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Wednesday, October 30, 2019
Brake disc Essay Example | Topics and Well Written Essays - 500 words
Brake disc - Essay Example The braking system is a crucial element of modern day automobiles (Kuroki, et al., 2000, p.34). Apart from automobiles, the brake system also plays a critical role in bicycles, carts, motorcycles and other motor-propelled machines in the transport sector. It is argued that the operation of the brake system involves a lot of friction between the brake disc and the wheel. In scientific terms, it is the change of kinetic energy into heat energy. During this process, the car rotor rotates in the clockwise direction, as the driver steps on the brake pedal the disc is pushed towards the rotor. The resultant friction causes the vehicle to stop (Brancolini, 2003, p. 441). The brake system is comprises three key parts the iron disc, the brake pads, and hydraulic pistons. The metal disc is fixed on the wheel on which friction is applied by the brake pad. The hydraulic pistons control the movement of the brake pads. The entire braking process is initiated the brake pedal. As the driver steps on the brake pedal, the hydraulic fluid moves from the master cylinder to the slave cylinder. As a result, it pushes the slave pistons; the slave piston pushes the brake pad on the metal disc. The resultant friction stops the vehicle. The hydraulic system reduces work easier since the pressure exacted on the lever is distributed to all wheels (Miller, 2002, p.43). Friction is a primary cause of wear and tear of the brake disc. Therefore, a number of conditions should be met to enhance its durability. During the braking process, kinetic energy is converted into heat energy. As a result, the temperature of the brake disc increases significantly. The high temperature has a major effect on the brake disc material resulting in wear and tear of the brake disc. According to research, the temperature generated on the brake disc is estimated to range from 300 to 800 degrees Celsius. Such high temperature causes the brakes disc to crack hence rendering it useless
Monday, October 28, 2019
Acoustics and You Essay Example for Free
Acoustics and You Essay The article is about waves; it clearly points out the importance of wave particles and energy to the survival of life on the planet with respect to the importance of sound waves; it includes the various applications to which sound waves have been put to use by man. The first and most important is communication, sound waves form the basis of our daily human interactions without which man would be reduced to mere inanimate objects strangulated in the wilderness of oblivion. The emphasis is on acoustics, the science of sound waves in relation to speech and hearing, engineering, physical acoustic and noise. The article spells out the areas of life where acoustics is applicable. It details the use of this science as a career to make a living. An understanding of these applications is an eye-opener to the opportunities that lie latent in this field. Indeed, one can make a fortune from such a carefully-thought out career. The points are well outlined by the author; his thoughts are simply and logically arranged in such a way that it is easy to understand for everyone. The presentation is really good. REFERENCES Acoustics and You. Accessed from http://nature. skku. ac. kr/~acoustic/acou-and-you. h
Saturday, October 26, 2019
Andrew :: essays research papers
Andrew Jackson and his policies strengthened the new American nationalism. Through his actions during his presidency, he changed the nation into a more nationalistic country. Jackson was a man of the people, and he strongly felt that the common man was the power behind government. There were many different aspects that mirrored Jackson and American nationalism. Many factors, including his personality, his policies, his actions, and the way he mirrored American nationalism changed America into what become less of an aristocracy and more of a democracy to benefit the common man. Jackson was a man of humble background. In his time, a man that was born in a cabin was looked upon highly, and some of those with more noble upbringings actually apologized for not being born in more humble surroundings. Jackson was a brash, strong-willed man. He first got his fame in 1815 when he defeated the British Army at New Orleans with his untrained militia. Then in 1818, he violated Spanish territory without any authorization and hung 2 Spanish subjects for supposedly aiding some of the Indians that were being hunted. He lost the election for presidency in 1824, and claimed it was done so by a "corrupt bargain: between Adams and Clay. He finally got his presidency in 1828. Most of his votes came from the West and South. When he was in office, he made it clear that he would get his way. He was labeled "King Jackson the First" by some and he expanded the power of the President. He supported a strong national government and used his power to get what he wanted. He vetoed 12 times in his 2 terms in office. His presidency was one of violence, and a sort of monarchy rule. The second main point that Jackson strengthened nationalism is his policies while in office. Jackson firmly believed that the government should be restricted to become the "simple machine which the Constitution created". He was truly a man of the people. He also ignored many of the decisions made by the Supreme Court. Another thing was the Jackson had a strong personality and was well liked. However, I feel that many of Jackson's supporters didn't know where he stood on the views, but they supported him because he was a man of the people. He didn't make his view clear many times, but still received support from the people.
Thursday, October 24, 2019
Healthcare-associated infections (HAIs) Essay
BACKGROUND Healthcare-associated infections (HAIs) are bacterial infections acquired during a patient’s stay in a healthcare institution. It imposes a huge burden on healthcare institutions, costing billions of dollars for additional care costs as well as a significant fraction of lost lives (Houghton, 2006). Current estimates depict that approximately 2 million patients acquire healthcare-associated infections (HAIs) or nosocomial infections each year, of which 90,000 to 100,000 patients die (Houghton, 2006), making HAIs not only a national health problem, but a global threat as well. Common HAIs include hematological, surgical site, dermatological, respiratory, urinary and gastrointestinal systems. In order to control the increase in number of healthcare-associated infections, it is fundamental to identify key factors that make healthcare institutions susceptible to such outbreaks. There is a need to evaluate the sensitivity and efficiency of healthcare institutions to healthcare-associated infections in order to prevent future outbreaks. PROBLEM STATEMENT            This study will investigate the sensitivity of detection and efficiency of reporting healthcare-associated infections to the hospital administration, in the context of providing measures in improving the current surveillance program in the country. The guidelines to identification of a healthcare associated infection will be evaluated through personal interactions with healthcare workers using questionnaires which will be designed using a multiple choice approach. CONCEPTUAL/THEORETICAL FRAMEWORK            This study is based on the need to address the current epidemic of healthcare-associated infection that is emerging around the world. Before an effective solution to the problem is designed, it is essential that shortcomings in the standard procedures of healthcare institutions be identified. This may be done by determining the level of sensitivity of healthcare personnel to symptoms of healthcare-associated infections, as well as knowing what are the first set of actions to be done once an infection is confirmed within a healthcare institution. This study may serve as the first measurement tool that addresses these aspects of the global epidemic.  RESEARCH QUESTION/HYPOTHESIS            This investigation aims to address the question of whether the current hospital administration is sensitive enough to detect and substantially efficient to report to healthcare institutions any incidents of healthcare-associated infections. This will be directly evaluated using survey data collections from retrospective cases of particular health institutions as related to dates of hospital admission, confirmation of infection and treatment time.  SIGNIFICANCE OF THE STUDY            There is a need for an effective surveillance and control program for healthcare-associated infections that are based on current settings in a healthcare institution. Through surveys that inquire on common practices and responses of healthcare workers, any shortcomings or avoidable gaps in the hospital system may be reformed, which in turn will alleviate the spread of infection in the healthcare institutions. Review of medical records and interviews with attending healthcare personnel will be performed in order to determine whether there are certain discrepancies and gaps in the healthcare protocol that facilitate contamination and further spreading of infectious microbials around the healthcare institution. This study may facilitate the identification of key factors that influence the increase in frequency of nosocomial infections in hospitals. The results of this investigation may positively serve as a tool to healthcare workers such as nurses and laboratory technicians. STATEMENT OF THE PURPOSE (OBJECTIVES)            This research will determine the sensitivity and response rate of healthcare workers to healthcare-associated infections. This proposal aims to develop a measurement tool that will determine the sensitivity for identification, efficiency of reporting and the response rate to a healthcare-association infection, with the aim of designing a cost-effective and quick way of controlling and ultimately eradicating the healthcare-related problem.   LITERATURE REVIEW            The prevention and control of HAIs requires a comprehensive approach that addresses as many pathogens as possible (Wiseman, 2006). Urinary tract infections (UTI) associated with catheter use are the most common HAIs, with hospital-acquired pneumonia having the highest mortality rate (Houghton, 2006). These infections are frequently problematic to treat due to the fact that the microorganisms involved have become resistant to antibiotics (Broadhead, Parra and Skelton, 2001). Recent media coverage of meticillin-resistant Staphylococcus aureus (MRSA) has increased the awareness of healthcare professionals to the threat of this particular microbe. S. aureus infections can result in cellulitis, osteomyelitis, septic arthritis and pneumonia, and some of the systemic diseases such as food poisoning, scalded skin syndrome and toxic shock syndrome (Zaoutis, Dawid and Kim, 2002).            MRSA and vancomycin-resistant Enterococcus (VRE) are the primary causes of nosocomial infections and are significant factors in increased morbidity and mortality rates. These microbes are currently endemic in many healthcare institutions, particularly problematic in intensive care units (ICUs) (Furuno, et al. 2005).  VRE Infections have become prevalent in U.S. hospitals over the last decade, increasing in incidence 25-fold (Ridwan et al., 2002). Vancomycin is the antibiotic frequently used to treat infections caused by MRSA, but recent years have seen the emergence of Staphylococcus aureus infections that have high-resistance to vancomycin, which makes the future effectiveness of this drug questionable (Furuno et al., 2005). All known variants of the vancomycin-resistant Staphylococcus aureus (VRSA) isolates have possessed the vanA gene, which carries with it resistance to vancomycin. This development is believed to have been acquired â€Å"when the MRSA isolate conjugated with a co-colonizing VRE isolate†(Furuno et al., 2005, p. 1539). This means that patients who suffer co-colonization from MRSA and VRE have an increased risk for colonization and infection by VRSA (Furuno et al., 2005). Furthermore, Zirakzadeh and Patel (2006) stated that VRE has become a major concern due, in part, to its ability to transfer vancomycin resistance to other bacteria, which includes MRSA.            Infection of susceptible patients typically occurs in environments that have a high rate of patient colonization with VRE, such as ICUs and oncology units (Zirakzadeh and Patel, 2006).  In these healthcare settings, VRE has been known to survive for extensive periods and research has also observed that VRE has the ability to contaminate virtually every surface (Zirakzadeh and Patel, 2006). Efforts to control HAIs, such as VRE, have focused on prevention, such as through hand hygiene, as the first line of defense.            Hand hygiene has been improved by using â€Å"user-friendly, alcohol-based hand cleansers, but there still remains the goal of achieving consistently high levels of compliance with their use†(Carling et al., 2005, p. 1).  Screening-based isolation practices have likewise improved transmission rates of MRSA and VRE; however, logistic issues and the cost-effectiveness of these practices are still being analyzed (Carling et al., 2005). Additionally, despite isolation practices, outbreaks and instances of environmental contamination have been documented in regards to MRSA, VRE and Clostridium difficile, which cannot be screened with any practicality (Carling et al., 2005).            The numerous obstacles that exist in regards to effective screening practices suggest that a focus on improving existing cleaning/disinfecting practices may prove to be more effective in halting the spread of HAIs (Carling et al., 2005). Studies over the last several decades have shown that there is often contamination of surfaces in and around the patient, as pathogens associated with the hospital environment have been known to survive on surfaces for weeks or even months (Carling et al., 2005). Significant rates of contamination with Clostridium difficile have been connected with symptomatic and asymptomatic patients (Carling et al., 2005).            