Congenital Adrenal Hyper Plasia Health And Social Care Essay

To, find the clinical presentation of inborn adrenal hyperplasia and to detect the short term response to intervention. Design: Case series survey.Topographic point AND DURATION OF STUDY:The survey extended over a period of one twelvemonth from July 2007 To July 2008 in Paediatric section Chandka Medical College Larkana.MATERIAL AND METHODS:All kids showing with purging desiccation, daze, failure to boom and equivocal genital organs were examined and investigated exhaustively. The chief stay of the diagnosing was raised degree of serum 17OHP in kid with implicative clinical characteristic.Consequence:A sum of 30 kids were found to hold CAH during the survey period. The major clinical characteristics a presentation were purging 8 ( 26.7 % ) , equivocal genital organs 7 ( 23.3 % ) emesis and failure to boom 1 ( 3.3 % ) . All the patients were followed up after induction of intervention and response was observed.Decision:The survey highlights the importance of common clinical symptoms like, purging being the presenting characteristics of CAH and the effectivity of the replacing therapy in bettering life endangering exigencies due to this status.Cardinal WORDS:Congenitaladrenalhyperphase ( CAH ) ,17 hydroxyprogesterone ( 17 OHP ) , cytochrome P 450 protein ( CYP ) . correspondence to: Dr. Shanti Lal, Assistant Professor Pediatricss *Dr. Abdul Ghani Shaikh Assistant Professor Surgery ** Dr. Amanullah Abassi Assistant Professor Urology Chandka Medical College, Larkana dr.shantilal @ yahoo.comIntroductionCAH is a familial upset characterized by a lack in the endocrine hydrocortisone and aldosterone and an over production of the endocrine androgen, which is present at birth and affects sexual development. The upset is inherited as an autosomal recessive defect in congenital enzyme synthesis. As such there is history of early neonatal decease in the household. The clinical manifestations of the disease relate to the grade of hydrocortisone lack, aldosterone lack, or lack of both and, in some instances, to the accretion of precursor adrenocortical endocrines. These precursors cause abnormalcies such as masculinization or high blood pressure when nowadays in supraphysiologic concentration many of the enzymes involved in hydrocortisone and aldosterone syntheses are cytochrome p450 proteins designated CYP. CYP21 refers to 21-hydroxylase, CYP11B1 refers to 11-beta-hydroxylase, and CYP17 refers to 17-alpha-hydroxylase. Excess adrenal androgen production be gins in early foetal life in authoritative CAH-21 affected babies, and causes unnatural growing of misss ‘ button and masculinisation of the genital-urinary constructions. Badly affected misss may be mistaken for male childs at birth. Affected male childs have no venereal deformities at birth, but continued androgen extra causes remarkably fast organic structure growing. Inappropriately early pubescence leads to premature completion of growing and short concluding grownup height [ 1- 3 ] . Severe signifiers of inborn adrenal hyperplasia are potentially fatal if unrecognised and untreated because of the terrible hydrocortisone and aldosterone lacks that result in salt cachexia, hyponatremia, hyperkalemia, desiccation, and hypotension [ 1,6,7 ] . Females with some signifiers of adrenal hyperplasia ( i.e. , CYP21 lack, CYP11B1, partial 3-beta-hydroxysteroid dehydrogenase lack ) have equivocal genital organs at birth ( authoritative masculinizing adrenal hyperplasia ) or later become virilized in childhood ( simple masculinizing adrenal hyperplasia ) or in adolescence and maturity ( nonclassic masculinizing adrenal hyperplasia ) . Males with CYP21 lack are non by and large identified in the neonatal period because their genital organs are normal. If the defect is terrible, ensuing in salt cachexia, these male babies are seen at 1-4 hebdomads of age because of failure to boom, recurrent emesis, desiccation, and daze. Some babies are ab initio misdiagnosed with stomach flu o r pyloric stricture [ 1,2,6 ] . Hyponatremia and hyperkalemia should raise the possibility of adrenal inadequacy. Two signifiers of adrenal hyperplasia ( i.e. , CYP11B1 lack, CYP17 lack ) consequence in high blood pressure [ 1,2,6,7 ] Congenital adrenal hyperplasia occur among people of all races. Congenital adrenal hyperplasia because all signifiers of inborn adrenal hyperplasia are autosomal recessionary upsets, both sexes are affected with equal frequence [ 1 ] . All kids including neonate who have purging and/or desiccating are diagnosed as acute stomach flu. This consequences in certain congenital mistakes of metamorphosis particularly CAH being overlooked, unsuitably treated and consequences in increasing preventable mortality earlier in life. The intent of survey is to depict our experience of placing CAH in footings of their presentation and short term intervention.Patients AND METHODSThis crossectional survey was carried out in paediatric section of Chandka Medical College Larkana from July 2007 to July 20 08. The chief purpose of the survey was to happen out the chief manners of presentation of CAH and to see the response of intervention on short term footing. A successful response to replacement therapy observed within a period of two to four was surcease of emesis, need for endovenous fluid therapy and failure to boom. All patients suspected to hold CAH i.e. with clinical characteristics and raised serum degrees of 170HP were included in the survey. A elaborate history ( purging, failure to boom, sibling decease ) followed by thorough physical scrutiny ( blood force per unit area, hydration, misss for equivocal genital organs and male childs for precocious pubescence ) was carried out. Probes done included complete blood count, blood sugar, serum carbamide and electrolytes ( Na 130 – 150 mmol/l ; potassium 3.5 – 4.0 mmol/l ) , karyotyping and serum17OHP degrees ( Normal & A ; lt ; 100 ng/dl ) . Classical salt blowing assortment have 17 OHP degrees & A ; gt ; 2000 mg/dl ; Classical virilizing & A ; gt ; 1000 ng/dl and nonclassical = 100 – 200 ng/dl. Karyotyping was done in patients with equivocal genital organs to set up the diagnosing of CAH in our survey. Classically they had to be female karyotype who was virilized [ 4 ] . Patients that had other grounds for equivocal genital organs and failure to boom like nephritic cannular defects etc were excluded from the survey. All probes were carried out in Patholo gy Department Chandka Medical College Larkana except 17 OHP and Karyotyping from Agha Khan University Laboratory. All patients were treated with replacing therapy including cortisol 50 mg/M2 stat followed by 1000 milligram / M2/ twenty-four hours 6 hourly, tapered to 20 milligrams / M2 /day. In salt losing assortment ab initio normal saline 20 milliliter / kilogram was repeated if necessary followed by florinated steroid ( fludrocortisone – 0.15 milligram / M2 ) was given. The response to the criterion paediatric pattern was studied.ConsequenceSum of 30 patients were diagnosed to hold CAH. The age scope of kids was from 4 to 180 yearss with a average age at the clip of presentation was 39.67 yearss. ( table-1 -fig-1 ) the sex distribution was about equal ( table-2-fig-2 ) . The chief clinical characteristics included emesis, equivocal genital organ, desiccation and failure to boom ( table-3 ) . Probes of all the patients showed raised degrees of 17OHP. Karyotyping was done in patients with equivocal genital organs. All instances diagnosed to hold CAH were put on replacing therapy. Short term response was observed after a period of 4 hebdomads. All instances showed positive response shortly after the induction of therapy. The patients who presented with failure to boom started deriving weight. As emesis was the major symptom at presentation, it responded good to intervention. Children showing with equivocal genital organs were put on replacing therapy and subsequently referred for surgical intervention i.e. clitoroplasty.DiscussionCAH is chiefly disease of early babyhood as the average age of presentation in our survey is 39 yearss. It is widely present all over the universe with equal male to female ratio [ 1,2 ] . The present survey besides shows the same consequence with average age of presentation being 39.67 yearss. However there is little male preponderance in our survey ( 56.7 % ) . Clinical characteristics observed in this survey are in conformance with other surveies.The frequent manners of presentation include purging, equivocal genital organ ( Fig-1 ) , daze and failure to boom [ 1,2 ] . Some patients presented merely one symptom and other with two or three marks and symptoms togetherTable- 1: Outstanding characteristics of the 30 instances studied.Average age of presentation ( yearss ) 39.67 Male: female ratio 1.5:1 Major symptom/sign ( purging n equivocal genital organs 10 ( 33.3 % ) Positive Family history/Neonatal decease 10 ( 33 % )Figure: 1Equivocal Genitalia Ambiguous GenitaliaTable-2: Gender distribution.No of PatientsPercentagesFemale 13 43.3 % Male 17 56.7 %Table-3: Presenting characteristics of the instances.No of PatientsPercentagesVomiting 8 26.7 % Equivocal genital organs 7 2.3 % Vomiting and equivocal genital organs 10 33.3 % Failure to boom 1 3.3 % Daze 4 13.3 %Figure: 2Equivocal Genitalia Ambiguous GenitaliaTable-4: Treatment.No of PatientsPercentagesHydrocortisone 7 23.3 % Hydrocortisone and fluodrocortisone 23 76.7 % Most of the kids in our survey presented with relentless purging since birth. This was ab initio thought of, because of enteric obstructor like pyloric stricture or simple regurgitation of milk, which is much more common in immature babies. Vomiting, as the lone presenting characteristic makes the diagnosing small hard but it is frequently associated with equivocal genital organs particularly in females i.e. clitoromegaly. Females are recognized because of equivocal genital organs, but males have normal genital organs and are non diagnosed until subsequently, frequently with a salt losing crisis [ 8 ] . Another of import clinical mark was failure to boom. It was present along with emesis and besides as the lone presenting characteristic. Salt also-rans besides presented in a province of daze. The criterion for diagnosing was raised degrees of 17OHP [ 4,5 ] . As the diagnostic installations are easy available, diagnosing at an early age with induction of intervention is possible. 21 h ydroxylase lacks ( CYP 21 ) is the most common signifier. Approximately 50 % of patients with authoritative inborn adrenal hyperplasia from CYP 21 lack have salt blowing due to inadequate aldosterone synthesis. One tierce of patients in our survey presented with grounds of salt blowing [ 8 ] . Bing an autosomal recessionary upset, there is 25 % opportunity that the status will be found in the siblings of the patient. In our survey there was an increased incidence ( 33 % of the patients ) of upset in siblings of patients in our survey. Incidence in all the patients could non be found as some of the patients were the first issues of the parents. Even in those, in whom the upset was suspected, merely clinical diagnosing was thought of on the footing of early neonatal decease. However attempts should be made in set uping antenatal diagnosing possible as intrauterine Decadron during the first trimester helps in cut downing opportunities of equivocal genital organ. This is done via chorio nic villus trying in first trimester at 8 hebdomads gestation [ 1-3 ] . Amniocentesis at 12 hebdomads can besides be done. As a antenatal direction step, Dexamethasone ( 10 – 20 ug /kg / twenty-four hours ) at diagnosing of gestation is started. Stop the intervention in male childs and unaffected misss. Affected misss in whom Decadron should be continued, maternal urinary estriol ( mark & A ; lt ; 375 ng/ deciliter ) are followed up [ 8,9 ] .DecisionFollowing points are drawn from our survey:  · CAH is fundamentally a disease of early babyhood  · The usual presenting ailments are really common like purging, desiccation and failure to boom.  · Prompt intervention with replacing therapy can efficaciously abort a life endangering province.

