Malaysian Speech Language Pathologists Practices Education Essay

1.0 IntroductionThe best indicant to find the local prevalence of kids with developmental disablement is from international surveies which have suggested that more than 10 % of all kids in the universe have developmental disablement ( Amar 2008 ) . Using this rate to local population under 15 old ages old with the figure of 9.2 million ( Department of Statistics Malaysia 2011 ) , approximative 920,000 kids with disablement would be found in Malaysia. Speech Language Pathologists ( SLPs ) play a important function in assisting the communicating development of individuals ( ASHA 2005 ) so that they are able to populate inclusively in society as stated in Persons with Disabilities Act 2008 ( Government of Malaysia 2008 ) . In the mid-1990, merely less than five Speech Language Diagnosticians who trained overseas were working locally in Malaysia which ensuing of amazing 1: 2.5 million Speech Language Pathologist to people ratio ( Ahmad 2010 ) . Finally, formal local Speech Language Pathologist preparation started in the late 1990 ( Sharma 2008 ) . Universiti Kebangsaan Malaysia ( UKM ) is the innovator to offer Bachelor of Speech Science with Honors while Universiti Sains Malaysia ( USM ) began offering their Speech Pathology plan in 2004-2005. By 2011, more than 175 Speech Language Pathologists had graduated from the universities ( Aishah 2012- unpublished ) and are functioning to the community in different scenes. Lian & A ; Abdullah ( 2001 ) found that the profession of Speech Language Pathologist is still in its babyhood phase in Malaysia. The profession still needs old ages to turn and maturate ( Kosta 2005 ) . Indeed, many Malayan Speech Language Diagnosticians have indicated that they face great challenges to keep good profession patterns. The challenges are unfavourable working environment, deficit of Speech Language Pathologists, high caseload, small chances for go oning instruction and other factors ( Ahmad 2010 ; Sharma 2008 ) . Despite many challenges that affect Malayan Speech Language Pathologists patterns when pull offing instances, the balance between pragmatism and professionalism should be achieved in order to supply equity and quality of service proviso ( Ahmad 2010 ; Taylor-Goh 2005 ) . American Speech-Language-Hearing Association ( ASHA ) and Centers for Disease Control and Prevention ( CDC ) define Developmental Disability ( DD ) as terrible chronic conditions that occur in an single due to physical and or mental damage. Examples of developmental disablement are rational disablement such as Down ‘s syndrome, neuromuscular upsets such as intellectual paralysis, sightlessness, hearing damage, larning disablements, epilepsy, and Autism Spectrum Disorder ( ASD ) ( Decoufle et al. 1994 ) . The oncoming of the conditions is before 22 old ages of age and will normally stay throughout the person ‘s life-time. Peoples with developmental disablement have restrictions and jobs in his or her major functional life activities such as acquisition, working, walking, speech production and other countries ( ASHA 2005 & A ; CDC 2011 ) . Paul ( 2001 ) described kids in the Developing Language Stage ( DLS ) as group of kids who are still at the period of larning to unite words into sentences and they have expressive vocabularies larger than 50 words. Developing Language Phase occurs between 2 and 5 old ages of age for typical developing kids. Another manner to depict Developing Language Stage is that it refers to linguistic communication degree in Brown ‘s Stage II-V. This indicated average lengths of vocalization ( MLU ) of more than two but less than five morphemes. The type of sentence produced by them are at the scope of additive simple sentences with outgrowth of grammatical morphemes, like â€Å" my cat ‘s feeding † to intensify sentences, like â€Å" I drink milk and daddy drink java † ( Shipley & A ; McAfee 2009 ) . Developing Language Phase is the most explosive phase of linguistic communication development for kindergartner to develop from telegraphic vocalizations to basic sentence constructions ( Paul 2001 ) . For kids with developmental disablement, they needs appropriate intercession to travel through this phase ( Paul 2001 ; International Centre for Allied Health Evidence 2007 ; Law et al. 2010 ) . Hence, this is an of import passage gate for them to either remain at the same phase or to turn and come in the Language for Learning Stage. Malayan Speech Language Pathologists play great function to ease the acquisition of this group of kids. This is because mean caseload seen by Malayan Speech Language Pathologists particularly those who are working general infirmary consists of paediatric instances ( Aishah 2012- unpublished ; Sharma 2008 ) . From all the paediatric instance, Speech Language Disorder ( SLD ) is the most prevailing type of communicating damage seen by Speech Language Patholo gists in general infirmary ( Aishah 2012- unpublished ) . Therefore, this survey will function as a mention for the professionals in address and linguistic communication pathology about the pattern by Malayan Speech Language Pathologists in pull offing kids with Developmental Disability in the Developing Language Stage. Opinions and recommendations by Malayan Speech Language Pathologists sing the bing issues will besides be collected to give more in-depth apprehension about the pattern by Malayan Speech Language Pathologists. Besides, this survey will supply feedbacks to the professional associations & A ; universities about the development of Malayan Speech Language Pathologists. Clinical pattern guidelines related to communicating upset in kids are good documented by professional association from western states because they provide relevant statements sing clinical direction that are based on the available current groundss including adept clinical sentiments ( Hargrove et al. 2008 & A ; Taylor-Goh 2005 ) . The guidelines besides assist Speech Language Pathologists in clinical determination devising procedure and to supply high criterions of minimal best patterns services ( Hargrove et al. 2008 ; SPA 2001 ; Taylor-Goh 2005 ) . Looking back to Malaysia, guideline constitution for the profession of speech linguistic communication pathology in the local context is still developing due to limited resources and work force. Based on the guidelines documented by American Speech-Language-Hearing Association and Royal College of Speech Language Therapists ( RCSLP ) , few common chief clinical procedures are highlighted and overly discussed to guarantee minimal best pa ttern to be practiced by the Speech Language Pathologists. The procedures are attack used in direction, appraisal, planning and intervention ( ASHA 2005 ; Gerber & A ; Prizant 2008 ; Taylor-Goh 2005 ) . Approach used in speech linguistic communication pathology direction could be delivered utilizing different attacks harmonizing to the state of affairs by either working independently or in close partnership with squad members ( SPA 2001 ) . However, coaction that involves household centered, squad working and culturally appropriate services is able to guarantee effectual direction to the kids with Developmental Disability in the Developing Language Stage ( ASHA 2005 ; Diane 2011 ; SPA 2001 ; Taylor-Goh 2005 ) . Family-centered is a set of interrelated beliefs, rules and values that practiced by the facilitators including Speech Language Pathologists to back up and beef up the kid ‘s household capacity to heighten and advance his development and acquisition ( Dunst 2002 ) . Through working in a multidisciplinary or interdisciplinary squad, Speech Language Diagnosticians do non provides services in isolation. Alternatively, this teaming establishes a joint intent and shared ends throughout the direction among the households, professionals and the kid ( ASHA 2005 ) . The cultural background of the households and the kid with Developmental Disability is really meaningful in service proviso particularly in Malaysia, a state which is good known by its multi-ethnicity, multi-cultures and multi-linguistics. Multicultural fluctuations that ever encountered by Speech Language Diagnosticians are values about acquisition, beliefs and perceptual experience about kid functions in the household, outlooks for child behaviour at different developmental degrees and household perceptual experiences and attitudes toward a â€Å" disablement † ( Diane & A ; Froma 2011 ) . Assessment involves roll uping relevant informations about the kid ‘s conditions to make a diagnosing while diagnosing entails placing and understanding the jobs or shortages of the kid ( Paul 2001 ) . Both assessment and diagnosing are ongoing procedures because the diagnosing of the kid could alter over clip as the turning and development of him or her are besides ongoing ( Haynes & A ; Pindzola 2004 ) . The chief grounds for appraisal are to get at a good apprehension of the kid ‘s job, to set up the baseline degree of operation, to ease ends be aftering for intercession and to mensurate the advancement of the kid in intervention ( Haynes & A ; Pindzola 2004 ; Paul 2001 ) . Appraisal with kids with Developmental Disability in the Developing Language Stage is encouraged to see all relevant modes across different contexts utilizing appropriate appraisal tools ( Paul 2001 ; Taylor-Goh 2005 ; Haynes & A ; Pindzola 2004 ) . In add-on, appraisal of developmental age or menta l age is normally used by Speech Language Pathologists during diagnosing to qualify the kid ‘s functional accomplishments. But, many Speech Language Pathologists excessively have been discouraged to trust entirely on the usage of developmental age appraisal during diagnosing because it could non reflect the high variableness among the kids ( DeVeney et al. 2012 ) . Based on the assessment findings, the planning of intercession plan specifies the ends and the procedure of intercession by sing the kid ‘s damage, demands and outlooks ( Paul 2001 ; SPA 2001 ; Taylor-Goh 2005 ) . The planning aims to place and develop meaningful and contributing acquisition environment for the kids with Developmental Disability in the Developing Language Stage in functional day-to-day activities ( ASHA 2005 ) . Hence, relevant and possible schemes, contexts, issues, result and timeline should be documented to ease the service provided by Speech Language Pathologists is coordinated, comprehensive and holistic ( Diane 2011 ; Paul 2001 ; SPA 2001 ; Taylor-Goh 2005 ) . Besides, Speech Language Diagnosticians are strongly encouraged to follow Evidence-Based Practice ( EBP ) to help clinical determination ( ASHA 2005 ; Brankenbury 2008 ; Diane 2011 ; Johnson 2006 ; SPA 2001 ; Taylor-Goh 2005 ) . Evidence-Based Practice ( EBP ) encourages the Speech Language Patholog ists to take consideration of ( a ) current high-quality scientific research ; ( B ) Speech Language Pathologists expertness and experience ; and ( degree Celsius ) household ‘s penchants, values, and involvements ( Diane 2011 ) . It is an of import portion of effectual and ethical directions as it guides Speech Language Pathologists to extinguish methods which appear no or minimal clinical effects ( Brankenbury 2008 ; Taylor-Goh 2005 ) . Besides, Evidence-Based Practice besides helps