In 2002, the CDC issued guidelines that called for hospitals to â€Å"thoroughly clean and disinfect environmental medical equipment†surfaces on a regular basis (Carling et al., 2005, p. 2). Other organizations have followed suit and stressed repeatedly the need for healthcare provides to focus on environmental cleaning and disinfecting activities, yet these guidelines have not provided directives that address precisely how healthcare providers can either evaluate their ability to comply with professional guidelines on this topic or ensure that their procedures are effective (Carling et al., 2005). Nevertheless, literature on the subject does offer some guidance.            Surveillance, evidence-based infection control practices and the responsible use of antibiotics have been determined to be crucial to controlling HAIs (Wiseman, 2006). The establishment of comprehensive surveillance programs has facilitated the creation of national databases the compile cases of infection which may be useful to researchers investigating progression rates and causal factors. Evidence-based control practices may be implemented by distributing guidelines for aseptic hospital protocols, hospital hygiene, personal protective equipment and disposal of biohazardous sharps. A review of commonly used antibiotics in terms of proper dosage and length of treatment based on clinical evidence and best practice guidance should also be performed.            Curry and Cole (2001) reported that the medical and surgical ICUs in large inner-city teaching hospitals developed an elevated patient VRE colonization rate. A multi-faceted approach was instituted to correct this problem, which involved changing behavior by â€Å"shifting norms at multiple levels through the ICU community†(Curry and Cole, 2001, p. 13). This intervention consisted of five levels of behavioral change. These encompassed: â€Å"1. intrapersonal and individual factors; 2. interpersonal factors; 3. institutional factors; 4. community factors and 5. public factors†(Curry and Cole, 2001, p. 13).            Educational interventions were developed that addressed each level of influence and behavioral change was predicated on â€Å"modeling, observational learning and vicarious reinforcement†(Curry and Cole, 2001, p. 13). These procedures resulted in a marked decrease of â€Å"VRE surveillance cultures and positive clinical isolates†within six months and this decrease has been consistent over the next two years (Curry and Cole, 2001, p. 13).            Research has shown that the nutritional status of preoperative and perioperative patients can influence their risk for acquiring a HAI (Martindale and Cresci, 2005). This is particularly true for patients who are undergoing surgery for neoplastic disease as this can commonly result in immunosuppression (Martindale and Cresci, 2005). Inadequate nutrition, â€Å"surgical insult, anesthesia, blood transfusions, adjuvant chemotherapy/radiation/ and other metabolic changes†have been identified as contributing to suppression of the immune system (Martindale and Cresci, 2005). Furthermore, studies have also associated infection risk with glycemic control Maintaining blood glucose levels between 80 and 110 mg/dL vs. 180 and 200 mg/dL has been shown to result in fewer instances of â€Å"acute renal failure, fewer transfusions, less polyneuroopathy and decreased ICU length of stay†(Martindale and Cresci, 2005, p. S53).            Citing Ulrich and Zimring, Rollins (2004) states that getting rid of double-occupancy rooms and providing all patients with single rooms that can be adjusted to meet their specific medical needs can improve patient safety by reducing patient transfers and cutting the risk of nosocomial infections. While these researchers admit that the up-front cost of private rooms is significant, this will be offset by the savings accrued through lowers rates of infection and readmission, as well as shorter hospital stays (Rollins, 2004).            A recent study conducted by researchers at Chicago’s Rush University Medical Center found that enforcing environmental cleaning standards on a routine basis resulted in less surface contamination with VRE, â€Å"cleaner healthcare worker hands, and a significant reduction in VRE cross-transmission in an ICU†(Cleaning campaign, 2006, p. 30). These improvement in VRE contamination continued to be experienced even when VRE-colonized patients were continually admitted and healthcare workers compliance with hand hygiene procedures were only moderate (Cleaning campaign, 2006). The strategies that the researchers implemented included that they: held in-services for housekeepers about why cleaning is important–emphasizing thorough cleaning of surfaces likely to be touched by patients or workers. increased monitoring of housekeeper performance. recruited respiratory therapists to clean ventilator control panels daily. educated nurses and other ICU staff on VRE and how they could assist housekeepers by clearing surfaces that need cleaning. conducted a hand hygiene campaign, including: mounting alcohol gel dispensers in common areas, patient rooms and every room entrance (Cleaning campaign, 2006, p. 30).            CDC guidelines indicate that if hands are not visibly soiled, using an alcohol-based hand rub should become habitual between patient contacts. When hands are visibly soiled, use of an anti-microbial soap and water is required. If contact with C difficile or Bacillus anthracis is possible, it is recommended that the healthcare provider wash with anti-microbial soap and water, as other antiseptic agents have poor efficacy against spore-forming bacteria and the physical friction of using soap and water at least decreases the level of contamination (Houghton, 2006). Page (2005) indicates that the CDC has joined with the US Department of Health and Human Services, the National Institutes of Health (NIH and the Food and Drug Administration (FDA) to lead a task force of 10 agencies and departments, which have developed a blueprint outlining federal actions to combat this problem. This template emphasizes the efficacy of hand washing, among other points (Page, 2005).            In 2002, the CDC issued updated hand hygiene guidelines, which address new development and research on this topic, such as â€Å"alcohol-based hand rubs and alternatives to antibacterial soaps and water†(Houghton, 2006, p. 2). However, while the efficacy of hand hygiene is well accepted, it is also well known that healthcare workers â€Å"of all disciplines†frequently fail to abide by adequate hand hygiene practices (Houghton, 2006, p. 2). In fact, research has shown that adherence rates to hand hygiene guidelines are lowest in ICUs, where to the frequency of patient care contact, multiple opportunities for hand hygiene exist on a hourly basis (Houghton, 2006). According to Houghton (2006), any direct patient-care contact, which includes contact with gloves and/or contact with objects in the immediate patient vicinity, constitutes an â€Å"opportunity†for appropriate hand hygiene.            This suggests that the proposed intervention should also include asking healthcare employees at the site of the intervention to participate in a survey that examines, first of all, how closely hand hygiene protocols are followed and, if they are not followed, why not. It may be that the activity level of ICUs is so great that the practitioners feel that they cannot take sufficient time to do adequate hand hygiene. If this is the case, alternative methods of hand hygiene to that institution’s traditional policy may need to be investigated.            Just as this study revealed factors that can be associated with non-compliance, a similar investigative effort may be called for to determine reasons why compliance may not be satisfactory for cleaning/disinfecting environmental surfaces. Again, it may be that non-compliance hinges on factors of time. It may be, therefore, expeditious for hospitals and other healthcare organizations to look into hiring additional personnel to aid with cleaning/disinfecting tasks. It may also prove necessary, to cope with factors of time and efficiency, to train cleaning personnel to take a systematic approach to patient room cleaning that includes all â€Å"high touch†areas. As noted previously, researchers at Chicago’s Rush University Medical Center found that holding in-service training for housekeepers was an effective component of their overall strategy in lowering VRE related infections (Cleaning campaign, 2006). This process could be facilitated by a checklist approach or by periodically reevaluating rooms according to the Carling et al. (2005) methodology.            Given these detailed accounts of healthcare-associated infections in hospitals, it is of significant importance that the sensitivity and response rate of health personnel be identified in order to know if there are any discrepancies and gaps in the standard hospital protocols that foster the expansion of microbials in hospitals. This study aims to determine the level of sensitivity and response rate of healthcare institutions to the growing epidemic of healthcare-associated infections.  SUMMARY            HAIs are an unnecessary tragedy, increasing morbidity and mortality figures and adding to healthcare costs. While there are ways to treat all the various HAIs, the clearest remedy for this insidious drain on healthcare resources and personnel is prevention, which begins with the simplest of acts–washing one’s hands–but also extends to considering all hospital surfaces as having the potential to harbor pathogens. This means rethinking some healthcare institutional procedures. It means habitually and routinely cleaning all surfaces, as well as everywhere and anything that is routinely touched, whether by a bare or gloved hand.            Stopping the spread of HAIs includes multiple factors, such as restrained and appropriate use of antibiotics. However, the first line of defense is cleaning/disinfecting procedures. This constitutes the â€Å"ground zero†foundational line for battling HAIs and this means that all healthcare practitioners should keep the goal of reducing the spread of HAIs foremost in their minds while going about their daily routines, washing hands between each patient contact and paying attention to other sepsis concerns. In other words, the first step in stopping HAIs is simply to keep them in the forefront of practitioner consciousness. References Broadhead, J. M., Parra, D. S., & Skelton, P. A. (2001). Emerging multiresistant organisms in the ICU: Epidemiology, risk factors, surveillance, and prevention. Critical Care Nursing Quarterly, 24(2), 20. Carling, P. C., Briggs, J., Hylander, D., & Perkins, J. (2006). An evaluation of patient area cleaning in 3 hospitals using a novel targeting methodology. American Journal of Infection Control, 34(8), 513-519. Centers for Disease Control and Prevention. (2006). Healthcare-Associated Infections (HAIs).  Retrieved March 17, 2007, from http://www.cdc.gov/ncidod/dhqp/healthDis.html Cleaning campaign targets VRE transmission. (2006). OR Manager, 22(7), 30. Curry, V. J., & Cole, M. (2001). Applying social and behavioral theory as a template in containing and confining VRE. Critical Care Nursing Quarterly, 24(2), 13. Furuno, J. P., Perencevich, E. N., Johnson, J. A., Wright, M.-O., McGregor, J. C., Morris Jr, J. G., et al. (2005). Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Enterococci co-colonization. Emerging Infectious Diseases, 11(10), 1539-1544. Harrison, S., & Lipley, N. (2006). Wipe It Out infection control initiative extended. Nursing Management – UK, 12(10), 4-4. Houghton, D. (2006). HAI prevention: The power is in your hands. Nursing Management, 37(5), 1-8. Johnson, A.P. Pearson, A. and Duckworth, G. (2005): Surveillance and epidemiology of MRSA bacteraemia in the UK.  J. Antimicrob. Chemo.  56:455–462. Lopman, B.A., Reacher, M.H., Vipond, I/.B., Hill, D., Perry, C., Halladay, T., Brown, D.W., John Edmunds, W. and Sarangi, J. (2004): Epidemiology and Cost of Nosocomial Gastroenteritis, Avon, England, 2002–2003. Emerg. Infect. Dis. 10(10):1827-1834. Martindale, R. G., & Cresci, G. (2005). Preventing Infectious Complications With Nutrition Intervention. JPEN, Journal of Parenteral and Enteral Nutrition, 29(1), S53. Page, S. (2005). MRSA, VRE and CDC’s plan to combat antimicrobial resistance. Vermont Nurse Connection, 8(3), 6-7. Parienti, J. J. M. D. D. T. M., Thibon, P. M. D., Heller, R. P. P., Le Roux, Y. M. D. D., von Theobald, P. M. D. D., Bensadoun, H. M. D. D., et al. (2002). Hand-rubbing with an aqueous alcoholic aolution vs traditional surgical hand-scrubbing and 30-day surgical site infection Rates. JAMA, 288(6), 722-727. Ridwan, B., Mascini, E., Reijden, N. v. d., Verhoef, J., & Bonten, M. (2002). What action should be taken to prevent spread of vancomycin resistant enterococci in European hospitals? British Medical Journal, 324(7338), 666. Rollins, J. A. (2004). Evidence-Based Hospital Design Improves Health Care Outcomes for Patients, Families, and Staff. Pediatric Nursing, 30(4), 338. Sheff, B. (2001). Taking aim at antibiotic-resistant bacteria. Nursing, 31(11), 62. STATA 8.0. College Station (TX): STATA Corporation; 2002. Stevenson, K.B., Searle, K., Stoddard, G.J. and Samore, M.H. (2005): Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci in rural communities, Western United States. Emerg. Infect. Dis. 11(6):895-903. Tacconelli, E. Venkataraman, L., De Girolami, P.C. and D’Agata, E.M.C. (2004): Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains. J. Antimicrob. Chemother. 