Marriage in Traditional African Society and It’s Televance Essay

The African marriage is full of deep-rooted culture that cannot be wished away. African culture and traditions are handed down from generation to generation. The African marriage is an integral part of the whole African culture and was a rite of passage for every mature man and woman. In African tradition, marriage was done after someone had gone through the adolescent stage where different lessons on respect, morality and upholding the tribes culture and traditions. Once the man found a lady who was willing to marry him and of his choice, the man and his kin would go and visit the lady’s family and get permission from the bride’s parents. He would visit the home with a few of his peers and they would wait in the simba (bachelors hut) as the man went to get confirmation from the bride’s family. If he received good news he would come back and tell his peers. This traditional practice is still relevant as it is respectful for a suitor to get permission from the bri de’s family if he should marry their daughter. Though not compulsory in today’s society, it is a good show of faith from the bride’s family that they entrust their daughter in the man’s hands. The dowry ceremony which was known as Ayie (which means I agree). The man’s family would visit the woman’s homestead. It is on the Ayie ceremony that a groom officially meets the parents of the bride for the first time; all other visits that could have taken place prior to the Ayie ceremony are unofficial and in some cases may attract disciplinary action on the groom. If a groom visits the parents of the bride but without the intention to pay Ayie during the visit, he may be considered undisciplined, as his action may be interpreted as arrogance or prematurely show off his relationship with the bride to her parents to time, although the mother of the bride may negotiate a higher price whilst the groom may also negotiate a lower price. The dowry ceremony is still relevant in today’s society as it’s a sign of appreciation to the bride’s family for taking care of her. Polygamy in traditional Luo society is rampant. The man was allowed to marry to marry as many wives as he wished.  This practice, though now constitutional is irrelevant in that most Luo men of today are Christians and conduct religious wedding ceremonies which forbid the union of a man to more than one woman. The practice is also expensive and does not cater for the needs of the women in the relationship. There was also wife inheritance in traditional Luo society. Once a woman’s husband died one of his brothers was to cater to all her needs and would take her in as a wife. This practice caused emotional distress to the mourning widow and also allowed for the spread of diseases such as HIV/AIDS. The traditional Luo marriage ceremony has its pros and cons. Like in every culture there are many important values to carry on and many practices that cannot be sustained in the 21st century. As individuals it is up to us to sift through the good in every culture and adapt it or throw away the irrelevant.

Effortless Cooking Every Day Essay Example | Topics and Well Written Essays - 500 words - 1

Effortless Cooking Every Day - Essay Example The second step is to drain meat. During this step, the cook should reserve sieved marinating liquid and dry meat with paper towel. It is possible to use glass or ceramic plates preparing meat. During the next step, the cook adds 1 T. butter to preheated browning skillet. Then, it is important to swirl skillet to coat bottom with melted butter. The next step is to add meat and cook it uncovered 4 minutes until meat is no longer pink. This step is very important because the quality and taste of meat will determine the taste and flavor of the finished dish (Barham, 2000).  The second step is to drain meat. During this step, the cook should reserve sieved marinating liquid and dry meat with paper towel. It is possible to use glass or ceramic plates preparing meat. During the next step, the cook adds 1 T. butter to preheated browning skillet. Then, it is important to swirl skillet to coat bottom with melted butter. The next step is to add meat and cook it uncovered 4 minutes until meat is no longer pink. This step is very important because the quality and taste of meat will determine the taste and flavor of the finished dish (Barham, 2000).   The next step is to choose a bowl for rice. To prevent boil-overs, it is better to choose large enough bowls. During this step, the addition of oil to cooking water will prevent boil-overs. It is very important to cook rice in a covered dish. A small secret is that rice requires virtually no stirring during cooking. In fact, less stirring is better since over-stirring can cause a ‘mushy’ texture.   In order to add a delicious taste to the dish, the cook can add sieved marinating liquid to rice while cooking. It is important to remember that the amount of rice should be equal to the amount of water. The cook should choose a bowl twice as large as the water amount. The next step is to heat water, add salt and stir the rice. The amount of time recommended is 15 minutes, but it depends upon the quality and the a mount of rice. If you are not sure about the exact time of cooking, it is possible to cook rice the amount of time recommended on the package.

Essay Example | Topics and Well Written Essays - 500 words - 76

Essay Example The ordinary citizens were not happy about the act which led to writings that were aimed at reminding the leaders that it was time they rose on their feet and advocate for better ways of governance (kovaly 59). Winston Churchill, after being awarded an honorary degree he read his speech which targeted at enlightening the people on the impact of the Soviet Union; division of countries were realised (Churchill 1). Songs were sung urging the leaders to feel the cry of the people. Bob Dylan in his song, â€Å"Blowing in the wind† which was released in 1963 was seen as a protest song against the cold war which the United States and the Russia countries were constantly involved in. He reminded the leaders of the cries of the citizens. The song â€Å"Surfin USA† released by Beach Boys in 1963 signified the amount of suffering the people had undergone, they feeling of taking summer holiday out of America by surfing through the ocean was the message being passed. The movie â€Å"Europa Europa† was based on a boy who survived attacks when his family was battle which led to his sister’s death. The movie was aimed at passing the message on the way the people were suffering. To make citizens understand why united States of America forces were taking part in the war, a film was produced (United States War Department). Modernisation was fought for by many women who were not allowed to be like their male counterparts. During the first world war when their men had to defend their country’s territory, women were left at home, they took care of the kids, did all the domestic duties and other odd jobs so that they could be in a position to support their families. Women learnt to be independent which led to the need for glamour. The youthful women were seen venturing into music and other bold activities which were prohibited, their boldness earned them the name flapper. Artistic expressions were

BHE 415 - Community and Domestic Violence (Module 1-SLP) Essay

BHE 415 - Community and Domestic Violence (Module 1-SLP) - Essay Example Violence may affect anyone, including us and our loved ones. With an increasingly violent society, how can we have peace of mind? How are we sure that the next victims are not us or our family members? The reasons for violence are multifold. There are some theories which say that violence is genetic. Each of us has our own biologic make-up, or a set of genes that we inherit from our parents. Some studies have pointed out that children born to violent parents have the tendency to become violent later on. This was viewed as a result to hormonal imbalances, such as serotonin, testosterone and low blood sugar levels. Some factors like poor nutrition, head injury, exposure to toxic waste and chemicals can also make a person to be prone to create violence. (Wilson, 1985) The next factor is psychological. A person grows through time not only physically and mentally but also psychologically. If a person was abused during his childhood, may it be physically or sexually; if there is deprivation of love, care and physical needs, if a person has been denied of his right to education, then that person is prone to violence. Drug abuse is also a contributing factor. Many crimes have been committed by people taking illegal drugs or alcohol. (Monahan, 1992) As a result, violence not only the health and welfare of individuals—it also affects communities. It affects families by weakening their bond and creating chaos among the family members. Violence also affects people psychologically; the feeling of fear, insecurity, inadequacy and helplessness are enough to make a person become psychologically deranged. Abused people may have low self esteem, anxiety and depression. These people are prone to post traumatic stress disorder and suicidal ideations. (Elliot, 1994) The direct effects of domestic violence are devastating. It leads to low birth weight disabled infants who have the risk of dying. Injured children who are

Claims and reflection Essay Example | Topics and Well Written Essays - 750 words

Claims and reflection - Essay Example My analysis majors on citizenship and identity in a European context. A lot of arguments concerning this area led to the development of the law pertaining to the freedom of movement of people within the Union. This will allow the citizens from other member states have equal rights and treatment as the domestic citizens. As I was writing my essay on what should be contained in EU and UK Bill of Rights, at first I thought that it may be a difficult paper to write since we have no written Constitution in the country, hence, it may be difficult finding a basis for my paper. UK being one of the world’s democracy without a written constitution, this does not mean one cannot find any documented rules and regulations in use by the British government and which is supreme over ordinary law in comparison to, I got some information from this website http://www.yourrights.org.uk/yourrights/rights-of-immigrants/european-union-nationalisits-and-european-union-assiations-agreements/difference s-of-approach-between-eu-and-uk-law.shtml. I found the information concerning the critical understanding of the interactions between UK and EU law’ in MLO1. It’s clear that the British legal system has laws that are a combination of statute law and the principles of the common law that are developed by the courts. It is based on the constitutional principles of Parliamentary sovereignty and the Rule of Law, compared to the EU whose laws are written in a Constitution. As I found in the website http://www.wlv.ac.uk/lib/PDF/Oxford%20Ver4%20July10%20HB.pdf, the British legal system is based on the idea of outstanding rights that