the profession of speech linguistic communication pathology to accomplish higher answerability and credibleness ( Johnson 2006 ) . Effective instruction techniques ( ASHA 2005 ; Dunst et Al. 2011 ; Law et al. 1999 ; Law 2003 ) are really of import to find the result of the intervention plan. There are three types ‘ of intercession methods that are didactic, realistic, and combination of didactic & A ; realistic attacks ( Dunst et al. 2011 ; Law et al. 1999 ; Law 2003 ) . The classification of different type of intercession methods is non purposes for Speech Language Pathologists to take merely one method and utilize it systematically. In fact, it prepares a repertory of methods available for Speech Language Pathologists to fit the acquisition of the kid with the specific ends that have targeted ( Paul 2001 ) . In this manner, the efficiency of the intervention for the kid with Developmental Disability in the Developing Language Stage is maximized. Introduction of appropriate stuffs or activities ( ASHA 2005 ) , single acquisition environment ( ASHA 2005 ; Dunst et Al. 2011 ) , assistive engineerings ( Sand ra & A ; Sahoby 2006 ) and Augmentative and Alternative Communication ( AAC ) systems ( Millar et Al. 2006 ; Rose et Al. 1999 ) are all portion of duties of Speech Language Pathologists in giving intervention to the kids with Developmental Disability in the Developing Language Stage. These constituents facilitate the acquisition and growth of the kid in a familiar nature environment which is filled with synergistic communicating and societal routines/activities. Besides, the debut besides promotes the kid to generalise the new accomplishments to new state of affairs that would go on in mundane contexts. Back to Malaysia, Joginder Singh et Al. ( 2011 ) reported that Malayan Speech Language Pathologists demonstrated best pattern in many countries but fail to make in some other countries when supplying services to pre-symbolic kids. Approach used in speech linguistic communication pathology direction which consist the coaction of household centred, squad direction and culturally appropriate services is found barely practiced ( Lim 2008-unpublish ) ; Diane 2011 ; Joginder Singh et Al. 2011 ; Othman 2010 ) . Furthermore, Lian & A ; Abdullah ( 2001 ) found that Malayan Speech Language Pathologists were likely to trust on informal appraisals because formal appraisals are limited in the local market. When measuring pre-symbolic kids, Malayan Speech Language Pathologists showed low trust of roll uping communicating sample and roll uping informations out of clinic ( Joginder Singh et Al. 2011 ) . Looking into intercession pattern, Malayan Speech Language Pathologists demonstrate different int ercession attacks and techniques across different scenes ( Lian & A ; Abdullah 2001 ) . In other custodies, Augmentative and Alternative Communication ( AAC ) systems and assistive engineerings are non famously introduced by Malayan Speech Language Pathologists to better the efficiency of the intervention plan ( Joginder Singh et Al. 2011 ) .2.0 RESEARCH QUESTIONSHow Malayan Speech Language Pathologists holistically manage kids with Developmental Disability in the Developing Language Stage? What are the bing issues faced by Malayan Speech Language Pathologists when pull offing kids with Developmental Disability in the Developing Language Stage? What are the recommendations for better pattern suggested by Malayan Speech Language Pathologists when pull offing kids with Developmental Disability in the Developing Language Stage?3.0 RESEARCH OBJECTIVE3.1 General ObjectiveTo analyze Malayan Speech Language Pathologists ‘ patterns in pull offing kids with Developmental Disability in the Developing Language Stage.3.2 Specific AimsTo find the specific clinical constituents practiced by Malayan Speech Language Pathologists in pull offing kids with Developmental Disability in the Developing Language Stage as are attacks used, assessment, planning and intervention. To find the bing issues faced by Malayan Speech Language Pathologists in pull offing kids with Developmental Disability in the Developing Language Stage. To depict the recommendations suggested by Malayan Speech Language Diagnosticians of better pattern in pull offing kids with Developmental Disability in the Developing Language Stage.4.0 METHODOLOGY4.1 Research DesignThis is a cross-sectional qualitative and quantitative survey via study.4.2 Sampling PopulationThe population of this survey covers all Malayan Speech Language Pathologists.4.3 Study SiteParticipants will be recruited from all 14 provinces in Malaysia.4.4 Sampling MethodPurposive sampling method is used for this survey. All participants who fulfill the inclusion standards ( Please refer to 4.6 ) will be recruited.4.5 Sampling FrameThe contact lists of Speech Language Pathologists who graduated from Universiti Kebangsaan Malaysia ( UKM ) and Universiti Sains Malaysia ( USM ) will be obtained in order to administer the study to all alumnas members. The study will be besides mailed or/and posted to all Speech Language Pathologists working with Ministry of Health and to all members listed in the directories of local professional organic structures ( i.e. Malayan Association of Speech-Language & A ; Hearing ( MASH ) and others ) .4.6 Sample Inclusion CriterionParticipants inclusion standards: Qualified Speech Language Pathologists and practising locally. However, Speech Language Pathologists who have non had experience in pull offing kids with Developmental Disability in the Developing Language Stage will be indicated in the study to return the study without farther responses ( Please refer Appendix A ) .4.7 Sample Size CalculationAishah ( 2012-unpublish ) reported that there are 175 SLPs registered in the UKM and USM alumni from local universities by the twelvemonth 2011. Besides Speech Language Pathologists who have obtained their makings locally, Speech Language Pathologists who graduated from overseas are besides included in the survey, with the status that they are presently practising locally. Hence, the population of Malayan Speech Language Pathologists is estimated to be between the scope of 175 to 250 Speech Language Pathologists. The mean of the scope of 210 Speech Language Pathologists will be used as N, in the undermentioned computation: I†¡A?NP ( 1-P ) = 3.84 ten ( 210 ) ( 0.5 ) ( 1-0.5 ) dA? ( N-1 ) + I†¡A?P ( 1-P ) 0.05A? ( 210-1 ) + 3.84 ( 0.5 ) ( 0.5 ) = 137 participants Happening of backdown and bead out of 10 % is farther considered in the sample size computation. Entire topics = nn__ 1-0.1 = _137_ 0.9 = 152 participantssubjects Therefore, a sum of 152 topics participants will be recruited in this survey.6.54.8 Data CollectionThe study utilized for this survey is adapted from several surveies that focus on happening similar results on SLP patterns ( Joginder Singh et Al. 2011 ; Mustaffa Kamal et Al. 2012 ; Othman 2010 ; Stuck 2012 ) . The study is constructed utilizing English because the participants involved in this survey are qualified Malayan Speech Language Pathologists who have English proficiency. The study contains the undermentioned subdivisions: Part A: Demographic Data Part B: Specific Clinical Components 7 parts that are Demographic informations, Approaches used, Assessment, Planning, Treatment, Opinions sing bing issue and Recommendations of better pattern. Close-ended inquiries utilizing 5 points LikertLikert grading and multiple picks are included in the study. Besides, and open-eopen-ended inquiries are besides included. nded inquiries are included. ( Please refer to Appendix A ) . Survey and information sheet will be distributed to the Speech Language Pathologists SLPs via electronic mail and/or gpost. QuestionPro ‘s online study package will be used to administer the study via electronic mail. Meanwhile, Ffor Speech Language Pathologists SLPs who will have the study and information sheet via postmailing, a reply-paid envelope is included for them to return the study. SLPs will be informed that the returning of completed questionnaire study indicate consent to take part in this survey. A follow-up reminder electronic mail or phone call will be sent to Speech Language Pathologists SLP ten 10 yearss after the initial distribution. A 2nd reminder electronic mail or phone call will be sent 2 hebdomads subsequently.64..96 Validity and Reliability of SurveyThe study will be piloted on 10 participants. Concept, content and face cogency will be determined by modifying the points consequently ( following the pilot survey ) through feedback from the participants. To find how closely related the set of points are grouped in the study, internal dependability of the study constituents will be assessedachieved by ciphering Cronbach ‘s Alpha Coefficientusing Cronbach ‘s alpha. This will demo how closely related the set of points are as a group in the study.6.74.10 Statistical TrialThe quantitative informations obtained from closed-ended inquiries in the study will be analyzed utilizing descriptive statistics. From the study, 11 out of 20 closed-ended inquiries are far ther divided into sub-items. Hence, factor analysis via chief component analysis ( PCA ) is used as a information decrease technique. Items in the study that measured the same implicit in concept will be grouped together. Analysis method used by Mathers-Schmidt & A ; Kurlinski ( 2003 ) will be adopted in this survey. Descriptive statistics ( per centums ) of the grouped-items is calculated to look into the grade of which specific clinical constituents are used. First, to find which specific clinical constituents of Speech Language PathologistsSLPs ‘ pattern are most normally used, the per centum of responses for each reply option ( ne'er, seldom, sometime, normally, or ever ) will be calculated. Percentages of response for option â€Å" normally † and â€Å" ever † are combined. The specific clinical constituents are so categorized into 3 groups: ( 1 ) constituents usually/always used by 90 % or more of the topics ; ( 2 ) constituents usually/always used by 50-90 % of the topics ; and ( 3 ) constituents usually/always used by less than 50 % of the topics. Second, consistence of the specific clinical constituents practiced by the topics will be determined. The information will be categorized as follows: ( 1 ) extremely consistent-75 % of topics indicated the same frequence of usage ; ( 2 ) reasonably consistent-50-75 % topics indicated the same frequence of usage ; ( 3 ) and inconsistent-less than 50 % of topics indicated the same frequence of usage for a peculiar clinical constituent.6.84.11 Research Procedure6.94.12 Gantt ChartYear/Month Undertaking Activities 2012 2013 July Aug Sept Oct Nov Dec Jan Feb Mac Apr May Literature Review Ten Ten Ten Ten Ten Ten Ten Ten Ten Ten Proposal Presentation Ten SurveyDevelopment Ten Ten Ten Application for Ethical motives Ten Ten Pilot Study Ten Ten Data Collection Ten Ten Ten Ten Datas Analysis Ten Ten Ten Ten Report Writing Ten Ten Ten Ten Ten Ten Ten Concluding Presentation Ten6.104.13 Information Sheet and Consent FormThe information sheet that will administer to the topics is attached in Appendix B. Meanwhile, the topics will be informed that the returning of completed questionnaire indicate their consent to take part in this survey.

