Pathophysiology of HELLP Syndrome

Pathophysiology of HELLP Syndrome Free Online Research Papers A maternity unit is generally filled with happy moments; however, when an obstetrical emergency walks through the door, those times can be hectic and chaotic. All persons involved need to be part of a delicate team who work together in order for the woman and her child to receive the best care and to ensure the most optimum outcome as possible. The preceding case study will show how to effectively manage HELLP syndrome, the acronym for hemolysis, elevated liver enzymes and low platelet count. N.N. is a 26-year old, gravida 2, para 1 at 37 weeks gestation per last menstrual period and early ultrasound. She presented to the labor and delivery unit with a direct statement of â€Å"I had HELLP syndrome with my last pregnancy and I think I have it again.† Her vital signs were: temperature 99.4 F, pulse was 126, respirations 26 and blood pressure was 156/93. Her weight is 185 pounds with a prepregnancy weight noted to be 167 pounds. This patient was placed on external fetal monitoring. The fetal heart rate was noted to be 145 beats per minute with moderate variability and shown to have a reactive strip. There were appropriate accelerations noted and no decelerations. Uterine contractions were shown to be irregular, 3-9 minutes apart lasting 40-60 seconds in duration. The uterine contractions palpated mild. Reflexes were tested and were abnormal at 3+ with clonus, and +2 pitting edema was noted in lower extremities. A cervical exam revealed a soft, thick closed cervix. An IV was started and lactated ringers was hung and infusing at 150 ml per hour. Labs were drawn for CBC, ABO RH and type and screen, comprehensive profile, PT, PTT, and a urinalysis. An ultrasound was ordered to rule out a hematoma on her liver and to check for a placental previa or abruption as well as to check for fetal well being. Her abdomen was soft, but tender to touch with pain in her upper right quadrant. She denied leaking of amniotic fluid and tested negative for nitrazine and ferning. She complained of a headache that she states she has had for two days. Her liver enzymes were elevated with an AST of 906 and ALT of 1042 and hemolysis of LDH at 1123. Her platelets were at 43,000. The urinalysis showed a trace amount of protein as well as ketones and bilirubin. The rest of the urinalysis was within normal limits. The ultrasound was negative for a liver hematoma. It also showed an active, apparent well fetus. She presented with 3+ pitting edema in her lower extremities. The PT, PTT and fibrinogen were within normal limits. The physician on call was immediately called and was on his way in. Because this patient had had HELLP syndrome in the past, it was likely she had it again. There is up to a 25% chance that a woman who has HELLP in previous pregnancies, she will have it again in subsequent pregnancies (Hagl-Fenton, 2008, p. 23.) Women who have had pregnancies complicated with preeclampsia have a 2-12 percent chance of developing HELLP in their pregnancy (Lealbe, Niebyt, Simpson, 2002, p. 956.) Many women who come into a labor and delivery unit are misdiagnosed because the symptoms mimic preeclampsia. The platelet count is one of the key indicators that it is more than preeclampsia, (O’Hara Padden, 1999, p. 829) as well as an increased bilirubin (Lealbe et al., p. 956.) There is not a definitive pathogenesis of HELLP syndrome. The discoveries of this multisystem disease are characterized by â€Å"abnormal vascular tone, vasospasm and coagulation defects† (O’Hara Padden, 1999, p. 830.) HELLP appears to be the last indicator of some attack that leads to microvascular endothelial impairment and â€Å"intravascular platelet activation† (O’Hara Padden, p. 830.) With the activation of the platelets, serotonin and thromboxane A are released, thus resulting in platelet agglutination and aggregation and then continued damage of the epithelium (O’Hara Padden, p. 830.) This can only be corrected by the delivery of the baby, if the gestation is greater than 32 weeks (O’Hara Padden, p. 32.) If the woman presents to a labor and delivery unit and is less than 32 weeks in gestation, medicinal therapeutics are first tried to help keep the patient pregnant as long as safe for her and her baby. Betamethasone 12mg IM is given twice in 24 hours to help mature the lungs of the premature infant. Giving Decadron, 10 mg IV every twelve hours, has been shown to improve many of the laboratory irregularities identified with HELLP syndrome (O’Hara Padden, 1999, p. 33.) Magnesium Sulfate, 4-6 gram bolus, intravenously, should be administered over a 20-30 minute time frame. A 2 gram maintenance dose of magnesium should be continued after the bolus is given. This can help lower the elevated blood pressure of the patient. A magnesium flow sheet should always be used to monitor for signs of magnesium toxicity. Reflexes should be tested each hour to assess for slow, sluggish or hyper reflexes. Visual disturbances, headaches and urinary output should also be assessed each hour. Platelet activation is believed to participate to the pathogenesis of preeclampsia and HELLP syndrome, which results in hemodynamic changes, vasoconstriction and endothelial injury (Sheu, Shen, Lin, Tzeng, 2002, p. 132.) Formation of Thromboxane A in platelets generally rises during pregnancy (Sheu et al., p. 133) and it has also shown that it is exacerbated when combined with a decrease in prostacyclin (Sheu et al., p. 133.) The hemolysis in HELLP syndrome is microangiopathic hemolytic anemia (O’Hara Padden, 1999, p. 830.) The red blood cells become odd shaped, known as traumatic hemolytic anemia. These red blood cells are seen in the peripheral blood when they are exposed to a large amount of turbulence and may been seen as schistocytes or echinocytes (burr cells) (Lowdermilk, Perry, Bobek, 1997, p. 792.) The persistent vasoconstriction that occurs causes fibrin deposits in the hepatic sinusoids (Leaton Martin, 2001, p. 32.) This block hepatic blood flow and changes liver function (Leaton Martin, p. 32.) The liver swells causing the pain in upper right quadrant as well as epigastric pain. ALT and AST are chief enzymes that initiate intracellular protein metabolism and are generally found in small quantities in the extracellular serum. An elevated AST may occur when there is liver ischemia. An increase in the ALT, found primarily in liver cells, is when the liver fails to function normally in its role of hemoglobin degradation. An increase in the bilirubin may also take place because of the effects on the liver (Lowdermilk et al., 1997, p. 792.) Vasoconstriction of the blood cells can cause