Duty of law Essay Example | Topics and Well Written Essays - 2500 words

Duty of law - Essay Example Emphasising on this understanding, the essay will aim at addressing the principles mentioned under the Corporations Act 2001 (Cth) concerning the fiduciary duties of directors in a company. The essay will also aim at analysing the purposes and effectiveness of these statutory principles to restrict the directors from performing unethical conducts or wrongdoings, taking the opportunity of the power enjoyed by them. 2.0. Background Companies act as an artificial legal entity which can be managed with the enforcement of its human legislatures. The board of director’s form an important part of any organization as the decision making and the managerial powers remain mainly with its directors (Austin & Ramsay (2013). For instance, as stated in section 198A (1) of Corporations Act 2001(Cth), the directors are eligible to manage the company’s affairs under their jurisdiction. ... Previous instances have often illustrated unethical conducts performed by the directors, misusing their power or authority to satisfy the organisational interests above their personal objectives (Austin & Ramsay, 2013). 3.0. Duty of good faith 3.1. Code of conduct As stated under the section 181 of Corporation Act 2001(Cth), duty with regards to good faith bestowed upon directors in compliance with the interest of the management is to avoid conflicts which might arise from personal benefits (Milne, 2006). Under this provision, if the directors of a company decipher reckless attitude and/or depict behaviour of intentional dishonesty, which in turn hampers the interests of the corporation at large. In this context a director of any corporation must enforce or exercise the bestowed responsibilities and powers with regards to good faith and for a ‘proper purpose’. If the director violate this duty or responsibility they are liable for punishment under civil penalty provision under section 1317E of Corporation Act 2001(Cth) (The Legal Exchange, 2012). 3.2. Case Examples According to the case of Charterbridge Corporation Ltd v Lloyds Bank Ltd (1970) a test was conducted to find whether the decision made by the director in relation to that situation was valid. As per the case convictions, it was held that directors in a particular company owe a certain degree of responsibility towards the company’s creditors at the time of its insolvency (Sourdin, 2009). It is worth mentioning in this context that even though the provision unambiguously dialects the implications of good faith, it fails to render a precise notion of ‘proper purpose’ and thus can be deemed as subjected to the judge’s rationality when assessing

Historic Sustainability Essay Example | Topics and Well Written Essays - 1500 words

Historic Sustainability - Essay Example It is worth noting that the prices of tea in the world market is falling drastically day by day, which have had nasty implications not only to the producers but also to the workers. All stakeholders need to join hands in unison and address the issue finally. The inauguration of tea as a major drink has been a milestone in not only the economic development of India but also worldwide countries. Essentially, tea has become a core part of majority of people’s daily lives. History shows that the current tea bushes did grow as wild vegetation in India. The natives’ settlers in India had a tendency of utilizing it in form of vegetables. It was a popular component of a locally made soup. Tea consumption has recorded an impressive evolution over time. This is an indicator of its crucial importance as a world’s second consumed drink. In India, tea remains the leading drink. It is available almost everywhere and all the times. Indian tea is named according to the region it emanates from (Hicks, 2009, pg. 253). Having been in the market for 172 years, Indian tea remains detrimental to the economy of the country. The industry is the backbone of the economy, employing millions of its citizens in diverse fields and bringing up an impressive foreign exchange count. The core tea growing regions in India are the highlands located in Eastern and Southern states. Its contribution to the Gross Domestic product is renowned. Its exports does account for 31% of the global tea production (Lutgendorf, 2012, pg. 14). The last 20 years have seen tea sector in India stabilize, gaining popularity in the world markets despite stiff competition from other countries. India remains both the largest consumer and producer of tea. 85% of its population consume tea. The country also account for at least 27% of the tea produced worldwide. Its exports account to 13% of

Understanding Traumatic Migrant Sex Workers and Trafficked Women Essay

Understanding Traumatic Migrant Sex Workers and Trafficked Women - Essay Example Although women trafficking and the trauma of the women have become foremost priority for social workers, yet they face daily challenges to get engaged with this group of migrants. I traveled to Italy from Nigeria with my aunt at the age of 16 for the purpose of working in her boutique. Once I reached there, I was forced to enter into prostitution. The money received from this was taken by my aunt and I was threatened to remain silent about the matter. For two years I was dehumanized, humiliated and maltreated after which I managed to escape from the ordeal. It was the most traumatic experience of my life as I had nowhere to go nor I could seek help from anyone. The modern concept of indigenization emerged in the third world countries initiated by the western power. The subject of social science was implanted from the West during colonialism in order to strengthen and make a permanent impact of the western power. As a result in the third world countries both political and academic ventures were influenced by the western colonialism. In order to achieve self governance it was important for â€Å"political decolonization and the indigenization of social sciences or intellectual decolonization.† (Yunong & Xiong, 2008, p.612) I chose migrant sex workers and trafficked women as the subject of my topic to discuss them in the background of indigenous social sciences. There are some liberal advocators of indigenization who admit that social sciences cannot be limited by any boundaries and conditions. They argue that the ideas and the principles are only common factors that are adopted from studies in western civilization. This group of advoc ators is more inclined towards a union of both perspectives and their attempt is to make social sciences more transcultural (Yunong & Xiong, 2008, p.612). In my opinion, the social policies of any particular country should

Ethics in Criminal Justice Essay Example | Topics and Well Written Essays - 500 words - 4

Ethics in Criminal Justice - Essay Example Blagojevich was, ultimately, found guilty of nearly 20 different counts of soliciting bribes, conspiracy to illicit and accept bribes, wire fraud, conspiracy to commit extortion, and attempted extortion.(Davey, and Emma G. Fitzsimmons ) But why does it exist? What causes people within politics to attempt such acts? What can be done to deter and prevent it? In order to get the answers to these questions it is necessary to understand more about corruption in government. Political corruption has a very strict definition, in that it involves political decision makers at high levels of the political system. When the people who are charged with the responsibility of making and upholding the laws are the very people who are corrupt, that is political corruption. It is widely accepted that corruption and the temptation to commit it is highly dependent on a person’s ability to believe they can successfully â€Å"get away with it.† The act of bribery, extortion, selling votes, accepting gifts and kickbacks are all reprehensible behaviors that can undermine the people’s faith in their elected officials. The overall cost of corruption is, also, rather high, and manifest in three typical ways. The first is, is the funds required to finance the bribes to get the favorable treatment , financing meetings, maintaining silence, and negotiating all add cost to whatever endeavor the involved group are attempting to illicit. The second, corruptio n can undermine the efficiency of the free market. Lastly, it can misrepresent resources towards the projects that generate â€Å"payoffs.†(Lanza, 2004) There are two ways that are encouraged to help curtail and deter corruption. The first is eliminating opportunity. Much in the way businesses are working harder and harder to fortify their companies from potential fraud. They structure their company to make the likelihood of successfully succeeding in committing fraud more and more risky to attempt.

Frankenstien essay Essay Example for Free

Frankenstien essay Essay How does Mary Shelley present Frankensteins monster and what is her message to readers? In this essay I shall be answering the question on how Mary Shelley present Frankensteins monster and what is her message to readers? I will also explore the irrational fears that existed, about the progress of science and scientific technology, in the 1800s and how they are addressed in the novel. I will conclude with a personal comment on Shelleys portrayal of the creature and scientific progress. Frankenstein or the Modern Prometheus was written by Mary Shelley in the early 19th century. At that time it was very unusual for women to write and even more so because she was only 19 years of age. At this time there were many ambitious scientists. These new scientists were eager to research things they had not researched before. She first published the book anonymously in 1818 when critics hailed it as the work of a genius and were very much surprised when they found out that a woman had written it. This was also how initially reacted. Many scientific advances took place in the 18th and 19th centuries such as the invention of the lightning conductor, and the creation of the first prototype electric battery. In some ways, the creation of the creature by Frankenstein shows the dangers of humans trying to overreach their potential with scientific research and knowledge. Victor Frankenstein, an ambitious Swiss university student, dedicates his entire life to trying to create life. Nonetheless, when he succeeds, the ugliness and repulsiveness of the creature forces Frankenstein to reject it. The creature faces a life of solitude and loneliness and society rejects him even when it tries to help. This leads to the death of Frankensteins brother, William, whom the creature kills, and the servant, Justine, is hung after being found guilty of the crime. Frankenstein then incurs the wrath of the creature by making a mate for it and then destroying it. This leads to the death of Henry Clerval, his best friend, and Elizabeth, his wife. In the end both the creature and Frankenstein die. The death of so many people can be a way of showing that scientific advance is not always the best way to go and that it can be dangerous at times. Themes which are, explored in Frankenstein; are madness, dreams and nightmares. During Shelleys time there was a fear of new technology because of the dread that machines would replace humans as workers; this would leave many of the peasants, and working class is out of a job. This led to riots and revolutions such as the Luddite riots of 1811, which saw machines smashed in violent reaction. This can be linked to riots and demonstrations today against abortion and test-tube babies that one sees in the media everyday. The novel begins with the expedition of an explorer named Walton. Walton is about to fulfill his ambition and go on his expedition to the North Pole. He wants to go to the North Pole because he wants to be remembered by discovering a place where no man has ever gone. Walton writes a letter to his sister from St. Petersburg. In his letter Walton says that he knows that ordinary people are worried about his ambitions. He says his sister regards it as an evil forbidding. Walton prepares for the expedition by being hard and very tough on himself as if he enjoys torturing himself. He states in the letter that he: Endured cold, famine, thirst, and want of sleep Victor Frankenstein wants to push back the boundaries of science. He wants to create life so that people would live longer. The reason he desires to bring back life is that no one else had accomplished this before. He is also a scientist and wants to be remembered like all scientists. Victor Frankenstein is also very excited because he not only thinks he can bring back life but he also thinks he could create life. He says: A new species would bless me as its creator and source He thinks hes going to be thanked and thought of like a god by the new species he is about to create. Frankenstein prepares for this by attending lectures, reading books, not sleeping and putting himself wholly into his work: Stars often disappeared into the light of the morning whilst I was yet engaged in my laboratory, meaning that Frankenstein spent so much time in the laboratory the nights passed quickly. This also shows the devotion to his work. His work appears to be dangerous because he went to places like charnel houses and vaults, which are considered to be very creepy. He spent days inside these places to collect raw materials, that is, body parts for his creation. This indicates that he is prepared to do anything to accomplish his ambition, to bring back life. When the creature is in the process of being created, Frankenstein is portrayed as a fanatic and maniac about what he is doing. He neglected his health due to his commitment to his work. I can discern this because he says: My cheek had grown pale with study, and my person had become emaciated with confinement. This tells me that he has become very ill because of his steadfastness on his mission to create artificial life. This can mean that he is too committed to reaching an objective that is out of any humans reach. In a way Mary Shelley also shows how Frankenstein is breaking societys taboos by: [collecting] bones from charnel houses; and disturbing, with profane fingers, the tremendous secrets of the human frame. This is shown as going against nature and as evil. He also describes his aim as filthy, with the use of the words: my workshop of filthy creation