Discuss the Following “Infection Prevention is Every Healthcare Professional’s Responsibility” Essay

This essay is to discuss the statement: ‘Infection prevention is every healthcare professional’s responsibility’. In order to identify the healthcare professional’s responsibility the author will be drawing from three different sources including documents from the Department of Health, the Nursing and Midwifery Council’s code of conduct and the Royal College of Nursing. After this, the essay will talk about two different practises that healthcare professionals can use to break the chain of infection. These will include the use of personal protective equipment (PPE) and the importance of hand washing and the impact these practises have on infection prevention. The essay will then focus on how such high standards of infection prevention can cause psychosocial repercussions on the patient and how visitors can have a compromising effect on healthcare professional’s efforts to break the chain of infection. The Department of Health (DoH), the Nursing and Midwifery Council (NMC) and the Royal College of Nursing (RCN) all provide documents and guidelines for the public to read about the role of the healthcare professional. They are all put in place to safeguard the public, the workers, and to help professionals deliver the highest quality service to the service users. It is possible to relate a lot of these documents and guidelines to infection prevention. These services have made it clear that infection prevention is every healthcare professional’s responsibility through their policies and guidelines. In the NMC’s Code of Conduct at the chapter on keeping knowledge and skills up to date, number thirty-eight of the code states ‘you must have the knowledge and skills for safe and effective practise when working without direct supervision’ (Nursing and Midwifery Council, 2008). This is important because if the healthcare professional’s knowledge and skills were not up to date then they would not understand common illnesses, causes or the most effective way to prevent them. This would therefore put the service users at risk and the healthcare professional could be held accountable. The RCN promotes good practise by setting eight main principles for professionals to take guidance from. Principle C states, ‘Nurses and nursing staff manage risk, are vigilant about risk, and help to keep everyone safe in places they receive healthcare’ (Royal College of Nursing, 2010). This is an important element of safe and effective care and provides an  understanding for the public and workers that infection is a risk that all health care professionals must be vigilant about and it is the workers as well as the public’s responsibility to make their best efforts to control it. The Department of Health creates legislation and policy which the healthcare system have to abide by. One policy document that was published by the DoH is the ‘Prevention and Control of Infection in Care Homes’ (Department of Health, 2013). It is targeted at healt hcare settings such as care trusts, and is about ‘best practise guidance’. The policy document includes information such as the chain of infection, hand washing techniques as well as asepsis and aseptic technique guidelines. The DoH has created this document to improve infection prevention by giving more responsibility to healthcare professionals and urging them to use these precautionary measures. ‘The RCN considers infection prevention and control to be a core element of quality, patient safety and governance systems and as such it is one of the RCN’s key areas of activity. Infection prevention and control is the clinical application of microbiology in practice’ (Royal College of Nursing, 2013). The chain of infection model displays the transmission of infection from one patient to another. The model has six components which if broken from the chain will prevent the infection from spreading. These components include; a causative micro-organism, reservoir, portal of exit, mode of transmission, portal of entry and susceptible host. As infection prevention is every healthcare professionals responsibility, healthcare professionals should work together to break the links in the chain of infection. A common component to break is the ‘reservoir’ link. Through employee health, environmental sanitation and disinfection. Another way to break the chain o f infection is to follow standard precautions by using personal protective equipment where necessary. Personal protective equipment (PPE) are special garments or equipment used by healthcare workers and service users to help protect against infections. It includes protective clothing, gloves, respirators and more. All these are essential in the discontinuation of the chain of infection. By law, employers have to supply healthcare workers with PPE and if not worn by the workers they may be held accountable. The different type of PPE used and when to use it will be stated in the service  users care plan as some service users are more high risk than others. It is therefore the healthcare workers responsibility to use personal protective equipment (PPE) to prevent the spread of infection. It is a well-known fact that hand washing significantly reduces the spread of pathogens within healthcare settings and decreases mortality rates. The Department of Health and the Association for Professionals in Infection Control and Epidemiology (APIC) regularly encourage professionals to follow guidelines they set. ‘Unhygienic practises, such as healthcare professionals not washing hands between treating patients, can spread infections’ (Parliamentary Office of Science and Technology, 2005). Studies show that regular hand washing is a fundamental procedure in the prevention of common infections such as Methicillin-resistant staphylococcus Aureus (MRSA). ‘If you make nurses wash their hands you can control 80% of [MRSA]’ Mark Enright, senior research fellow in microbiology at Bath University’ (Eaton, 2005). Furthermore, according to the US Centers for Disease Control (CDC), ‘hand washing is the single most important procedure for preventing the spread of infection’ (Walker-Barrs, 2000). The APIC has produced a clear guide to hand washing that all healthcare professionals should follow. Workers in the health industry come into contact with bodily secretions often infected with pathogens and therefore hand washing is advised to be carried out before and after seeing a patient (even if personal protective equipment is used). The APIC guide to hand washing also advises on the different types of soap to use. Signs in patient’s rooms should be placed to encourage visitors, staff and patients to wash hands regularly. It is the healthcare professional’s responsibility to place and emphasis on the importance of hand washing to prevent infection. Common healthcare associated infections (HAI’s) can all be reduced by putting appropriate infection prevention measures in place. Methicillin-resistant staphylococcus Aureus or MRSA is a well-known common infectious pathogen commonly found in healthcare settings. It attacks people with compromised immune systems therefore hospital wards are high risk settings. This puts an emphasis on how important it is to follow appropriate infection prevention methods. However, studies have undergone to find out if single room or  cohort isolation can reduce the spread of MRSA in intensive care units. The results were unexpected showing that isolating patients with MRSA doesn’t affect the chances of infection and has negative outcomes that are discussed later. ‘Moving MRSA-positive patients into single rooms or cohorted bays does not reduce cross-infection. Because transfer and isolation of critically ill patients in single rooms carries potential risks, our findings suggest that re-evaluation of isolation policies is required in intensive-care units where MRSA is endemic, and that more effective means of preventing spread of MRSA in such settings need to be found’ (Cepeda, 2005). Infection prevention in health care settings is important, however, it can have negative effects on the patient. Single room isolation is for people with serious infectious diseases and is often necessary as contact with other people can boost the chain of infection. However, there are various psychosocial implications for the client. ‘Health-care workers are half as likely to enter the rooms of patients in contact isolation’ (Kirklanda, 1999). Barriers used to protect the spread of infection like PPE can have a negative effect on the patient. For example, wearing gloves prohibits physical contact between the healthcare worker and the patient. This could give the patient a feeling that they are ‘infected’ or ‘dirty’. Furthermore, service users that get put into protective isolation may experience feelings of depression and loneliness as it reduces their contact with friends and family. These pointers require us to think about the way we go about infection prevention, for example, it would be essential to wear PPE when dealing with a patients bodily fluids however depending the type of illness they have, it may not be necessary to wear gloves when carrying out actions such as holding a patients hand. Isolation is costly, labour intensive and inconvenient for the patient and the healthcare employees. Additionally isolation is more likely to lead to patient neglect and error. A study investigating patient’s put into isolation for infection control was carried out. It found that: ‘compared with controls, patients isolated for infection control precautions experience more preventable adverse events, express greater dissatisfaction with their treatment, and have less documented care’ (Stelfox, 2003). Furthermore, Wilkins et al (1988) focused on ‘discovering whether isolation may induce mental illness†. He found that isolation  increases feelings of boredom, loneliness and insecurity. Ward, D. (2004) looked at ‘reducing the psychological effects of isolation’ and went on to find that after ‘the questionnaires were completed by 21 patients, nine participants identified negative emotions associated with isolation’ (Ward, 2004). Therefore, infection prevention is every healthcare professional’s responsibility, however, st udies have proof that some forms of infection prevention that are used today are harmful both socially and mentally. Moreover, healthcare professional’s efforts are undermined when visitors contaminate the healthcare setting with pathogens from outside. ‘The Centers for Disease Control and Prevention (CDC) has estimated that, nearly 2 million patients each year acquire an infection that is linked to a hospital visit. Of those, about 90,000 result in death’ (Davis, 2006). Despite hand gels, wash basins and personal protective equipment being provided as well as signs to encourage usage, visitors still do not understand the risk they are taking upon the service users when they do not acknowledge the importance of these measures. Visitors act as the ‘mode of transition’ within the chain of infection and influence the spread. As we cannot stop the public from visiting their friends and loved ones, it is the healthcare staff’s responsibility to encourage visitors to use appropriate precautions when entering and leaving the healthcare environment. The healthcare st aff may feel that there is no point in making infection prevention their responsibility if their efforts are simply disregarded and undermined by the public. To stop the spread of pathogens, visitors should be encouraged to wash their hands as often as possible, stay at home if they are unwell and ensure their immunisations are up to date. Additionally, limiting visitors will decrease the chance of the spread of infection. An article titled ‘Limit Visitors to Help Cut Hospital Infections’ states that ‘Chris Beasley said â€Å"visitors increase the risk of hospital-acquired infections† (HAIs) and that she is thinking of ways to reduce the number of non- patients in hospitals’. The article then goes on to suggest ‘patients undergoing elective surgery could have to identify their key visitors’’ (Harrison, 2005). The ‘key visitors’ idea proposed by England’s chief nursing officer provides a means to cutting the spr ead of infection by visitors. Consequently legislation putting this idea into place would support their  role of healthcare professional making infection prevention their responsibility. Through the course of this essay it has been proven that infection prevention is every healthcare professional’s responsibility and is backed up by policies, legislation and guidance from the Department of Health, the Nursing and Midwifery Council and the Royal College of Nursing. They have published guidance on hand washing and the use of personal protective equipment but most importantly they have set a foundation for good healthcare practise to safeguard the public. In the NMC code of conduct, numbers thirty-eight to forty-one are focuses on keeping knowledge and skills up to date. Good knowledge and skills are essential in the awareness of common illnesses such as MRSA and without them the healthcare professional is not making infection prevention their responsibility. Even though it has been proven that high levels of infection prevention can cause negative effects to the service healthcare professionals provide, there are actions we can implement to conquer them, for exa mple only using personal protective equipment when necessary as well as using single room isolation as a last resort. References Cepeda, A. (Jan 2005). Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two centre study. The Lancet. 365 (9456), p295-296. Davis, S. (2006). Breaking the Chain – Eight Strategies for Reducing Risk of Hospital Acquired Infection. Environmental Sciences. 19 (12), p43-45. Department of Health and Health Protection Agency (2013). Prevention and Control of Infection in Care Homes. London: Department of Health and Health Protection Agency. P1-16. Eaton, L. (April 2005). Hand washing is more important than cleaner wards in controlling MRSA. Available: http://www.bmj.com/content/330/7497/922.3. Last accessed 18th October 2013. Harrison, S. (2005). Limit visitors to help cut hospital infections. Nursing Standard. 19 (41), p6. Kirklanda, K. (1999). Adverse effects of contact isolation. The Lancet. 354 (9185), p1177-1178. Nusing and Midwifery Council (2008). The Code: Standards of conduct, performance and ethics for nurses an d midwives. London: NMC. p6. Parliamentary Office of Science and Technology. (July 2005). Infection Control in Healthcare Settings. Postnote. 247, p2. Royal College of Nursing. (2010). The Principles of Nursing Practise. Available: http://www.rcn.org.uk/development/practice/principles/the_principles. Last accessed 2nd November 2013. Royal College of Nursing. (2013). Infection Prevention and Control. Available: http://www.rcn.org.uk/development/practice/infection_control. Last accessed 20th October 2013. Stelfox, H. (2003). Safety of Patients Isolated for Infection Control. The Journal of the American Medical Association. 290 (14), p1. Walker-Barrs, A. (July 2000). Hand washing: Breaking the Chain of Infection. Available: http://www.infectioncontroltoday.com/articles/2000/07/handwashing-breaking-the-chain-of-infection.aspx. Last accessed 18th October 2013. Ward, D. (2004). Infection control: reducing the psychological effects of isolation. Available: http://www.internurse.com/cgi-bin/go.pl/library/article.cgi?uid =5527;article=BJN_9_3_162_170;format=html. Last accessed 2nd November 2013.