limitations on the blood flow, thus hindering the blood from getting to the vital organs of both the mother and the fetus in the complication of decreased organ perfusion. If the placenta is not receiving sufficient blood, the baby can have complications that can be assessed by the fetal monitor. These complications can be seen as variables or decelerations. If the baby has run out of fetal reserves, the baby may not survive due to the lack of placental perfusion. Vasoconstriction has also been associated with intrauterine growth retardation (IUGR) (Robillard, Chaline, Chaouat, Hulsey, 2003, p. 131.) The obstetrician on-call that night was in the hospital within 12 minutes of the call he received. He assessed the patient and looked at the labs that were taken. He rechecked her cervix which showed no change in dilatation. Because of her gestation age of 37 weeks, the decision for an immediate cesarean was brought forth. He was concerned for the possibility of a long labor. The fact that she did not have a favorable cervix and using pitocin to augment her labor, could have had a poor outcome for both the mother and her baby. The time between decision for the cesarean section to incision was 17 minutes. N.N. had a 7lb. 13oz. baby boy. His apgars were eight at one minute and nine at five minutes. APGAR is an acronym for the scale or scoring used to determine how well the baby did after delivery. APGAR stands for activity (muscle tone), pulse, grimace (reflex ability), appearance (color of the newborn), and respirations. Each score rates either 0, 1, or 2. Two is the best a baby can achieve with each section of the scoring tool. This baby had one point taken off for color and tone at one minute and one point taken off for color at five minutes. There was no need for further intensive care for this baby. During the post partum period, the patient recovered without any further problems. The AST and ALT were back within normal limits by the second post partum day. Another ultrasound was done on her liver the second post partum day which showed no evidence of enlargement, bleeding or rupture. There was no evidence of post partum hemorrhage. Urinary output was greater than 30ml per hour after her cesarean section. By the third post partum day, the edema in the lower extremities was down to 1+ edema with no evidence of pitting. Her post op pain was controlled by as needed opioid medications as well as NSAID’s. The first nursing diagnosis that could have been used for this patient was risk for injury: maternal, related to vasospasm, high blood pressure. A second nursing diagnosis could have been anxiety related to fear of disease process and possible outcomes. A third nursing diagnosis could have been altered protection related to decreased platelet count as evidenced by platelet count of 43,000. A fourth nursing diagnosis could have been pain related to post operative procedure. The interventions used for this patient were used to help ensure the positive outcome for herself and her newborn. She was assessed and properly diagnosed within a very short period of time. The interventions that were done were to promote the patients comfort from the pain she was experiencing from both her abdomen and her head. She was placed on her side in order to not obstruct the blood flow from the vena cava; this can happen if the patient is lying flat on her back. She was assured as well as comforted to help to reduce the anxiety that she was feeling from the fear of what was happening to her. From the time she arrived on to the unit, until the time of her cesarean section, the time lapsed was only approximately 45 minutes. Had she not stated that she had, had HELLP syndrome with her first pregnancy, she may have been diagnosed with preeclampsia or another pregnancy related issue. The fact that she told the nursing staff when she arrived helped us by knowing what to order, what to look for when the results came back and how to properly treat her. The physician on call was not her regular physician and had never seen this patient before. As he was assessing this patient, he was also looking through her prenatal to view her history. With the patient’s symptoms, the fact she has had HELLP syndrome in the past and the labs and the radiology reports that came back, this patient had the best possible procedure that gave her the best outcome for her and her baby. Had this patient been under 36 weeks, she would have been transported to a level three hospital. Our hospital is a level one, community hospital and do not generally deliver babies under 36 weeks unless there is a risk to the mother or fetus. If this is the case, the neonatal intensive care unit (NICU) team from the level three hospital is called and informed. HELLP syndrome is a very traumatic and scary disease process for the patient. Without thorough evaluation and assessment of the patient and her fetus, both she and her baby could have been subjected to a very different outcome. Through team work by the medical staff, the nursing staff as well as the rest of the ancillary members that were involved with this patients care, the patient went home, with a healthy newborn, both with no residual damage. References Hagl-Fenton, D. J. (2008, March 2008). Beyond Preeclampsia. RN, 71(3), 22-25. Lealbe, S. G., Niebyt, J. R., Simpson, J. L. (2002). Obstetrics-Normal and Problem Pregnancies (4th ed.). Philadelphia, Pa.: Churchill Livingstone. Leaton, M. B., Martin, P. S. (2001). Dealing with coagulopathies of PIH. Nursing2001, 31(3), 32-35. Retrieved from ProQuest September 16, 2008 Lowdermilk, D. L., Perry, S. C., Bobek, I. M. (1997). Maternity Women’s Health Care (6th Ed.). New York, NY: Mosby. O’Hara Padden, M. (1999, September 1, 1999). HELLP syndrome: Recognition and perinatal management. American Family Physician, 60(3), 829-836. Retrieved from ProQuest September 16, 2008 Robillard, P. Y., Chaline, J., Chaouat, G., Hulsey, T. C. (2003). Preeclampsia/eclampsia and the evolution of the human brain. Current Anthropology, 44(1), 130-134. Retrieved from ProQuest September 30, 2008 Sheu, J. R., Shen, G., Lin, M. Y., Tzeng, W. Y. (2002). The hyperaggregability of platelets from normal pregnancy is mediated through thromboxane A2 and cyclic AMP pathways. Clinical Laboratory Haematology, 24(2), 121-129. Retrieved from ProQuest September 30, 2008 Research Papers on Pathophysiology of HELLP SyndromePersonal Experience with Teen PregnancyArguments for Physician-Assisted Suicide (PAS)The Relationship Between Delinquency and Drug UseLifes What IfsThe Hockey GameGenetic EngineeringWhere Wild and West MeetResearch Process Part One19 Century Society: A Deeply Divided EraTwilight of the UAW