Impact Of Culture And Employee Voice In Organizations Management Essay

Impact Of Culture And Employee Voice In Organizations Management Essay Culture is the shared assumptions, values, and beliefs of a group of people which result in characteristic behaviors (Hobfoll, 2001). People communicate with each other from different cultural background. Culture as a factor influences the following facets of organizational life. Employee voice, through direct or indirect methods, plays an important role in organizational communication. It is evident that computer-mediated communication has become very common in work life, just like through the media of e-mail, mobile phone and even MSN, which facilitates our communication and makes lives at work easier. Nevertheless; some people choose the face to face communication pattern. In their belief, it helps have a relationship with other people directly; however, people can communicate indirect voice including the media of the work council and some union. Also through collective bargaining, people contact each other and change ideas and thoughts with each other freely. And the same conditi on of supervisory boards. In this essay the author will critically evaluate the relationship and impact between culture and employee voice in the context of modern corporations. In the conduct of this discourse, definitions and discussion of culture will be presented followed with explanation and discussion on culture and employee voice in organizations. Some examples will be used to illustrate the basic premise that this culture-voice coupling can be an area of tension for the employee relations practices of multinational corporations. 2.0 Discussion on Culture and Employee Voice in Organization Management. 2.1 Culture and Employee Voice Basically, organizational culture is the personality of the organization, which comprised of the assumption, values, norms and tangible signs of organization members and their behaviors (Hobfoll, 2001). When the members of an organization work together, they soon come to sense the particular culture of an organization. For example, the culture of a large, for-profit corporation is quite different than that of another corporation. Culture plays a vital role in modern society, especially in international businesses among companies. Different culture represents different thoughts, values and way of thinking owing to the different social background (Hobfoll, 2001).. In modern organizations, people work together in the same company may come from different places even different countries. Therefore, the communication between them is of great importance to the development of company. And the concept of culture is particularly important when attempting to manage organizations. Employee voice refers to the participation of employees in influencing corporate decision making. Employees are given a voice through informal and formal means to minimize conflict, improve communication and encourage staff relation through motivation and fair treatment. Employee participation is a form of empowerment and motivation that leads to increased productivity and retention. The term employee voice provides a useful way to examine both its purpose and practice, which is allowed to transfer union and non-union, individual and collective. The purpose of the voice as the articulation of individual dissatisfaction overlapped with notions of employee contribution through communication channels. Second the articulation of voice as collective organization was rather less central than other individualistic definitions of voice (Jeffrey and Linn,  2001). In contemporary organizations, competitive advantage can come from ideas employees communicate to supervisors for improving processes, products, and services. One approach to studying employee communications with supervisors is voice behavior. Different culture has different behavior norm and moral constraints for its employees in a company. Culture will exert great influence on the way employees communicate with each other. Meanwhile; employee voice is a way to represent the organization communication. And the voice of employees conveys their certain culture. Take the Japan Company and American company as examples. In Japan Company, employees are required to hold the creed of discipline and they have high performance work system. Japanese employees should be in charge of their own business individually rather than cooperate with others (Bae, et al., 2001). While in American company the culture is quite different. The employees usually behave directly to others and most of times they will share with the work. What the difference of them show in the aspect of their human management. In some famous Japan companies like SONY, whose employees will be divided into different groups and keep the groups as separate as possible according to their different cultures so as to avoid the cultural clashes with each other. But the feedback of this system is that it is difficult to hear different voices from employees, which will of course constraint the quicker and healthier development of the organization. The condition is opposite of the American company. It can be seen that employee voice in organizations can be greatly influenced by organizational culture. Thus, managers should consider cultural factors when managing employee voice. In all, culture plays an important role in both international business and international human resource management, which has great impact on employee voice, an effective way of organizational communication in organizational management. In modern business world, the fierce competition between companies mainly depends on their cultural advantage through the effective management. Culture difference between employees in companies may lead to the dominant troubles in communication (Hobfoll, 2001). The securing of credibility, the nurturing of goodwill, the motivation of a workforce and the development of a marketable product, all translate into the bottom-line of the success or failure of a business activity. In this regard, the securing of these prizes, in the international context, has prompted multinational corporations to seek to establish a corporate culture across borders, and conduct appropriate measures with employee voice. 2.2 Direct Employee Voice and Indirect Employee Voice Employee voice is attained through both direct voice and indirect voice. Direct employee voice includes general conversation between employees and employers, email communication, employee surveys and notice board at the workplace. While indirect voice includes work council, union, collective bargaining and supervisory board. (Jeffrey  A  L,  Linn  V  D,  2001) The direct voice is most certainly one of the most impressive forms of mediumship whereby the people present are able to very clearly hear Spirits speak aloud in their normal voices, exactly the same voices as they were known by in physical life, and to engage in long conversations with them. The indirect voice represent that enjoy a high-quality, cost-effective, public-switched voice solution for calls to local, national and international, phone destinations. (Burke, R. J. 2001). Organizational values, work experience and satisfactions among managerial and professional women. Direct and Indirect Voice services are specifically designed for business customers concerned about the quality and cost of their voice communications. Indirect access is the simplest way to enjoy all the benefits of becoming a customer of one of our partner supplies. (Buelens, M. and H. Van den Broeck 2007) Our partners indirect voice services allow you to take advantage of their own highly working networks. T his, combined with a detailed approach to building dependable interconnections with other operators across the UK ensures a reliable telephony service for all your communications needs. While direct voice can provide employees an opportunity to exchange ideas and thoughts directly, even face to face. This kind of voice is easily to be heard and accepted by the company. Through the direct employee voice, people can exchange ideas and thoughts with others directly. And this kind of communication can reflect some problems existing in employees. While through the indirect employee voice, it is probably not easy to achieve the result of communication between employees, maybe it will cause some misunderstandings. The experience of the McDonalds EWC suggests that where workforce has low levels of unionization and employees are opposed in principle to the prescribed arrangement, a non-union firm can frustrate even the limited aims of the Directive. Furthermore, legally underpinned national-level substructures, which are often assumed to make such European-level bodies accountable, may fail to do so in practice. Multinational corporations have been defined as enterprises which own or control production or service facilities in more than one country. (Enderwick, P. 1986) It is the dimension of ownership and control of value-adding activity that sets the MNC apart from the organization which simply trades internationally. Moreover this feature of ownership or control brings with it the challenge of managing human resources in different national contexts. It is within this field of organizational life that this essay will be concerned. This can be contested territory for multinational corporations. There will be a practice and experience in the organizations country of origin but the form and content of this may not fit comfortably or favorably in other countries where there is a different cultural disposition to voice. Conclusion Culture as a factor influences the different facets of organizational life in regard of members behavior, belief and human management of an organization. In some certain, employee voice reflects by culture plays an important role in the organization management. The role of employee voice as the articulation of individual dissatisfaction overlapped with notions of employee contribution through communication channels. In the conduct of this discourse, definitions and discussion of culture have been presented followed with explanation and discussion of employee voice. Therefore; the conclusion about this culture-voice coupling is that organizational life should pay primary attention to the culture difference between its members. Only in this way the further development of an organization might be possible.