“Bonum Ex” Principle Essay

The principle â€Å"bonum ex integra causa, malum ex quocumque defectu† means â€Å"an action is good when it is good in every respect; it is wrong when it is wrong in every respect.† This means that in order that an action may posses in an essential degree — no action is absolutely perfect — its moral perfection, it must be in conformity with the law in three respects. First, the action, considered under the character by which it ranks as an element of conduct, must be good. The physical act of giving another person money may be either an act of justice, when one pays a debt, or it may be an act of mercy or benevolence, as it is if one give the money to relieve distress. Both, of these actions possess the fundamental element of goodness (bonum ex objecto). The motive, if there is a motive beyond the immediate object of the act, must also be good. If one pays a man some money that one owes him with the purpose, indeed, of paying one’s debts, but also with the ulterior purpose of enabling him to carry out a plot to murder one s enemy, the end is bad, and the action is thereby corrupted. The end which is the motive must also be good (bonum ex fine). Thus, an action, otherwise good, is spoiled if directed to an immoral end; conversely, however, an action which in its fundamental character is bad is not rendered good by directing it to a good end. The end does not justify the means. The circumstances under which the action is performed should be in entire conformity with reason, otherwise it lacks something of moral completeness, though it may not be thereby rendered totally immoral. We frequently say that something which a person has done was right enough in itself, but he did not do it in the proper place or season. Hedonism The supreme good of man according to Aristippus is pleasure or the enjoyment of the moment, and pleasure is essentially gentle motion. Pleasure can never  be bad, and the primary form of it is bodily pleasure. But, in order to secure the maximum of pleasure, prudent self-control is necessary; and this is virtue. Epicurus held that pleasure is the chief good; but pleasure is rest, not motion; and the highest form of pleasure is freedom from pain and the absence of all desires or needs that we cannot satisfy. Hence an important means towards happiness is the control of our desires, and the extinction of those that we cannot gratify, which is brought about by virtue Utilitariansism Utilitarianism is a modern form of the Hedonistic ethical theory which teaches that the end of human conduct is happiness, and that consequently the discriminating norm which distinguishes conduct into right and wrong is pleasure and pain. Moral Positivism Positivism asserts that sense experiences are the only object of human knowledge, but does not prove its assertion. It is true that all our knowledge has its starting point in sense experience, but it is not proved that knowledge stops there. Positivism fails to demonstrate that, above particular facts and contingent relations, there are not abstract notions, general laws, universal and necessary principles, or that we cannot know them. Moral Rationalism Rationalism is used to designate any mode of thought in which human reason holds the place of supreme criterion of truth; in this sense, it is especially applied to such modes of thought as contrasted with faith. In other words, man’s ultimate truth is what our reason dictates. Communism In its more general signification communism refers to any social system in  which all property, or at least all productive property, is owned by the group, or community, instead of by individuals. Thus understood it comprises communistic anarchism, socialism, and communism in the strict sense. The complete equality sought by communism is a well-meant but mistaken interpretation of the great moral truths, that, as persons and in the sight of God, all human beings are equal; and that all have essentially the same needs and the same ultimate destiny.

Despite the failure of the Constitutional Treaty in 2005, Europe truly Essay

Despite the failure of the Constitutional Treaty in 2005, Europe truly has a constitution. This fact gives support to the existe - Essay Example The implication is that the positive impact is founded on the existence of European Public Law. It is important to understand whether European Public Law does exist today and what form it has at present. Various manifestations have been seen throughout the years, including the Roman Law during the Roman Empire (Birkinshaw, 2001). The discussion shall now cover an overview of public law, moving into a more detailed attempt to determine the manifestation of the European Public Law. Discussion Public law implies a system of provisions which manages public activities and affairs. It mainly relates to the application and non-exercise of public powers, including the private actors, legality, and rationality. It also represents provisions which are founded on historical and cultural elements, including political practice (Birkinshaw, 2003). Public law also manifests differently in other European processes where it is indicated via special courts and differentiated from private law as it is not as stable as in the English and Irish laws. There are various incarnations of the European Public Law. ... EU law includes the relations between the EU, the member states, the citizens, EU organizations and agencies, citizens from non-member states, as well as regulatory law. Such regulatory laws have become more imposing throughout the years, with competition laws impacting so much on Europe. A common law of Europe seems to be viewed negatively, even as it supports the growing number of scholars and their research goals in public as well as private law (Birkinshaw, 2003). It is not favourable if it is perceived as a monument being imposed by higher authorities without much consideration to the general sensitivities for member states, possible new members, the Council of Europe, including other non-members (Majone, 2002). The goal of supporters is to secure provisions inching towards common effects and goals. There should be an acceptance on the lack of boundaries in common laws. There are rich sources for common law, including those which relate to human rights, political, and religious ideals. Another possible incarnation for the European Public Law is the European Convention on Human Rights (Birkinshaw, 2001). The success of this law has also impacted on English legal practitioners, specifically in instances where there is an objection to the fact that treaties set by these practitioners seek to prevent the mistakes of the Second World War; such contention has often been used mostly against the UK, not other ratifying countries (Hunt, 1997). English judges have suggested preferences for patriation, not the blending of the Convention into the UK laws with the Human Rights Act of 1998. Even prior to the incorporation, case laws have indicated the focus on common laws on its traditions for the management of human rights, with the inclusion of US and the

Kroger Essay Example | Topics and Well Written Essays - 500 words

Kroger - Essay Example The exact number and details pertaining the businesses discussed above is as follows: (i) The company owns two thousand six hundred and forty one grocery retail stores all across 34 states in America. The stores are in formats that include multi-department stores supermarkets, supercenters and price-impact warehouses. All these stores contain all national brands and other merchandise (Operations). (iv) It operates 38 manufacturing plants that process food substances. This forms one the largest string of private manufacturers in the country. The companys private products manufacturing plants are thirty-seven in number operating in seventeen states (Operations). The company practices sustainability measures to ensure that it keeps up with the environmental standards. In addition, the operations conserve energy usage in all the sectors. Such measures have reduced energy usage in the retails distributed throughout the country (2013 Sustainability report). For the company to sustain a quick and steady growth it needs to follow the following measurers. It needs to improve the execution of the company infrastructure. A good infrastructure would maintain the management of a large company with distributions throughout the country. To achieve this form of infrastructure network, the firm should do away with departmental silos, using performance drivers that conform with the strategy at hand, and finally grooming leaders at all levels in the different outlets. Having well trained leaders facilitates good management in the whole company. For a firm with several branches such as this, it is advantageous to have leaders heading for the same goal to facilitate good growth (THREE STRATEGIES FOR ACHIEVING AND SUSTAINING GROWTH ). The second stage is identifying and implementing strategies that would be fruitful to the growth of the firm. To implement this, the first things is to concentrate in the core business. The

Market Entry Strategy of Kraft Foods Group Essay

Market Entry Strategy of Kraft Foods Group - Essay Example Apart from this, the quantity of resources is also extremely high within the region of the country which acts as a catalyst for the nation. This helps the nation in increasing its position and prosperity regarding wines in the global perspectives as compared to others (Levitt, 2007). Along with this, the capital resource of the nation is also quite high that proved effective in increasing its production quantity to increase the reputation and attractiveness in the market. Varieties of wine in Greece:Greece produces a majority of the varieties of grapes such as Macedonia, thrace, Epirus, thessalia, sterea ellada, Peloponnese and many others. These varieties of grapes helps in manufacturing varied types of wines such as red wines, white wines. This is mainly due to the Mediterranean climate and rainy winters that helped in the development of the finest quality of grapes (Porter, 2011). Therefore, the demand and total sale of the product of wine is higher to its excellent taste. 1.1.2 H uman resources: The education level of the citizens in the region of Greece is comparatively higher as compared to its neighboring nations. So, the rate of unemployment is quite lower rather than others (Porter, 2008). Therefore, the literacy rate of the labors within the region of Greece is lower as compared to its adjoining regions and this acted as a boon for the organisation functioning in the section of wine. However, the skill to handle advanced machines is quite lower among the individual of Greece, but it need to be improved in future.