Most Common Book or Essay Organization Patterns

Most Common Book or Essay Organization Patterns To improve your ability to understand a difficult book or passage, you might start by finding the organization pattern. This may sound more difficult than it is. There are a few ways that writers can choose to organize their work, and the organization depends very much on the topic. If you were writing a description of your bedroom, for example, you would most likely use a spatial organization pattern. In other words, you would most likely start by describing one space and move on to another space, and keep going until youve covered the entire room. Spatial organization would be a suitable type of pattern for real estate professionals to use when describing a property.   Then again, if you were required to describe the events that led up to a certain event in history, your most likely organization pattern would be chronological. Chronological refers to the order that things happen in time. You might describe the legislation that set the stage for a particular event, followed by the public response to that legislation, and followed again by social conditions that changed because of the previous events. So, one of the first things you should do when trying to understand a difficult text is to figure out the particular organization pattern. This helps you frame the entire work in your brain or on paper, as when youre writing  an outline. Chronological Organization A chronological organization is used by writers when they want to describe what happened or happens in a particular order. Your entire history book is most likely written in a chronological patter. Some of the types of work that might follow this patter include the following. You can see that this type of organization is best when describing things that happen over time. History chaptersBiographiesSummer vacation essaysLegal case studies Logical Organization A logical organization might be used in many ways. Logical organization refers to works that express a point or position using evidence. Argument essaysComparison essays Functional Organization A functional organization system is used to explain how or why things work. The following types of writing might use this organization pattern most effectively. How-to essaysStep-by-step essaysInstruction manuals  Recipes Spatial Organization Spatial organization is used in essays that describe or give direction concerning a physical location. DirectionsDescriptionsLayoutsAnatomy essayDescriptions in fiction The purpose of developing and understanding organization patters is to help our brains set the stage and know what to expect. These patterns help us to build a framework in our minds and place information in the correct places on that framework. Once you determine the overall organization of any text, youll be better equipped to process information as you read. When writing your essays and chapters, you should keep your intended organizational pattern in mind as you work, to provide your readers with a clear message that is easily processed.

Teacher Contract Negotiations Essay Example | Topics and Well Written Essays - 1000 words

Teacher Contract Negotiations - Essay Example There are conditions that each individual should meet in order to receive unemployment compensation benefit. Each state has different conditions for an individual to qualify for unemployment compensation. The two most important determinants for eligibility to unemployment compensation benefit are contract and reasonable assurance. Discussion Unemployment compensation is also commonly known as unemployment insurance (UI). It is a program by the government which provides financial support to unemployed workers who are qualified. The federal government sponsors and administers the benefit program through the taxes collected from employers. However, in every state there are different conditions and rules to qualify to unemployment compensation benefits. In the case of Harker v. ... act† which is defined as any written, oral, implied, expressed or even a notice of appointment that indicates individual’s services are being accepted. â€Å"Reasonable assurance† means a written, oral or implied agreement that individual will perform services in an institution of education or government agency in an instructional, research, principal administrative, or any other capacity during the ensuing academic year or term (Harker v. Shamoto, No.25615, 2004). http://www.state.hi.us/jud/22784sdo.htm (see 1) Since the records of the employer showed that Harker was on the preferred list of three schools in his district and even accepted and worked 90 assignments at 8 different schools beginning on July 9, 2000, he was disqualified to apply for unemployment compensation (Harker v. Shamoto, No.25615, 2004).http://www.google.com.ua/#sclient=psy-ab&hl=ru&source=hp&q=worked+90+assignments+at+8+different+schools+beginning+on+July+9%2C+2000%2C&pbx=1&oq=worked+90+assig nments+at+8+different+schools+beginning+on+July+9%2C+2000%2C&aq=f&aqi=&aql=1&gs_sm=s&gs_upl=20042l21665l5l22413l1l1l0l0l0l0l291l291l2-1l1l0&fp=f0afe8921f3de3cb&biw=1133&bih=770 In the case of Ideal Academy Public Charter School v. Bernola, No. 07-AA-1224 (2009), the case stated District of Columbia’s conditions of â€Å"unemployed† individual that may receive unemployment compensation and defined the meaning of being â€Å"unemployed.† According D.C.Code  §?51-109 (2001), an individual is unemployed â€Å"with respect to any week during which he performs no service and with respect to which no earnings are payable to him [.]† and to meet this definition, â€Å"an individual must not have performed any services or received any earnings during the period benefits are claimed.† Even if Bernola received the