Country Report on the Philippines

Country Report on the Philippines The Philippines is an amazing country. Many tourists go there to see the many beautiful views. We decided to do the Philippines as our country because two-thirds of the group is filipino. The Philippines is an interesting country to research because there are many things we dont know about it. An interesting fact about this country is that the Philippines was the first country in Southeast Asia to gain independence after World War II, in 1946. In filipino, the Philippines is called Republika ng Pilipinas. Although, in English it is just the Philippines. It was named after the King Philip II of Spain, in honor of him. The Philippines is located on the continent of Asia. It borders the country of Malaysia. The area of the Philippines is 115,831 miles squared, but the area of the United States is 3.797 million miles squared. The Philippines compared to the United States is that it is 3,681 less miles. The Philippines produced 11 percent of the worlds nickel in 2010. The countrys rich natural resources also include major copper deposits, chromium, gold, and silver;minerals made up 8 percent of merchandise exports in 2011. One popular foods that they eat in the philippines is Adobo. Adobo is a meat, seafood, and vegetable dish. Another common dish in the philippines is Afritada, Afritada is a meat dish cooked in tomato sauce. Lechon is also a common dish in the philippines. Lechon is a dish that is made by roasting  a pig over charcoal. However, the most popular food thats eaten in the philippines is rice. Majority of the people in the philippines love rice. The relationships with family that filipinos have with each other is what makes them connect. The American culture is different from the filipino culture in a few ways. For example, in the American culture, the children are expected to be independent with a little help of their parents. However, in the filipino culture, the parents expect the children to follow their directions step by step and how they say it. Another difference between the two cultures is the amount of privacy they each get. What I mean by this is, in the filipino culture, all of the family is close by and could possibly live together. However, in the American culture, the families are spread out and dont all live in one house. Finally, another difference between the two cultures is the equality. In the American culture, it is known to be said that everyone has equal rights. Also, when greeting it is acceptable to call someone sir or maam. Nonetheless, in the filipino culture, the elderly is treated better/before e veryone else, and everyone is greeted with a handshake, a smile, and some friendly words such as Hi, how are you? or Hi, hows your day so far? One thing that someone researching or learning about the philippines would be about King Philip II of Spain. This would be the most important thing to know because he was the first one to make it to the philippines and, because the philippines was named after him. Since the Philippines was named after King Philip II of Spain, the island country has been under Spanish rule for centuries. To go more in depth, he ruled the Philippines for over 300 years in total. Today, it is the largest Roman Catholic country in Asia. The Philippines is an interesting country to learn about with amazing views to see as you are there. After reading this, you will learn that the Philippines is a very different country from other countries. There are many different and interesting cultures you may learn about. Once you actually experience the Filipino culture, you will see a whole different world. There are many interesting facts about the Philippines, but the most interesting one is that the Filipino flag is the only flag in the world that you can determine whether or not they are at peace or at war. You can tell at how the flag is flown. If the flag is flown with the blue on top they are at peace, but when the flag is flown with the red on top you can tell they are at war.

Lord of the Flies by William Golding Essay -- community, socialism, lif

Isolation is the state in which a person is separated from the presence of other beings. Isolation can take three forms which include social, self-inflicted, and forced isolation. Each form is damaging to one’s well-being including their physical and emotional health. Isolation is portrayed through the novels, Lord of the Flies by William Golding, One Flew over the Cuckoo’s Nest by Ken Kesey, and Brave New World by Aldous Huxley through the inclusion of certain characters. Although all forms of isolation are detrimental to a person, social isolation causes the most wide spread damage to the individual. Social isolation is the most destructive form of isolation because it forces an individual to be excluded from the company of others even while the individual longs to be included. In the novel Brave New World, John portrays characteristics of someone who is isolated by force, through his mother’s destructive actions. John’s mother is extremely promiscuous and acts like she is from the World State even though she and John are actually living in the Reservation. She has sex with other women’s husbands, which makes them ostracized by the community. When they enter the World State, they don’t understand how the people there live such a controlled lifestyle, because they were accustomed to living in such a carefree society. John describes the reason he moved to the world state as â€Å"to escape further contamination by the filth of civilized life, it was to be purified and made good; it was actively to make amends† (Huxley 247). John and his mother long to live the perfect life they assume everyone is living, but they are sadly mistaken as their helicopter lands in the World State. The citizens of the World Sta te s... ...t and care taker personality, as Bernard is socially isolated for his free-thinking mind. Chief chooses to isolate himself from the other mental hospital patients by pretending that he is deaf and mute. Isolation affects all those that encounter it throughout their lifetime by making them feel alone, deserted, and detached in this sometime cruel world and society. Social isolation can affect the way a person lives and acts for the rest of the individual’s life by destroying the individual’s sense of unity and feeling of belonging, the person can feel alienated throughout the course of their life. Works Cited Aldous Huxley. Brave New World. New York: HarperCollins Publishers, 1932. Print. Ken Kesey. One Flew Over the Cuckoo’s Nest. New York: Penguin Group Incorporated, 1962. Print. William Golding. Lord of the Flies. Salisbury: Faber and Faber, 1954. Print.

The Euthyphro Dilemma Essay -- Philosophy Plato Euthyphro

The Euthyphro Dilemma In Plato's dialogue, 'Euthyphro', Socrates presents Euthyphro with a choice: `Is what is pious loved by the gods because it is pious, or is it pious because it is loved [by the gods]?' Euthyphro responds by asserting that piety is that which is approved [loved] or sanctioned by the gods; whence impiety is whatever is disapproved of by the gods. However, as Socrates points out, the question poses a dilemma for those who believe as Euthyphro does that Truth is revealed by divine authority alone. Now, a dilemma is an argument forcing a choice of two unfavourable alternatives. The important point here is that the alternatives must be equally unfavourable. Simply to be faced with two alternatives is not to be faced with a dilemma. To appreciate why each of the options set out above are unpalatable for Euthyphro, we need to unpack the import of each alternative carefully. In drawing out the implications of Socrates' argument, I intend to substitute the word `God' for Plato's `gods'; this change will not affect the potency of the argument, and will make the dilemma more topical and relevant to the modern reader. Essentially, the dilemma faced by Euthyphro is this: If it is maintained that certain actions and dispositions are good simply because God favours them, then it seems that the distinction between good and evil, right and wrong, is purely arbitrary; for no reason can be given why God should favour one kind of action rather than another. The distinction is solely a matter of God's `taste', just as it is a matter of my taste that I prefer prawns to oysters. As no reason can be given why God should favour, say, justice and kindness, he might equally have favoured their opposites. In which case ... ...d so, the dilemma has not been resolved completely after all. Undoubtedly, anyone holding a theistic conception of morality must find some place for divinely revealed moral commands; but it may be that in so doing the theist weakens their resolution of the dilemma. On the one hand, they want to say that the question of whether an alleged special revelation concerning moral matters comes from God is to be answered in the light of our rationally established criteria of good and evil. This suggests that morality has no need of revelation. On the other hand, they want to say that, for the theist, ultimate questions of good and evil cannot be answered apart from reference to special revelation. This suggests that, in the final analysis, our reason is inadequate as a source of the knowledge of good and evil. It is hard to see how the theist can have it both ways.

Health care cost Analysis Essay -- essays research papers

Health Care Costs Analysis   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Healthcare is expensive and Americans want the best possible healthcare they can get. Consumers are demanding more tests, better drugs and insurance coverage. Americans desire a high quality of life and insurers/employers are trying to provide the means, but cost effectively and without raising costs. In order to do this, â€Å"consumers will have to make more decisions, pay more and perhaps demand greater value† (Barr, Paul).   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"The common forces driving utilization and costs are medical technology advancement, demanding consumers, and an aging population† (Barr). Advancements can be seen all over the medical field in areas such as MRIs, new cardiology procedures, highly specialized drugs, cancer treatments, and new laboratory procedures. Consumers are savvy and know their options. There is advertising from pharmaceutical companies and medical technology corporations promoting their drugs and products nationally via the Internet, magazine and television ads. The aging population is also living longer.   Ã‚  Ã‚  Ã‚  Ã‚  This population is living longer due to technological advances and insurance coverage. A huge portion of this coverage provided is by Medicare. Generations have paid into and depended upon this source of funding for years. It is projected that Medicare will be exhausted within the next 14 years. Currently Medicare â€Å"is the biggest single p... Health care cost Analysis Essay -- essays research papers Health Care Costs Analysis   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Healthcare is expensive and Americans want the best possible healthcare they can get. Consumers are demanding more tests, better drugs and insurance coverage. Americans desire a high quality of life and insurers/employers are trying to provide the means, but cost effectively and without raising costs. In order to do this, â€Å"consumers will have to make more decisions, pay more and perhaps demand greater value† (Barr, Paul).   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"The common forces driving utilization and costs are medical technology advancement, demanding consumers, and an aging population† (Barr). Advancements can be seen all over the medical field in areas such as MRIs, new cardiology procedures, highly specialized drugs, cancer treatments, and new laboratory procedures. Consumers are savvy and know their options. There is advertising from pharmaceutical companies and medical technology corporations promoting their drugs and products nationally via the Internet, magazine and television ads. The aging population is also living longer.   Ã‚  Ã‚  Ã‚  Ã‚  This population is living longer due to technological advances and insurance coverage. A huge portion of this coverage provided is by Medicare. Generations have paid into and depended upon this source of funding for years. It is projected that Medicare will be exhausted within the next 14 years. Currently Medicare â€Å"is the biggest single p...