53:474-479. Wiseman, S. (2006). Prevention and control of healthcare associated infection. Nursing Standard, 20(38), 41-45. Zaoutis, T., Dawid, S., & Kim, J. O. (2002). Multidrug-resistan organisms in general pediatrics. Pediatric Annals, 31(5), 313. Zirakzadeh, A., & Patel, R. (2006). Vancomycin-resistant enterococci: Colonization, infection, detection and treatment. Mayo Clinical Proceedings, 81(4), 529-536. METHODOLOGY            A retrospective non-probability cluster surveillance study will be performed on hospital records of two health institutions, Assir Central Hospital and Khamis Mushait Hospital from January 2002 to December 2006. Such coverage will represent a larger population of similar environmental and socioeconomic settings, which may also influence the frequency of healthcare-associated infections in the area. This type of non-probability cluster sampling will be used because it will benefit the split-level definition that will be followed, distinguishing normal hospital cases and healthcare-associated infections or outbreaks, based on the CDC’s guidelines for healthcare-associated infections. Ethical approval from the respective ethics review committee of each hospital will be obtained before the study will be conducted. Study population. Thà µ study population will includà µ 5,000 patià µnts that have been admitted at the Assir Central Hospital and Khamis Mushait Hospital from January 2002 to December 2006. These hospitals were chosen in order to primarily focus on collection of reliable, high-quality data based of systematic sampling. The hospital’s administrative database will serve as the main source of information for this study. For purposes of anonymity, patient’s names will be kept confidential and will be replaced with a case number instead. A retrospective non-probability sampling using patià µnt cases will be classified according to gender, age, diagnosis upon admission, length of stay and treatment received. The treatment category of the patients will be further characterized as surgical, respiratory, urinary, urological, obstà µtrical, intensive care, cardiac or trauma. Any co-morbidities will be taken note of in every patient included in the study.  Patient records will also be reviewed to determine whether and when a healthcare-associated infection was observed after admission to the hospital or during the patient’s stay in the hospital and will be identified as the time-at-risk, or the time when the infection has been ascertained and may most probably be contagious to the patient’s immediate environment. Among the inclusion subjects are healthcare workers such as nurses, laboratory technicians and other hospital staff members will be included in the study as population at risk. Exclusion subjects are those patients that were not admitted into the hospital because their stay in the hospital was not recommended during their healthcare.           The database of the infection control team of each of the two hospitals will be reviewed to gather information on the study population in the hospitals. Infection control nurses are responsible for monitoring any outbreaks in each hospital during hospital ward rounds, or are identified as the point-of-contact personnel that is alerted as soon as an HAI incident is suspected to occur in the specific ward of the hospital. Cluster sampling will be performed when an infection does happen that fits the clinical definition of an HAI, the healthcare institution is required to report this incident to the area’s or county’s health protection agency. The area or county health protection agency is in charge of ensuring the comprehensiveness of incident reports, monitoring data entry and conducting analyses. The health protection agency also collects reports during months that no infections were reported to verify that no inf ections occurred at that time. Tools to be employed. To determine whether a case patient has contracted a healthcare-associated infection, the system definitions established by the Center for Disease Control and Prevention’s National Nosocomial Infection Surveillance (NNIS) will be followed, with slight modification for usà µ in a rà µtrospà µctivà µ study. Thà µ NNIS dà µfinitions were dà µvà µlopà µd according to a prospà µctivà µ approach to hospital survà µillancà µ and arà µ dà µsignà µd to bà µ quità µ spà µcific. Bà µcausà µ clinical dà µcisions arà µ oftà µn not madà µ on thà µ basis of survà µillancà µ dà µfinitions, wà µ bà µlià µvà µ that somà µ casà µs of clinically suspà µctà µd infà µction would mà µÃ µt most but not all of thà µ NNIS crità µria and thus bà µ classifià µd as non-HAI, à µspà µcially on a rà µtrospà µctivà µ chart rà µvià µw. Wà µ designed a retrospective-based data classification scheme that follows the following criteria: patià µnts who were not infà µctà µd, thosà µ with suspà µctà µd HAI, and thosà µ with confirmà µd HAI. In gà µnà µral, patià µnts with suspà µctà µd HAI will includà µ thosà µ who have received antimicrobial thà µrapy for a condition that appà µarà µd 148 h aftà µr hospital admission and who will mà µÃ µt all but onà µ clinical crità µria for a confirmed infà µction. Dà µfinitions for a confirmed HAI will bà µ the samà µ as thosà µ usà µd by thà µ NNIS, à µxcà µpt that rà µcà µipt of appropriatà µ antimicrobial thà µrapy will bà µ à µxcludà µd as a crità µrion for a confirmà µd infà µction. Thà µsà µ crità µria will bà µ finalizà µd bà µforà µ chart data abstraction bà µgins. Thà µ à µconomic pà µrspà µctivà µ will bà µ usà µd for mà µasuring costs incurred by thà µ hospital, bà µcausà µ thà µ hospital administ ration will bà µ thà µ dà µcision makà µr for instituting and financing infà µction control programs. Data collà µction. Clinical cases of healthcare-associated infection identified by the clinical laboratories of the two participating hospitals will be compiled. Demographic, medical history and other epidemiologically relevant data on each reported case will be collected. The microbiology laboratory of the hospital may also contribute information to the data collection. The patient’s medical record will serve as the primary source of information for this study. The data collected will be recorded in a standardized data collection form. In addition, outbreak or infection summary forms that were previously completed by infection control nurses and reported to health protection agencies as a healthcare-associated infection will be collected and integrated into the study database. The duration of an outbreak will be determined by taking note of the date the first case of the infection was reported and correlating this date to the date when the last case of the infection was reported at the healthcare institution (Lopman et al. 2004). All data will abstracted from patià µnt mà µdical rà µcords of the healthcare facility. Intà µrratà µr rà µliability will not bà µ mà µasurà µd, bà µcausà µ à µach abstractor will bà µ focusà µd on rà µcording a singlà µ à µlà µmà µnt of data for à µach patià µnt, similar to an assà µmbly linà µ. All data gathering will bà µ dirà µctly supà µrvisà µd by a member of the research program. Patià µnts with suspà µctà µd or confirmà µd HAI will bà µ idà µntifià µd on thà µ basis of thà µir vital signs, laboratory and microbiology data, and clinical findings documà µntà µd in the respective physician’s progrà µss and consultation notà µs. To improve the validity of the collected data, the following approaches (Stevenson et al. 2005) will be employed: 1) a data dictionary and operations manual will be created with explicit instructions for completion of the data collection forms; 2) the data collection protocol will be discussed during conference calls along with frequent one-on-one communication; and 3) anomalous data in the data reports will be routinely searched for and corrected. The definitions employed in this study will concentrate on the location of the patient at the time of microbiological testing for infection diagnosis, and the presence or of exposure to the healthcare environment.  The study will emphasize the time of response of any member of the healthcare institution to the definitive diagnosis of the healthcare-associated infection (Johnson et al. 2005). Each identified HAI case will be further analyzed for its causative agent, such as MRSA or VRE. All included in this study were HAI cases with any prior history of hospitalization, out-patient surgery, residence or care in a home/health agency with documented healthcare-associated infections in the last 6 months. Examples would include former out-patient cases with post-operative infections. Other coexisting factors that may be associated with healthcare-associated infections such as diabetes mellitus, immunosuppression, renal failure and other antimicrobial drug treatments, will also be included in the data collection form. The incidence rates of each type of healthcare-associated infection will be calculated for each hospital from January 2002 to December 2006. Any patient cases that could not be ascertained to be completely reported in the medical records will not be included in the analysis. The incidence rates will be expressed as the number of healthcare-associated infections per 10,000 patient-days or number of community cases per 10,000-person-years, based on county population (Taconelli et al. 2004). Instruments including reliability and validity. A data collection form will be designed for use in this investigation. Essential entry data will include case number (patient name is kept confidential), hospital name, date of admission, diagnosis upon admission, treatment regime, date of detection of healthcare-associated infection, treatment of healthcare-associated infection, date of admission of treatment of healthcare-associated infection, identification of HAI etiologic agent, resistance of HAI etiologic agent and date of patient discharge. The healthcare institution personnel that have attended to the patient will also be noted, such as attending physician, consults, nurses, technicians and technologists.          In order to ensure reliability and validity of the data inputted into the application form, only medical records that have been completely filled will be used in this investigation. In addition, there will be questions in the application form that will determine whether the patient has undergone any previous exposure to any hospital for outpatient or inpatient hospital or nursing facility in the last 6 months. This is done to make sure that the source of the HAI is determined, whether it is coming from within the hospital or from another healthcare institution. Data Analysis. The collected data will be entered and stored in an AccessTM relational database (Microsoft, Redmond, WA) for analysis. AccessTM is a database management system that is very useful for handling and manipulation of data that are designed in the query format. It provides the analyst an easier way to extract data from the database according to selected fields or variables, as well as compare or combine two variables at one time. Data analyses will be performed using Microsoft ExcelTM and Stata 8.0 (2002). Proportions of total cases meeting specific epidemiologic criteria will be calculated, and characteristics of each category will be compared by using Fisher exact testing. To compare means, the t-test will be employed, and to compare proportions, the Ç2 test will be used. All continuous data will be analyzed using linear regression. To assess linear correlations between two variables, the Spearman rank test will be used. Census data and ages of patients in each category will be compared using the Kruskal-Wallis equality of populations rank test.  The relationship of healthcare institution response rates to the infection and other covariates will be modeled by using random effects Poisson regression. Each hospital will be taken into account as a unit and treated as a random effect. During thà µ initial phasà µ of data collection, dà µscriptivà µ statistics will be used to dà µscribà µ and summarizà µ thà µ data obtained in thà µ study. Thà µ sà µcond phasà µ of analysis will focus on thà µ usà µ of multivariatà µ analysis to dà µtà µrminà µ thà µ rà µlationship bà µtwà µÃ µn variables such as length of stay and the severity of infection. This will bà µ conductà µd through thà µ usà µ of cross tabulation of nominal data bà µtwà µÃ µn sà µlà µctà µd variablà µs in thà µ study. Statistical significancà µ is to bà µ sà µt at an alpha là µvà µl of 0.05; ANOVA will bà µ usà µd to à µxaminà µ thà µ variation among thà µ data. Along with it, ordinary là µast-squarà µs (OLS) rà µgrà µssion will bà µ usà µd to tà µst for linà µar rà µlationships bà µtwà µÃ µn variables tested. Suspà µctà µd HAI, confirmà µd HA I, and admission to ICU will bà µ codà µd as dummy variablà µs, with thà µ valuà µs of 1 that will bà µ assignà µd for patià µnts with thà µ attributà µ and 0 for thosà µ without it. Whà µn prà µsà µnt, thà µsà µ dichotomous variablà µs act as intà µrcà µpt shiftà µrs but do not changà µ thà µ slopà µ of thà µ à µstimatà µd rà µgrà µssion linà µ. Limitations of the study.  Since the study population is focus only on admissions in two hospitals, this investigation may not fully represent the country’s conditions on healthcare-related infections. However, such initial surveys on reaction rate of hospital administration to healthcare-associated infections may provide a baseline foundation for larger surveys around the country.   Ethical considerations.  There may be some hospital cases that are deemed private or uninvestigable. These will not be included in the investigation. In addition, this study will not consider race or ethnicity differences, because it is not necessary to consider such factors in this type in infectious disease research project.  Feasibility of the scope of this study. This investigation is feasible to conduct given the resources and time available to the investigator because it is a retrospective study that will only deal with medical records. Should the investigator feel that analysis of five years’ worth of patient cases from two hospitals is overwhelming, the duration of survey may be shortened to two years instead of five years. This will decrease the robustness of the data analysis, but it would also serve as a preliminary test to determine whether there are any initial trends that may be observed from the data collected from hospital-case data compiled for a two-year duration. Summary assessment. This study aims to assess the sensitivity and response rate of healthcare institutions to healthcare-associated infections by performing a retrospective analysis of hospital records from two participating hospitals for a duration of five years. Such information may be helpful in the evaluation of current guidelines for detection of nosocomial infections and the standard operating procedures as soon as ascertainment is reached. Recommendation. It is recommended that other hospital administrations collaborate with this investigation in order to generate a more comprehensive analyses of the current status of response rates of healthcare institutions to infections or outbreaks. Such collaborative effort may benefit the healthcare system in the near future and may also provide new measures on how to deal with factors that influence or cause etiologic agent-specific outbreaks.