Public Policy- Environmental Policy Essay Example | Topics and Well Written Essays - 1000 words

Public Policy- Environmental Policy - Essay Example and more so, the influences of population growth, urbanization, industrialisation, new expanding technological advances, exploitation of resource and their impact. Critical value of restoring as well as enhancing environmental quality to the welfare and progress of man are well emphasized. The role of stakeholders- Federal Government, public and private organizations in using practicable measures and means that include technical and financial assistance to promote the welfare and maintain states under which nature and man can coexist in a productive way to fulfil the economic, and social needs of future and present generations .The policy was to directly educate the Americans that, safe, aesthetically- culturally pleasing, healthful, productive, safe, important historic, and natural aspects of our heritage, biodiversity, and free choice can only be attained through environmental preservation. And this could only be achieved when a state of equilibrium is attained between population and the available resource for use to allow high standards of living and enhance promote renewable resources and approach to maximise recycling of the non-renewable resources. This therefore calls for recognition that every person is entitled to enjoy a healthful environment and the responsibility he has to contribute towards preserving and the environment. The policy vividly states the responsibilities of each individual as trustee of the environment for succeeding generations and assure the society of productive ,culturally, safe, healthful, and aesthetically pleasing surroundings the legislation should further enhance positive use of the environment without degradation other unintended consequences. Furthermore it stresses that government should utilize interdisciplinary approach to ensure integrated use of social and natural sciences in planning and for indecision making to impact on the environment. In the present societies, economic and social activities are

Conclusions with further remarks Essay Example for Free

Conclusions with further remarks Essay Undeniably, the factors that seemingly adhere onto the level of security of certain vicinities may be hard to simplify. Given the fact that individuals come in different ideals, beliefs and characteristics, the greed over power and sovereignty is implicitly the main reason why the issue on security and the plague on terrorism are undeniably swallowing the minds of the society (Laqueur, 1999). With such, it is an astounding standpoint that countries are now paying much attention on the ‘security’ of its people and the preparations onto competence in the arena of globalization (Buzan et al. , 1997). As the Australian Securitisation Forum Inc. notes in their mission: â€Å"To shape the future of the Australian securitisation industry for the ongoing benefit of its members,† piously, if the mission be fulfilled in the most ideal sense as it had been established, the attainment of the goals and hopes of the nation and of the world will be at reach in the most unifying array. Our purpose is an examination of the second issue—the politys response to the government’s move to the provision of security. Consequently, while passing reference may be made to causative factors (indeed, governmental response and the labeling of security may be viewed as causative) (Snyder, 1999), this work is most concerned with the manner in which conflict and consensus theories might interpret and predict governmental reactions to violence and other threats of the like. In essence, this horizon of defining the exactness of ‘security’ is still vague as of the time being because keeping up a nation under â€Å"maximum security† is vulnerable to jeopardizing consequences. References: BUZAN, B. W? VER, O. (2004) Regions and Powers: The Structure of International Security, New York, Cambridge University Press. BUZAN, B. , WVER, O. , WILDE, J. D. WAEVER, O. (1997) Security: A New Framework for Analysis, Florida, Lynne Rienner Pub. DEACON, J. (2004) Global Securitisation and CDOs, New York, Wiley. HAFTENDORN, H. (1991) The Security Puzzle: Theory-Building and Discipline-Building in International Security KRAUSE, K. WILLIAMS, M. C. (1996) Broadening the Agenda of Security Studies: Politics and Methods. Mershon International Studies Review, 40, 229-524. KUPCHAN, C. A. KUPCHAN, C. A. (1995) The Promise of Collective Security. 20, 52-61. MANWARING, M. G. (2003) The Search for Security, New York, Praeger Publishers. MORRISSEY, H. (1992) International Securitisation, New York NY, Ifr Publishing. PAQUETTE, L. (2002) Strategy and Ethnic Conflict: A Method, Theory, and Case Study, New York, Praeger Publishers. SNYDER, C. (1999) Contemporary Security and Strategy, New York, Routledge.