Obtaining Mental Health Services

Being a probation officer is not easy.   It requires a lot of knowledge, skills, and experience to be an effective probation officer.   Having a golden heart is fine – believing that these offenders can change their lifestyle, supporting them in their intention to function in the community, and making sure that the people within the community where these offenders are staying would be safe from any danger.   However, objectivity should always come first since many lives are dependent on the probation officer’s ability to supervise and monitor these offenders’ performance. A probation officer also uses his resources in the community to assist his client, the offender in seeking employment or services such as medical care, alcohol treatment, mental health treatment, and the like.   The probation officer explains all the terms to the offender’s temporary release and the consequences for violating them under probation.   Everything is made clear. In the case of this 22-year-old man who have been convicted four times in two years straight for driving while under the influence of alcohol, thorough investigation should be done.   This man may be telling his substance abuse counselor that he is clean.   He may be present in all his counseling appointments.   Nevertheless, these claims do not prove that he has stopped alcohol consumption.   Furthermore, having eccentric ideas and opinions – this man telling you that his neighbors are monitoring his breathing through the television – proves that there is something terribly wrong about this person.   So, what do I plan to do about the matter? First, researching and investigating about this man’s personal history , such as his family to start with, would be a good start.   Knowledge about his childhood, his relationship with his co-family members, and his plight during his growing-up years are vital information in knowing how and why he acquired such behavior, vices, and even beliefs that he still carry on up to this day. A background check of his life three to five years prior the present date could also come in handy.   Past relationships usually contribute to a person’s perspective and sanity.   Another background check would be his scholastic and interpersonal performance in school given that he went into one.   Based from his interaction with these people, I might find clues to some grounds as to why and how this person came to be the way he is. Second, talking with this man would give me hints and clues about the way he thinks, the way he answers questions – may it be rational, practical or not, and the way he views the world.   Upon acquiring his personal background, a brief interview about his family and previous relations with others would somehow prove if this man is reliable or not.   This would be necessary because inconsistencies on his statements would prove irregularity of his character, therefore making him a threat, somehow, to the community. Third, I would discuss with his substance abuse counselor all my findings so we could come up with proper procedures needed to prove his mental capability or incapability.   I would suggest that the substance abuse officer gives my client some intellectual tests because my client is showing signs of a paranoid schizophrenic or of a person just having paranoid reactions that may be due to depression or trauma Fourth, I would require my client to undergo not only the psychological tests that his substance abuse counselor would give him but also a series of physical exams for instance urinalysis, blood tests, and the like to see if he really is clean or if he went back to alcohol or worse took other substances and mixed it with alcohol altering the effects of the alcohol-intake alone. Fifth, I would reiterate to my client the sanctions that he might be subjected to if his tests prove that he is positive of alcohol and/or substance intake.   Such are necessary actions for me to accurately and objectively assess him and propose certain measures. References Civil Service Associations, Inc. (August 2000). Examination Preparation Booklet.. Principles and Practices in the Treatment of the mentally Ill/Emotionally Disturbed, Problems of the Mentally Ill/Emotionally disturbed, booklet #10. pp. 4-5. Retrieved October 10, 2007, from http://www.csea9200.com/pdfs/TestPrepBks/TreatMIllBook10.pdf Court and Community.   (January 2003). Probation Officers. p2, numbers 4 – 6 . Retrieved October 10, 2007, from

Falsifiable Scientific Theories Essay

This paper is about the comparison and contrast of two equally strong theories about the view of the universe and its entities’ strategic formation. The geocentrism and heliocentrism theories are to be examined in terms of their falsifiability, as both had been cause of conflict of scientific thought in the earlier times. In Karl Popper’s account, any theory in the science can only be proven as scientific if and only if it is falsifiable. The conflict of thought between the two major structures of planetary movements, geocentrism and heliocentrism, we take into account the points wherein each is deemed falsifiable. The geocentric theory, as developed by Ptolemy, was the worldview which says that the Earth I the center of the universe, where other planets and objects go around it. This theory was then supported by the seemingly cyclical revolution of the stars and the sun around the Earth, and concentrating on the perception of Earth to be unmoving and stationary. To further show that the Earth was still, some people tested the reaction of birds whenever they let go of a tree branch – the birds did not get thrown off into the sky. In the 5th century BC, Plato was able to develop a mythical explanation of the cosmic movement of the Sun and the stars: that the cosmos is the Spindle of Necessity where Sirens turned the three fates. This mythological explanation is a ground for the falsification of the theory since it suggested trivially unscientific explanations. Euxodus who worked with Plato derived a mathematical explanation of the planetary movements, basing on Plato’s principle that all planetary phenomena in the universe could be explained by uniform circular motion. Aristotle also deduced that all cosmic entities rotate around the Earth, and there were 56 concentric spheres that are attached to thee heavenly bodies. The moon is supposedly the innermost sphere which gets dark upon contamination with the Earth. This dark spot is late on deduced as the lunar eclipse. This notion of geocentrism which was then the leading theory of the structure of the universe proved it to be indeed fully scientific since it was able to create a model that made correct predictions of future observations. The parallax was described in the geocentric theory to result as either the Earth is stationary and so no effect exists, or the stars are so far away the effect was undetectable. The Ptolemaic system was scientific in the sense that it produced testable results and was modified over time in response to observations. It was also supported by the prevailing philosophies of the time. The support for this position was varied: from the basic fact that we don’t feel the earth rotate to the idea that if it did, the winds would be enormous because the air would stay fixed (it actually doesn’t, but they thought it would). With the addition of epicycles, it was possible to predict eclipses and the position of the planets to a fair accuracy. However, this theory was put into criticism and question in 1543 when Copernicus challenged it with his De revolutionibus orbium coelestium, which explains that the planets, including the earth, revolve around the Sun. The Sun is deemed to be the center of the universe. The heliocentric theory made better predictions of more kinds of observations, but most of these were not available until Galileo. Nevertheless, there was also strong scientific evidence against heliocentrism. Before the invention of the telescope, there was but one potential experiment that could demarcate between geocentrism and heliocentrism: that of the parallax of the stars. Parallax is the apparent displacement or difference of location or orientation of an object which is seen along two different lines of sight. It is measured by the angle inclination between those two. The experiment showed results which favored the geocentric model. Lack of parallax was a fully scientific falsification of heliocentrism. The heliocentric theory could not explain the parallax of the stars until Galileo was able to observe completely the moons of Jupiter and the complete phase of Venus. Obviously, these two scientific theories are deemed falsifiable in terms of Popper’s criteria. Each has its own way of falsifying the other in terms of scientific basis. The Quine-Duhem principle has been employed in thee observations: we can not test a scientific hypothesis in pure isolation because a relatively plausible explanation would require one or more background assumptions in testing its empirical truthfulness.

Goss V Lopez Brief

i. Case Citation Goss v. Lopez, 419 U. S. 565 (1975) ii. Facts Public school students from Columbus, Ohio brought this suit. They claimed that their constitutional right to due process was violated. The students were suspended without hearing prior to their suspension. They were suspended for destroying school property but principals can only suspend up to 10 days or expel them. If suspended they must notify parents without 24 hours and give the reasons. Students may appeal to the board of education. iii. Primary Issue Can students be suspended without due process? No iv. Decision or conclusion of the courtGoss established that due process is required when a student is suspended. It also established that you can’t suspend a student for more than 10 days and you have to notify the parent. Due process will be required depending on the severity of the consequences of the students. When it is a longer and severe case you usually are required witnesses. v. Reasoning Under Ohio law you have a right to public education. School has the authority to establish code of conducts however; authority is subject to constitutional limits. Students have a right to education under the Fourteenth amendment.The court reasoned â€Å"Having chosen to extend the right to an education to people of appellate class generally, Ohio may not withdraw that right on grounds of misconduct, absent fundamentally fair procedures to determine whether the misconduct has occurred, and must recognize a student's legitimate entitlement to a public education as a property interest that is protected by the Due Process Clause, and that may not be taken away for misconduct without observing minimum procedures required by that Clause. † Reference: http://en. wikipedia. org/wiki/Goss_v. _Lopez

Character of Mrs. Sparsit in Hard Times

MRS. sparsit is an elderly lady who is highly connected and have a huge aristpcratic bvackground. her husband belonged to the family of â€Å"POWERLS†. Scadgers†¦. she is a widow now, fallen yupon evil days to take up job. She works as a housekeeper olf mr. Josiah Bounderby. bounderby treats her in the most polite manner and never fails to pay compliments and regards to her excellent background. Mrs. Sparsit is very much proud of her coonnectipons.The jnovelist descxribes her as a p;erson haveing dense black Coriolanian eyebrows and a thick roman nose with classical eyes.. o stress on her aristocratic background in a satirical way. dickens have also mafde her the object of satire with reference to her pride and vanity for her high connections. It is because of this pride that sjhe shares her employers contempt for the workers. It is due to this disdain she treats Stephen Blackpool with total lack of symparthy when he comes tp Bounderby to discuss his matrimonial troubles. she even regards him as an â€Å"Impiety of people†. Bounderby's decesipn top marry Loiusa ; Gradgrind's daughter is obviously unfavourable to MRs.Sparsits, bu t she dint utterd a word against it,. Bounderby was aware of her dissaproval regarding his marrige so hi took a bottle of smelling salts witrh him under the impression that she wou;d faint on hearing the unwelcomed news. But to the utter surprise of Bounderby she saw no sign of trouble or dissaproval on her face. Instead she looked at him in a pityful manner and extended her goodwishes to bounderby. BOunderby seems to understand mrs. sparsit well therefore he asserted at once dat his housekeeper woyuld not be abel to beer the site of hiss would be wife.

Chewing and Sound Localization Research Paper Example | Topics and Well Written Essays - 1750 words

Chewing and Sound Localization - Research Paper Example Sound localization is the ability of a listener to identify the source or origin of a sound, in this paper we focus on the factors affecting sound localization, this study is performed to establishing whether chewing has an effect on sound localization. Chewing leads to head movements that may affect sound localization, according to previous studies undertaken head movements affect sound localization. This paper analysis response from ten participants whose sound localization errors were recorded while and while not chewing, data collected helped test the hypothesis whether chewing affected localization. The following is an analysis of research undertaken by scholars in the past and the results of the study. Many studies have been undertaken in the past regarding sound localization, however majority of this studies have been undertaken with immobilized heads and very few have been undertaken while respondents were chewing. A study by Wallach (1939) showed that head movements affected sound localization, in his study participants were allowed to rotate their head, tip their head and even pivoting. Results show that head movements affected sound localization by participants. However it was also evident that the sound moved with the head. Mangles and Runge (1967) sound localization study results showed that Monaural is as good as binaural when movements were allowed, participants were a... Hypothesis and prediction The hypothesis that was tested is whether chewing have any effect on ability to detect the direction of sound, the null hypothesis is that chewing has no effect on sound localization and the alternative hypothesis is that chewing increased the mean error score for localization. We test this hypothesis by performing a T test that will compare the two means from the two tests, we expect that we will reject the null hypothesis that the two means are equal and accept the alternative hypothesis that states that the two means are not equal. Null hypothesis: a = b where a is the mean error score for localization for test one and two are equal and alternative hypothesis a b or a Methods: In order to test our hypothesis a sample of ten individuals was randomly selected. The sample was further subdivided into two groups which included those would first chew and data collected and then data recorded with the absence of chewing. For the other group data was to be collected without chewing and then data would be collected while chewing. The experiment was carried out using MAT LB computer software, participants sat in front of a computer and given headphones, they were then asked to locate the source of sound 180 degrees in front. The condition was that the participants would chew and then stop chewing and then they were allowed five minutes where they would continue with the second condition which is no chewing and then chew. For each of these two conditions