Wednesday, October 23, 2019
Multimedia Technology Essay
This paper critically examines the affects of eCommerce on organisations and the significant growth of the technology. Many organisations are adopting the new technology to retain excellent relationship with customers, and the significant growth of eCommerce application is discussed and noted in this paper. This growth has raised numbers of security concerns and this paper outlines the security risks that associates with eCommerce and describes a number of ways to maintain and reduce the risks. In this paper, it is demonstrate how Cascading Style Sheet can be used to control the appearance and structure of the web-site, and also examine the use of open source reflective programming languages mainly used to develop server-side application and dynamic web content. This paper also examines the use of open source MySQL database application and its ability to store, retrieve and search data. By creating the web-site application, it shows how Cascading Style Sheet can control the appearance and structure of web-sites, and PREFACE The purpose of this project is to describe the essentials of eCommerce, how it is conducted and managed as well as assessing its limitation, issues and risks. An eCommerce is an interesting topic and it interest people in government, educational, heath services and other areas will benefit from the knowledge of eCommerce. Today eCommerce is going through a period of change for new technologies and ideas to be adapted to strategy implementation and profitability. ACKNOWLEDGEMENTS First, my most heartfelt thanks go to the lord (Allah), for given me strength and knowledge to complete this project. Next, I thank my family especially my parents for showing concern and frequently enquiring how well I was doing and frequently asking when I was going to finish my project. Next is my partner Shada Abood who has been the most supportive, enthusiastic and constantly trying to help to test my product and spotting any mistakes in this report. I also thank my supervisor Nigel Newbutt, who was very supportive and was there to advise me when I had a family problem. Special thanks go to the technicians at King William Lab; I appreciate their support and valuable contribution. Finally, I would like to thank my friends for understanding for being antisocial to complete this project.
Tuesday, October 22, 2019
Free Essays on Cat In The Rain
In the short story â€Å"Cat in the Rain†, Hemingway portrays/ describes a relationship at risk and infers that the relationship will not survive. Hemingway contrasts the male and female characters against the background of a rainy day in Italy, because of the weather, the differences between them are brought out, her being restless and him being passive. The characters are an American couple apparently on vacation. The story opens with George the husband lying in bed neglecting the needs and wants of his wife The American girl. The American girl lonely and neglected spots something outside her window. By George neglecting his wife from the beginning we can reflect that the rainy day in Italy has set George’s tone and show’s his neglecting of responsibilities as a husband. The American wife’s feelings of dissatisfaction are focused on a cat she sees outside sheltering from the rain. At that very moment she realizes that the cat was the only thing that can make her feel warmth inside or maybe was she thinking about the padrone. Thinking about herself, she continuously annoys her husband with the idea of her having a cat. Leaving her room walking slowly down the hall she stumbled upon the padrone. â€Å"The wife liked him. She liked the deadly serious way he received any complaints. She liked his dignity. She liked the way he waned to serve her. She liked the way he felt about being a hotel-keeper. She liked his old, heavy face and big hands.†(line 30-33). Was all this talking in her head the way of telling herself that there are other people that really care about her? Still walking she reaches the door, was this the door that was about to change her life. As she walks outside she noticed the table under the window but no cat. Devastated and almost heart-broken she walks back into the hotel and feels a sense of real importance from the padrone, for that one special moment she truly felt the way she’s been wanting to feel but ha... Free Essays on Cat In The Rain Free Essays on Cat In The Rain Ernest Hemingway’s â€Å"Cat in the Rain†Hemingway’s â€Å"Cat in the Rain†is a short story depicting a couples stay in Italy. The woman in the story sees a cat stranded outside in the rain and wants to bring him to her hotel room. When she goes to retrieve the cat, it is gone. However a short while later the cat is delivered to her room by the hotelkeeper. Hemingway helps the reader to appreciate â€Å"Cat in the Rain†through his use of setting, writing style, and character. Ernest Hemingway uses the setting in the short story â€Å"Cat in the Rain†to set a unique feeling. In the story â€Å"it was raining. The rain dripped from the palm leaves.†(Hemingway 408). The hotel is where the whole story takes place. The hotel was not very active on the rainy day. â€Å"There were only two Americans stopping at the hotel. They did not know any of the people they passed on the stairs on their way to and from their room.†(Hemingway 408). The Italian atmosphere with the American guests in it gives definite volume to the setting. Ernest Hemingway also uses his writing style in â€Å"Cat in the Rain†to aid the reader in understanding and interpreting the short story. The point of view Hemingway tells â€Å"Cat in the Rain†from is very sexist. Hemingway displays his sexist attitude in the short story when the man, George, compliments the woman saying, â€Å"You look pretty darn nice,†(Hemingway 409), then in his next breath degrades her by telling her to â€Å"shut up and get something to read.†(Hemingway 409). Hemingway’s opposition to women is one of his notorious traits. Hemingway is also known to use little description in his works but rely confidently in the dialogue. In â€Å"Cat in the Rain†Hemingway balances both description and dialogue quite well. When describing the woman finding the cat, Hemingway writes: The American wife stood at the window looking out. Outside right under their window a cat was crouc... Free Essays on Cat In The Rain In the short story â€Å"Cat in the Rain†, Hemingway portrays/ describes a relationship at risk and infers that the relationship will not survive. Hemingway contrasts the male and female characters against the background of a rainy day in Italy, because of the weather, the differences between them are brought out, her being restless and him being passive. The characters are an American couple apparently on vacation. The story opens with George the husband lying in bed neglecting the needs and wants of his wife The American girl. The American girl lonely and neglected spots something outside her window. By George neglecting his wife from the beginning we can reflect that the rainy day in Italy has set George’s tone and show’s his neglecting of responsibilities as a husband. The American wife’s feelings of dissatisfaction are focused on a cat she sees outside sheltering from the rain. At that very moment she realizes that the cat was the only thing that can make her feel warmth inside or maybe was she thinking about the padrone. Thinking about herself, she continuously annoys her husband with the idea of her having a cat. Leaving her room walking slowly down the hall she stumbled upon the padrone. â€Å"The wife liked him. She liked the deadly serious way he received any complaints. She liked his dignity. She liked the way he waned to serve her. She liked the way he felt about being a hotel-keeper. She liked his old, heavy face and big hands.†(line 30-33). Was all this talking in her head the way of telling herself that there are other people that really care about her? Still walking she reaches the door, was this the door that was about to change her life. As she walks outside she noticed the table under the window but no cat. Devastated and almost heart-broken she walks back into the hotel and feels a sense of real importance from the padrone, for that one special moment she truly felt the way she’s been wanting to feel but ha...
Monday, October 21, 2019
Free Essays on Raphael
The subject matter of Maddona and Child was a very popular one for artists of the sixteenth century. Rapahel, and Giovanni Bellini both painted numerous versions of the Maddona and Child. While both of the artists viewed the subject as a religious and highly emotional expression, their portrayal of many other aspects differed greatly. While Raphael portrayed what seems to be a loving, warm relationship between mother and child, a lifelike Christ child, and serenity within his paintings, Bellini portrayed a relationship that seems distant relationship between mother and child, a deathlike image of the Christ child and a sense of depression and uneasiness within his works. Differences between the views of the artists on the portrayal of Maddona and Child can clearly be seen through the artists' use of colour, backgrounds in which the figures are placed, the poses of the figures and their relationships to one another. These can all be seen in many of the works by Bellini and Raphael, sp ecifically, "The Small Cowper Madonna", and "Maddona Del Granduca" by Raphael and "Greek Madonna" and "Madonna of the Meadow" by Bellini. The subject of Maddona and Child is one that is highly emotional. Raphael and Bellini portray the Virgin and Child in two very different emotional states. Raphael, in his paintings, "The Small Cowper Madonna" and "Madonna Del Granduca", illustrates a very intense feeling of love between the Virgin and Child and a feeling of content with the love that the mother and child share. In both The Small Cowper Madonna and Madonna Del Granduca, the Virgin is looking at her son with an expression that seems very tranquil. She is almost smiling yet at the same time praying, in The Small Cowper Madonna. She seems to be totally engrossed with her child, (Web Museum). At the same time, the Child seems totally comfortable with this mother. He looks out at the viewer with a visionary, yet amiable gaze, showing his carefree, comfortable st... Free Essays on Raphael Free Essays on Raphael The subject matter of Maddona and Child was a very popular one for artists of the sixteenth century. Rapahel, and Giovanni Bellini both painted numerous versions of the Maddona and Child. While both of the artists viewed the subject as a religious and highly emotional expression, their portrayal of many other aspects differed greatly. While Raphael portrayed what seems to be a loving, warm relationship between mother and child, a lifelike Christ child, and serenity within his paintings, Bellini portrayed a relationship that seems distant relationship between mother and child, a deathlike image of the Christ child and a sense of depression and uneasiness within his works. Differences between the views of the artists on the portrayal of Maddona and Child can clearly be seen through the artists' use of colour, backgrounds in which the figures are placed, the poses of the figures and their relationships to one another. These can all be seen in many of the works by Bellini and Raphael, sp ecifically, "The Small Cowper Madonna", and "Maddona Del Granduca" by Raphael and "Greek Madonna" and "Madonna of the Meadow" by Bellini. The subject of Maddona and Child is one that is highly emotional. Raphael and Bellini portray the Virgin and Child in two very different emotional states. Raphael, in his paintings, "The Small Cowper Madonna" and "Madonna Del Granduca", illustrates a very intense feeling of love between the Virgin and Child and a feeling of content with the love that the mother and child share. In both The Small Cowper Madonna and Madonna Del Granduca, the Virgin is looking at her son with an expression that seems very tranquil. She is almost smiling yet at the same time praying, in The Small Cowper Madonna. She seems to be totally engrossed with her child, (Web Museum). At the same time, the Child seems totally comfortable with this mother. He looks out at the viewer with a visionary, yet amiable gaze, showing his carefree, comfortable st...