Postmodern Culture Essay Example | Topics and Well Written Essays - 1500 words

Postmodern Culture - Essay Example The recent commercialisation of culture is observed to be aligning the culture with the practical life. The postmodern era is a complex culture that inflicts social change and leads to political transformation. Postmodernism is identified as the mythical heads of the hydra, which has successfully changed the culture of a society (Horn, 2000). With this regard, the essay elaborates on postmodernism and its analysis, detailing the different effects the postmodern culture on the life of the people and society. Postmodern culture can be identified to be conjoint in nature owing to the lack of unity among the postmodern society. With the openness of the postmodern society, there has been a lot of subjectivity that has been inflicted among the people. Furthermore, postmodern society is majorly observed to be controlled by the mass media and powerful institutions. The reality of the world in this postmodern era is highly controlled by the different images and pictures of the mass media. In this respect, commercialisation is observed to be having a huge effect in the virtualisation of a society at large (Strinity, 2004). In the postmodern society, people are often viewed to be having a virtualised belief of the culture. The effect of commercialisation in the modern world positively triggered that people draw the inferences of their real life from the commercialisation and modern life. The postmodern era even evidence the use of comic stories as well as the different virtual imagery, which is r eplacing novels and books. The different novels and epics are being replicated through virtual images that are observed to be providing a virtual lifestyle to the real world. This post-modern era of culture is observed to be developing boundaries between imagery and real life. The postmodern culture has been internationally ambiguous and severely complex for people to understand the actual effect of culture (Grossberg, 2014; Foster,

Ethical and legal issues concerning at-will employment Research Paper

Ethical and legal issues concerning at-will employment - Research Paper Example Employers should be careful at every stage of the hiring process to avoid illegal discrimination of any applicant on grounds of color, gender, age, national origin, disability and religion. Applicants are aware that indication of bias in the hiring process may lead to severe legal repercussions. In contractual employment, the law considers the relationship between an employer and employee as being on equal ground in terms of bargaining power. The employment at will reflects the belief that people are free to enter into employment contracts of specified length of time, without obligations attached to either employee or employer. In this arrangement employees are able to resign from a position they no longer care about and employers are permitted to discharge employees at their pleasure. The law in general presumes one is employed at will unless they have proof indicating otherwise. Written documents detailing one’s employment or oral statements from their employer are means of proof. For this reason, employers go to pains to point out, in applications, handbooks, job evaluations, handbooks, or other documents related to employment, that their employees work at will. It is important to be aware of the status of one’s employment, whether it is at will or otherwise. Ethically, the employer could expressly indicate the terms in a written document that the applicant has the choice to sign. If no at-will agreement is signed, one can check the employee manual or any other written workplace policy document. If these documents state ; that one could be fired at any time, could be fired without cause or for any reason, even if the word at will is not expressly used then you are under an at-will policy. Professional ethics encourage the employer to have some written policies that call for good reason to fire. Such policies could provide an exclusive list of reasons for which employees can be fired or offer some job protections. Employees are entitled to rely on these kinds of policies if their employer has adopted them. Legally if the contract promises job security, then one is not an at will employee. This could be in form of a contract that clearly states that the employee is on a three-year contract and they could be fired in that time only for committing a crime. If in this event they are fired for any other reason not specified in their contract they may have legal claim for breach of contract. Employers often take this employment means as a measure of protecting their interests. With uncertain economic systems and means of sustenance companies feel the need to cushion themselves or have some weather room in the event of downsizing. In other instances, the employee may need an employee for particular tasks which may be for specific durations. In case the task is completed before the expiry of the contract the employee may feel the need to let go of the extra hands. It is unethical in the public for an employee to hire with the sole intention of covering their back. The result is that the new hires, will not be motivated or feel challenged in the work and may underperform. In a clear situation where the employee and employer both know the terms of the agreement, the law has little to do in case either party bailed out. Ethics encourage serving a notification

Managing Conflict Essay Example | Topics and Well Written Essays - 500 words

Managing Conflict - Essay Example According to Benjamin (2007), conflicts sometimes may be a tricky issue to solve or handle which may always necessitates consultations from different quarters. For instance the Chief Executive officer of a shipping company may approach the human resource manager to seek guidance on the excessive drug use by some section of company employees. In the recent past, the company has experienced a series of plant accidents which the Chief Executive Officer alleges can be attributed to machinery operation under influence. The Chief Executive Officer have therefore ordered a compulsory for a mandatory drug test among the existing employees and the new employees too.However,the labor union have openly opposed such a move despite the company assuring them that those found positive will undergo treatment sponsored by the company and attend company financed cessation seminars. Despite such a situation being tricky, a solution must be found and the relevant advice given to the Chief executive Officer by the Human resource manager. Whether the employees are guilty of the Chief Executive Officers assertion or not, one aspect must remain outstanding: that at the end of the day, the decision reached must consider the good long term future of the company (Benjamin, 2007). As the Human Resource manager, the following recommendation may be helpful to address the conflict in an amicable manner and in such away the labor union may readily accept the adoption of the company’s new policy. The employees who use drugs and those who do not should not be coerced to undergo drug testing but the company should formulate an internal regulation to punish those who go to work under influence. This can be done through the introduction of operation fitness desk. This desk can serve the function of clearing employees before they embark on operating machinery. Those under influence when on duty should not be allowed to operate machinery and if possible face internal disciplinary measures

Democracy and Technology Essay Example for Free

Democracy and Technology Essay While technologies such as the use of internet and e-democracy have made the dissemination of ideas quicker, they have also resulted in the increase in a groups power to manipulate general opinion. The technologies aiding democracy today, such as computers, satellites, radio, telephones and television have undeniably changed the face of modern democracy. What constitute positive spill outs of these technologies for democracy also in some cases have a detrimental effect on it. While it increases the reach among people and nations, enriching both formal and business communication, it also provides these opportunities to fundamentalists to create rumours and channels individuals or a group of people against democracy. However a little caution such as verifying the news from multiple sources will easily reveal these elements and thus the negative influence of misleading a large group of rational individuals can be easily curtailed. The rise in literacy level and the positive trend of e-democracy deepens the process of democracy and empowers the individuals not only to have a say in the election of their government as earlier, but also empowers the citizens to have greater say in the decision making process of the government. With increasing literacy levels, as the citizens become more aware of the power of technology, they will find it easier to organise themselves for pressing on social, economic and political reforms from the government at helm thus ushering a truly democratic era where the citizens role is not only limited to electing their representatives but also to correct them if they are being found negligent in fulfilling their duties. However for this to happen in the future, it should be ensured that technology and their benefits are not limited to a select few in the upper echelons of society and that they are made available to those at the lowest level for complete integration of the masses to the democracy. References Allison, Juliann Emmons. (2002). Technology, development, and democracy. SUNY Press.