Alcohol Abuse Essay Example | Topics and Well Written Essays - 3000 words

Alcohol Abuse - Essay Example This is harmful to health especially for underage drinkers. Alcohol use, unhealthy diet, and tobacco use are some of the leading cause of death in many nations today (Shumaker, Ockene and Riekert 2008, p.5). Drinking alcohol significantly affect young individuals in terms of their academic performance, social lives and relationships as well as their general health. Some of the negative consequences resulting from excessive drinking include death, assault, sexual abuse, injury and accidents, academic problems, suicide attempts, and health problems among others. Today, underage drinking is a widespread public health problem which needs attention and should be dealt with or addressed accordingly. There is need to advise young adults, support them and create awareness on the damaging effects of alcohol abuse. There are many diseases and conditions related to alcohol drinking including heart and liver diseases. Alcohol abuse also leads to deterred brain development. Alcohol abuse negatively influences the lives and social relationships of many adolescents and teens. In most cases, drinking adolescents have academic and behavioural problems, slurred speech and coordination problems, and difficulty in establishing lasting relationships with their peers among others. Alcohol abuse has negative impacts on young adults. Studies confirm that many under age lose their lives daily as a result of alcohol related car or motorcycle crashes, suicides, and other serious injuries including falls, drowning and burns among others. More so, drinking alcohol forces young adults to make wrong decisions which may in turn result to risky behaviours such as driving while drunk, engaging in violence and irresponsible sexual behaviours among others. In addition, youths who are drinking excess alcohol are more likely to engage in or fall the victim of physical or sexual assault. Moreover, alcohol abuse has been noted as a common cause

Explain how krebs in a soldier home would rather observe life than Essay

Explain how krebs in a soldier home would rather observe life than live it. give reason as to why he feels that way use exa - Essay Example But in the later part of the story he is referred to as Krebs, to elucidate the transformation in his character. The Krebs is a German word which in English means cancer. The author very interestingly refers to Harold’s character as Krebs in the later part of the story because he wants to describe the transformation that the character went through, which completely left him disdained from all earthly emotions. He wants to be part of a simple life than involve in complexities. He has transformed into a person who just observes life rather than living it. In the story â€Å"A Soldier’s Home†, Hemmingway describes three very important situations which mark Harold’s transformation into Krebs. It was the time of the First World War, when most of the young lads joined the army to fight for their motherland. Harold Krebs was one such young man who joined the army after college. It was only after his return from the war that the first instance of his transformatio n was marked. Krebs was a little late to return home and was not part of the celebration that the other soldiers received on their return. By the time he came back all the hysteria regarding the war has settled down, people were no longer interested in war stories but Krebs wanted to experience the thrill and in couple of occasions he even lied about the stories. People were interested in lies not the realities of war. This gave birth to a raging conflict within Krebs, against the entire community. People were not interested in his stories and that left him in a state of shock. There were many criticisms regarding this point. As Hemingway’s "Soldier’s Home" opens, Harold Krebs, the protagonist, has just come back from World War I. All the other young men his age have settled back into small-town life and found a niche for themselves as contributing members of the community. But Harold, for some reason, cannot do this; instead, he plays pool, "practice[s] on his clarine t, stroll[s] down town, read[s], and [goes] to bed."(Bernardo, K., n. d.) "Nothing was changed in the town except that the young girls had grown up". â€Å"It appears as if the town was never affected by the war, not as Krebs had been. The town radiates conformity, such as the girls all wearing the same clothes. Harold's mother and father wish for him to conform too, as he once did in college where he too wore the same clothes as his fraternity brothers†(Comtois, Jean P., n.d.).   The second instance in the story which depicts Krebs character slowly turning into an observer of life rather than living it is when he starts appreciating the beauty of the girls of his hometown, but does not want to involve into any relationship with them. In war he had learnt that, one did not need girls to survive, though few of his soldier friends thought differently, he did not believe that the complexities of relationship were worth it. When all of his other contemporaries had returned from the war and settled down into the culture of the town, it was he who could not relate to any emotion and did not even feel it to be worth it. He only felt comfortable eyeing things from a distant. Even this phase of Krebs life was up for many criticisms some of which are, â€Å"

Benefits and shortcomings of getting this additional degree Speech or Presentation

Benefits and shortcomings of getting this additional degree - Speech or Presentation Example Tuition for one semester costs $685 (15 or more credit hours), or he can pay $55 per credit hour if he takes less than 15 credit hours. It will also cost him $5 per credit hour for Student Fees and there is a technology fee of $16 per semester. Jose will need to take 14 more 3 credit courses to complete a degree in electronic commerce. He figures that he will need to attend school for 3 more consecutive semesters (1 full year plus 5 months) to complete the electronic commerce degree. Textbooks will cost him $95 per class. a. Jose is planning on taking five courses during his first two semesters in the electronic commerce program, and four courses during the third semester. How much will it cost to get this second degree? b. Jose needs to determine how much money he will need to borrow if he works 15 hours a week at a local video store making $9.50 per hour (take-home = assume 4 weeks per month). He will be able to rent a room from a friend for $200 per month, who is also willing to share groceries and phone costs. Williams share of the food and phone expenses will be $130 per month. He estimates other expenses such as car insurance and clothes to come to about $300 per month. How much will he need to borrow to complete the second degree in 1 year and 5 months? 4. What do you think? Using the evidence from above, explain in a well-structured essay the benefits and shortcomings of getting this additional degree. Research the trends, salaries, and job availability of entry-level graphic design jobs in the electronic commerce industry. Be sure to consider both short-term and long-term

Regulating Units Essay Example | Topics and Well Written Essays - 1000 words

Regulating Units - Essay Example A valve positioner is a device which exactly positions a control valve to the required position as per the signal given to it. Positioner senses the valve opening through a position feedback link connected to valve. Controlled external supply air to positioner provides power to positioner to position a valve. A globe valve is that in which inlet and outlet openings are arranged in several ways to suit varying requirements of flow. It can give straight flow, angular flow and cross flow. The major application is to get good flow control. Picture below: Ball valves are stop valves that use a ball to stop or start the flow of fluid. When operated, the ball rotates to a point where the hole through the ball is in line with the valve body inlet and outlet. Picture below: Gate valves are used when a straight-line flow of fluid and minimum restric ­tion is desired. The part that either stops or allows flow through the valve acts somewhat like the opening or closing of a gate and is called, the gate. Butterfly valves are used in a variety of systems aboard ship. These valves can be used effectively in freshwater and saltwater. It consists of a butterfly disc which when rotated determines the flow of liquid through it. It is used for Good flow control at high capacities. Valve positioners compare a control signal to a valve actuator’s position and move the actuator accordingly. The most modern valves come with following specifications. Deadband -

Due Diligence of PepsiCo Case Study Example | Topics and Well Written Essays - 500 words

Due Diligence of PepsiCo - Case Study Example Today, the company has under its brand, products like Pepsi, Frito-Lay, Tropicana, Gatorade and Quaker. It has organized itself under three banners, namely, PepsiCo Americas Beverages, PepsiCo Americas Foods, and PepsiCo International. PepsiCo, as a leader in the Beverage Industry, is also very committed to its Corporate Social Responsibility and believes in giving back to the community. Its current growth strategy is 'Performance with Purpose', which lays down its commitment towards the community. It outlines PepsiCo's idea of being a leader with people's support. Apart from focusing on the larger community, PepsiCo also believes and works towards keeping its main people happy---PepsiCo's workforce is the focus of the company. The workforce receives great benefits and packages, as part of working with the leader. It is PepsiCo's way of retaining the talent pool, while also keeping them happy with the company's success. PepsiCo does not solely rely on financial rewards, packages and recognitions to keep its workforce happy. It also is well-dispositioned in terms of its commitment to diversity. The workforce at PepsiCo comprises people from different backgrounds, nationalities and ethnicities.

CSR in particular industry Essay Example | Topics and Well Written Essays - 500 words

CSR in particular industry - Essay Example However, in the early days, many researchers were convinced that CSR strategies and activities were homogeneous across different industries. However, advanced research has revealed that CSR is a heterogeneous field. Such heterogeneity means that some industries have to exhibit more effort in developing effective CSR. Therefore, CSR activities vary across industries. Moreover, assessment of effective CSR strategies also varies across the industries. This paper will discuss the reasons why CSR activities, exhibit such variance across industries. Research has identified that CSR strategies depend on several factors for each organization. These factors include the characteristics of the organization, the national framework of CSR, the nature of business activities, the category of labour involved, the risk of harming the environment, and finally the society where the business is located. Different industries exhibit varied characteristics. They depend on different stakeholder groups, have varied proximity to the consumers, and usually have differential potential in causing social or environmental adverse effects. This only means that industries that are likely to pose potential environmental damages or negative social effects have to define more CSR strategies. Moreover, industries exhibiting a close proximity to consumers have to be more focused on SCR that ensure consumer safety (Mullerat & Brennan 2011, p. 113). Moreover, such industries have to be more critical of their supply chains. On the other hand, some industries do not have the compulsion to define numerous CSR activities depending on the nature of their business activities. In order to illustrate the points described above, examples of different industries and the level of CSR activities expected of them will be presented in this section. Financial institutions do not pose great risks to the environment, but are required to promote sustainability and protect the environment