Sunday, October 20, 2019
How to Get Your High School Diploma Online
How to Get Your High School Diploma Online A growing number of teenagers are earning their high school diplomas through the internet. Distance learning is often a great option for students who need to stay home for health reasons, desire to work at their own pace, find themselves unable to concentrate on their work in the traditional setting, or need to schedule their learning around a career (such as acting). Finding an online high school can be a challenge; many schools make big claims but few live up to their promises. Parents generally have two options for their children: private online schools or public online schools. Private online schools function much like traditional private schools, while public schools must follow national and state regulations. Private Online High Schools For the most part, private schools act independently of government regulation. Just like traditional private schools, they create their own regulations and have their own learning philosophy, which varies greatly from school to school. Tuition is often high since parents are charged for all costs related to their childs education, including hardware and software.These high schools may or may not be accredited by the proper regional association. If you choose a school that is not accredited, check with the academic advisers of a few colleges to make sure that the schools transcript will be accepted should your child apply to attend a college.Many well-established universities are beginning to offer online high schools; these schools are probably the best bet since they are tied to credible institutions that have been around for years. A few schools to consider include: Allied National High SchoolPenn Foster High SchoolKeystone National High SchoolChrista McAuliffe Academy OnlineMore online private high schools... Online Charter Schools If your state allows charter schools, you may be able to enroll in an online high school for free. Charter schools are publicly funded but have more freedom from government control than regular public schools. This is one of the best deals out there since public schools are not allowed to charge tuition and are generally accredited by the proper organization. States such as Minnesota and California have provisions in their state laws that permit students to enroll in charter programs that are paid for by the government. Schools Blue Sky in Minnesota offers students the chance to earn a diploma without paying for classes or materials. Choice2000 in California is completely online, completely free, and completely accredited by the Western Association of Schools and Colleges. Some schools even provide computer equipment and hands-on materials free of charge.Find a no-cost program in your area by searching the directory of online public charter schools. Transitioning to an Online Program Whether you choose a private school or a public school, do a little investigating before you enroll your teenager. Interviewing the school of your choice can be a great way to make sure that youll get the resources you need and checking with the correct regional accreditation board can ensure that your school is properly accredited. Finally, make sure your child is emotionally and academically prepared to learn through the internet. Many students struggle being away from social events and friends and have difficulty avoiding the many distractions in the home. But, if your teenager is prepared and you choose the right school, online learning can be a great asset to her future.See: Online High School Profiles
Saturday, October 19, 2019
Schizophrenia Essay Example | Topics and Well Written Essays - 1500 words
Schizophrenia - Essay Example The characteristic age of commencement is the late 20s for women and the early 20s for men. Moreover, women are more expected to have a ‘first break’ later in life. Consequently, approximately one third of women have a commencement of illness after age 30. Among the minor socioeconomic classes, schizophrenia is diagnosed disproportionately. Ordinarily, schizophrenia is caused by a multifaceted contact between thousands of genes and several environmental risk aspects, of which none causes schizophrenia on their own. The developing brain is also possibly to be affected by environmental risk factors. In addition, prenatal infection can cause delicate changes in neuron movement and placement, which would eventually result in irregular connections. It can also act directly on developing circuits and synapses. Immune and stress reactions can be changed permanently by prenatal exposure to infection or stress. This makes an individual to be more sensitive to succeeding environmental stressors that cause irregular associations in the brain (Gilmore, 2010). The causes of schizophrenia are extensively alleged to have a neurobiological foundation. The dopamine hypothesis, which is the main significant theory, asserts that schizophrenia is caused by hyperactivity in brain dopaminergic pathways. This theory is in conformity with the efficiency of antipsychotics and the capability of drugs such as amphetamines or cocaine that arouse dopaminergic activity to provoke psychosis. Moreover, Postmortem studies indicate higher numbers of dopamine receptors in precise subcortical nuclei of schizophrenics than in ordinary brains. Functional and structural abnormalities through brain imaging of schizophrenics and control populations have been an area of concern in recent studies (Podosyan, 2009). Long (2009) explains that schizophrenia frequently commences between the late adolescents and the mid-30s, while
Friday, October 18, 2019
Elizabeth Murray'abstract art gives me special meanings Essay
Elizabeth Murray'abstract art gives me special meanings - Essay Example She portrayed a gloomy home life by bathing cartoonish technique, comprising kitchen utensils, desks, shoes, and others seen in houses. Personally, her paintings pushed me to think more profoundly about their goofy, ridiculous, and comical nature, but I only felt somewhat disturbed. In her earlier works, Murray depicted human features, by interweaving non-figurative colors, lines, and shapes. She used multi-paneled installations, alongside vibrant and daring colors to fascinate and trick the viewers’ eyes. She made use of every dimension, and is particularly recognized for her designed canvasses (Lacayo para 2-3). Her naughty, silly, and wild technique is all about colorful composition and wild forms against the organized and methodical abstract art. She totally recreated Modernist abstraction into cartoonish humor and essence. The above picture is one perfect example of Murray’s wacky, spirited, yet deliberate, calculated technique. In this painting, she is combining abstract three-dimensional canvases to form scenery of unique shades, colors, and systematic mixtures. It is a large image of a hotchpotch, painting, and figure; mixed all in all and colored vibrantly and raises a sense of wackiness, but sympathetic accuracy which is integrated in all its exquisite disorder (PBS(a) para 4). The application of smooth, horizontal color reveals that she is not attempting to mislead the viewers or make them believe there is something deeper than what has been painted or shown in front of them. Based on my analysis, I think she is trying to guide her viewers to the reality that abstract images can be objects too. Even though these are not ordinary, mundane objects that can simply be recognized, I think she is attempting to copy commonplace objects employing her own artistry, ingenuity, and imagination. She makes use of living organic shapes all over the painting which look like human body parts. By condensing and squashing these humanlike shapes into her
Allemande Essay Example | Topics and Well Written Essays - 750 words
Allemande - Essay Example Allemande is played through the musical voice of the cello, giving a reverberatingly cool voice somehow imitating in voice the cool gush of winds on the forests. Musical notes seem to dance in a waltzing style through the fast and happy beat of the classic, making use of the cello’s wide voice range to construct a melody playing from the lower end of the pitch range, to the higher end and on the middle. Allemande’s composition consists mostly of repetitive movements or of movements with somehow similar style as the master style of the song. The song does make use of a lot of vibrato that it adds up to the regular yet well-placed interval pauses from the rapid and graceful movement of the lower notes. The ritardando placed from the transition from one movement to another adds up to the smooth switch from the two movements. The song seems to require a high-level technique of switching hand positions and powerful bowing and strumming of the cello. ... The thick musical background song of drums percussion and electric overdrive characterizes the up-beat and metallic rhythm to convey a message of a New World Pop Culture based on Rock ‘n Roll and Metal Gore. The song portrays a protest against the classics that is primarily based on techniques, forms, and structure, by changing everything and basing the song on expression and not just on the technique of the song. The use of untraditional sound effects of the song on the intermission part of the song where the lead guitar and the drummer bangs their instrument portrays an unconventional utilization of sounds to produce a musical composition that appeals to the ears of the public mass. Lyrically, the song seems to convey a testimonial of a user addicted to depressant drugs, or maybe an obsession to a beautiful girl. Crazy Crazy, like the previous song, Purple Haze, does not follow a uniform pattern for its movements, and just like the previous song, it expounds more on the expre ssion of the message rather than the technique used on the song. Unlike Purple Haze, however, Crazy makes use of a soft harmonizing background to relay the message of the lyrics effectively to the audience for a smooth and understandable listening even for just a single run of the song. Patsy Cline’s soft tremble voice, projecting the subject as innocent and pure, makes the lyrics more powerful to the audience, and thus, the impact more intense. As for the background tune, on the other hand, makes use of repetitive chords to harmonize with the melody of the song, which eventually adds up to the aesthetic value of the song. The bass guitar further thickens the harmony, along with the second bass vocals. The bass, the vocals, the percussions, the keyboard, and other instruments mix up
Thursday, October 17, 2019
Molecular Basis of Pernicious Anaemia Lab Report
Molecular Basis of Pernicious Anaemia - Lab Report Example This process is important because it is a requirement needed for the maturation of red blood cells, putting forward a relation with the disease2. Parietal cells are found in the gastric glands where there major function is to produce hydrochloric acid that is involved in the first stages of digestion. For gastric acid secretion, the gastric H positive or the proton pump enzyme that consists of ninety five kDa alpha subunit and a sixty to ninety kDa alpha subunit3. Auto anti bodies contained in serum from different patients having pernicious anaemia react with either or both of the alpha and beta subunits of the gastric proton pumps. Knowledge about this antibody response provides a useful diagnostic tool for the pernicious disease. Also, the most widely used method for analyzing protein mixtures is by gel electrophoresis. The most commonly used type of gel is the SDS polyacrylamide. It essential to realize that proteins are solubilized in sodium dodecyl-sulphate (SDS) , an anionic de tergent that binds to the hydrophobic regions of proteins causing them to unfold hence acquiring an overall negative charge. Inclusive is a reducing agent that is included to disrupt any disulfide bonds that are within the bonds. Avery good example of a commonly used reducing agent is the 2-Beta mercaptoethanol. On electrophoresing the proteins through a polyacrylamide gel, the negatively charged proteins migrate towards the anode and separation done with regard to their size, with smaller proteins moving the furthest. It is possible to perform an analysis of the size of proteins in the mixture if molecular weights of running proteins are known. This report tests antibody from the serum samples of different patients and the results to be used to identify if any of them reacts with gastric proton pump. The results acquired from the tests will hence provide a guide to finding a diagnosis of pernicious anaemia. For accurate results it is important to use two different methods which wil l determine the presence of anti-proton pump antibodies in serum samples4. Method one (Practical three) Separate proteins extracted from mouse stomachs by SDS poly acrylamide gel electrophoresis, and transfer the proteins to a nitrocellulose membrane. Stain a section of a mouse stomach with haemotoxylin and eosin so that it becomes familiar with the structure and cells types within the stomach. It is essential to realize that the cells in the mouse stomach are similar to those of a human’s anti-proton pump antibodies. For this reason, they cross react with the equivalent mouse proteins. Method two (practical 4) Perform Western Blotting on the gastric proteins using sera from patients who may or may not have pernicious anaemia. Western blotting has this procedure. First, an individual acquires the SDS-PAGE of mouse stomach proteins. These proteins are transferred to nitrocellulose membrane by electrophoresis. The membrane is stained with Ponceau S so as to confirm protein tran sfer from gel to membrane. After that process, the membrane is de-stained and then stored in blocking buffer until next usage. Use H19 to incubate strips of membrane and then wash the membrane strips and incubate in blocking buffer. The membranes are incubated in secondary anti-bodies and in luminous detection buffer. Lastly, the markers are reassembled and test strips are visualized with Chemi -doc system5. Also, perform immune peroxidase staining of mouse stomach