3-Methylglutaconic Aciduria Research

3-Methylglutaconic Aciduria Research A distinct type of 3-methylglutaconic aciduria due to a mutation in the Translocase of Inner Mitochondrial Membrane 50 (TIMM50) gene Abstract BACKGROUND: 3-methylglutaconic aciduria biochemically characterized by increased urinary excretion of 3-methylglutaconic acid result from defective leucine metabolism and disorders affecting mitochondrial function though in many cases the cause remains unknown. Recently mutations in mitochondrial TIMM50 gene has been reported in four patients from two unrelated families. We report additional mutations in TIMM50 gene in 6 individuals from two unrelated consanguineous families with a distinctive type of 3-methylglutaconic aciduria. METHODS:Â  We report on three patients of South Asian ancestry with intractable epilepsy, microcephaly, developmental delay, visual deficit spastic quadriplegia and three Caucasian patients of eastern European origin with intellectual disability with or without seizure. Metabolic testing revealed mild lactic acidosis and excretion of large amount of 3-methylglutaconic acid in urine in all patients. Full exome sequencing was performed using genomic DNA isolated from one surviving patient, two healthy siblings and both parents of South Asian family. Exome sequencing was also performed for Caucasian patients of eastern European origin. RESULTS:Â  Exome sequencing identified two homozygous mutation Gly372Ser and Iso392Thr mutations in the gene TIMM50. There were no other candidate alterations in exome that could explain the phenotype in the proband. The mutations are located in the conserved C-terminal domain of the Tim50 protein that interacts with the N-terminal domain of the Tim23 protein in the intermembrane space and regulates mitochondrial protein import of presequence-containing polypeptides Both parents are heterozygous. CONCLUSION: Given the phenotypic similarilty of the patients from two unrelated families and an earlier report of mutations in additional family, we conclude that TIMM50 gene mutation results in a novel mitochondrial disorder with 3-methyl glutaconic aciduria. INTRODUCTION 3-methylglutaconic aciduria (MGCA), an increase in urinary 3-methylglutaconic acid or 3-methylglutaric acid, can be a nonspecific finding in mitochondrial disorders, organic aciduria, urea cycles disease, neuromuscular disorders. but is a consistent abnormality of 3-methylglutaconyl-CoA hydratase deficiency and patients with mutations in TAZ, SERAC1, OPA3, DNAJC19 and TMEM70 gene1. These genes all encode mitochondrial membrane or membrane related proteins. In 3-methylglutaconyl-CoA hydratase deficiency due to mutation in AUH gene , 3-methylglutaconic acid derives from 3-methylglutaconyl CoA (3MG CoA), an intermediate in leucine catabolism1. It has been proposed that in other disorders, 3-methylglutaconic acid derives from aberrant isoprenoid shunting from cytosol to mitochondria via mevalonate pathway or redirection of mitochondrial acetyl CoA toward production of 3MGA due to an increase in the intra-mitochondrial NADH/NAD+ ratio resulting from mutation induced impairment in electron transport chain or Kreb cycle function 2. Examples of mitochondrial include Barth syndrome, a cardioskeletal myopathy with neutropenia, abnormal mitochondria and MGCA. Barth syndrome is caused by X-linked recessive mutations in the TAZ gene which encodes the mitochondrial membrane localized transacylase involved in the maturation of cardiolipin. Autosomal recessive mutations in the OPA3 gene (OMIM: 606580), the mouse ortholog of which encodes a mitochondrial inner membrane protein of unknown function, cause MGCA3 (OMIM: 258501), a neuroopthalmologic syndrome characterized by early-onset bilateral optic atrophy and later-onset spasticity, extrapyramidal dysfunction and cognitive deficit. MGCA5 (OMIM: 610198) is yet another form of MGCA caused by autosomal recessive mutations in the DNAJC19 gene (OMIM: 608977) and in addition to increased urinary excretion of 3-methylglutaconic acid, patients present with infancy or childhood onset dilated cardiomyopathy, microcytic anemia, mild muscle weakness and ataxia. Many patients die of cardiac failure. The DNAJC19 gene encodes the human homolog of the yeast Tim14 which is a part of the Tim23 mitochondrial protein import machinery and hasbeen shown to interact with the mtHsp70 in an ATP-dependent manner to regulate Tim23 function (Davey, 2006). WE report a distinct type of 3-methylglutaconic aciduria resulting from a mutation in mitochondrial TIMM50 gene in 3 sibs from a consanguineous family. We initially reported these xases in abstract form. Recently two different mutations in mitochondrial TIMM50 gene have been reported in four patients with 3 methylglutaconic aciduria, epilepsy, severe intellectual disability and lactic acidosis. Subjects Family 1 Family 1 has three affected sibs of South Asian ancestry with intractable epilepsy, microcephaly, developmental delay, visual deficit spastic quadriplegia. Two affected sibs died unexpectedly when they were visiting families in a remote area of a South Asian country. Metabolic testing had revealed large amount of 3-methylglutaconic acid in urine in all three affected sibs. The patients have a healthy brother and a healthy sister. Mother and father are first cousins. Detailed clinical history, imaging, EEG and metabolic testing were obtained for all affected persons. Full exome sequencing was performed using genomic DNA isolated from one surviving patient, two healthy siblings and both parents. Patient IV-1. Patient IV-1 was the first born child of the parents and was born at 36 weeks gestation after a normal pregnancy and delivery. Her weight at birth was 1.99 kg. Her weight, height and head circumference were always below 5th centile. She also had asthma and frequent episodes of pneumonia presumably due to aspiration, but the family refused G-tube placement. She was severely delayed. She never sat, stand or spoke. She has poor head control, truncal hypotonia but very brisk tendon jerks and sustained clonus. Funduscopy revealed bilateral optic atrophy. She developed seizures at 1 year of age. EEG revealed multifocal spikes arising from both hemispheres. She was treated with phenobarbital and Zonegran but family was noncompliant with medications. She continued to have daily myoclonic jerks. MRI at 2.5 and 5 years of age showed increased T2 signal in basal ganglia and periventricular white matter, brain atrophy, prominent ventricle, increased extraxial fluid. Normal liver en zymes and blood count, normal blood and CSF glucose and a serum ammonia of 21. Several serum lactate levels were mildly elevated. Lactate 2.8, 4.5 (Pyruvate 0.23), 5.4 (normal 0.7 to 2.1) Lactate to pyruvate ratio 20:1. Urine organic acid analysis revealed very high lactic acid, 3-methylglutaconic acid, and 3-methylglutaric acid. Muscle biopsy revealed only scattered atrophic muscle fibers on electron microscopy. Respiratory chain enzyme activities were within normal limits. She died at 7.5 years of age apparently due to complications from an infection while she was visiting families in a remote area of a South Asian country. Patient IV-4 was twin A born at 36 weeks gestation after an uncomplicated twin pregnancy. Her weight, height and head circumference were always below 5th centile. She was severely delayed. She never sat, stand or spoke. She has poor head control, truncal hypotonia but very increased reflexes and spasticity in the limbs. At nine-month-of age, she started to experience several episodes of eye fluttering and body jerking. Her EEG reved slow background, poor sleep architecture and frequent multifocal spike and sharp wave activities coming from both the left and right hemispheres. Her seizures were treated with Zonegran and was poorly controlled but parents refused more aggressive treatment of seizures. Metabolic testing revealed mild elevation of lactate and moderate increase of 3 methylglutaconic, 3 methylglutaric acids in urine. A brain MRI at 11-month-of age revealed diffuse volume loss supratentorially with prominent sulci and extraaxial fluid spaces, mild enlargement of the ventricl es and patchy signal abnormalities in the basal ganglia bilaterally, especially involving the caudate nuclei and putamen. On spectroscopy with voxel placed in the right basal ganglia with short and long TE, there was a lactate peak which inverted on long TE spectrum. Also, the NAA peak was low with NAA to creatinine being 1.15 on short echo and 1.29 on long echo spectrum. Also, the choline was elevated with choline/creatine ratio being 1.00 on short echo and 1.41 on long echo images. She died at 1.5 years of age apparently due to complications of an infection while she was visiting families in a remote area of a South Asian country. Patient IV-5 is a 13 year old female of South Asian ancestry, with 3-methylglutaconic aciduria intractable epilepsy, microcephaly, developmental delay, visual deficit and spastic quadriplegia. She was born at 36 weeks gestation after an uncomplicated twin pregnancy. She was twin B and stayed in NICU for 18 days for feeding issues. Her weight was 1.4 kg and she was not intubated. Patient first presented with seizures at 3 months of age with eyelid fluter and jerking of extremities. Her initial EEG revealed multifoal spikes. Initial biochemical evaluation revealed normal serum and CSF glucose, normal ammonia and liver enzymes. Serum lactate and CSF lactate 4.24 mmol were mildly elevated . Lactate was 2.7. Ammonia 25. Serum amino increased alanine 43.6 micromol/dl (9.9-34.5). Csf lactate 4.24 mmol. CSF alanine 7 micromol/dl (0.6 -4.7). There were also mild elevations of serum and CSF valine, leucine, isoleucine and alanine and lysine. Urine organic analysis revealed moderate increase of 3 methylglutaconic, 3 methylglutaric, glutaric, adipic, suberic, and sebacic acids. MRI of brain at 11 months of age revealed severe atrophic changes involving gray and white matter, predominantly of the cerebrum. Grossly abnormal signal is seen in the basal ganglia, particularly the caudate nucleus and the putamen with relative sparing of the globus pallidus and thalamus. A recent MRI (at age 13 years) reveals severe but stable atrophic changes of the gray and white matter of the supra and infratentorial brain, stable white matter changes of the putamen, caudate nucleus and periventricular white matter, Scattered diffusion restriction in the retrotrigonal white matter, compatible with active demyelination and atrophic changes of the optic nerves. Her seizures were treated with with Keppra, Lamictal, Zonegran and Onfi. She also receives carnitine. She continues to have brief episodes of whole body stiffening each week, but the family was also not very compliant with medications. He r current EEG shows slow background for age, poorly formed sleep spindles indicatvie of diffuse neuronal dysfunction, frequent multifocal interictal spike and wave suggests increased risk of seizures arising from multiple foci and hypsarrhythmia in sleep . She has failure to thrive despite G-tube feeding. At 