How the Australian Great Barrier Reef Succeeds at Preservation and Sust

How the Australian Great Barrier Reef Succeeds at Preservation and Sustainable Use and How it Applies to a Worldwide Problem Coral bleaching is a somewhat recent phenomenon that has prompted many communities and countries around the world to enact policies and legislation that deal with their dying coral reefs. In early 1998, a mass coral bleaching event took place on the Australian Great Barrier Reef, and broad scale aerial surveys confirmed that most of the inland reefs had experienced at least some bleaching (Lally 1999). The following analysis of the Great Barrier Reef will illustrate that a successful policy process must incorporate the people who live, work, and depend on the fragile environment into the decision-making about preservation policies, regardless of the method or policy tool chosen to do so. Effective management and policy tools must also carefully weigh both extractive and non-extractive uses - to not only preserve, but also sustain, the use of the coral reef ecosystem. First, I will give some background information about why the Australian Reef is of importance and why dying reefs are a worldwide problem. I will then further explain the scientific background of what coral reefs are, what coral bleaching is, and the human activities and other factors that cause it. Second, I will further explain the issues involved with the policy process of preserving coral reefs, and which is the priority that stands above the rest. Third, I will explain who the actors are and what their roles are in the policy process. Fourth, I will define the instruments that are used to guide the policy process. Lastly, I will explain the lessons, outcomes and alternatives that exist in the policy process of preserving coral reef... ...wan, R., N. Knowlton, A. Baker and J. Jara, "Landscape ecology of algal symbionts creates variation in episodes of coral bleaching," Nature, Vol. 388, No. 6639, p. 265-269, July 1997. Warner, M.E., "The Effects of Light and Elevated Temperature on the Photosynthetic Physiology of Symbiotic Dinoflagellates: Potential Pathways To Coral Bleaching," Dissertation Abstracts International Part B: Science and Engineering, Vol. 59, No. 10, p. 5213, April 1999. Warner, M.E., W.K. Fitt and G.W. Schmidt, "Damage to photosystem II in symbiotic dinoflagellates: A determinant of coral bleaching," Proceedings of the National Academy of Sciences, Vol. 96, No. 14, p. 8007-8012, July 6, 1999. White, M. "Sensitive Marine Environments and the Regulation of Shipping: The Great Barrier Reef Experience," Asia Pacific Journal of Environmental Law, Vol. 4, No. 3, 1999, p. 219-242.

Meaning of life essay Essay

?â€Å"You will never be happy if you continue to search for what happiness consists of. You will never live if you are looking for the meaning of life† (Camus). If you spend your whole life searching for one thing you will waste your life and it will only take a few moments for time to pass you by. The meaning of life is nonexistent and imponderable. ?â€Å"The meaning of life is contained in every single expression of life. It is present in the infinity of forms and phenomena that exist in all of creation† (Jackson). The meaning of life is simply the way you view it. Like religion everyone has different philosophies and opinions and only those who give life a meaning have the true understanding of the meaning of life. My Opinion on the Meaning of Life I believe the meaning of life is to give life a meaning, because there truly is no meaning otherwise. I believe everyone adds their own meaning to life. The meaning of life is never universal, never complex. I believe the meaning of life should be simple and potentially whatever we want it to be. I do what I do because I want to. It’s that simple for me; I do it because it means something to me. â€Å"Life is a great big canvas, and you should throw all the paint on it you can† (Kaye). I believe this quote is saying that you should give life your all and do whatever it takes to make your life the way you want it. This is saying someone should do what you believe the philosophy of your life is. Many people go about their lives searching for the meaning of life and how it applies to them but in reality they will waste their lives away looking for something that does not exist. â€Å"There is not one big cosmic meaning for all; there is only the meaning we each give to our life, an individual meaning, an individual plot, like an individual novel, a book for each person† (Nin). â€Å"Life has no meaning. Each of us has meaning and we bring it to life. It is a waste to be asking the question when you are the answer† (Campbell). This is saying how we bring the meaning to life and our thoughts and ideas on what we believe life is and should be. I do not believe in the idea of there being one specific meaning but millions for each and every soul around the earth. Various populations will all agree to disagree about their views but in retrospect you realize that everyone is right. Everyone gives their own meaning to the idea. Purposes and meanings will change, but the overall meaning to life, that there is no true meaning, will always stay the same. I believe the meaning of life is to give life a meaning. Works Cited ?†Albert Camus Quote. † BrainyQuote. Xplore. Web. 23 Mar. 2015. . ?†Anais Nin Quote. † BrainyQuote. Xplore. Web. 23 Mar. 2015. ?†Danny Kaye Quote. † BrainyQuote. Xplore. Web. 23 Mar. 2015. . ?†Michael Jackson Quote. † BrainyQuote. Xplore. Web. 23 Mar. 2015. .