Review of the Book Economics in One Lesson Essay
Review of the Book Economics in One Lesson - Essay Example Unfortunately, most of the time this fact is always hidden because bad loans made by the government are hidden in most federal spending. On the other hand, when banks collapse due to bad loans, it is announced all over the news. Political considerations further hide the bad loans as a result of government lending. This does not happen in the private sector unless the firm in question is affected by a politically motivated legislation. The community reinforcement act is an example of a legislation that advocates for loans to individuals who do not qualify. The book cites the Bush administration endeavors to ensure that banks lend more money. Based on the current times, Hazlitt argues that tariffs such as NAFTA are harming the economy. Hazlitt states that both consumers and producers are hurt by the tariffs. His argument is the opposite of the common notion that tariff affects consumers only. He explains that tariff forces consumers to pay much higher than they could have had to pay wi thout it. This means the extra dollar spent due to the tariff could have been used elsewhere. Therefore, this denies producers of other goods and services that dollar. Tariffs are aimed at protecting local industries against competition from foreign goods. On the other hand, imports are good because they provide other countries with local currency necessary for buying domestic goods Hazlitt addresses the economic impact of government actions and remains silent on protectionism due to national security. He states that the real gain from foreign trade for any country lies in its imports and not its exports (Tom the Redhunter para 11). He supports his statement by arguing that businessmen imports products because they are cheaper for the consumers compared to domestic products.... This paper offers a comprehensive review of the book Economics in One Lesson by Henry Hazlitt. The book introduces the common man to simple and clear economic thought. The author does not object public program spending but rejects the use of public projects as a plan of injecting money into the economy. He argues that public projects should be justified based on their importance to the economy. Based on the current times, Hazlitt argues that tariffs such as NAFTA are harming the economy. Hazlitt states that both consumers and producers are hurt by the tariffs. His argument is the opposite of the common notion that tariff affects consumers only. He explains that tariff forces consumers to pay much higher than they could have had to pay without it. Hazlitt addresses the economic impact of government actions and remains silent on protectionism due to national security. He states that the real gain from foreign trade for any country lies in its imports and not its exports. The book also addresses the fallacy that cost of production determines the market prices. Hazlitt argues that demand and supply determines the market price. Bailouts are necessary to save collapsing industries. The book lays emphasis on the importance of extensive analysis of both primary and secondary consequences of proposed policies. The free economy needs to be revived by removing unnecessary government intervention but still maintain important interventionism. The government needs to learn from past mistakes so as to make better informed decisions later.
Wednesday, October 16, 2019
Molecular Basis of Pernicious Anaemia Lab Report
Molecular Basis of Pernicious Anaemia - Lab Report Example This process is important because it is a requirement needed for the maturation of red blood cells, putting forward a relation with the disease2. Parietal cells are found in the gastric glands where there major function is to produce hydrochloric acid that is involved in the first stages of digestion. For gastric acid secretion, the gastric H positive or the proton pump enzyme that consists of ninety five kDa alpha subunit and a sixty to ninety kDa alpha subunit3. Auto anti bodies contained in serum from different patients having pernicious anaemia react with either or both of the alpha and beta subunits of the gastric proton pumps. Knowledge about this antibody response provides a useful diagnostic tool for the pernicious disease. Also, the most widely used method for analyzing protein mixtures is by gel electrophoresis. The most commonly used type of gel is the SDS polyacrylamide. It essential to realize that proteins are solubilized in sodium dodecyl-sulphate (SDS) , an anionic de tergent that binds to the hydrophobic regions of proteins causing them to unfold hence acquiring an overall negative charge. Inclusive is a reducing agent that is included to disrupt any disulfide bonds that are within the bonds. Avery good example of a commonly used reducing agent is the 2-Beta mercaptoethanol. On electrophoresing the proteins through a polyacrylamide gel, the negatively charged proteins migrate towards the anode and separation done with regard to their size, with smaller proteins moving the furthest. It is possible to perform an analysis of the size of proteins in the mixture if molecular weights of running proteins are known. This report tests antibody from the serum samples of different patients and the results to be used to identify if any of them reacts with gastric proton pump. The results acquired from the tests will hence provide a guide to finding a diagnosis of pernicious anaemia. For accurate results it is important to use two different methods which wil l determine the presence of anti-proton pump antibodies in serum samples4. Method one (Practical three) Separate proteins extracted from mouse stomachs by SDS poly acrylamide gel electrophoresis, and transfer the proteins to a nitrocellulose membrane. Stain a section of a mouse stomach with haemotoxylin and eosin so that it becomes familiar with the structure and cells types within the stomach. It is essential to realize that the cells in the mouse stomach are similar to those of a human’s anti-proton pump antibodies. For this reason, they cross react with the equivalent mouse proteins. Method two (practical 4) Perform Western Blotting on the gastric proteins using sera from patients who may or may not have pernicious anaemia. Western blotting has this procedure. First, an individual acquires the SDS-PAGE of mouse stomach proteins. These proteins are transferred to nitrocellulose membrane by electrophoresis. The membrane is stained with Ponceau S so as to confirm protein tran sfer from gel to membrane. After that process, the membrane is de-stained and then stored in blocking buffer until next usage. Use H19 to incubate strips of membrane and then wash the membrane strips and incubate in blocking buffer. The membranes are incubated in secondary anti-bodies and in luminous detection buffer. Lastly, the markers are reassembled and test strips are visualized with Chemi -doc system5. Also, perform immune peroxidase staining of mouse stomach
Tuesday, October 15, 2019
Focus Groups Essay Example | Topics and Well Written Essays - 750 words
Focus Groups - Essay Example The colours used to identify objects, the tone used to communicate , and the environment in which it is done all are important with teaching a particular subject matter. The method by which an instruction is passed on coupled with the quality of content also has an impressionable impact on understanding capability of the recipient. To support the above hypothesis a study was conducted on two groups of children from kindergarten, each group comprising of 10 children between the age group of the age 4 to 5 years .So that there is minimum disparity in the final results due to the level of understanding among the children of the two groups the IQ of the children in both the groups was almost the same. The main purpose of choosing this segment of kids was their total dependence on their facilitators for explaining the content to them. Unlike a slighter older group who can get study materials from reference libraries and the internet, this group due to their limited exposure, would have minimal external influence on the material they would be taught . Their understanding on the subject matter would depend mainly on the method of instruction, the kind of content and the mediums used to deliver it. The first group ( Group 1) was exposed to Montessori way of education and the second group (Group 2) to the traditional public elementary school way of conducting classes. The experiment was presided over by two experienced teachers. Children from both the groups were to be evaluated on a spelling test of 30, five lettered words which would be conducted after a period of about 20 days. The outcome of the two groups would be evaluated on the average scored, scored by each group. Group 1 was introduced to phonetics through the Montessori method of education which lays more emphasis on child development and the over all build up of the child. Here the children were exposed to phonetics in the play way method which helps them learn the spellings by recognising
Cyberterrorism Essay Example for Free
Cyberterrorism Essay The term cyberterrorism was created in the mid 90’s by combining cyberspace and terrorism. The term has been widely accepted after being embraced by the United State Intelligence Community. Janczewski and Colarik describe cyberterrorism as â€Å"Premeditated, politically motivated attacks by subnational groups, clandestine agents, or individuals against information and computer systems, computer programs, and data that result in violence against non-combat targets†(Janczewski Colarik, 2005, p. 43). Cyberterrorism is a form of terrorism that uses any form of connected source to engage in attacks of information systems, incitement to violence, theft of data, and planning of terrorist attacks (Britz, 2011, p. 197). As an introduction into the topic, the following definition is key to understanding the definition: â€Å"Cyberterrorism is the convergence of terrorism and cyberspace. It is generally understood to mean unlawful attacks and threats of attack against computers, networks, and the information stored therein when done to intimidate or coercer a government or its people in furtherance of political or social objectives. Further, to qualify as cyberterrorism, an attack should result in violence against persons or property, or at least cause enough harm to generate fear. Attacks that lead to death or bodily injury, explosions, plane crashes, water contamination, or severe economic loss would be examples. Serious attacks against critical infrastructures could be acts of cyberterrorism, depending on their impact. Attacks that disrupt nonessential services or that are mainly a costly nuisance would not†(Denning, 2000). Cyberterrorism is considered an act of violence or intimidation using cyberspace. It is more complicated than simply hacking into a system to see what damage can be done; it has to stem from a motivational source such as politics, foreign government, or some other rousing source (Gross, 2003). Enemies of the U. S. are strongly motivated by hate. Hate can be a strong motivator when it comes to cyberterrorism, and just terrorism in general. When hate is the driving factor of actions, the consideration for the targeted group is very minimal, and the results of hate crimes are usually violent and gruesome acts. The FBI’s definition isn’t that far off from Denning’s. They have published three different distinct definitions of cyberterrorism: â€Å"Terrorism that†¦initiates attacks on information†– â€Å"the use of Cyber tools†– and â€Å"a criminal act perpetrated by the use of computers (Baranetsky, 2009). Most government agencies that have a response program for cyberterrorism have their own published definition of cyberterrorism. The question rises ‘why does cyberterrorism occur? ’ The answer is that the terrorist want cause specific damage to the target. There are three factors that are considered when this question is asked, the first being the fear factor. It is the most common denominator of the majority of terrorist attacks. The attackers want to create as sense of fear in individuals, groups, or societies – whomever they are targeting (Janczewski Colarik, 2005, p. 45). Perhaps a cyber example of this could be the attack of IT installations. Then there is the spectacular factor. Spectacular means that the attacks are aimed at creating direct losses or resulting in a lot of negative publicity (Janczewski Colarik, 2005, p. 45). An example of the spectacular factor at work was in 1999 when Amazon. com was closed because of a Denial of Service (DOS) attack. They suffered losses from the attack, but the worse affect was the publicity that that was received (Taylor, Calabresi, Krantz, Pascual, Ressner, 2000). The last factor is the vulnerability factor. This is simply when vulnerability of an organization is exposed (Janczewski Colarik, 2005). An example of this could