12 years of age, G-tube was placed due to history of aspirations. Height, weight and head circumference below 5th centile. She is severely delayed. She is nonverbal and never learned to sit independently, stand or walk. She recognizes family members, responds to their voice and looks and smiles at them. Her fundoscopy shows mild optic atrophy. She has bilateral esotropia and dysconjugate gaze. She has poor head control and truncal hypotonia, but her limbs are spastic and her tendon reflexes are very brisk. Family 2 Patient V:1 was the first son of Caucasian consanguineous parents (IV:4 and IV:5) of Eastern European origin. Within the context of an organic acid and amino acid study in young and adult subjects with non-syndromic developmental delay and intellectual disability, he was investigated at the age of 17 years and presented with a developmental language disorder (involving semantic, syntactic, and pragmatic components of the linguistic system), emotional and communicative problems (fearful, aggressive, and loner), and hyperactivity. On neuropsychological testing he showed a short attention span. The child was born at term after an uneventful pregnancy and his birth weight was 2.9 kg. At 4 months of age he was affected by myoclonic jerks that were controlled by administration of valproic acid and lamotrigine. Developmental delay was observed starting from the middle of the first year of life, accompanied by decreased muscle tone. He could walk without support only at 6 years. At last medi cal exam, the patient showed a reduced muscle mass (height 148 cm, Z-score 3.43; weight 38 kg, Z-score 4.21; BMI 17.1 kg/m2, Z-score 2.02) and a head circumference of 51 cm (Z-score 2.76). Due to refusal of parents, no brain imaging studies could be performed. Fundoscopic examination was normal. Laboratory tests, including creatine phosphokinase (CPK), liver enzymes and plasma amino acids, were normal. The profile of urinary organic acids showed a large peak of 3-methylglutaconic acid (113 mmol/mol creatine) and a slightly increased level of 3-methylglutaric acid (17 mmol/mol creatinine). Patient V:3 was the younger brother of V:1, the third child of IV:4 and IV:5. He was investigated at the age of 11 years and presented with a clinical phenotype (developmental delay and intellectual and behavioral disorder) similar to that of his brother. The pregnancy and early postnatal course was unremarkable and birth weight was 3.1 kg. At 3 months he received valproic acid and lamotrigine to control tonic seizures with sudden stiffening movements of arms and legs. The boy walked independently at 4 years. When he was 9 years, his growing parameters were: height 119 cm (Z-score 2.47), weight 22 kg (Z-score 1.91), BMI 15.5 kg/m2 (Z-score 0.38), and head circumference 48 cm (Z-score 3.52). Neuropsychological exam revealed mental retardation and impaired communicative skills, including poor language abilities (few repetitive words with no sentences). Occasionally, the patient is aggressive. Ophthalmologic examination revealed left esotropia. High levels of 3-methylglutaconic acid (15 5 mmol/mol creatine) were identified in urine, together with smaller amounts of 3-methylglutaric acid (22 mmol/mol creatinine). Patient V:5 was the second son of consanguineous parents (IV:9 and IV:10) related to those of patients V:1 and V:3. The girl was delivered by cesarean section because of growth arrest at 37 week. The neonate showed no external malformations. Birth weight was 2.1 kg. In the following years, the clinical phenotype was characterized by delayed developmental milestones, nocturnal enuresis, severe cognitive impairment, speech retardation, and lack of communicative skills. Results of the electroencephalogram were normal. No brain imaging data are available. On a few occasions, levels of ammonia and lactic acid were found to be slightly elevated, but these results could not be confirmed by repeated blood analyses. Plasma levels of amino acids are within normal range. Fundoscopic examination was normal up to 7 years, but since then there is evidence of mild bilateral optic atrophy. Urine levels of of 3-methylglutaconic acid and 3-methylglutaric acid were 176 mmol/mol creatine and 29 mmol/mol creatinine, respectively. DISCUSSION Deleterious Nature of the TIMM50 gene alteration: TIMM50 NM_001001563 c.1114G>A p.G372S The p.G372S variant (also known as c.1114G>A), located in coding exon 9 of the TIMM50 gene, results from a G to A substitution at nucleotide position 1114. The glycine at codon 372 is replaced by serine, an amino acid with somewhat similar properties. The alteration is not observed in healthy cohorts: Based on data from the NHLBI Exome Sequencing Project (ESP), the TIMM50 c.1114G>A alteration was not observed among 6,503 individuals tested. Allele frequency data for this nucleotide position are not currently available from the 1000 Genomes Project and the alteration is not currently listed in the Database of Single Nucleotide Polymorphisms (dbSNP). Though some variants may appear to be rare due to database-specific ethnic underrepresentation, rare missense alleles commonly exhibit a deleterious effect on protein function (Kryukov, 2007; Tennessen, 2012). The altered amino acid is conserved throughout evolution: The G372 amino acid position is completely conserved in eukaryotes all th e way from the yeast Saccharomyces cerevisiae to humans (Mokranjac, 2003). The alteration is predicted deleterious by in silico models: The p.G372S alteration is predicted to be probably damaging and deleterious by PolyPhen and SIFT in silico analyses, respectively. The amino acid is located in a functionally important protein domain: The p.G372S alteration is located in the conserved C-terminal domain of the Tim50 protein that interacts with the N-terminal domain of the Tim23 protein in the inter membrane space and regulates mitochondrial protein import of presequence-containing polypeptides (Geissler, 2002; Yamamoto, 2002; Guo, 2004). The alteration cosegregated with disease in the family herein: Co-segregation analysis revealed that this alteration is present in a heterozygous form in the mother, father and brother, and absent in the sister. Based on the available evidence, the TIMM50 c.1114G>A (p.G372S) alteration is classified as a likely pathogenic mutation. The TIMM50 gene is not currently known to underlie Mendelian disease (aka clinically novel). The TIMM50 gene function is consistent with the probands clinical presentation: The Translocase of Inner Mitochondrial Membrane 50 (TIMM50) gene (OMIM: 607381) is located on human chromosome 19q13.2 and consists of 11 exons. It encodes the Tim50 protein, a 353 amino acid 40 kDA homolog of the yeast Tim50 protein that functions as an integral part of the mitochondrial Tim23 protein import machinery by linking protein translocation across the outer and inner mitochondrial membranes. This interaction was confirmed by the coprecipitation of Tim50 with an antibody against Tim23 (Geissler, 2002; Yamamoto, 2002; Guo, 2004). The authors further confirmed that the C-terminal domain of Tim50 is located in the inter-membrane space (IMS) where it stably binds to the segment of Tim23 that spans the IMS and regulates its function. Nuclear encoded mitochondrial proteins are synthesized in the cytosol and subsequently imported into the mitochondria through the function of translocators, the TOM complex of the outer mitochondrial membrane (OMM), and the Tim23 and Tim22 complexes of the inner mitochondrial membrane (IMM) (Jensen, 2002). While the Tim22 complex is involved in the transport and insertion of proteins lacking the presequence into the inner membrane, the Tim23 complex is required to process and insert presequence-containing precursor proteins. The IMM generates a proton motive force that is critical for cellular energy synthesis (Stock, 2000) and the permeability barrier of the IMM needs to be maintained during the transport of proteins through the pore-forming Tim23 protein associated with other IMM proteins such as Tim14 (human DNAJC19), Tim17, Tim21, Tim44 and Tim50. Using various yeast IMM protein mutants, Meinecke et al. (2006) demonstrated that tim17 and tim21 mutant mitochondria displayed membra ne potential values that were comparable to wild type mitochondria, whereas tim50 mutant mitochondria showed a drastic reduction of the membrane potential. Further functional studies revealed that the Tim23 channel is tightly regulated by Tim50 in its inactive state to maintain the IMM permeability barrier and is opened only when presequence-containing polypeptide chains need to be translocated into the mitochondrial matrix or the inter membrane space (IMS). Loss of Tim50 function in yeast led to cellular growth arrest and reduced cell viability (Mokranjac, 2003). Knockdown to Tim50 expression in cultured human cells using RNA mediated interference resulted in an increase in the release of cytochrome c and apoptosis in response to cell death stimuli (Guo, 2004). A 50 kDa isoform of the human mitochondrial TIM50, TIM50a, consisting of 456 amino acids has been found to localize in nuclear speckles, specifically in the Cajal bodies, and interact with small nuclear ribonuclear proteins (snRNPs), the coilin protein and the Survival of Motor Neurons (SMN) protein (Xu, 2005) which has been implicated in Spinal Muscular Atrophy (SMA). The protein sequences of the mitochondrial TIM50 and the nuclear TIM50a are identical with the exception of additional 103 amino acids at the N-terminal of TIM50a that are the result of an alternative translational start sequence. This additional N-terminal sequence in TIM50a is thought to contain a putative nuclear localization sequence that allows the Tim50a isoform to display a nucleus specific localization. Based on their results, Xu et al. hypothesized that Tim50a might be involved in the regulation of snRNP biogenesis and possibly the function of the nuclear SMN protein encoded by the SMN1 gene. One of our patien ts had mulsle biopsy. Although there were atrophic changes, no neuropthic pattern was seen. Reference List (1) Wortmann SB, Kluijtmans LA, Rodenburg RJ et al. 3-Methylglutaconic acidurialessons from 50 genes and 977 patients. J Inherit Metab Dis 2013;36:913-921. (2) Ikon N, Ryan RO. On the origin of 3-methylglutaconic acid in disorders of mitochondrial energy metabolism. J Inherit Metab Dis 2016;39:749-756. Legends Legend to Figure 1 Five-generations pedigree of the family with mild 3-methylglutaconic aciduria in which the TIMM50 p.(Ile293Thr) was identified. Subjects V:1, V:3, and V:5 (filled symbols) are patients suffering from intellectual disability and increased urinary excretion of 3-methylglutaconic acid. They are born to consanguineous parents and homozygous for the TIMM50 c.1011T>C mutation predicting the replacement of isoleucine 293 with threonine in the encoded protein. The mutation was inherited by a common ancestor (either I:1 or I:2) and has been identified in the heterozygous state in the clinically and biochemically unaffected subjects III:3, III:4, III:9, IV:2, IV:4; IV:5; IV:9, IV:10, and V:2.