Alternative to GDP

Topic: â€Å"There is rising criticism of the widespread use of GDP as an indicator of the health of an economy. In fact, some experts are of the opinion that GDP growth is making the society poorer. Critically analyse this opinion in view of the concept of sustainability and also discuss some alternate measures being suggested and their implications to the businesses? † GDP as an economic measure of the economic progress of a country Gross domestic product (GDP) is considered one of the most important factors that determine the economic activity and hence the progress of the development of a country. It is the monetary value of all the final goods and services produced by a country in a specified time. Therefore, it is considered that if the country’s economic production increases, other factors remaining positive, then it positively benefits all the citizens of the country. It is hence used as an indicator for the country’s standard of living[1]. Therefore, greater the GDP, better the health of an economy and hence better the lives of the citizens. Reasons for criticism on the use of GDP as an indicator of economic progress As GDP measures the monetary value of the final goods and services produced, it means that the money spent on the country’s well-being for example, millions spent on manufacturing fancy electronic gadgets, constructing a prison, cutting forests to use wood for production of further goods – are all considered at par while measuring the GDP. There is no emphasis on the quality of the output, the progress of the country in terms of the social state of affairs, human happiness, etc. As these are essential ingredients in determining the health of an economy, the concept of using GDP as a measuring scale of the economic progress of a country if criticised. Disadvantages of GDP GDP is criticised on many aspects – it obscures growing inequality, aids depletion of resources and one of the most prominent criticisms is that it measures expenditure on education at par with expenditure on cigarettes i. e. it does not differentiate whether the spending that aids the GDP percentage is going towards a positive or negative cause. GDP does not measures the economic services that nature provides – for example, prevention of floods and landslides by existence of dense forests – it does not account for health, clean environment, etc. i. e. GDP falls short in taking into account equally important things that exist to make a country liveable by fostering social cohesion, along with just the monetary value of goods and services * GDP takes into account the gove rnment spending, but from where the funding is sourced and where it is utilized is not taken into account. Hence, government borrowing is considered good for a country as far as GDP calculation is concerned * Money transactions that take place unofficially and go unrecorded are not accounted for in the calculation of GDP. Hence it does not help in avoiding taxes or prevention of illegal transactions and spending of such huge amount goes unnoticed * Harmful side effects like, pollution is not accounted for in the GDP. No deductions are made from GDP for their harmful effects but addition to GDP is made by market transactions that aid in removing these harmful effects. Hence the calculation of GDP is not balanced * The GDP takes into account the goods and services produced but not exchanged for money. For example, volunteer work or growing own food and consuming it is not included in the GDP whereas expenditure on buying food from the market is taken into account [2]. Adverse effects of using GDP as a sole measure for economic success As GDP takes into account only some value created in the country and does not take into account several key transactions, GDP often increases at the expense of real growth and progress. The result is that GDP fails miserably as an indicator of economic success on the sustainability scale. The environmental and social aspects are not covered by the GDP. Alternative measures & their business implications There are several alternative indicators of the progress of a country. These measure economic activity, environmental or social activities, well-being or changes in environmental, social or human capital. * Genuine Progress Indicator (GPI): It provides a complete picture of economical and social progress. There are several indicators used to calculate GPI that are broadly classified under three categories – economic, environmental and social. The economic category indicators are similar to gross product measurement. The environment factors measure cost of pollution, cost of change to natural resources, cost of climate change, etc. The social indicator includes the value of education, lost leisure time, cost of crime, etc. This indicator has been adopted by the state of Maryland and is altered to include the impact of income inequality on the economy of the state. This indicator indicated the need to focus on reducing the level of income inequality in order to improve Maryland’s overall economic and social growth. Hence, this indicator has been successfully implemented that includes all the factors of well-being in a society. This leads to modified business practices in order to reduce inequality and improve economic, environmental and social spheres of the state * Human Development Index (HDI): It is used by the UNDP to show how the improvement in economic growth and human development is improving conditions of the human in the various countries. The HDI is defined as process of widening choices available to humans in order to live an educated, long and healthy life and to have access to resources to have a healthy and decent standard of living. It makes use of political freedom, human rights and self-respect to measure the index but as they are difficult to measure, the index uses longevity, knowledgeable and decent standards of livings as indicators in lieu of prosperous and long lives. * Gross National Happiness (GNH): It is frequently used as an alternative measure of progress. It was originally suggested by Bhutan to be used instead of using GDP as an appropriate measure of progress. It measures quality of life or social progress in consistency with Bhutan’s culture and spiritual values rather than focusing more on economic activity. It measures seven types of wellness – economic, environmental, physical, mental, workplace, social and political. Several conferences have also been held on use of GNH and it was primarily used to base the progress of the country on reflections of the country’s Buddhist origins[3](Coztanza, Hart, Posner & Talberth, 2009). Conclusion There are several alternative measures that are suggested to be used to measure the progress and the social well-being of a country. GDP is flawed such that it aids detrimental activities and does not take into account the positive activities of a country. Hence, an alternative that measures not only the market value of final goods and service but which also takes into account the social, economic and environmental factors while calculating the progress of a country is imperative to lead to sustainable development. The current use of GDP leads to more consumption of harmful cigarettes with no emphasis on the environmental degradation from the industrial and business rocesses. Hence, although the economy is progressing in certain spheres of economic activity, it is indeed lagging on sustainable development which requires pollution control, reduced resource usage, better social and income equality. Therefore, alternate measures that take into account all the factors that impact a nation should be developed and the alternative measure that is a composite of all the factors should be used to ensure sustainable develop ment of the economy that reflects progress in daily lives of its citizens. References: 1. http://www.investopedia.com/terms/g/gdp.asp 2. http://zorach.wordpress.com/2010/08/27/why-gdp-gross-domestic-product-is-a-poor-measure-of-wealth-and-prosperity/ 3. (Coztanza, Hart, Posner & Talberth, 2009) – http://www.bu.edu/pardee/files/documents/PP-004-GDP.pdf

Сhromosomal abnormalities Essays

Ð ¡hromosomal abnormalities Essays Ð ¡hromosomal abnormalities Essay Ð ¡hromosomal abnormalities Essay The development of psychotic disorders has been linked to chromosomal abnormalities. Research conducted to establish whether there is a link between psychotic disorders and chromosomal abnormalities show that Schizophrenia and bipolar disorder are associated with chromosomal disruptions (Muir et al, 2008). Studies that have been conducted on patients who have been diagnosed with psychotic disorders show that about 30 per cent of the patients have a micro deletion at chromosome 22q11. In addition, researchers associate gene G72/G30 at chromosome 13q33.2 with susceptibility gene for developing schizophrenia at childhood. The development of brief psychotic disorder has been linked to the genes, and this support the claim that psychotic disorders have a biological origin. The link of brief psychotic disorder to the genes is due to the fact that for people who have family members who have bipolar disorder or have shown symptoms of mood disorder, development of brief psychotic disorder is common. However, arguments that the brief psychotic disorder is caused by poor coping skills shows that the genes are not the major cause of the disorder. A traumatic experience or major stress in a person increases one vulnerability to develop the disorder. Genes may increase one’s risk of developing the disorder and although the brief psychotic disorder has been associated to the genes one inherits from the parents, carefully controlled clinical studies have not been able to show that psychotic disorders are biological in origin. Manic depression which characterizes the brief psychotic disorder is associated with an imbalance of serotonin and norepinephrine in the body. During the depressed period, these two are in low levels while during the manic periods the chemicals are in high levels. The predominance of the bipolar disorder has been linked to genetic inheritance. A study done on twins supports the argument that psychotic disorders may have a biological origin . The study that has been conducted on twins show that bipolar disorder is predominant in identical (monozygotic) twins as compared to fraternal (dizygotic). This indicates that a greater chance of inheriting the disorder is in monozygotic twins The fact that psychotic disorders are treated using medication shows that the disorders have a biological component (Samuel, 2003) . For example, the bipolar disorder can be treated using medication. Examples of medication that is used to treat the disorders include mood stabilizers and medication that tries to balance the depressive and manic states in patients. The use of lithium results to counterbalancing of depression and mania effects since it increases the reuptake of nonepinephinne and serotonin. Anticonvulsants such as Carbamazepine (CBZ) and Valproate (VPA) are prescribed to treat bipolar disorders. A case of three sisters who had shared psychotic disorder in United States show that individual who are close can be affected by delusions. The disorder which is shared by individuals who had emotional ties involved three sisters (Kaustubh et al, 2006). The three sisters’ illness was linked to the family’s psychiatric history which showed that the sisters had two first degree relatives diagnosed with schizophrenia. Both the mother and brother had the psychotic disorder and the mother had been hospitalized often- based on this case. The information relating to the disorder show that the case of shared psychotic disorder may involve members of one family and cases of the disorder are more common in members of the same family. It is more common between sisters than in brothers. Research has been conducted on twins and multiple families and show that genetic factors play a major role in promoting the development of psychotic disorders. Studies that have been conducted on twins show that when one twin develops mood disorder, the identical twin is three times more likely to develop the disorder as compared to fraternal twins or siblings who have not been born as twins. In addition, researchers have asserted that the neurotransmitter system in one’s body plays a role in the development of bipolar disorder. However, more research is recommended to determine the exact role of neurotransmitter system in the development of the bipolar disorder. The potential cause of delusional disorder which characterizes psychotic disorders includes neurological abnormalities and changes in brain chemistry as well as heredity. In addition, the disorder has been associated with abnormalities in the limbic system. The limbic system in the brain regulates emotions. Research studies to determine whether biological factors play a role in causing schizophrenia have involved establishing whether there is any connection between Val66Met which is a brain-delivered neurotrophic factor. The results indicate that homozygous carriers Met/Met increased the risk of one developing schizophrenic by 10 percent (Gratacos et al, 2007). The connection between Val66met to the development of schizophrenia shows that psychotic disorders may have a biological origin. The development of psychotic disorder is linked to biological functioning of the brain. An imbalance of the neurotransmitting chemicals in ones brain contribute to the development of psychotic disorders. The imbalance is considered to be inherited or triggered by physical or psychological events. For example, some disruption of early brain development while in the womb may trigger psychotic disorders. Substance-induced psychotic disorders may be caused by one’s withdrawal from using a certain drug and this may to some extent support the claim that the development of the disorder has a biological component (Matcheri and John,1991). For instance, recreational drugs such as cocaine, PCP, Marijuana, alcohol, and hallucinogenics may result to psychotic reaction when a user withdraws from using them (Rashmi and Mark, 2009). In addition, psychotic symptoms may be induced by prescribed medication such as anticonvulsants, chemotherapeutic agents and steroids. Conclusion Psychotic disorders cause abnormal perceptions and thinking in patients. Hallucinations and delusions are two major symptoms of the disorders. Individuals who are affected by psychotic disorders have their ability to make good judgments and to think clearly altered. There are various types of psychotic disorders which vary in cause and treatment. Treatment of the disorder includes therapy and medication. Research that have been conducted in relation to psychotic disorders show that some cases of the disorder may have a biological origin. However,research on the disorders indicate that the disorders result from the interaction of biological, psychosocial and environmental factors. References Bentall, R. , and Slade, P. 1988. Sensory Deception. Taylor and Francis Publishers. Daryl, F. , and Iqbal, A. 2007. The spectrum of psychotic disorders: neurobiology, etiology, and Pathogenesis. Cambridge University Press Freudenreich, O. 2007. Psychotic Disorders: A Practical Guide, Practical Guides in Psychiatry Gratacos, M ET al. 2007. Brain-Derived Neurotrophic Factor Val66Met and Psychiatric Disorders: Meta-Analysis of Case-Control Studies Confirm Association to Substance- Related Disorders, Eating Disorders, and Schizophrenia Biological Psychiatry, Volume 61, Issue 7, Pages 911-922 Habermann, T. , and Ghosh, A. 2006. Mayo Clinic. Mayo Clinic Internal Medicine Board Review, CRC Press Publishers, 2006

Types of Ignorance

Types of Ignorance Types of Ignorance Types of Ignorance By Maeve Maddox As a teacher, I am always pained when I hear ignorant used as an insult. ignorance: n. lack of knowledge Everyone is born ignorant into the world. The word ignorance is from Latin ignorantia. The prefix in means not; Old Latin gnarus means aware, acquainted with. Mere ignorance is nothing to be ashamed of. Ignorant is not a synonym for stupid. Catholic theology recognizes three categories of ignorance: invincible ignorance: lack of knowledge that a person has no way to obtain vincible ignorance: lack of knowledge that a rational person is capable of acquiring by making an effort nescience: lack of knowledge that doesnt matter in the circumstances (from Latin ne-, not plus scire, to know. In Catholic theology, invincible ignorance, whether of the law or the fact, is always a valid excuse and excludes sin. In the secular realm, however, all ignorance is seen as vincible. For logicians, the term â€Å"invincible ignorance† means â€Å"the fallacy of insisting on the legitimacy of one’s position in the face of contradictory facts.† If the facts are presented, theres no excuse to refuse to acknowledge them. The law likewise does not allow for a category of information unavailable to the lawbreaker that would forgive the breach of the law: ignorantia juris non excusat, â€Å"ignorance of the law does not excuse.† Heres a lengthier definition of the secular take on invincible ignorance from Wikipedia: invincible ignorance: a deductive Fallacy of Circularity where the person in question simply refuses to believe the argument, ignoring any evidence given. Its not so much a fallacious tactic in argument as it is a refusal to argue in the proper sense of the word, the method instead being to make assertions with no consideration of objections. Fitness expert Greg Glassman has this recommendation for dealing with invincible ignorance: some simply cannot be swayed toward your way of thinking, so don’t try. †¦you’re probably best to walk away from a pointless debate. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Expressions category, check our popular posts, or choose a related post below:Writing Prompts 10155 Boxing Idioms20 Ways to Laugh

Introduction to Microeconomics Essay Example | Topics and Well Written Essays - 1000 words

Introduction to Microeconomics - Essay Example pply in positively related to price because at a higher price producers can earn more profit by supplying more output.(Ian Hobday, p 100,105) In a market price is determined at the level at which demand equate supply as illustrated in figure 3. This discipline also offers explanation of factors that determine demand and supply. The factors that determine and influence demand are many. Demand is determined by changes in incomes of consumers, changes in tastes and fashion, changes in income tax, changes in population, changes in price of related goods, advertising and others. All of these factors bring shifts in demand curve and change equilibrium price and output. â€Å"British Gas reported 98 percent increase its six months operating profits of 2010 as compared to the same period during previous year â€Å"The profits reached to ?585m due to unusual cold winter which boosted the demand of  gas prices  by 8 percent.†( Aubin Lawrence, 2010) Price of related goods affects de mand has been witnessed, â€Å"With oil constantly trading above $100, consumers -- particularly those looking to buy cars -- are vying for alternatives that aren't too heavy on their wallets†(Debarati Bose,2011) Supply is determined by changes in costs of production, technical progress, changes in weather/disasters and others. All of these cause supply curve to shift and change equilibrium price and quantity.(Dan Moynihan and Brian Titley , p158-165) see figure 4 .On many occasions shortages are observed due to climatic changes and so forth. â€Å"European wheat stocks are expected to hit a 30-year low as dry weather could cut yields of some major European producers up to 20 percent†( Cat Contiguglia, 2011).See figure 4. Microeconomics analysis tells firms whether of raise prices or to decrease them. This...This paper demonstrates the main concepts of the Microeconomics. There is also 4 figures in the essay which graphically illustrates these concepts Microeconomics can be defined as a study of market behavior at micro level such as behavior of households and firms. It focuses on interactions between individual buyers and sellers and the factors that influence their decisions. In its broadest sense study of microeconomics deals with the efficient allocation of limited recourses that are available to fulfill unlimited wants of the society. This concepts is known as the basic economic problem which occurs due to scarcity. Due to scarcity individuals have to make a choice. This applies the principle of â€Å"opportunity cost† which is the cost of next best alternative forgone. Goods and services are produced by bringing together the four factors of production namely, land, labor, capital and enterprise. Production Possibility curve demonstrates principles of opportunity cost and full-employment Microeconomics explains price determination in goods and services markets and analyses the behavior of firms and consumers. This discipline also offers explanation of factors that determine demand and supply. Demand is determined by changes in incomes of consumers, changes in tastes and fashion, changes in income tax, changes in population, changes in price of related goods, advertising and others. Supply is determined by changes in costs of production, technical progress, changes in weather/disasters and others. with the help of microeconomics societies can predict behavior of firms and consumers and respond to possible changes in the markets. Causes and correlations can be identified with the help of theories that the disciple offers.

Globalization of operations management Essay Example | Topics and Well Written Essays - 250 words

Globalization of operations management - Essay Example raw materials, skilled and low-cost labor force among others (Mahadevan 121). Economies of scale also arise after a company expands it production capacity due to lower cost of operation. The service sector on the other hand has capitalized on the skilled labor force available overseas at low cost e.g. outsourcing firms relocating to India (Mahadevan 138). This expansion or shifting centers of operation also affect operations management adversely. There is the need for the firm to operate within the laws and standards of the new markets which are not necessarily similar to those of original market. Client’s special needs and preferences should also be considered in production which can increase on costs. Global market place is also quite competitive raising the need to have sound operational management strategies. CONCLUSION Globalization has taken many organizations to greater heights in the competitive global market. This scenario has enabled them to gain competitive advantag e and increase on production which results to higher margins. A firm going global should therefore appreciate that it will have to initiate changes in its operations to suit the new market dynamics. Works cited Mahadevan, B. Operations Management: Theory and Practice. Pearson Education India, 2010.