be the vandalism of an organizations webpage. The importance and significance of cyberterrorism is a very debatable topic. Kim Taipale, founder and executive director for the Stilwell Center for Advanced Studies in Science and Technology Policy believes â€Å"cyberterrorism, whatever it is, is a useless term. Taipale believes that, â€Å"terrorists will use any strategic tool they can†so â€Å"cyber†terrorism is no more important then other forms (Baranetsky, 2009). The statements by Taipale are strong, and arguments could be made supporting her, and arguments could be made that go against her beliefs. It is true that terrorism is growing all over the world, and terrorists are beginning to use various outlets to threaten nations, groups, and individuals. So the case could be made stating that cyberterrorism is just an accessible outlet terrorists have, because of the access that is granted to an individual on cyberspace. In conflict with that argument is the argument that cyberspace is not monitored and policed enough, and has little to no restrictions as to what can be done in cyberspace. This is an ongoing debate that will not be discussed in this paper. Different Forms of Cyber Attacks Various types of cyber attacks are used within the terrorist aspect of cyberspace. According to the Center for Strategic and International Studies, cyberterrorism is â€Å"the use of computer networks to shut down critical infrastructure (such as energy, transportation, government operations) or to coerce or intimidate a government or civilian population†(Lewis, 2002, p. ). The most commonly used tactics used to neutralize critical infrastructure are attacks known as the Trojan horse, viruses, phishing, Denial of Service (DoS), and Direct Denial of Service attacks. The first of the types of the cyber attacks to be discussed is the Trojan horse. A Trojan horse is a computer program that conceals a harmful code. Relating to the well know tale of the Trojan horse, it allows you into a system, and then leaves an outlet that allows you to get back into the system. In essence, it is software that appears to perform one action while actually performing another (Gohring, 2009, p. 6). A Trojan horse is a program that appears harmless but hides malicious functions. The most common Trojan horse of today’s day and age is NetBus, which was used for illegally breaking into computer systems and, in particular, used to plant child pornography on computers of people of integrity. Viruses are another form of cyber attack. Viruses are programs that â€Å"infect computer files, usually executable programs, by inserting a copy of itself into the file. These copies are usually executed when the infected file is loaded into memory, allowing the virus to affect other files. A virus requires human involvement to spread†(Kuehl, 2012). Virus writers write programs that infect the systems of certain users, but needs direct involvement by the creator or another human source to spread the virus. Very similar to a virus is a worm. The worm works just like a virus, implemented into a system by a creator. The difference between a worm and a virus is the fact that a worm doesn’t need the hands-on human involvement. Back in 2003, SQL Slammer worm spread throughout the cyber world. This was a worm that exploited a buffer overflow vulnerability of Microsoft’s SQL Server. Six months prior to the launch of the worm, the vulnerability was taken notice of and a patch was developed to strengthen the vulnerability. The worm worked by generating random IP addresses, and if belonged to an SQL Server that was not covered by the patch, it was infected and immediately began sending out more copies of the worm to more random IP addresses (Leyden, 2003). There was no human involvement after the worm was created initiated by the creator. It spread itself to random IP addresses, which categorizes it as a worm. Phishing is a form of deception used in cyberspace. Phishing attempts to trick users into giving out their personal data. The techniques used in phishing attempts are emails and websites that are designed to look like legitimate agency websites asking for an individual’s bank and financial account information and passwords (Kuehl, 2012). This method is not used so much by cyberterrorists, but the possibility is there. A more serious cyber attack comes in the form of a Denial of Service (DoS) attack. DoS attacks deny system access to users by overwhelming the target source with messages and blocking legitimate traffic (Kuehl, 2012). It causes a system overload, and can block the ability to exchange data between systems using the Internet. DoS attacks usually target banks, and earlier this year in September, several major banks were attacked using DoS. The websites of Bank of America, JPMorgan Chase, Wells Fargo, U. S. Bank, and PNC Bank all were victims of a DoS attack (Goldman, 2012). The websites were overloaded with traffic directed at them causing them to crash. Most of the time while the cyberterrorists use these attacks to steal information from bank customers, but in this case the motivation was simply to temporarily take down the banks’ public-facing websites, putting them under extreme heat from the public and potentially tarnishing their reputations. There are three levels of cyber capability that need to be taken into thought when considering types of cyberterrorism attacks. The first is simple-unstructured capability. This allows a cyberterrorist to conduct basic hacks against individual systems using tools created by someone else. The organization possesses little target analysis, command and control, or learning capability (Denning, 2000). This level is sometimes not considered to be cyberterrorism, because of the simplicity of the attack. There is slight to no attention focused on the target, which does not reveal any sort of motivation. Referring back to the definition of cyberterrorism, it has to stem from a motivational source to be considered cyberterrorism (Gross, 2003). The simple-unstructured capable individuals are basically the ones who hack into systems just to see what kind of damage they can cause. The second level of capability is the advance-structured level. This is the competence to conduct more sophisticated attacks against multiple systems or networks and possibly, to modify or create basic hacking tools. The organization possesses a straightforward and uncomplicated target analysis, command control, and learning capability (Denning, 2000). These organizations have motivations, but they are not strong enough to cause serious damage to the identified target. The last capability is the complex-coordinated capability. This is the ability for coordinated attacks capable of causing mass-disruption against integrated, heterogeneous defenses. They have the capacity to create sophisticated hacking tools. There is a highly capable target analysis, command control, and organization learning capability (Denning, 2000). Organizations with this type of capability are highly sophisticated with dangerous motivations. These dangerous organizations are the ones that can cause millions of dollars of damage, and also tons of negative publicity, two of the main objectives of cyberterrorist. There are cases when terrorists actually run other forms of terrorisms, such as bombings, with the use of cyberspace. The anonymity and global reach of the Internet has helped facilitate terrorism (Cole Glasser, 2009). â€Å"They put up websites to spread their messages and recruit supporters, and they use the Internet to communicate and coordinate action. However, there are few indications that they are pursuing in cyberterrorism, either alone or in conjunction with acts of violence†(Denning, 2000). There is an example of this from the late 90’s. In February 1998, Clark Staten, executive director of the Emergency Response and Research Institute in Chicago, testified before the Senate Judiciary Committee Subcommittee that it was believed that â€Å"members of some Islamic extremist organizations have been trying to develop a network of hackers to support their computer activities in offensive information warfare attacks in the future†(Denning, Cyberterrorism, 2000). It is the perfect way to recruit, because of the anonymity that is granted to the individual. â€Å"The Internet is the ideal medium for terrorism today: anonymous but pervasive†(Cole Glasser, 2009, p. 95).
Sunday, October 13, 2019
Polycystic Kidney Disease Causes and Treatment
Polycystic Kidney Disease Causes and Treatment  Introduction: Polycystic kidney disease effects roughly 10 million people worldwide. Even though this disease is so prominent it lacks research in the field of therapeutics from biopharmaceutical companies as they invest their resources into fields which are seen to be more profitable i.e. cancer research. This lack of research is what enticed us to carry out our project on polycystic kidney disease. This project will firstly outline the history of the polycystic kidney disease, how it effects patients, the cause of the disease and the current therapeutic treatment available to combat polycystic kidney disease in section 1. Section 2 will look at the current diagnostic methods employed by a physician to see if a patient is suffering from polycystic kidney disease. Diagnostic methods such as imaging and genetic testing will be dealt with here. Lastly section 3 will look at a potential new diagnostic technique which has been formed using proteomic techniques to identify the difference between a healthy polycystin-1 protein compared to a mutated polycystin-1 protein. The first record of Polycystic Kidney Disease (PKD) is from the 16th century. In 1586, the King of Poland died from cysts on his kidneys. The cysts were described by his surgeon as large like those of a bull, with an uneven and bumpy surface. At the time of his death he was diagnosed with meningeal abscesses. It wasnt until a group of physicians re-examined the records of the Kings death over 300 hundred years later that his cause of death was agreed to be PKD. The term polycystic kidney disease was first used by Fà ©lix Lejars in 1888, although the mode of inheritance of this disease wasnt understood for almost another one hundred years. In the 1990s, the formation of cysts was understood at a molecular level. This helped in the discovery of the genes that cause PKD (Ayse, 2016). Figure.1 A visual representation of the transmembrane proteins Polycystin-1 and Polycystin-2. Also seen is the Polycystin-1 receptor located in extracellularly. (Gallagher, Germino and Somlo, 2010) PKD is a genetic disease in which the renal tissue within the outer cortex and inner medulla is replaced with fluid filled sacs (or cysts). These cysts enlarge the kidneys and inhibit kidney function. Hypertension, hematuria and chronic pain are the most common symptoms associated with PKD (Seeger-Nukpezah et al., 2015). PKD has two forms; Autosomal Dominant (ADPKD) and Autosomal Recessive (ARPKD). ADPKD is the result of the inheritance of one mutant PKD1 or PKD2 gene, which affects ~1:750 people worldwide. 85% of ADPKD cases are caused by mutations in PKD1. Mutations in this gene lead to earlier disease onset. The other 15% of cases are attributed to a mutation in PKD2. All ADPKD patients inherit one normal allele and one mutant allele. Cases where both alleles have the dominant mutation lead to embryonic lethality. ARPKD is caused by the inheritance of two recessive mutated PKHD1 genes. ARPKD is considerably less common with an incidence of 1:20,000. ARPKD progresses at a much faster rate than ADPKD. It usually causes death at birth or requires transplantation in early childhood. Multiple different types of mutations in PKD1, PKD2, and PKHD1 have been researched, including frameshifts, deletions, and premature stop codon insertions (Wilson, 2015). In the dominant form of PKD there is only one mutated gene inherited. This mutated gene is unable to produce the proteins PC-1 or PC-2. However, the non-mutated allele can still function as normal and can produce enough of the polycystin proteins to maintain kidney function. It is only when a somatic mutation occurs causing the normal allele to become inactivated that symptoms of the disease will occur. (Torres and Harris, 2010) PKD-1 is located on the short arm of chromosome 16 (16p13.3). PKD-2 gene is located on the long arm of chromosome 4 (4q21) (Nowak et al., 2016). Polycystin-1 and 2 are large transmembrane proteins which are encoded by PKD1 and 2. Both proteins affect multiple downstream signalling proteins (Seeger-Nukpezah et al., 2015). In a normally functioning nephron as the urinary filtrate flows by and causes the primary cilia to bend polycystin 1 and 2 respond by allowing calcium influx which activate pathways in the cell which inhibit cell proliferation. PC1 has the ability to sense when the primary cilia bends which activates PC2 calcium channels. If either PC1 or PC2 is absent the signal to inhibit cell growth is not received (Chebib et al., 2015). PKD1 or PKD2 mutations cause a reduction in intracellular calcium. This triggers a change in the response of the cell to cyclic adenosine monophosphate (cAMP) from suppression to proliferation. The concentration of cAMP directly affects the activity of Protein Kinase A. Four cAMP molecules are required to activate one PKA enzyme. The increased production of cAMP via adenylyl cyclase 6 is dependent on vasopressin (Chebib et al., 2015). Despite the many breakthroughs in research allowing for a greater understanding of the disease, there is