EXAM PAPER Assignment Example | Topics and Well Written Essays - 750 words

EXAM PAPER - Assignment Example The steps that I would take are as follows. The first step is to collect the travel cost and the visitation information or rather the data. Direct costs are the costs used in this method. They are the costs which are normally related to the whole process of visiting the National Botanic Gardens directly. The costs of fuel, accommodation, food, and all other expenses that will be required in the whole process are used. It is very important to ensure that all the travel costs to the National Botanic Gardens are represented in the calculation. The next thing is the travel time. A lot of weight should be given on this area. The appropriate value to assign to the travel time should be considered very carefully. It should be the wage rate when people do not have the option to work during the weekends. The children should also be included in the travel time. Visit time is that time spent while at the National Botanic Gardens. The best method to use is the individual method where the visit r ate is normally calculated per individual in a given time period. The factors that influence this rate are for that specific person. It does not require averaging and a lot of calculations. Some of the challenges that are involved in using this method include the presence of substitute sites. Those who prefer one site over the others have higher values compared to other people. This should be differentiated. Statistical problems might also affect the obtained results. The choice of the variables and the method used should be done very carefully to avoid this. There are also those people who live near the site so as to reduce transport costs and time during this travel. Their value is higher and this should be noted keenly. Most people also view travelling as a hobby and hence a great experience and not a huge cost. This should be noted during the calculations. Estimating the generation function is done using this formula: Averages across the zones normally limits the number of obser vations because you will only take groups of people and then divide by the population of that zone. Working with individual counting increases the number of observations and hence a much more accurate result. Multiple regression analysis uses the following formula y = ax3 + bx2 + cx + d + ?  where a, b, c, d and e are the variables used in the calculations. The environmental management decisions that are made under the conditions of risk are normally in situations where people or rather the managers lack the complete information on the issue at hand. This condition is rather difficult since the manager may comprehend the alternatives and the problem at hand, he or she does not have a guarantee on how each of the solution will work out. When an unfamiliar problem comes up, haste decisions which had not been planned before are normally used to solve the current situation. This decision normally involves the human judgment more than computer assistance. Since risks are normally bound to happen, putting early warning information crisis, developing management crisis plans are the best ways to help avert these problems. This is the condition of risk where virtually no information is available to help know what will happen in the future and be in a position to take the necessary precautions. The managers or rather the involved parties will therefore be risking and will rely heavily on emergency decisions. In a condition of uncertainty, the

Poet’s emphasis Essay Example for Free

Poet’s emphasis Essay Although poem A contain a thematic unity but it is manifested that poet’s emphasis remained on creating a homogeneous lyrical whole instead of developing the theme in an elaborative way and in an elevated poetical manner. There is weak sentimentality that pervades the whole poem. The most important defect of the poem is that it takes into account a wide range of human roles in life and tried to culminate this human experience into the ultimate reality of death. In this attempt, poet fails to create a unifocal and forceful impact about death in the mind of the reader. Although the main though is not traditional or orthodox but poet does not present any philosophical facets, psychological impact or any other unique reflection about death. Furthermore, he is unable to manifest a great skill in making use of the arts and artifices of verse. So poem is an abject failure. Poet is unable to enjoy the visual delight of death or suffer from it pain and terror. He only changes from one role to another role with the sad demise of the first. Personal Preferences Ranking Poem F Poem C Poem D Poem E Poem B Poem A Poem F The theme is same as other poem ranked above but thematic expressions is the most important thing that elevates this poem above all other poems. Thematic expression manifested in a subtle and delicate way. So delicacy of thought mingles with height of literary expression. Subtle metaphorical attributions to seasons are another important feature of the poem. He does not rely on a single set of metaphors or symbol but he uses the financial symbols in the next quatrain to covey his message and skillfully relates it to the main theme of death and destruction. The most beautiful line of the poem is line 7 where he terminates the effect of death. He is of the view that by reproduction and regeneration, one can produce a replica of his own self, so death can not destroy him. He can conquer the death and destruction. Hence these off-spring(s) will make â€Å"thee living†. So poet has pitched the though at a higher level as compared with other poet and have utilized his language skills to create an effective expression to convey that style. Poet does not show any mystery or fascination about death. If death results in despair and terror, it also brings rest and peace. Poet negates both these conventional concept and gives a new idea that death does not terminate life if one wishes to. He can reproduce siblings like him and this is a continuation of his life. There is not magical abstraction in the poem and everything is presented and represented in clear manner with the help of concrete imagery.

Acute Kidney Injury Aki Health And Social Care Essay

Acute Kidney Injury Aki Health And Social Care Essay The first description of ARF, then termed ischuria renalis, was by William Heberden in 1802.25 At the beginning of the twentieth century, ARF, then named Acute Brights disease, was well described in William Oslers Textbook for Medicine (1909), as a consequence of toxic agents, pregnancy, burns, trauma, or operations on the kidneys. During the First World War the syndrome was namedwar nephritis26, and was reported in several publications. The syndrome was forgotten until the Second World War, when Bywaters and Beall published their classical paper on crush syndrome.27 However, it is Homer W. Smith who is credited for the introduction of the term acute renal failure, in a chapter on Acute renal failure related to traumatic injuries in his textbook The kidney-structure and function in health and disease (1951). Unfortunately, a precise biochemical definition of ARF was never proposed and, until recently, there was no consensus on the diagnostic criteria or clinical definition of ARF, re sulting in multiple different definitions. DEFINITION AND CLASSIFICATION Acute kidney injury (AKI) is a protean syndrome of varied severity. It is characterized by a rapid (hours to weeks) decline in the glomerular filtration rate (GFR) and retention of nitrogenous waste products such as blood urea nitrogen (BUN) and creatinine.2,3 In recent years, it has been recognized that the time-honored term acute renal failure (ARF) fails to adequately describe what is a dynamic process extending across initiation, maintenance, and recovery phases, each of which may be of variable duration and severity. The term acute renal failure suggests that the syndrome is dichotomous and places an undue emphasis on whether or not renal function has overtly failed. This belies the now well-established fact that even mild decrements in glomerular filtration may be associated with adverse clinical outcomes.28-32 The alternative proposed term acute kidney injury has much to recommend it, perhaps better captures the diverse nature of this syndrome, and has entered into widespread clinical use. Historically, patients with AKI have been classified as being nonoliguric (urine output >400 mL/day), oliguric (urinary out-put 26.5 mmol/l) when they occur within a 48-hour period.24 Two recent studies examining large databases in the USA40 and Europe41 validated these modified criteria. Thakar et al. found that increased severity of AKI was associated with an increased risk of death independent of comorbidity.40 Diagnostic criteria for acute kidney injury24 An abrupt (within 48 hours) reduction in kidney function currently defined as an absolute increase in serum creatinine of more than or equal to 0.3 mg/dl (≠¥ 26.4 ÃŽ ¼mol/l), a percentage increase in serum creatinine of more than or equal to 50% (1.5-fold from baseline), or a reduction in urine output (documented oliguria of less than 0.5 ml/kg per hour for more than six hours). A major challenge in the investigation and management of AKI is the timely recognition of the syndrome. It remains difficult to easily and reliably measure rapid changes in the GFR. Although the severity in decline in GFR correlates with the onset of oliguria, the latter is insensitive marker of the syndrome because many subjects with severe renal failure remain nonoliguric. In AKI, there is poor agreement between serum creatinine and GFR, at least until a serum creatinine steady state is reached, and even then, the absolute rise in serum creatinine must take into account differences in creatinine generation rates.42 As a result, definitions of AKI that are based on a fixed increment in serum creatinine would be expected to be biased toward making an early diagnosis in well-muscled as compared with malnourished subjects or in men as compared with women. Creatinine clearances, especially when measured over a short time frame such as 2 to 4 hours, has some utility but may substantially overestimate GFR at low levels of renal function owing to a relatively high proportion of tubular secretion. Even the use of markers such as iothalamate to estimate GFR may be less precise in the acute as compared with the chronic setting owing to alterations in their volume of distribution as well as issues relating to tubular obstruction and backleak. INCIDENCE Acute kidney injury is a common and important diagnostic and therapeutic challenge for clinicians.43The incidence of AKI is difficult to estimate because no registry of its occurrence exists and because up until recently there was no standardized definition. From a variety of predominantly single center studies it is estimated that 5% to 7% of hospitalized patients develop AKI.44-47 More detailed information is available regarding its development in the intensive care unit (ICU) environment, where approximately 25% to 30% of unselected patients develop some degree of AKI, although again estimates vary considerable depending on the definition used and the population casemix. Renal replacement therapy is typically required in 5% to 6% of the general ICU population or 8.8 to 13.4 cases per 100,000 population/year.30,43,48-53 AKI is also a major medical complication in the developing world, particularly in the setting of diarrheal illnesses, infectious diseases like malaria and leptospir osis, and natural disasters such as earthquakes. The incidence of AKI has grown by more than fourfold in the United States since 1988 and is estimated to have a yearly incidence of 500 per 100,000 population, higher than the yearly incidence of stroke. AKI is associated with a markedly increased risk of death in hospitalized individuals, particularly in those admitted to the ICU where in-hospital mortality rates may exceed 50%.44 AKI IN THE DEVELOPING WORLD The epidemiology of AKI differs tremendously between developed and developing countries, owing to differences in demographics, economics, geography, and comorbid disease burden. While certain features of AKI are common to both-particularly since urban centers of some developing countries increasingly resemble those in the developed world-many etiologies for AKI are region-specific such as envenomations from snakes, spiders, caterpillars, and bees; infectious causes such as malaria and leptospirosis; and crush injuries and resultant rhabdomyolysis from earthquakes.44Factors responsible for this higher incidence of AKI in the tropics include hot climate in conjunction with excessive sweating, increased predisposition to hypovolemic insults, poor nutritional status and increased susceptibility to infections.