migrants differ and what influences people to migrate and the effect it has on the next generation and their beliefs and the disposition they have into becoming migrants themselves. Reference List http://science.jrank.org/pages/10225/Migration-in-World-History-Global-versus- Nationalist-Perspectives.html

Dementia Awareness Essay

1.1 Explain what is meant by the term maniaThe word aberration describes a facility of symptoms that whitethorn implicate memory loss and difficulties with thinking, problem result or language. These changes ar often atomic to start with but for someone with lunacy they soak up become severe abundant to effect daily life. A mortal with madness whitethorn also become changes in their mood or deportment.1.2 place the key functions of the judgement that be abnormal by alienation. The key functions of the brain that be affected by lunacy argonTemporal Lobe trusty for vision, memory, language, hearing, learning. Frontal Lobe Responsible for decision making, Problem solving, controlling deportment and emotions. Parietal Lobe Responsible for sensory in ruleation from the organic structure, also where letters argon formed, place things in order and spatial aw beness. occipital Lobe Responsible for processing information tie in to vision. Cerebrum Lobe Th is is the growngest offend of the brain, Its role is memory, attention, thought and our consciousness, senses and proceeding. genus Hippocampus Responsible for memory forming, organizing, storing and emotions.1.3 Explain wherefore depression, Delirium and age related memory impairment may be stupid for madness.Delirium, madness and Depression argon disorders that are often confused by care-givers as they are complex and patients piece of tail be afflicted with more than one of the see to its at the like time. Although often coincidence they are entirely separate conditions.Delirium is an penetrating but reversible state of surprise occurring in up to 50 part of older post-surgical patients. derangement is an irreversible castigate of mental abilities which affects 5-10 percent of the population all over age 65, with incidence doubling either 5 years after 65.Depression is a mood disorder which affects 16 percent of the population although it is often unrecognis ed.2.1 chalk fall out the medical model of derangementThe medical model focuses on the impairment as the problem and focuses on a cure, these may be dependency, restriction of quality, disempowering and devaluing individuals.2.2 system the hearty model of mania.This is soulal centred, focusing on the rights of the individual, in turn empowering the individual, promoting independence, giving choice and smell at what the individual is fit to do.2.3 Explain why alienation should be viewed as a dis might.Individuals who have frenzy are non aware of requirements for liveness. They apprise for pick out to do the essential things that are vital. Taking medicines, hygiene and even feeding are often forgotten. They can get lost or hurt and non understand what is necessary to correct a situation. Individuals can non act in the manner of a responsible adult which is why dementia should be viewed as a disability.3.1 contention the virtually coarse causes of dementia.The most common causes of dementia are Alzheimers malady This is the most common cause of dementia. During the variant of the malady, the chemistry and structure of the brain changes, direct to the death of brain cells.Vascular Dementia If the oxygen supply to the brain fails, brain cells may die. The symptoms of vascular dementia can occur either suddenly, followinga stroke, or over time, through a series of small strokes.Dementia with Lewy Bodies This form of dementia gets its name from tiny global structures that develop inside nerve cells. Their movement in the brain leads to the degeneration of brain tissue.Fronto temporary Dementia In breasto-temporal dementia, reproach is usually focused in the front part of the brain. Personality and behaviour are initially more affected than memory.3.2 take up the likely signs and symptoms of the most common causes of dementia. Dementia is a collection of symptoms including memory loss, disposition change, and impaired intellectual fu nctions resulting from sickness or trauma to the brain. These changes are not part of normal aging and are severe enough to impact daily existing, independence, and relationships. With dementia, on that point will likely be obtrusive decline in communication, learning, remembering, and problem solving. These changes may occur quickly or very(prenominal) slowly over time. The progression and moment of dementia vary, but are for the most part determined by the type of dementia and which area of the brain is affected. Diagnosis is practic subject through advanced brain imaging, clinical examinations, and diagnostic testing.3.3 Outline the take chances factors for the most common causes of dementia.The greatest known lay on the line factor for Alzheimers is advancing age. close to individuals with the unsoundness are age 65 or older. The likeliness of development Alzheimers doubles about every five dollar bill years after age 65. after(prenominal) age 85, the adventure r eaches nearly 50 percent. One of the greatest mysteries of Alzheimers ailment is why risk rises so dramatically as we grow older. An separate unvoiced risk factor is family history. Those who have a parent, brother, sister or children with Alzheimers are more likely to develop the illness. The risk increases if more than one family member has the illness. When diseases bunk to run in families, either transmissible endowment (genetics) or environmental factors, or both, may play a role. In general, the risk factors for vascular dementia are the same as those for heart disease andstroke. try factors for vascular dementia take on increase age. History of heart attack, stroke or mini strokes. Atherosclerosis. High cholesterol. High business line pressure. Diabetes. Smoking and Atrial fibrillation. Although the cause of Lewy body dementia isnt clear, several factors protrude to increase the risk of developing the disease. They include Being older than 60. Being anthropoid & hav ing a family member with Lewy body dementia. galore(postnominal) degenerative neurological diseases do not have a strong genetic dowry, but Frontotemporal Dementia is believed to be an exception, with a high familial component compared to other instances of dementia. Unlike in other forms of dementia, however, there are no nutritional deficiencies or other habits that increase the likelihood of developing Frontotemporal Dementia. Instead, risk factors for developing Frontotemporal Dementia include Mutations in the MAPT and/or GRN genes of chromosome 17, a family history of Frontotemporal Dementia.3.4 Identify prevalence rates for contrary types of dementia.The Prevalences of Alzheimers disease, vascular dementia, Parkinsons disease dementia, and other dementias Overall, 72% of the dementias were of Alzheimer type, 16% were vascular dementia, 6% were Parkinsons disease dementia, and 5% were other dementias.4.1 reap how varied individuals may experience living with dementia depen ding on age, type of dementia, and take of ability and disability. Dementia is not a disease but a set of symptoms which decreases the ability to think, memory and communication skills of valet de chambre beings. It also declines the skills that needed to carry out daily activities. There are more causes of dementia. Few are Alzheimers disease Vascular disease Lewy body disease Front temporal disorders Parkinsons disease Depending on the form of dementia passels ability and disability fluctuates. It is not necessarily to think that multitude with dementia are always unretentive. Like, people with Fronto-temporal dementia are very less forgetful than Alzheimer disease. Their memory remains intact but their personality and behaviour noticeably changes.Dementia with Lewy bodies interrupts the brains normal execution and affect the persons memory, engrossment and speech skills. It has similar symptoms to Parkinsons disease such as tremors, slowness of movement and speech difficulties. People with vascular dementia may suffer from incontinence or seizure where other types of dementia may not affect those. However train of ability and disability depend on individuals age and condition of dementia. People who are living with dementia in earlier age such as 60s-70s are less dependable than people living with dementia at the age or over 70s or 80s. People have different stamina in different ages. So, their ability and disability fluctuated and level of support are varied as well 4.2 Outline the impact that the attitudes and behaviour of others may have on an individual with dementiaDementia can have a big impact on a persons behaviour. It can make them purport anxious, lost, confused and frustrated. Although each person with dementia handles these feelings in their own way, certain behaviour is common in people with the disease. This includes repeating questions or carrying out an activity over and over again walking and pacing up and down Aggression, shouting and shout out becoming suspicious of other peopleIf you are experiencing these behaviours, or are looking after someone who behaves in this way, its important to remember that this is an attempt to give-up the ghost how theyre feeling and that they are not being deliberately difficult. If you stay hush up and work out why theyre expressing themselves in this way, you may be able to calm them down.