currently no cure for PKD. However, there are drugs which can suppress symptoms brought on by the disease. Beta blockers such as, Tenormin, can be used to treat hypertension and haematuria can be treated with antibiotics. Understanding the effect of PC1 and PC2 mutations on the vasopressin receptor in the cell lead to the development of Tolvaptan. This drug slows down the formation of cysts in the kidneys. Tolvaptan blocks the vasopressin receptor, which will stop the signalling pathway. Therefore, cAMP production will be reduced. (Ema.europa.eu, 2017) The current diagnostic methods for polycystic kidney disease include genetic testing, pre-natal testing and imaging studies in the form of ultrasounds, CT (Computed Tomography) scans and MRI (Magnetic Resonance Imaging) scans The imaging studies take a scan of the kidneys to identify the presence of any abnormalities in the form of renal cysts. An ultrasound mechanism uses high frequency sound waves to capture and visualise images that cant be seen with the naked eye. The CT scan combines many x-ray images with the aid of a computer to generate cross sectional views and/or three-dimensional images of the kidneys and the MRI scan uses a magnetic field and pulses of radio wave energy to from pictures of the kidneys. The appearance of three or more renal cysts, either unilateral or bilateral, on the image is enough to diagnose a patient between the ages of 15 and 39 with polycystic kidney disease. In patients aged 40 59, the presence of two or more cysts in each kidney fulfils the criteria to diagnose the patient with polycystic kidney disease. The presence of four or more cysts in each kidney is used to diagnose older patients (F. Belibi et al., 2008). The kidneys on an image may appear enlarged but retain their normal reniform shape in the case of a patient presenting with possible polycystic kidney disease. The medullary pyramids in the centre of the kidney may be more visible on an image in contrast to the cortex which can give a peripheral halo on the image obtained. High resolution imaging studies allows the visualisation of numerous cylindrical cysts within the medulla and the cortex which represent ectatic collecting ducts within the kidney (F. Gaillard, 2015). Genetic testing for polycystic kidney disease is for those who have a family history of polycystic kidney disease who has no symptoms and may consider being screened for the disease. Genetic tests can be done to screen for both PKD1 or PKD2 mutations. A method of PCR known as PCR- SSCP (Polymerase Chain Reaction Single Strand Conformation Polymorphism) is used to view mutations, if any, in the patients genomic DNA. In SSCP analysis, a mutated DNA sequence is detected as a change of mobility in polyacrylamide gel electrophoresis caused by the altered folded structure of single-stranded DNA (K. Hayashi, 1991). The genomic DNA of the white blood cells in patients with the possible polycystic kidney disease gene are isolated. These samples of genomic DNA are then amplified by PCR using two primers to amplify the potential polycystic kidney disease genes (R. Jas et al., 2012) The PCR product is then analysed using the SSCP method. This method involves loading the PCR product samples onto the acryl amide gel and gel electrophoresis occurs. After completion of the gel electrophoresis step, the gel is subjected to silver staining to visualise the SSCP band patterns (B. Yadav et al., 2009). The silver stained gel is kept on a transilluminator and the SSCP variants are recorded. DNA samples from the abnormal bands seen on the transilluminator are sequenced to see what kind of mutation and where the location of the mutation is on the polycystic kidney disease gene (Z. Dian-Yong et al., 2002). In PCR-SSCP analysis, changes in several hundred base pairs are detected in contrast with other techniques in which changes in relatively short sequences can be detected. Because of this, PCR-SSCP analysis is much more sensitive to the replication errors that can occur during the PCR process (K. Hayashi, 1991). Diagnosis of polycystic kidney disease can also be done prenatally. If the parents agree, a prenatal diagnosis can be done on the developing fetus if there is a history of polycystic kidney disease in either the parents or extended family . A DNA sample is taken from both parents and a sample of tissue is taken from the fetus. The tissue sample is obtained from the fetus by a procedure called aminocentesis which involves passing a needle into the mothers lower abdomen and into the amniotic cavity inside the uterus. The sample is then amplified by PCR to detect any mutations in the DNA that could lead to the fetus developing polycystic kidney disease in the future (K. MacDermot et al., 1998). The imaging studies, genetic testing and prenatal testing for polycystic kidney disease have advantages and disadvantages. One advantage of the imaging studies is that they are reliable, inexpensive and a non-invasive way to diagnose polycystic kidney disease (A.Khan, 2015). A disadvantage of imaging studies is that while they are sensitive in the detection of polycystic kidney disease, problems may arise with smaller cysts. Smaller cysts on scans may not be easily differentiated from small, solid masses within the kidneys (A.Khan, 2015). An advantage of CT scans when compared to MRI scans is that the cysts on the kidney will enhance on the image when dye is administered into the patient intravenously (A. Khan, 2015) (F. Gaillard, 2015). MRI scans of the kidneys are becoming a useful technique in diagnosing more complicated cysts and can be used in addition to or instead of CT scans (A. Khan, 2015). The advantage of genetic testing as a method of diagnosing polycystic kidney disease is that it can determine if a person who has a relative with polycystic kidney disease will in the future start showing symptoms of the disease. Some disadvantages of genetic testing as a method of diagnosing polycystic kidney disease is that they are extremely costly tests to carry out and sometimes they cant pick up on certain gene mutations that could eventually lead to the person having polycystic kidney disease (National Kidney Foundation, 2016). The major advantage of prenatal testing for polycystic kidney disease is the fact that treatment using cyst suppressing drugs can be used early in the diseased patients life meaning the formation of renal damaging cysts will be slowed down drastically compared to a patient who was not on the cyst supressing treatment early in their life time. The negative of prenatal testing is of course the invasive nature of extracting tissue from the foetus which many parents would not agree with however the benefits of early diagnosis of this disease will lead to a better quality of life for the child in their later years. As discussed in the previous section the current diagnostic methods for diagnosing polycystic kidney disease is through the use of various scans and genetic testing. The genetic testing is carried out by analysing the DNA sequence in order to identify any mutations which may be present. As a new method of diagnosing this disease a study of the protein polycystin-1 which when mutated is responsible for polycystic kidney disease, will be analysed by using proteomic methods. Firstly, the polycystin-1 protein must be extracted from a patient who wishes to obtain diagnosis of the disease. Since polycystin-1 is a membrane protein and is located in the kidney it will be necessary to extract kidney tissue from the patient by carrying out a quick and simple biopsy procedure. The biopsy removes kidney tissue by inserting a thin biopsy needle through the skin and into the kidney whilst the patient is under local anaesthetic. Now that tissue containing the polycystin-1 or its mutated form is extracted from the patient it must be treated in order to release the proteins contained within the tissue. The tissue will firstly be homogenized and lysed in order to release the proteins into solution. The sample will then be centrifuged at 14,000 rpm at 4ÃÅ'Ã… C for 15 min. This centrifugation step removes any insoluble material and the supernatant will contain the proteins from the tissue sample including the protein of interest polycystin-1. This method was carried out by Malhas, Abuknesha, and Price 2001 whilst trying to crystalize the polycystin-1 protein. Now that polycystin-1 is in solution it can be separated from the other proteins by means of 2D gel electrophoresis. This technique will separate the polycystin-1 protein from other proteins based firstly on their isoelectric points (pIs) and secondly by their molecular weight. After carrying out this two-dimensional separation the gel is stained with stains such as coomassie brilliant blue (CBB) or silver staining in order to visualize the spots on the gel. By carrying out bioinformatical analysis the molecular weight and pI of polycystin-1 can easily be obtained (Mishra 2010). The molecular weight of polycystin-1 is 460.3 kDa and it has a pI of 6.27. With this information, the band which corresponds to the molecular weight and pI of polycystin-1 can be easily identified and excised from the gel. Before excising the polycystin-1 protein from the gel it must first be fragmented into peptides using trypsin cleavage. By fragmenting the protein with trypsin, peptide molecules are formed which are now suitable to be sequenced using MALDI-TOF mass spectrometry. These peptides must then be suspended in a matrix suitable for MALDI-TOF MS. An example of such a matrix is ÃŽÂ ±-cyano-4-hydroxycinnamic acid which was used in the work carried out by Malhas, Abuknesha, and Price, when they crystallized the polycystin-1 protein using the MALDI-TOF technique. This matrix is suitable as the peptides are below 5 kDa. The matrix and peptide mixture is then loaded onto the metal plate of the MALDI-TOF MS analyser where it will be hit by a pulsing UV laser. The matrix molecules absorb the UV light causing the matrix molecules to enter the gas phase along with their coupled vaporised peptides which then become ionized. The TOF MS then measures the time it takes the ions to fly as lighter ions travel faster. The ions will then hit the ion detector and the on board computer will produce the plot of the mass spectrum (Kraj and Silberring 2008). MALDI-TOF MS is the ideal method to analyse the polycystin-1 protein as like ESI, it is a soft ionization technique meaning there will be little or no fragmentation of the compounds being analysed. Once the mass spectrum is obtained it is then compared to the mass spectrum of the normally functioning polycystin-1 protein which can theoretically be fragmented by trypsin in the online databases. Any differences between the sample and the known mass spectrum of the normal protein will signal a mutation has occurred. This method of protein analysis is a very effective and efficient way of screening for the mutated proteins. The study carried out by Brioude et al 2016 proves this as they looked at using MALDI-TOF MS to test for mutated proteins leading to lung tumours. In this study, they concluded that the method is very promising and it should be used in several surgical settings where rapid evaluation of abnormal tissue is required. This highlights how this new method of analysing polycystin-1 for a mutation could prove very effective in diagnosing polycystic kidney disease. This method holds a distinct advantage over the imaging methods currently in use as diagnosis can be made early in a patients life before they show symptoms or the formation of cyst on their kidneys which are associated with polycystic kidney disease. Early diagnosis of this disease means that drugs for the prevention of cyst formation such as Jinarc © which contains the API Tolvaptan can prolong a patients kidney function by slowing down the rate at which the fluid filled cysts on the kidneys are formed. This method is used to identify a mutation of the polycystin-1 protein which attributes to 85% of autosomal dominant polycystic kidney disease cases. The other 15% is made up of mutations of the protein polycystin-2. Fibrocystin is the mutated protein responsible for autosomal recessive polycystic kidney disease. Both the dominant and recessive forms of this disease can be diagnosed using the above method in order to identify a mutation in either polycystin-2 or fibrocystin proteins if there is no mutation of polycystin-1 observed. From the above sections, it can be seen how sever and prominent polycystic kidney disease is worldwide. Although this disease is genetically inherited from or both parents, symptoms of the disease are slow progressing. In 85% of cases the disease will not advance to renal failure until the patient is 50-60 years of age. The current diagnostic techniques currently used by doctors such as imaging and genetic testing have their benefits however they are also flawed. The major disadvantage seen in this project regarding the current diagnostic techniques is the diagnosis of polycystic kidney disease in a patient where uncontrolled cyst formation has already occurred and serious renal problems have begun. With the use of our new proteomic technique earlier diagnosis will be possible before the disease has progressed to renal failure. Early diagnosis means that the use of drugs such as Tolvaptan © can be used to significantly slow down cyst formation which will ultimately increase the length of time a patient suffering with polycystic kidney disease has before renal failure occurs. 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