Comparison of Business Practices in the US and China

Comparison of Business Practices in the US and China Diverse cultures of US and China Culture rules nigh on every particular phase of your life and like many, you are completely unacquainted of this. If inquired, you would define culture as architecture or language, music, visual arts, literature and you wouldnt be wrong. Nevertheless you wouldnt be completely right either. The United States of America is one of the multi ethnical, multi racial and multi cultural countries in the world. It has a highly diverse culture which has helped in forming its unique values. This diversity in culture can also be distinguished geographically where certain groups in different geographical locations have formulated a unique culture among themselves which is quite contrastingly diverse from mainstream American culture. They are Asian-American, Afro-American and Hispanic cultures. China can be listed as a country that has a very rich culture, certain aspects of which dates back to the ancient civilizations 5000 years back. This has been passed down from generation to generation thus preserving its identity and richness. It can be stated that it’s unique, diverse and yet harmoniously blended culture is a priceless asset to the world. The business practices of China and US The world of international business as we all know consists of people from different real and virtual work places in countries. Therefore it is important to know about a countries culture in order to adapt to it and be successful. Culture is complex and multi dimensional, to understand its basic nature we need to consider the Elements of culture. â€Å"Language† the key to culture transmits information. The Americans have commonly around 15 languages. Their main languages are English, Spanish and Indo European. Chinese have over 90 languages with 8 main languages where Mandarin is commonly used. A low context culture’s communication is precise and direct. But in terms of High context culture a lot of terms and facts that go unsaid. Practically Americans tend to communicate directly while the Chinese communicate indirectly, which eventually turns out to be a frustrating situation for Americans as they are quite unsure of what the Chinese expect. This is so while the Chinese feel unsettled by their direct approach. There are over 15000 â€Å"religions† in the world. China is a multi religious country which comprises mainly of three religions such as Confucianism, Taoism and Buddhism. They believe that this world is an illusion and that everything is temporary. Also, that all living things including human beings constantly go through a process of life and death. They also believe in reincarnation. Somehow on the other hand, America comprises mainly of Christian believers and the minorities of around 6% belong to other religions. There are also those who don’t practice in any religion. Every country has their â€Å"values and attitudes† that distinguish them from others. There are different sets of attitudes towards time and future. In US time is important and is equivalent to money while China’s attitudes differ from that. They believe that time is required to make important decisions and look out for long term relationships with their business partners. This creates a contrast affecting their business transactions. â€Å"Customs† too are related to international business. US is physically isolated from all countries except Canada and Mexico. This has contributed to the isolation and the lack of concern towards the rest of the world unless they are threatened by another country or state. China however is connected to many other Asian countries and tends to be interdependent and concerned other nations. Americans have their food eaten using the folk and spoon while the Chinese use chopsticks. Americans tend to shake hands, hug, kiss on the cheek, gesture with one’s hands and use the first names while speaking to adults. Chinese however tend to bow or nod and use fewer gestures as possible. These extreme diversities could be no challenge if each country respects each other’s culture. We live in a technologically advanced global age. So its fairly obvious that international businesses take place among various countries. So how do people understand and communicate among each other? How do people understand their cultures respectively? Its rather difficult. But International businesses are taking place among each and every country due to the wide spread technological and demographical advancement of the societies living on earth. So to understand better and improve the standard of living, people should firstly understand the framework of assessing various cultures. These values are explained as Dimensions of culture by psychologist Dr Geert Hofstede. He further went on to explain that this cultural dimension consists of 5 principles. Power distance Individualism/ collectivism Masculinity/ femininity Uncertainty avoidance Long term/short term orientation Dr. Hofstede found many similarities and differences among these 5 dimensions. And he elaborated that, Building connections with people from around the world is just one dimension of cultural diversity. And therefore we should need to factor it into motivating people, structuring business related projects and developing strategy. USA and China we find similarities and differences with regard to these 5 dimensions. So for simplicity we could explain the dimensions, in a line graph between both China and the United States. Comparison between China and USA in regard to the 5 dimensions of Hofstedes values The buying behavior of consumers Buyer behavior refers to the decision making process and acts of the buyer in purchasing a particular good or a service. The buyer behavior regarding a product may change with the type of culture existing in a country. However the steps in the consumer decision making process remains the same and thus can be used as a suitable instrument in analyzing the behavior of consumers in two countries that are culturally contrasting. Figure 1 consumer decision making process In China, the key cultural drivers of purchasing decision making are philosophies such as Confucianism and Taoism as well as the collectivist nature of society. China being collectivists in nature gives much consideration to the voice of the public as well as ‘face’ (Mianzi) and ‘relationship’ (Guanxi) issues. In the USA, individualism plays an important role in all consumer decisions as well as religion, race and geographic location. China US Need recognition and problem awareness Both Confucianism and Taoism focus on family values. Chinese individuals have a deep sense of immediate family bindings. In every family unit, the elders are greatly respected. At the same time youngsters are also given importance and prioritized for being the ‘roots’ of generation continuation. As a result, when recognizing the needs of family, the needs of their children are given more importance. Ex: education needs of children are considered crucial in Chinese households as well as children’s healthcare products. As a developed western country, individualism tends to be the key ingredient that drives buying decisions. Individuals are encouraged to trust their personal judgment and thus when recognizing needs, individual needs are given more preference rather than collective needs. Information search In China, the buyers prefer word of mouth information to other sources. This aspect is related to collectivism. Buyers want to ‘be the same’ as others in their respective group so that they will be accepted. Acceptance is a vital factor for them. Due to this, they inquire from their friends, acquaintances or relatives regarding a certain product. This is how conformity of a product is decided. In mainstream culture of US, buyers receive information mainly through digital networks due to the various advancements available in electronic medias and the flexibility of US individuals to adapt to new technology. Meanwhile in varied sub cultures located across geographic boundaries traditional means are also used in getting informed regarding a certain product. Evaluation of alternatives In terms of public reputation (Mianzi) issues, Chinese individuals wish to put up a good ‘face’ for the others in their respective group to show their wealth and certain other factors. This issue distinctively promotes purchase of luxury products. But it has been also found out that there is more involvement in evaluation of alternatives when purchasing a product for social value rather than for private consumption. Americans usually do not bargain in front of a store owner. The social environment could affect the consumer behaviour in America. For example they would prefer eating corn flakes and ham instead of rice. Americans tend to seek goods with variety and have impulse purchases. This is so because they live a faster life than of Asian countries. Post purchase evaluation Buyers usually show concern post purchase and feel that an alternative would have been preferable. In this case, brand switching occurs the next time which the customer purchases. But, if they receive the social recognition intended for which they originally bought the product or receive a positive feedback from the society, the brand switching decision would not necessarily be taken. Americans usually would try something new when purchasing the next time. However if they are fully satisfied with a product they shall preferably buy it the next time as well. But their decision is rather unpredictable. Future economic development of China and US In 1978, china was one of the poorest countries in the world. Their real per capita GDP in China was one-fourth of US real per capita GDP. Since then every year China was able to grow at 8% every year. As a result they are now one-fifth of the US level and at the same level as Brazil. China was under the communist rule since the revolution in 1949. After the leadership in 1978 china moved away from the central planning and government oriented policies towards a more decentralized economy. China is now a market economy making it a strong role for development of the state. The United States were always a market economy and the economy represents very small roles played by the government. When focusing on the employment rates and wages of the Chinese labour force it is relatively cheaper in a global context. This could lead China to being one of the strongest economic forces of the future and it could also be a significant factor for many international businesses. In china it is believed that work-life is about integration and harmony within work forces. A balanced work life and family life is not a significant aspect in China. Chinese employees do not interact socially but are more domestic oriented. US employees on the other hand are more work oriented. But it also differs according to their social class. For Example the lower level employees work seven extra hours a week which is equivalent to an average day’s work. The Chinese employment relationship strongly influences the work place to be â€Å"family like† while US prefers to have a professional working environment. The concept â€Å"work hard play hard† applies directly to the US work forc e. China has the largest population in the world being 1.357 billion as at 2013 where as the US population only counts to 316.1 million as at 2013. Firstly, internal migrants have supplied abundant labour to the Chinese economy. Secondly a large number of Chinese are 60 years or older and Finally, Chinese families have only one child based on their three decade old policy. These factors will in future represent a crisis since these effects are hard to reverse back. The US population mostly consists of senior citizens. That is, 13% of the population are more than 65 years old and is expected to increase to 20% by 2050. Also the population of young people is expected to rise in contrast to China. Since 2002 US is the largest economy in the world. China achieved a rapid growth in 2010 where it became the second largest economy, beating Japan. Since then US and China are the competitive nations of the world. The predictions of future economic rates as at 2019 are that the US GDP would be 22.1 trillion dollars compared to China with 14.8 trillion dollars. US is more service oriented where as China has a balance between Service and Industries The Unemployment Rate in China as reported by the Ministry of Human Resources and Social Security of the people’s republic of china has remained unchanged being 4.10 percent in the third quarter of 2014. Compared to China, even though the rate of unemployment in USA is high â€Å"6.2%†; USA has achieved a drastic drop in its unemployment rate compared to its figures in the last five years, Which is a highly favorable for its economic growth in the future. However, china has not made any measures to address their rate of unemployment.   Chinese still poses less prospective than Americans to Say They Live Comfortably:Superficially at odds with the countrys growth and sense of economic positivity, the Chinese have not grown more likely to feel they can live comfortably on their current income over the past six years. In 2012, 58% said they were able to get by on their current earnings, an amount that has remained relatively fixed. About a third (32%) is finding it verydifficult to earn just enough money to live on, and this rate has similarly continued basically constant. This would seem to suggest that economic progress has not yet directly translated into a more monetarily secure population, or, on the other hand, that as the Chinese sense wealthier, they find themselves attaining new requirements. And, one in 10 Chinese claim that they are living comfortably on their current revenue, a percentage that has shown no growth over time. Americans continue to maintain a much better average than the Chinese regarding their individual revenues. A plurality (38%) in 2012 said they were living comfortably on their current revenue; additional 34% said they were getting along. A quarter of Americans have found it very difficult to live with their current income. Although they are greater than the Chinese on this metric, Americans opinions of their capability to live a comfortable life have been affected by the recession. They are a reduced amount to be expected now than in 2007 to feel they can live comfortably on their present-day income and more probably to feel it is challenging to live on it. Reference List Hofstedes Cultural Dimensions Cross-Cultural Skills from Mind Tools. 2014.Hofstedes Cultural Dimensions Cross-Cultural Skills from Mind Tools. [ONLINE] Available at: http://www.mindtools.com/pages/article/newLDR_66.htm. [Accessed 22nd October 2014]. Journal of Communication Volume 48, Issue 4 December 1998 Wiley Online Library. 2014. Journal of Communication Volume 48, Issue 4 December 1998 Wiley Online Library. [ONLINE] Available at: http://onlinelibrary.wiley.com/doi/10.1111/jcom.1998.48.issue-4/issuetoc. [Accessed 22nd October 2014]. Chinese Culture, China Culture Center, Facts, Ancient Custom and Tradition. 2014. Chinese Culture, China Culture Center, Facts, Ancient Custom and Tradition. [ONLINE] Available at: http://www.chinahighlights.com/travelguide/culture/. [Accessed 25thOctober 2014]. Chinese Traditions and Culture. 2014.Chinese Traditions and Culture. [ONLINE] Available at:http://www.chinese-traditions-and-culture.com/. [Accessed 27th October 2014] Lesson in American Culture and American Values. 2014. Lesson in American Culture and American Values. [ONLINE] Available at: http://www.internationalstudentguidetotheusa.com/articles/culture.htm. [Accessed 28th October 2014]. Need Recognition. 2014. Need Recognition. [ONLINE] Available at: https://www.boundless.com/marketing/textbooks/boundless-marketing-textbook/consumer-marketing-4/consumer-decision-process-40/need-recognition-200-4088/. [Accessed 1st November 2014]. Opinion Briefing: U.S. vs. China Strengths and Weaknesses . 2014. Opinion Briefing: U.S. vs. China Strengths and Weaknesses . [ONLINE] Available at: http://www.gallup.com/poll/162965/opinion-briefing-china-strengths-weaknesses.aspx. [Accessed 2nd November 2014]. China has the worlds fastest growth in living standards China.org.cn. 2014. China has the worlds fastest growth in living standards China.org.cn. [ONLINE] Available at: http://www.china.org.cn/opinion/2013-10/24/content_30391004.htm. [Accessed 2nd November 2014]. China’s Population Destiny: The Looming Crisis | Brookings Institution . 2014. China’s Population Destiny: The Looming Crisis | Brookings Institution . [ONLINE] Available at: http://www.brookings.edu/research/articles/2010/09/china-population-wang. [Accessed 2nd November 2014]. The Changing Demographics of America | 40th Anniversary | Smithsonian. 2014. The Changing Demographics of America | 40th Anniversary | Smithsonian. [ONLINE] Available at: http://www.smithsonianmag.com/40th-anniversary/the-changing-demographics-of-america-538284/?no-ist. [Accessed 2nd November 2014]. Journal of Consumer Psychology | Vol 12, Iss 2, Pgs 69-176, (2002) | ScienceDirect.com. 2014.Journal of Consumer Psychology | Vol 12, Iss 2, Pgs 69-176, (2002) | ScienceDirect.com. [ONLINE] Available at:http://www.sciencedirect.com/science/journal/10577408/12/2. [Accessed 2nd November 2014]

Evaluation of the Fractal Dimension of a Crystal :: Chemistry Chemical Papers

Evaluation of the Fractal Dimension of a Crystal Abstract The purpose of this experiment was to determine the effects of voltage and molarity changes on the fractal dimension of a Cu crystal formed by the re-dox reaction between Cu and CuSO4. Using the introductory information obtained from research, the fractal geometry of the Cu crystals was determined for each set of parameters. Through the analysis of data, it was determined that the fractal dimension is directly related to the voltage. The data also shows that the molarity is inversely related to the fractal dimension, but through research this was determined to be an error. Introduction A fractal is a geometric pattern that is repeated indefinitely that it cannot be represented with typical mathematics. Fractals can be seen in nature in the way minerals develop over time, the manner in which trees limbs shoot from the trunk, and the development of the human body (i.e. the lungs)1. These fractals determine a way to attempt to simplify the randomness of the universe via probability and theories regarding diffusion and intermolecular attractions. The way dimensions in typical geometry are the typical 0-D, 1-D, 2-D, and 3-D. However, much matter does not fit these basic categories. A great example is a snowflake. If the negligible depth of a snowflake were ignored, it would be considered a 2-D object. However this is not completely true. A 2-D object can always be described by a finite number of tiles all in the same plane, because the snowflake cannot be described with only planes and also requires lines, it can be assumed it possesses properties of both a 1-D and 2-D object. A snowflake can be loosely approximated as a ~ 1.5-D object. This is fractal dimension of the object. In order to determine a more exact fractal dimension of an object, smaller and smaller pieces are zoomed in upon and used to determine a rough estimate of the amount of pieces that exhibit the same pattern (self-similarity) as the whole object. The relationship between the zoom and self similarity of the object determine the fractal dimension: