Alzheimer s Disease A Progressive Neurodegenerative...

Alzheimer’s Disease is a progressive neurodegenerative disease that results in dementia, disorientation, problems with speech, and behavioral issues within a person. This disease is detrimental and has no cure. Almost every single person knows someone that has this disease, or has known someone that has had this disease. That is the reason that I chose to research this particular topic. In 2013, my great uncle was diagnosed with Alzheimer’s Disease. He was the most down to earth man you would ever meet. He had a great sense of humor and always kept a smile on his face as well as the faces of the people that he was around. When he was diagnosed, we were devastated because we knew that this disease would eventually consume and take over his life. One of the very bold memories that I have of him after a year after his diagnosis was when we took a family trip to the mountains. We have a pretty large family, so we stayed in a mountain house. Well, the kids wound up sleeping down stairs together. On the second night that we were there. I woke up at 3 o’clock in the morning to yelling that was coming from the top of the stairs. I immediately recognized that it was my uncles voice and I began to get worried. Everyone was asleep, but I could hear him telling my aunt that he needed to go down stairs and make those kids stop playing basketball. I knew in that moment that his diagnosis was getting worse and worse by the day. This was the type of thing that scared me. Alzheimer’sShow MoreRelatedAlzheimer s A Progressive Neurodegenerative Disease860 Words   |  4 PagesAlzheimer’s is a progressive neurodegenerative disease that steadily destroys the memory and other important mental functions such as social skills, intellect, and memory (4). Although the exact cause of Alzheimer’s is not known, most cases of the disease are caused by genetic mutations passed from the parent to the child (1). There are several genes associated with Alzheimer’s one in particular is apolipoprotein E (1). The presence of one or more of these genes does not necessarily mean thatRead MoreAlzheimer s Disease : A Progressive Neurodegenerative Disease2372 Words   |  10 Pagesdementia is brought forward. Alzheimer’s Disease (AD) is a brain disease, is the most common type of dementia, and affects majority of people 60 years or older (1,14). It is a progressive neurodegenerative disease, which only continues to worsen over time. Each individual is affected differently with symptoms and the progression. As of right now there is no cure for it (14). Biology of Alzheimer’s Disease Alzheimer’s is a progressive neurodegenerative disease, which attacks the brain. It is not knownRead MoreAlzheimer s Disease : A Progressive And Neurodegenerative Form Of Dementia2437 Words   |  10 PagesAlzheimer’s Disease (AD) is a progressive and neurodegenerative form of dementia that causes problems with memory, thinking, reasoning, judgement and decision-making, recognizing, as well as behavior, and is serious enough to interfere with daily life and activities, that eventually leads to profound physical as well as mental disabilities, resulting in the need for institutional care (Hoyer Roodin, 2009). AD is most widespread in senior population aged 65 and over, which constitutes approximatelyRead MoreAlzheimer s Disease : A Progressive And Fatal Neurodegenerative Condition2426 Words   |  10 PagesAlzheimer’s disease is a progressive and fatal neurodegenerative condition that is characterized by a decline in the individual’s memory and cognitio n, problems with carrying out daily living skills. There are no exact imaging tests or laboratory tests we can use to diagnose Alzheimer’s. The only way to 100% diagnose Alzheimer’s are when the person dies and has a brain biopsy. The best treatment we have now is medication to help slow the progression and different types of therapy. Caregivers willRead MoreAlzheimer s Disease And Its Effects On The Lives Of Millions Americans Essay1714 Words   |  7 Pages â€Æ' Introduction Neurodegenerative diseases continue to affect the lives of millions Americans each year, with incidence and prevalence rates ever increasing. These diseases cause degeneration or death of nerve cells in the brain. These diseases can cause a financial and emotional burden on not only patients themselves, but also family members and care givers as well. Molecular mechanisms that underlie these diseases have remained relatively unclear, despite much research. Understanding the mechanismsRead MoreAlzheimer s Disease : A Common Neurodegenerative Disease1110 Words   |  5 PagesAlzheimer’s disease is a common neurodegenerative disease. It is the most common form of dementia which is a general term for memory loss and other intellectual abilities serious enough to interfere with daily life (Alzheimer’s Disease Dementia). Dementia and Alzheimer’s have been around for centuries, but Alzheimer’s disease wasn’t first described until 1906 by Dr. Aloysius Alz heimer. In the past, there was a stigma for elderly people with the disease. People with dementia and Alzheimer’s wereRead MoreHealth Care and Stage Dementia Support Essay example1302 Words   |  6 Pagesin Australia every year. Harris, Nagy and Vardaxis (2006) stated  ¡Ã‚ ®dementia is a progressive organic mental disorder characterised by chronic personality disintegration, confusion, disorientation, stupor, deterioration of intellectual capacity and function, and impairment of control of memory £Ã‚ ¬ judgement and impulses. ¡Ã‚ ¯ (p.501) Brown Edwards (2005) noted that the decline in cognitive functions affect individual ¡Ã‚ ¯s ability to work and therefore they are not able to complete the tasks. In an aetiologyRead MoreAlzheimer s Disease : A Progressive Disease925 Words   |  4 PagesAlzheimer s disease is a progressive disease that destroys memory and other vital mental functions. Alzheimer s disease is the most common cause of dementia, a group of brain di sorders that cause the loss of intellectual and social skills. AD can eventually render a person unable to function in society and to even care for themselves. Since the disease is the 6th leading cause of death in the United States constant research is being done to try to prevent it and to find a cure. Alzheimer s diseaseRead MoreMedical Management Decisions And The Plan Of Care Decisions Essay1102 Words   |  5 PagesAlzheimer’s is a chronic medical neurodegenerative disease, therefore is a neurological illness which departures the brain cells, causing it to act in memory loss and mental failure. Early-onsets Alzheimer’s can be noticed in an individual beginning from ages 40-50s. Statistics show that of the 5.4 million Americans with Alzheimer s, an estimated 5.2 million people are age 65 and older, and approximately 200,000 individuals are under age 65 (Alzheimer’s Association, n.d.). The course of this disorderRead MoreEffects Of The Brain On Alzheimer s Disease1467 Words   |  6 PagesChanges in the brain may a play role in Alzheimer’s disease Introduction â€Å"Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks individuals with AD may start having symptoms their mid-60s† (nih.gov). AD is a multifactorial and progressive neurodegenerative disease. â€Å"Parts of AD, for example, increased oxidative state, amyloid plaque deposition, and neurofibrillary tangle of tau

Brief Biography of Berenice Abbott - 1829 Words

â€Å"Photography can never grow up if it imitates some other medium. It has to walk alone; it has to be itself.† – Berenice Abbott. An American photographer best known for black and white photography of New York, Berenice Abbott believed a photograph are special and unique. It cannot be copied or mimic others. A photograph will represent the historical picture of the past. The historical past or memories of the photograph usually have a very meaningful and emotional story behind it. A photograph has its own significant meaning, which communicates through the details of the photo. The photograph on the left that I have found is Migrant Mother, taken by Dorothea Lange in 1936. In 1935, Lange and her husband, Paul Taylor, was transfer to the Resettlement Administrations, one of Roosevelt’s New Deal programs designed to help the country recovers from depression. She began working as a photographer and took snapshots of events that happened after the depression. The caption for this piece of photograph is title as Migrant Mother, which will give away a hint of what the photograph is about. People would start to have an assumption that it is a woman who is migrating to another place with her children. What kinds of assumption would you make by observing the photograph of a mother and two lovely sons with their face turn away? In most cases, when people first look at this photograph, they will interpret that they are poor. However, they will not know the true meaning behind

Leverage and leveraged finance Free Essays

Leveraged finance usually means funding a company with more debt than it is worth. Leveraged finance is used to gain specific, short term objectives like acquiring a company through buy outs or buy-ins, or parking funds in assets which generate fast and excessive returns over the cost of funding. The Sub – Prime crisis of recent times makes it important to keep the above definition in mind. We will write a custom essay sample on Leverage and leveraged finance or any similar topic only for you Order Now Implicit in all finance deals is the ‘down-side ‘or risk that a lot of value (money in plain terms) would simply disappear if the wrong calculations are made. In finance a lot of calculated instinct is based around the capacity of an entity to service or repay its loans. This also raises the question of faith – on the organization’s capacity to perform and therefore repay its debts along with associated costs, chiefly interest related, and returns. Putting a lever to something means firmly positioning it to perform a task. In the language of finance, leveraging would mean to strengthen the power of a company’s funds to attract more returns by borrowing yet more funds – usually short term.   Leveraged financing is the issue of high yielding bonds or funds borrowed from banks to fund the takeover of companies or buy outs by existing members (buy in) or an outside stakeholder (takeover). The ratio of the company’s debts (borrowings) and the company’s return on equity (money borrowed and invested elsewhere) decides the risk rating of a borrowing entity. Simply put, the company has to earn enough to repay the cost of its borrowings and make an extremely high profit for its stakeholders. If the cash flow from the operation is negatively affected by the high cost of debt servicing or interest for borrowed funds – the position of the lender is riskier. Therefore the interest or the ‘risk cost’ will be higher. (Fletcher, 288-92) The principle is utilized in investing in stocks. The price of a stock is a reflection of its debt to equity ratio at its market or book value.   Financial leveraging calculates the varying effects of one or the other in arriving at a ratio. It allows higher return to the investor. The loss may be higher too, for the company has to pay servicing costs for borrowings even if its stock is completely eroded. There are levels of leverage financing – either secured bank loans or bonds or comparatively ‘less senior’ subordinated bonds or loans. A leverage financier has to calculate how the finance is to be raised. If he overestimates a company’s capacity pay back the loan, he might lend too much at very low margins. The outcome of this would be that the financier will be unable to sell these loans or bonds. Then again, if a company’s value is underestimated, then the transaction results in a huge loss. The objective of leveraged buy outs is to acquire assets without utilizing its own capital. The following case studies illustrate the impact at different periods in recent times. The Sub Prime Crisis Sub Prime borrowers are those whose debt rating is ‘high risk’ – their ability to pay back their loans is considered weak by banks or financial companies. As compared to ‘prime’ borrowers like companies who are financed with ease, a sub prime or non prime borrower’s credentials are considered poor. This is because they are likely not to repay due to insufficiency of funds. They are then financed at sub prime or higher rates of interest than normal. This makes it profitable for lending institutions. In the USA, the bulk of sub prime borrowers are people who seek to buy houses. The majority has no stable income or is in employment which does not earn enough. Only some months back, in the USA debt was freely available to those who asked – in fact, banks fought among themselves to offer loans to leveraged takeovers and hired the services of agents to ferret out possible borrowers. But now, the markets are talking of credit squeeze. Banks are scrambling to tone up their balance sheets. What led to this problem? It is good to remember that householders, commercial banks, brokers and companies all use leverage differently. Homeowners are said to be ‘anti cyclical’ in their leverage. When assets (in this case, property values) appreciate faster, leverage – a factor of debt to equity, decreases. When asset values shrink, leverage rises. This is because householders keep paying mortgages regardless of cycles of increase or decrease in property values or share prices. When a householder takes, say, $300,000 on a $400,000 house, he has equity of $100,000 or a leverage ratio of 3. Supposing the house price was to increases to $500,000, his equity doubles to $200,000 toning down the leverage ratio to 1:5 (Kar, 165-71) Banks and companies are neither strongly anti nor pro cyclical, choosing fixed leverage ratios whatever happens to the market. Investment banks and broking houses are extremely pro cyclical, ramping up their leverage as asset prices move upward. Brokers employ specialized risk based accounting which allows increased borrowing while prices are rising. Conversely, they have to borrow less as prices fall. While adjusting to risk is natural, these brokers acted against what would be prudent judgment. To explain this – an amateur might think that high priced portfolios run a higher risk. On the other hand, a ‘calm’ market would make him cautious in anticipation of a storm. The finance professionals turn this judgment on its head through an instrument which they have devised called ‘Value at Risk’ (VAR) which considers current market values, no matter how unpredictable the market is. For example, in the valuation of complex portfolios, brokers tended to assume only recent history. A short calm period is taken to project future ‘tranquility’ for more years. So, when a real market risk is present, the ratio of VAR to valuation of assets is low. Companies would consequently be compelled to leverage more when, in fact, they should not have. Till 2007, brokers kept increasing their portfolios of householder finance, apparently because there was apparently less risk. Just as the signal would have been to buy when prices were high, the now confusing indications, based on wrong models, led to prospects of selling when   the housing markets was turbulent. As result, brokers are left with assets of almost $300 billion of hung deals- householders had simply walked away. (King, 68-71) The Long Term Credit Management Crisis of 1998 Another example of the failure of valuation models and the intervention of leveraged funds this crisis had a major impact on global markets. Long Term Capital Management (LTCM), founded in 1994 by John Meriwether, decided to deal in US and other government bonds. The idea was that over time government bonds would be identical in value if released within short gaps of each other. The rate at which these bonds appreciated would be different as in the case of US government bonds which would rise in value faster. The profit would be taken from selling costlier bonds and buying cheaper bonds. The profits did come to such an extent that LTCM had to look around for areas to invest its capital .It went into risk arbitraging -this was outside their expertise. They had to resort to highly leveraged finance to sustain return on equity. Their equity was almost 5 billion dollars against borrowings of $125 million. The proceeds were also used in investing in equity derivatives. By end August 1997, the company had lost most of its capital due to some downtrends which its managers could not read earlier –specially the Great Asian Meltdown of 1997 – and still had to pay the huge borrowing costs. Leverage had doomed the company. The Dot Com Bubble Through the early 90’s and till the first years of 2000, information technology was surging forward on extremely encouraging forecasts about its future in the world. Entrepreneurs were able to float technology companies, financed by venture capital which was riding on the prospects of fantastic returns. No one realized that these companies had nothing up front to offer which could be valued in rational terms. Huge leverage was sought in order to follow this boom around the world. The bubble was pricked as fast as it had been blown up – and companies and capital vanished. (Lamb, 434-38) Works cited: Fletcher, Robert. Art of Financial Economics: Beliefs and Knowledge; Believing and Knowing. Christchurch: Howard Price. 2006 Kar, Pranab. History of Modern American Finance. Kolkata: Dasgupta Chatterjee 2005 King, Herbert. Fiscal Fitness Today Vol. IV Plymouth: HBT Brooks Ltd. 2005 Lamb, Davis. Cult to Culture: The Development of Civilization on the Strategic Strata. Wellington: National Book Tru How to cite Leverage and leveraged finance, Essay examples

Protozoa Infections Pictures Example For Students

Protozoa Infections Pictures entamoeba histolytica entamoeba histolytica (intestinal ulcer) entamoeba histolytica (flask shaped ulcer) entamoeba histolytica (trophozoa with ingested RBCs) entamoeba histolytica (black hole liver abscess) entamoeba histolytica (+cytotoxic assay) entamoeba histolytica (cyst) naegleria fowleri (meningoencephalitis) naegleria fowleri (acanthamoeba) acanthamoeba (keratitis) naegleria fowleri (trophs in sterile fluid) giardia lamblia (adhesive disks) giardia lamblia (showers of cysts and trophs) giardia lamblia (trophs) with pinworm infection dientamoeba fragilis trichomonas vaginalis (troph) trichomonas vaginalis (troph) trichomonas vaginalis (troph in discharge sample) leishmania donovani (visceral leishmaniasis/kala azar) leishmania donovani (amastigotes) leishmania tropica (cutaneous leishmaniasis/oriental sore or delhi boil) leishmania braziliensis (mucocutaneous leishmaniasis) leishmania tropica (cutaneous leishmaniasis/oriental sore or delhi boil) trypanosoma gambiense or rhodesiense (african trypanosomiasis/sleeping sickness-winterbottoms sign) trypanosoma cruzi (chronic chagas disease-cardiomegaly) trypanosoma cruzi (chagas disease) trypanosoma cruzi (chronic chagas disease-cardiomegaly) balantidium coli balantidium coli (troph) plasmodium (malaria- blackwater fever) plasmodium (thick and thin smear) plasmodium (schizont-prior to lysis) plasmodium (ring stage) plasmodium ovale (gametocyte) plasmodium falciparum (gametocyte) toxoplasma gondii (cyst in muscle) toxoplasma gondii (tachyzoites) toxoplasma gondii (hydroencephalus) toxoplasma gondii (hydroencephalus/suture opening) toxoplasma gondii (macular lesion of retina) cryptosporidium parvum (intestinal lining) cryptosporidium parvum (acid-fast stain) cryptosporidium giardia (IFA) isospora belli (oocyst)

Limiting Childrens Access To Internet Pornography Essays

Limiting Children's Access To Internet Pornography Limiting Children's Access To Internet Pornography Pornography is one of mankind's most revered, respected, and repulsed pastimes. Adults can use pornography to relieve stress, enhance their sex lives, or simply as a means of entertainment. One of the easiest and most popular ways of obtaining pornographic material is over the Internet. The only downside is that the Internet is accessible to children; therefore, pornography is accessible to children. While adults should have limitless access to Internet porn, minors should be kept away from this concubine. Usage of Internet pornography grows rapidly every day. It can be accessed easily enough by anyone that wishes to see the material, has a modem, and some times a wishful intent. The material ranges from semi-nude photos to videos of men and women having sexual intercourse with farm animals. Porn is attainable by going to a site that advertises it, or by typing anything remotely perverted in your web browser. The problem with this is that most pornographic sites do not use adult verification systems. Even if they do, the material can still be sampled before users fully journey into the site. This is where the problems lye; because of Internet pornography's popularity and the growth being so strong it is everywhere and has become hard to adequately control. It is probable to say that anyone who has been on the net long enough, regardless of age, will come across Internet pornography. Proprietors of Internet pornography are in business to make money, and will do anything to achieve this. They advertise their websites by a variety of ways, one of which is by buying space on a website. With this many problems arise, for anyone who visits these sites become unwilling subjects of Internet porn. The Internet porn industry has little regards for the unknowing victim. Some advocates of decency have taken up the tremendous workload of taming Internet pornography. Their biggest reason is the endangerment of American children that use the Internet. Children can be endangered in many ways, one of which is being lured by a pedophile and possibly sexually assaulted. A pedophile is an adult with a psychosexual disorder where children stimulate sexual arousal. There is evidence that children who have been sexually victimized are more likely to be troubled adults. Advocates worry about the safety of the American children and wish to eliminate this from happening. A recent example is People v. Barrows, 174 Misc. 2d 367, 664 N.Y.S. 2d 410 (1997): an adult, James Barrows, entered an AOL chat room and seduced what he thought was a thirteen year old girl, who in actuality was an officer of Kings County District Attorney. Barrows had transmitted pictures of under-aged children having sex, engaged in sexually explicit conversations and attempted to lure the child to engage in sexual acts. Barrows was one of the few pedophiles to be caught and brought to justice. One proposal that was struck down from protecting children is the Communications Decency Act (CDA). Janet Reno, Attorney General of the United States, argued that the CDA was in violation of the U.S. Constitution and laws that would be enacted were clear and undefined. If made into law, the CDA could severely censor the Internet in ways that were never attempted before. It would filter out anything that is deemed obscene and pornographic. Those opposed to the CDA claim because of its ambiguity, the CDA could infringe on American's Constitutional rights. The CDA proposed that anyone sending material classified as obscene to a minor would be penalized and prosecuted under law. The question in debate is who and what would determine the classification of obscene. Even if the CDA was passed little that can be done to stop all transmitted obscene material. The Internet has experienced an extraordinary growth. The number of host computers?those that store information and relay communications?increased from about 300 in 1981 to approximately 9,400,000 by the time of the trial in 1996. Roughly 60% of these hosts are located in the United States. About 40 million people used the Internet at the time of trial, a number that expected to mushroom to 200 million by 2000. How can it be possible to regulate all Internet transmissions with user numbers at 200 million? Another problem that arises is the fact that not all Internet sites can quantifiably prove that the user wishing to browse their domain is of legal age. An annoy-mailer can be used to hide the identity of the user. Some sites require the use of a credit card in order to view its contents, but credit card numbers are easy

Baker College on-line Integrated Project Portfolio †Business Essay

Baker College on-line Integrated Project Portfolio – Business Essay Free Online Research Papers Baker College on-line Integrated Project Portfolio Business Essay Students attending Baker College on-line are required to write papers for their Integrated Project Portfolio (IPP). Each core course requires a student to complete a research paper.This paper should demonstrate the student’s ability to comprehend the course material in each of his or her core courses. The student’s paper can pertain to any topic of his or her choice, as long as it relates to the materials and concepts learned in the specific course. In addition to the IPP papers, a student must relate the topics to an umbrella topic, or over-all theme. The purpose of this essay is to introduce my umbrella topic and individual IPP paper topics for the accelerated Human Resources Management program. Umbrella Topic: The Retail Industry The Retail Industry is the umbrella topic I have chosen to be included in my IPP. The reason for this topic, the retail industry, is due to the fact that I am a convenience store manager. As the store manager, I deal with many aspects of the retail industry. I purchase products and sell these items for profitable gains. My position deals greatly with the retail goods and services found in the retail sector. I interact with individuals and other companies located within this sector of the market. Using the retail industry as my umbrella topic can be an added benefit to my studies at Baker College and my work experiences, too. I can apply my knowledge and training to allow myself better on-site work performance. The following paragraphs discuss my core courses and related topics for the accelerated Human Resources Management program at Baker College. The subheading represents each course in the program and is preceded by the selected topic for my paper. Each paragraph explains the topic’s relevance to the course and the umbrella topic I have chosen. BUS 311: Accounting for Managers Business accounting procedures This topic deals with the accounting practices used by businesses in the Retail Industry. Managers, owners, creditors, and government agencies all need accounting information. Customers and clients use accounting information, too. I plan to address the purpose of accounting and the effects accounting has on various aspects of a business. I will describe the accounting process and go into great detail about how the process affects different ownership structures and types of businesses. This topic will be related to the retail industry and the impact accounting has on this section of the market. BUS 371: Financial Analysis and Application Business finance options The topic I have chose for the course dealing with financial analysis and application is business finance options. After conducting research, I plan to write my paper about the options businesses have for financing. There are many ways a business can finance its operations. I will include detailed information about each different loan or method of finance. I will also define terms and highlight the benefits of each option. This paper will be tied into my umbrella topic, the retail industry, by including the specific finance options of most retail businesses and discussing the more favored options of today’s retail businesses. HRM 435: Global Human Resources Management Stages of Internationalization Internationalism deals with the aspect of nations cooperating together because they have common interests that exceed their differences. In this paper, I plan to describe what internationalism is and the reasons companies seek internationalism. There are different views dealing with internationalism. This paper will address these different views and parts of internationalism. My paper will also compare the international sector of the market with the domestic market. Next, I will relate the international sector with the retail sector of the market, discussing their different aspects and then their similarities. I will explain the important roles each sector plays within the market. HRM 425: Negotiating labor/Management Relations Collective Bargaining Analysis What is collective bargaining? The paper I write analyzing collective bargaining will answer this question. I will also address the National Labor Relations Act. This paper’s focus will be primary collective bargaining and the purpose for its use. I will address the benefits created by the use of collective bargaining and how it affects both employers and employees. The paper will also discuss how collective bargaining is used by retail businesses. There will be a section dealing with the benefits created by use of collective bargaining within the Retail sector. HRM 325: Ethics in Human Resources Employer Rights All businesses and those who are employed should have a general knowledge of employer and employee rights. Most individuals have a better knowledge of employee rights than of employer rights. I plan to discuss the difference between employer and employee rights. My main focus will be employer rights and the effects these rights have on employers, employees, and customers. I will relate this paper to my umbrella topic, the retail industry. All employers have certain rights. These rights may vary depending on the type of business in operation. I will include a section pertaining to the rights of different businesses and companies. HRM 335: Strategic Human Resources Maximizing employee productivity During this course, I plan to write a paper that deals with employee productivity. I will address many issues concerned with maximizing employee productivity. This paper will highlight many of the motivational factors that encourage employees to be successful and how to utilize these factors for above-average business performance. I will also discuss factors that influence poor employee performance or production. The paper will have a section relating the use of motivational factors in a retail business. I will explain the benefits a retail business can add to its level of productivity when using positive reinforcement techniques such as motivational tools and incentives. As I have stated earlier, each of these courses will have its own topic. A topic I have briefly discussed and introduced. I will create a paper for each course/topic to include in my Integrated Project Portfolio. Each paper will be related to my over-all theme or umbrella topic, the Retail Industry. I previously mentioned I chose the retail Industry as my umbrella topic because it is closely related to my current occupation and future career goals. It is also a topic I feel will bring me greater knowledge through my studies during the accelerated Human Resources Management program at Baker College. Research Papers on Baker College on-line Integrated Project Portfolio - Business EssayStandardized TestingAnalysis of Ebay Expanding into AsiaDefinition of Export QuotasIncorporating Risk and Uncertainty Factor in CapitalThe Project Managment Office SystemOpen Architechture a white paperResearch Process Part OneEffects of Television Violence on ChildrenBionic Assembly System: A New Concept of SelfPETSTEL analysis of India

IT in Supply Chain Management Essay Example | Topics and Well Written Essays - 2500 words

IT in Supply Chain Management - Essay Example The traditional supply chain had limitations caused by power structures, limited information processing ability, and limited coordination and communication paths (Christiaanse & Kumar, 2000). Today organizations are facing complex changes to combat which Mutsaers, Zee and Giertz (1998) proposed the Nolan and Crosson six-stage model. it has become essential for organizations to be flexible and deliver a wide and changing variety of products. This requires a shift from â€Å"make and sell† approach to an externally-oriented â€Å"sense and respond† structure. This in turn implies the need for real time information. Real time information can be feasible only with the application of information technology in the different processes and functions. To meet the changing market requirements, companies have decentralized their value-adding activities by outsourcing and developing virtual enterprises (Gunasekaran & Ngai, 2004). All these highlight the importance of integrating IT with supply chain partners in the virtual enterprise or the supply chain. Demand for new information services like query processing, knowledge sharing and data mining led to the extension of information system engineering to support new, flexible software architecture so that the information system could contain new as well as legacy data and software components (Mylopoulos, 1998). IT has been recognized as a critical factor in the supply chain as they have demonstrated positive contribution to the performance of the firm and the supply chain (Jin, 2006). Technology is essential as it provides direction to the procurement, production and supplies strategies. When suppliers are able to meet customer demands compatibility of exchanges has occurred (Halley & Nollet, 2002). Success of incorporating technology depends upon the personnel’s ability to extract information (Lin & Tseng, 2006). Hence firms rely on technology to increases the flow of information across organizational boundaries and

Business Environment Essay Example | Topics and Well Written Essays - 1750 words - 3

Business Environment - Essay Example It has Banks, supermarket, local supermarkets, online services and stores. LE-PEST C analysis comprises of legal, environmental, political, economical, social, technological and competitive analysis. It is important to analyse the how Sainsbury Company services are being influenced by all these external features. First of all, it is guided by the need to provide the best services to its customers and to ensure that their shareholders earn high financial returns every year. Moreover, it is employee oriented as its goal is to have well rewarded employees who can have the opportunity to expand their knowledge and abilities on the activities they provide for the company. The company also aims at building a very strong relationship with its suppliers. This will definitely ensure that the needs of the customers are highly satisfied. The total number of stores owned is 301 and 455 supermarkets that serve approximately sixteen million people weekly. It has approximately 148000 employees whose work is to deliver food and other products at a very fair price (Killgre n, 2007, pp.34-75). The LE-PEST C analysis recognises the importance of the legal sector in influencing how companies operate. The legal sector can either reduce the competitive nature of a company or increase it. It lays down strict rules to ensure that the general public is safe from any substandard goods and services. The Sainsbury Company has not been left behind as the government of the UK has had a history of strengthening laws that are linked to drinks and foods. The rules target how products are packaged and labelled. Because food and drinks are very sensitive goods and they can cause a lot of destructions in an economy, then it is very important to package food using the right containers to avoid contamination. This helps in enhancing public health. Labelling laws are made to avoid counterfeit goods thus a

For Now, Fed Succeeding by Doing Nothing Essay Example | Topics and Well Written Essays - 250 words

For Now, Fed Succeeding by Doing Nothing - Essay Example The decreasing gross domestic product and the increasing bond rate is an indication the stagflation may be the next condition of the economy. In a report released by the commerce department showed that GDP has decreased to 2.2 percent, from its original 5.6 percent (Schoen, 2006). Following the speculations of various Fed watchers, Schoen has come up with the conclusion that the economy at this moment can move in any direction given the corporate landscape where companies are paying good dividends and at the same time the stock prices need to be improved. In order for us to understand Schoen’s direction of thinking, we have to understand how interest rates impact the economy in general and how the Feds have been able to control inflation and initiate economic growth. However, we can question the fact that the stable interest rates can also lead to stagflation given the condition of the economy. The stable interest rate may not have the desired effect as inflation continues to increase. If we take this line of reasoning seriously, we will realize that this is a time where the corporate world can come to help by developing strategies to improve stock prices. If we fail to take this line of reasoning seriously, we may go speculating the direction of the economy and grow pessimistic at the forecasts being released. The author, in this article, is presenting his own conclusion of the speculation of the Fed

Emotion Recognition System for Affective Text

Emotion Recognition System for Affective Text K.Thendral, Dr.S.Chitrakala, S.P.Surendernath ABSTRACT: Mining social emotions deals with a new aspect for categorizing the document based on the emotions such as happy, sad, sympathy, etc., theyhelp online users to select related documents based on their emotional preferences. Aiming to find the connections between social emotions and affect terms and thus predict the social feeling from text content mechanically. Joint emotion-topic model by augmenting Latent Dirichlet Allocation with an additional layer for emotion modelling initially generates a group of latent topics from emotions, followed by generating affect terms from every topic. The techniques involved in this are emotion term model, topic model and emotion topic model. The emotion-topic model utilizes the complementary advantages of both emotion term model and topic model,and is not only effective in extracting the meaningful latent topics, but also improves the performance of social emotion prediction. Keywords – Affective Text,Emotion-topic model, Latent Dirichilet Allocation. 1. INTRODUCTION: An emotion is a Meta communicative pictorial representation of a facial expression which in the absence of body language and probably draw to serve a receiver’s attention to the tenor or temper of a sender’s nominal verbal communication, changing and improving its interpretation. It expresses-usually by means of punctuation marks – a person’s feelings or mood and can include numbers and letters. The interrelation of text and emotions has been a captivating topic for centuries. What makes people feel what they read? How is the writer’s emotion conveyed in a text? How can we write to communicate an emotional message more clearly? A number of researchers have attempted to obtain answers to these questions for a long time and there is an enormous amount of literature on techniques and devices for emotion detection. (Bloom, Garg, Argamon, 2007;) Two attempts to measure emotions are based on two different models: dimensional and categorical. In the categorical model emotions are labelled, say that a person is â€Å"happy† or â€Å"sad†and people get a sense of what others mean. In the dimensional model the representation is using multidimensional scaling (e.g. â€Å"pleasant-unpleasant†, â€Å"excitement†, and â€Å"yielding-resisting†). In the affective computing domain, supervised learning techniques are preferred due to strong performance. However, a challenge to using supervised techniques is the need for corpora with text that has been annotated with emotion labels. These are time consuming and expensive to produce. Unsupervised techniques do not have these requirements but are often less precise. 2. RELATED WORK Many methods have been proposed to mine emotions from the text and social networks. Affective text mining deals with mining emotions from affective words. SemEval introduced a task named â€Å"affective text† in 2007 [2], aiming to annotate short headline texts with a predefined list of emotions and/or polarity orientation (positive/negative).There is a large body of previous work on mining affective content from text documents, product reputation mining [10], customer opinionextraction/summarization[11], [12], and sentiment classification [13]. However, none of these studies explores the connection between social emotions and affective terms. An online system Mood Views has also been developed for tracking and searching emotion annotated blog posts [12], [13], [14], [15]. The posts are published with an indicator of the â€Å"current mood† of the blogger, at the time of posting the blog. Mood-Views is a platform for collecting, analyzing, and displaying aggregate moods in the blog space. Launched in mid-2005, Mood Views continuously collects these emotion indications, as well as the blog posts themselves, and provides a number of services. Despite the success of previous work on emotion prediction, existing approaches usually model documents under the â€Å"bag-of-word† assumption, so that the relationship across words is not taken into account. This also prevents us from further understanding the connections between emotions and contents in the topic level, because it is arguable that emotions should be linked to specificdocument topics. D.M. Blei, A.Y. Ng, and M.I. Jordan [8] proposed Latent Dirichlet Allocation generative probabilistic model for collections of discrete data such as text corpora. LDA is a three-level hierarchical Bayesian model, in which each item of a collection is modelled as a finite mixture over an underlying set of topics. Each topic is, in turn, modelled as an infinite mixture over an underlying set of topic probabilities. In the context of text modelling, the topic probabilities provide an explicit representation of a document. Joint latent topic model for text and citations [8].The Pairwise-Link-LDA model combines the ideas of LDA [4] and Mixed Membership Block Stochastic Models [1] and allows modelling arbitrary link structure. However, the model is computationally expensive, since it involves modelling the presence or absence of a citation (link) between every pair of documents. The second model solves this problem by assuming that the link structure is a bipartite graph. As the name indicates, Link-PLSA-LDA model combines the LDA and PLSA models into a single graphical model. I. Titov and R. McDonald [8] proposed statistical model which is able to discover corresponding topics in text and extract textual evidence from reviews supporting each of these aspect ratings – a fundamental problem in aspect-based sentiment summarization. Achieve high accuracy, without any labelled data except the user opinion ratings. Rosen-Zvi et al. [3] merged author factors with document generation to jointly estimate document contents as well as author interests. From the perspective of model generation, their author variable shares some similarity with the emotion variable in this model. The key difference lies in different sampling distributions. Their author variable is chosen uniformly from a set of authors while emotion variable is sampled from multinomial distributions by the emotions contributed by web users. 3. PROPOSED SYSTEM An online text collection D is associated with a vocabulary W,and a set of predefined emotions E. Comparing the extracted and optimized content with the already founded latent topics that relating to the extracted and optimized content with the already founded latent topics that relating to each emotion. Based on the result we are finding which emotion the particular content represents. Based on the user emotion requests the categorized content will display. Objective is to accurately model the connections between words and emotions, and improve the performance of its related tasks such as emotion prediction. Both the emotion –term model and emotion-topic model can be applied to emotion prediction by estimating their probability to evaluate their prediction performance.In this paper, proposing a joint emotion-topic model for social affective text mining, which introduces an additional layer of emotion modelling into Latent Dirichlet Allocation (LDA). Proposed model follows a three-step generation process for affective terms, which first generates an emotion from a document-specific emotional distribution, then generates a latent topic from a Multinomial distribution conditioned on emotions, and finally generates document terms from another Multinomial distribution based on latent topics. Because its exact inference is intractable, developing an approximate inference method based on Gibbs sampling. For social emotionprediction, the proposed model outperforms the emotion term model, term-based SVM model, and topic-based SVM model significantly. 3.1 EMOTION TERM MODEL Emotion-term model,follows the Naive Bayes method by assuming words are independently generated from social emotion labels. It generates each word wi of document d in two sampling steps, i.e., sample an emotion ei according to the emotion frequency count d, and sample a word wi given the emotion under the conditional probability P (w|e). The model parameters can be learned by maximum likelihood estimation. It can be formally derived based on the word and emotion frequency counts. To use the emotion-term models for predicting emotion on a new document d, apply the Bayes theorem (1)under the term independence assumption. P (e|d) = P(d|e) ÃŽ ± P (d | e) P(e)(1) P(d) where P(e) is the a priori probability of emotion e. It can again be calculated by maximum likelihood estimation (MLE) from the emotion distribution of the entire collection. 3.2 TOPIC MODEL Many topic models have been proposed and well-studied in previous work, of which, LDA [8] is one of the most successful models. LDA addresses the over fitting problem faced by other models like pLSI by introducing a Dirichlet prior over topics and words. Although LDA can only discover the topics from document and cannot bridge the connection between social emotion and affective text, for the ease of understanding in the following description, a simple review of LDA is here. In the first study of LDA, proposed a convexity-based variation inference method for inference and parameter estimation under LDA. P(zi=j|z-i,w)ÃŽ ± + ÃŽ ² + ÃŽ ± (2) + | W | ÃŽ ² +|Z| ÃŽ ± where n-i means the count that does not include the current assignment of zi, is the number of times word w has been assigned to topic j, and is the number of times a word from document d has been assigned to topic j. Fig.1. Proposed System Architecture 3.3 EMOTION TOPIC MODEL Emotion-term model simply treats terms individually and cannot discover the contextual information within the document. While topic model utilizes the contextual information within the documents, it fails to utilize the emotional distribution to guide the topic generation. In this paper, proposing a new approach called emotion topic model. The importance of this latent topic generation in the affective text mining is very much Likewise, different latent topics are discovered based on the emotions involved in it. Those latent topics should be collected together as a whole so that whenever needed it can be referred. After collecting each and every topic, it should be categorized on the basis of the different emotions such as love, happy, sad, sympathy, worry etc..They are used to select the document based on the preference assigned to the emotions. Relate the social emotions with an affective term that predict the emotions automatically from the text. After collecting and categorizing each latent topic based on different emotions, are stored to check with the extracted content. Then the topics are compared with the extracted content as a result of which it will generate topics and get processed. For each word the posterior distribution on emotion â€Å"Æ Ã¢â‚¬  and topic â€Å"z† based on the following conditional probabilities which can be derived by the following equations (3). P(Æ i=e|ÃŽ ³, Æ -i, z, w;ÃŽ ±,ÃŽ ²) ÃŽ ± ÃŽ ±+* ÃŽ ³ di,e(3) |z|ÃŽ ±+ÃŽ ³di,eà ªÃ… ¾Ã…’ Where e and z are the candidate emotion and topic for sampling.di D indicates the document from which current word wi is sampled.is the number of times topic z has been assigned to emotion e. 4. EXPERIMENTAL RESULTS This section presents the experimental results on both joint emotion topic modelling and its application to emotion prediction .News articles were collected from the news portal and the input data’s are pre-processed to remove stem and stop words and perform tagging to extract the explicit words.Word frequency, document frequency were calculated. Emotion term model performs calculating word frequency and the emotion frequency count and the corresponding terms and emotion were obtained. (a) Topic modelling which generates set of topics for the input documentConsists of the word and associated topic. (b) Emotion topic model bridges the connection between words and the emotion with the associated topic. (c) The standard parameters which are used for experimental evaluation are precision,recall and accuracy.Precision is defined as number of retrieved relevant documents divided by total number of retrieved documents and the recall is the number of retrieved relevant document divided by total number of relevant documents in the database. Accuracy can be calculated as relevant document retrieved in top T returns divided by T. Precision = Number of retrieved relevant document Total number of retrieved documents Recall = Number of retrieved relevant document Total number of relevant documents Accuracy = Relevant documents retrieved in top T T (d) Emotion Distribution (e)Precision, recall and f-score Fig.2.(a)Emotion term model (b) Topic model (c) Emotion topic model(d) Emotion distribution(e)Precision, recall 5.CONCLUSION This paper, presents and analyse a new problem called social affective text mining, which aims to discover and model the connections between online documents and user-generated social emotions. To this end, proposing a new joint emotion-topic model by augmenting Latent Dirichlet Allocation with an intermediate layer for emotion modelling. Rather than emotion term model that treats each term in the document individually and LDA topic model that only utilizes the text co-occurrence information, emotion-topic model allows associating the terms and emotions via topics which is more flexible and has better modelling capability. REFERENCES [1] R. Cai, C. Zhang, C. Wang, L. Zhang,  Music Recommendation Using Emotional  Allocation,†Proc. 15th Int’l Conf. Multimedia, pp. 553-556, 2007. [2] C. Strapparava and R. Mihalcea,  Ã¢â‚¬Å"Semeval-2007 Task 14: Affective Text,†Ã‚  Proc. Fourth Int†¢fl Workshop Semantic  Evaluations (SemEval‘07), pp. 70-74, 2007. [3] C. Yang, K.H.-Y. Lin, and H.-H. Chen,  Ã¢â‚¬Å"Emotion Classification Using Web Blog  Corpora,† Proc. IEEE/WIC/ACM Int†¢fl  Conf. Web Intelligence (WI ‘07), pp. 275-  278, 2007. [4] C.O. Alm, D. Roth, and R. Sproat,  Ã¢â‚¬Å"Emotions from Text: Machine Learning for Text-Based Emotion Prediction,† Proc. Joint Conf. Human Language Technology and Empirical Methods in Natural Language Processing (HLT/EMNLP ‘05), pp. 579- 586, 2005. [5] C. Strapparava and R. Mihalcea,  Ã¢â‚¬Å"Learning to Identify Emotions in Text,†Ã‚  Proc. 23rd Ann. ACM Symp. Applied  Computing (SAC ‘08), pp. 1556-1560,2008. [6] A. Esuli and F. Sebas,â€Å"Sentiwordnet: A Pub-Licly AvailableLexical Resource for Opinion Mining,Proc. Fifth Int’l Conf. Language Resourcesand Evaluation (LREC ‘06), 2006. [7] C. Strapparava and A. Valitutti,â€Å"Wordnet-Affect: An Affective Extension of Wordnet,†Proc. Fourth Int’l Conf. Language Resources and Evaluation  (LREC ‘04),2004.   [8] D.M. Blei, A.Y. Ng, and M.I. Jordan,  Ã¢â‚¬Å"Latent Dirichlet Allocation,† J. Machine  Learning Research, vol. 3, pp. 993-1022,  2003. [9] C.P. Robert and G. Casella, Monte Carlo Statistical Methods, seconded. Springer Publisher 2005. [10] Mihalcea, R. and Strapparava. C. (2006). â€Å"Learning to laugh (automatically)†: Computationalmodels for humour recognition. Computational Intelligence, 22(2), pages 126–142. [11] A.-M. Popescu and O. Etzioni, â€Å"Extracting Product Features and Opinions from Reviews,† Proc. Joint Conf. Human Language Technology and Empirical Methods in Natural Language Processing (HLT/EMNLP ’05), pp. 339-346, 2005. [12] B. Pang, L. Lee, and S.Vaithyanathan, â€Å"Thumbs Up? Sentiment Classification Using Machine Learning Techniques,† Proc. Conf. Empirical Methods in Natural Language Processing (EMNLP ’02), pp. 79-96, 2002. [13] M. Rosen-Zvi, T. Griffiths, M. Steyvers, and P. Smyth, â€Å"The Author-Topic Model for Authors and Documents,† Proc. 20th Conf. Uncertainty in Artificial Intelligence (UAI ’04), pp. 487-494, 2004. [14] Alm, C.O., Roth, D. and Sproat, R. (2005). â€Å"Emotions from text: machine learning for textbased emotion prediction†. In Proceedings of the Joint Conference on Human LanguageTechnology / Empirical Methods in Natural Language Processing. [15] Mihalcea, R. and Liu, H. (2006). â€Å"A corpus-based approach to finding happiness†, in the AAAI Spring Symposium on Computational Approaches to Weblogs, Stanford, California, USA. [16] M. Hu and B. Liu, â€Å"Mining and Summarizing Customer Reviews,† Proc. 10th ACM SDIGKD Int’l Conf. Knowledge Discovery and Data Mining (SIGKDD ’04), pp. 168-177, 2004. [17] G. Mishne, K. Balog, M. de Rijke, and B. Ernsting, â€Å"Moodviews: Tracking and Searching Mood-Annotated Blog Posts,† Proc. Int’l AAAI Conf. Weblogs and Social Media (ICWSM ’07), 2007. [18] K. Balog and M. de Rijke, â€Å"How to Overcome Tiredness: Estimating Topic-Mood Associations,† Proc. Int’l AAAI Conf.Weblogs and Social Media (ICWSM ’07), 2007. [19] K. Balog, G. Mishne, and M. Rijke, â€Å"Why Are They Excited? Identifying and Explaining Spikes in Blog Mood Levels,† Proc. Ninth Conf. European Chapter of the Assoc. for Computational Linguistics (EACL ’06), 2006. [20] Mihalcea, R. and Liu, H. (2006). â€Å"A corpus-based approach to finding happiness†, in the AAAI Spring Symposium on Computational Approaches to Weblogs, Stanford, California, USA. [21] G. Mishne and M. de Rijke, â€Å"Capturing Global Mood Levels Using Blog Posts,† Proc. AAAI Spring Symp. Computational Approaches to Analysing Weblogs (AAAI-CAAW ’06), 2006. [22] I. Titov and R. McDonald, â€Å"A Joint Model of Text and Aspect Ratings for Sentiment Summarization,† Proc. 46th Ann. Meeting of the Assoc. for Computational Linguistics (ACL ’08), June 2008. [23] Mihalcea, R., Corley, C., Strapparava, C. (2006). Corpus-based and Knowledge-basedâ€Å"Measures of Text Semantic Similarity†. Paper presented at the Proceedings of theNational Conference on Artificial Intelligence. [24] Lichtenstein, A., Oehme, A., Kupschick, S., Jà ¼rgensohn, T. (2008). Comparing TwoEmotion Models for Deriving Affective States from Physiological Data. Affectand Emotion in Human Computer Interaction, 35-50. [25] H. Liu, T. Selker, and H. Lieberman, â€Å"Visualizing the AffectiveStructure of a Text Document,† Proc. CHI ’03 Extended Abstracts on Human Factors in Computing Systems Conf., 2003. [22] T. Hofmann, â€Å"Probabilistic Latent Semantic Indexing,† Proc. 22ndAnn. Int’l ACM SIGIR Conf. Research and Development in Information  Retrieval (SIGIR ’99), 1999. [23] M. Rosen-Zvi, T. Griffiths, M. Steyvers, and P. Smyth, â€Å"The Author-Topic Model for Authors and Documents,† Proc. 20thConf. Uncertainty in Artificial Intelligence (UAI ’04), pp. 487-494,  2004. [25] X. Wang and A. McCallum, â€Å"Topic over Time: A Non-Markov Continuous-Time Model of Topical Trends,† Proc. 12th ACM SIGKDD Int’l Conf. Knowledge Discovery and Data Mining (SIGKDD ’06), pp. 424-433, 2006. Department of Computer Science and Engineering, K.S.R. College of Engineering (Autonomous), Tiruchengode-637215

Dolomite and Peaty Wheat Straw Essay -- Film, Race

I have seen many from Dolomite and Peaty Wheat Straw by Rudy Ray Moore, Willy Dynamite starring Roscoe Orman, and The Mack Starring Max Julien and so on. The way these actors portrayed the characters of Willy Dynamite, Dolomite, and Goldie the way the talked the jive the way they walked the walk more than likely set the black race back by decades. Grabbing there groins and having a glide in their stride, wearing big hats, capes, and over exaggerated gestures help create stereotypes and threadbare ideals of the black race that are prevalent even today. In 1987, Robert Townsend wrote, starred, and directed a behind the scenes parody of those types of movies called Hollywood Shuffle, while on one hand Townsend is exhibiting his blackness by pointing out the obvious bias behavior of the white studios but also exhibiting the talent and recognition seeking of the black actor. Townsend’s almost biographical parody of movies, television shows not only his range as an actor but also h is since of humor of the angst of being an actor chosen solely for the color of your skin. Robert Townsend through situational and dramatic irony and by exhibiting how the white ideals shape the identity and description of what is black and how Hollywood has warped it. Robert Townsend plays Bobby Taylor a struggling young man actor who is with a healthy imagination and a dream of becoming a serious actor. Bobby family reluctantly supports him in his endeavors but his mother, and grandmother played by Starletta DuPois and Helen Martin secretly pass judgment on his chosen career path while his co-worker Donald and Tiny at the Winky-Dinky Dog played by co writer Keenan Ivory Wayans and Lou B. Washington openly mocks his dream. Crushed are Bobby dreams of playi... ...ood Shuffle" And "I'm Gonna Git You Sucka." Cinema Journal 38.3 (1999): 50-66. JSTOR Arts & Sciences III. Web. 3 Dec. 2011. Fanon, Frantz. Black Skin, White Mask. New York: Grove, 1967. Print. Grant, William R. Post-soul Black Cinema: Discontinuities, Innovations, and Breakpoints, 1970-1995. New York: Routledge, 2004. Print. Harrison, C. "W.J.T. Mitchell, What Do Pictures Want? Chicago: University of Chicago Press, 2005. 380 Pp., 16 Col. Plates, 84 Halftones, 10 Line Drawings. Hardback $35, 24.50 ISBN 0-226-53245-3." Journal of Visual Culture 6.1 (2007): 160-63. Print. "The Souls of Black Folk Study Guide - W. E. B. Du Bois - ENotes.com." ENotes - Literature Study Guides, Lesson Plans, and More. Web. 03 Dec. 2011. . Tourà ©. Who's Afraid of Post-blackness?: What It Means to Be Black Now. New York: Free, 2011. Print.

End Stage Renal Disease ESRD Health And Social Care Essay

End Stage Renal Disease ( ESRD ) is defined as an irreversible nephritic failure which needs to have nephritic replacing therapy ( RRT ) or undergo long term dialysis [ 1 ] . There are three types of nephritic failure replacing therapy which are hemodialysis ( HD ) , peritoneal dialysis ( PD ) and nephritic graft. In Malaysia, Continuous Ambulatory Peritoneal dialysis ( CAPD ) patients are increasing from 1525 patients in twelvemonth 1999 to 1744 patients in December 2008, an addition of 12 % [ 2 ] . Malnutrition is really common in end phase nephritic disease patients on care dialysis [ 2 ] . In Malaysia, national information showed that merely 13 % of CAPD patients are good nourished where serum albumen is above 4.0 g/dL [ 3 ] . Majority of patients ( 87 % ) undergoing CAPD are malnourished. Protein energy malnutrition ( PEM ) is one of the most prevailing complications looking in patients undergoing dialysis and it is associated to high morbidity and mortality [ 4,5 ] . Malnutrition is an of import factor associated with increasing hazard of mortality in Chronic Kidney Disease ( CKD ) patients. Hence, it is of import to measure the nutrition position of patients. Screening for malnutrition is an of import constituent of dietary pattern and improves the ability to prioritize intercession to those most at hazard [ 6 ] . Early acknowledgment and intervention can give better outcome [ 7 ] . Nutrition showing is a executable option for placing patients at hazard of PEM [ 4 ] . Screening tools are largely designed for general intents every bit good as for specific topics as aged, institutionalised person and hospitalized patients [ 4 ] . There are several showing tools available for CAPD patients. These are Malnutrition-inflammation mark ( MIS ) , nutritionary hazard showing ( NRS ) , Malnutrition Universal Screening Tool ( MUST ) , Malnutrition Screening Tool ( MST ) , geriatric nutritionary hazard index ( GNRI ) and capable planetary appraisal ( SGA ) . Among them, none was antecedently studied for usage in Malayan chronic kidney disease patients on dialysis. The dietitian plays an indispensable function in nutritionary showing. In Malaysia, entree to dietitian is limited in most dialysis Centres. Hence, nurses will play an indispensable function to place the malnourished patients. On the other manus, a comprehensive nutritionary appraisal is time-consuming and requires both subjective and nonsubjective opinions from the tester. Therefore, important preparation is necessary to guarantee consistent consequences among assorted testers and periods of appraisal. Therefore, there is a demand for a simplified nutritionary showing tool which can be used by dieticians or nurses that can be performed easy.1.1 Objective1.1.1 Main ObjectiveTo place a simplified nutritionary showing tool which compares good with the Malnutrition Inflammation Score ( MIS ) , Subjective Global Assessment ( SGA ) and with assorted single nutritionary steps for Continuous Ambulatory Peritoneal dialysis ( CAPD ) .1.1.2 Specific aimTo depict the human ecology, anthropometr y, biochemical analysis features and dietetic form of CAPD patients. To depict the per centum of malnourished patients harmonizing to BMI, serum albumen, MSGA, and MIS. To formalize the usage of MIS and mSGA in CAPD patients against anthropometric ( BMI, Triceps Skinfold, computed Mid Arm Muscle Circumference ) and biochemical ( serum albumen ) appraisals ; To compare the usage of simplified tools: NRS, MUST, MST and GNRI showing tools in CAPD patients.Chapter 2: Literature Reappraisal2.1 Overview of kidney mapKidney maps to modulate organic structure homeostasis system [ 8 ] . Kidney plays a critical function in keeping circulatory and organ system functional homeostasis. Other than that, kidney is the site of synthesis of some endocrines and an of import catabolic site for several polypeptide endocrines. ( Table 2.1 ) Table 2.1: Components of kidney map Elimination of metabolic waste merchandises ( urea, creatinine, uric acid ) Elimination and detoxification of drugs and toxins Care of volume and ionic composing of organic structure fluids Acid-base ordinance Regulation of systemic blood force per unit area Production of erythropoietin Control of mineral metamorphosis through endocrinal synthesis ( 1,25-dihydroxycholecalciferol and 24,25-dihydroxycholecalciferol ) Degradation and katabolism of peptide endocrines ( insulin, glucagon, parathyroid endocrine endocrines ) and low-molecular-weight proteins ( ?2-microglobulin and light ironss ) Regulation of metabolic procedures ( gluconeogenesis, lipid metamorphosis ) Beginning: Mitch ( 2009 ) [ 8 ]2.2 Causes of kidney failureThere are two types of kidney failure which are acute kidney failure and chronic kidney failure. Acute nephritic failure is defined as sudden decrease of glomerular filtration rate ( GFR ) or loss of kidney map which is reversible [ 9 ] . Table 2.2 shown causes of acute kidney failure. Chronic kidney failure is defined as structural or functional abnormalcies of the kidney for more than 3 months [ 10 ] . It is an irreversible advancement of kidney harm. The causes of chronic kidney failure are shown in Table 2.2. Table 2.2: Causes of kidney failureAcute Renal FailureChronic Renal FailureAcute cannular mortification ( Trauma ) Nephrotoxicity ( antibiotics and drugs ) Infection Urinary piece of land obstructor Acute glomerulonephritis Diabetess Mellitus Uncontrolled high blood force per unit area Familial disease of kidney Obstructive Uropathy Inflammation or infection of kidney Beginning: KDOQI, 20012.3 Nephritic failure and dialysisGlomerular filtration rates ( GFR ) is an first-class step of filtrating capacity of the kidneys. GFR have been used to quantify the degree of kidney map [ 10 ] . There are 5 phases of GFR degree from phase 1-normal, to present 5-severe. A lessening in GFR precedes kidney failure in all signifier of progressive kidney disease [ 10 ] . In phase 5, where GFR is less than 15 ml/min, it is considered as terminal phase nephritic failure ( ESRD ) . Phase of chronic kidney disease was shown in Table 2.3. Table 2.3: Phases of chronic kidney disease Phase GFR Description 1 90-130 ml/min Kidney harm with normal or higher GFR 2 60-89 ml/min Mild lessening in kidney map 3 30-59 ml/min Moderate lessening in kidney map 4 15-29 ml/min Severe lessening in kidney map 5 Less than 15 ml/min End phase nephritic failure Beginning: KDOQI There are three types of intervention for nephritic failure which are kidney organ transplant, hemodialysis ( HD ) and peritoneal dialysis ( PD ) [ 9 ] . Peritoneal dialysis can foster split into three methods, including uninterrupted ambulatory peritoneal dialysis ( CAPD ) , automated peritoneal dialysis ( APD ) and combination of CAPD and APD [ 9 ] .2.4 CAPD processIn Continuous Ambulatory Peritoneal Dialysis ( CAPD ) , semi permeable membrane of the peritoneum is used as the filtration membrane [ 9 ] . A catheter is surgically implanted in the venters and into peritoneal pit. In CAPD, the dialysate is left in the peritoneum and exchanged manually [ 9 ] . A dialysate battalion is connected to the catheter while another tubing is connected to an empty battalion outside to have the waste fluid merchandises. A high-dextrose concentration dialysate is instilled into the peritoneum by the catheter. The dialysate diffusion carries waste merchandises from the blood through the peritoneal membrane and into the dialysate [ 9 ] . The waste merchandises and dialysate work interdependently via osmosis to transport out the waste merchandises. The waste fluid merchandises are withdrawn and discarded. Exchanges of dialysate are done for four to five times a twenty-four hours [ 9 ] . There are different concentrations and volumes of dialysate used which depend on the patient ‘s status.2.5 Nutrition demands for CAPD patientsIn peritoneal dialysis, Calories absorbed from glucose in the dialysis fluid are included in the computation of dietetic energy consumption. Approximately, 90 % of glucose is absorbed during dwells over 8 hours a twenty-four hours and 70 % is absorbed during short dwell [ 11 ] . Therefore, the sum of saccharide absorbed should be calculated to forestall overconsumption of ene rgy particularly for diabetes patient. From KDOQI 2000, the energy demand for chronic peritoneal dialysis patients who less than 60 old ages of age is 35 Kcal/kg organic structure weight per twenty-four hours [ 2 ] . For those who above 60 old ages of age, 30 to 35 kcal/body weight per twenty-four hours is recommended due to more sedentary life style [ 2 ] . Protein need in peritoneal dialysis patient is higher than hemodialysis patient. Peritoneal protein losingss average approximately 5 to 15 g/24 hours [ 2 ] . Generally, dietetic protein demand is to keep positive N balance and prevent malnutrition. Dietary protein more than 1.2 g/kg BW/day associated with impersonal or positive N balance [ 12,13 ] . KDOQI 2000 suggest that 1.3 g/kg BW/day protein for peritoneal dialysis patient and at least 50 % of protein should be from high biological value ( HBV ) [ 2 ] . Continuous Ambulatory Peritoneal Dialysis ( CAPD ) patients have higher cholesterin, triglyceride, LDL and lipoprotein degree [ 14 ] . The abnormalcy of lipid profile for CAPD patients is due to loss of protein from dialysis fluids and soaking up of glucose from dialysis fluid [ 14 ] . Therefore, 25 to 35 % of fat from entire Calories is recommended for CAPD patients [ 15 ] . Calcium and P are mineral demand in our organic structure to keep bone wellness. Conversion of vitamin D from inactive signifier to active signifier is impaired due to kidney failure [ 16 ] . When vitamin D lack develops, it may take to faulty enteric soaking up of Ca. In contrast, phosphorus elimination becomes restricted because of reduced cannular map. Therefore, dietetic phosphate limitation is necessary. Harmonizing to KDOQI guideline, 800-1000mg phosphate per twenty-four hours is recommended [ 2 ] . Furthermore, add-on of unwritten phosphate binder is besides needed to command serum phosphate degree [ 16 ] . The grade of Na sensitiveness is increasing exponentially with declined kidney map [ 17 ] . Nevertheless, sodium limitation can assist to command blood force per unit area. Excessive Na consumption may do thirst and increase fluid gained which in bend cause oedema [ 9 ] . Malaysia Medical Nutrition Therapy ( MNT ) guideline recommends 1500mg of salt intake per twenty-four hours and no add-on salt in cookery. Suggested unstable consumption is up to 1500ml per twenty-four hours [ 15 ] . CAPD patients may be hypokalaemic due to potassium loss during dialysis procedure. Therefore, potassium limitation is non necessary for CAPD patients. Persons with CAPD peculiarly have vitamin lack [ 18 ] . Hence, vitamin addendum is recommended for CAPD patients. Table 2.4 shows the recommended alimentary consumption for CAPD patients. Table 2.4: Recommended foods intake for CAPD patientsFoodRecommendationKilogram calories 35 kcal/kg BW/day for & A ; lt ; 60 old ages old 30-35 kcal/kg BW/day for & A ; gt ; 60 old ages old Protein 1.3 g/kg BW/day, 50 % HBV Carbohydrate 50-60 % of energy consumption Fat 25-35 % of energy consumption Sodium 1500 mg/ twenty-four hours Potassium 3-4g adjust to serum degree Fluid Up to 1500 ml/day Phosphate 800-1000 mg/day Calcium Calcium from diet and phosphate binder non transcend 2000 mg/day Vitamin B: Thaimine Vitamin b2 Vitamin b6 Vitamin bc Addendum to run into recommended day-to-day consumption Vitamin C Supplement up to 60-100 mg/day Beginning: Malaysia Medical Nutrition Therapy guideline, 20052.6 Malnutrition among CAPD patients2.6.1 DefinitionLack of protein and energy consumption or both is mentioning as protein-energy malnutrition ( PEM ) [ 19 ] . PEM is a status ensuing from long-run unequal consumption of energy and protein which can take to blowing of organic structure tissues and increased susceptibleness to infection [ 19 ] . PEM is strongly linked to malnutrition and mortality rate in person who undergoes care dialysis [ 2 ] . CAPD patients are more prone to malnutrition compared to HD patients. In CAPD, protein lost during dialysis procedure will ensue in protein lack and cause malnutrition [ 2 ] .2.6.2 PrevalenceBy the terminal of twelvemonth 2008, there are 3836 patients who are new to dialysis out of entire 19000 patients. The entire dialysis prevalence rate in December 2008 is 680 [ 3 ] . Patients who undergo CAPD are increasing twelvemonth by twelvemonth. Chronic kidney disease patients who underg o CAPD were 1744 patients out of entire 19221 patients in December 2008. The gender distribution is male ( 55 % ) and female ( 45 % ) from a entire 18856 patients [ 3 ] . The primary cause of nephritic disease is diabetes mellitus ( 55 % ) followed by high blood pressure ( 7 % ) from entire 3836 new dialysis patients on twelvemonth 2008 [ 3 ] . Protein-energy malnutrition ( PEM ) is really common among patients with advanced chronic nephritic failure ( CRF ) and those undergoing care dialysis ( MD ) therapies worldwide [ 2 ] . K/DOQI guideline proposed that, both work forces and adult females patients undergoing maintenance dialysis to accomplish BMI of at least about 23.6 kg/m2 and 24.0 kg/m2, severally. There are 14 % of CAPD patients who are scraggy ( BMI & A ; lt ; 18.5 kg/m2 ) . In Malaysia, malnutrition among dialysis patients is of great concern as it remains to be one of the strongest forecasters of morbidity and mortality [ 2 ] . There are 87 % of CAPD patients have serum albumin degree ( & A ; lt ; 4.0g/dL ) which assigned as malnourished [ 3 ] . Table 2.5 shows the categorization of serum albumen degrees. Table 2.5: Categorization of serum albumens degreeStatusSerum albumin degreeWell nourished 4.0 g/dL Mild undernourished 3.5 – & A ; lt ; 4.0 g/dL Moderate undernourished 3.0 – & A ; lt ; 3.5 g/dL Severe undernourished & A ; lt ; 3.0 g/dL Beginning: KDOQI, 20002.7 Factors doing malnutrition among CAPD patientsThere are multiple factors that cause malnutrition in these patients [ 2,20 ] . They are chiefly categorised into three causes: unequal dietetic consumption, disease conditions and intervention or dialytic factors. Inadequate dietetic consumption will take to malnutrition among dialysis patients. Altered gustatory sensation esthesiss caused by unequal dosage of dialysis, emotional hurt, anorexia and unpalatable prescribed diets ensuing in patients ‘ hapless unwritten consumption, and later impair their nutritionary position [ 20 ] . Disease status is besides a factor causes malnutrition in dialysis patients. Uremia is the most of import subscriber to inadequate nutrition in CAPD patients. As the Glomerular Filtration Rate ( GFR ) declines, azotemic toxins accumulate, taking to sickness and diminished appetite. Patients on dialysis have exposed to chronic inflammatory province will increase hypercatabolism and loss of thin organic structure mass when there is negative nitrogen balance [ 2 ] . Inflammation caused by infection, periodontic disease and familial factor will besides take to hapless nutrition intake [ 20 ] . Ascitess patient is at higher hazard of PEM. Ascites is another disease status doing protein loss more than 30g per twenty-four hours particularly after peritoneal dialysis induction. However, the sum of protein loss will decrease over clip [ 20 ] . In dialysis intervention, unequal dialysis might bring on anorexia and decreased gustatory sensation sharp-sightedness [ 20 ] . In add-on, dialysis promotes blowing by taking foods such as aminic acids, peptides, protein, glucose, water-soluble vitamins, and other bioactive compounds, and promotes protein katabolism, due to bioincompatibility [ 2 ] . In CAPD patients, redness of catheter site, bioincompatibility of dialysis solution will impact the nutrition position [ 20 ] . Besides, dialysis therapy may besides take to peritonitis. Transportation of K and azotemic toxin down a concentration in peritoneal capillaries will do protein loss. Furthermore, peritoneal inflammation will do ‘leaky ‘ in peritoneal capillaries and prolong peritoneal redness ensuing in release of cytokine and protein loss, which in bend influence patient ‘s nutrition position. Intra-peritoneal force per unit area is another factor impacting dietetic consumption. An addition in intra-abdominal force per unit area will take to symptoms of decrease in dietetic consumption and early repletion by delayed gastric emptying [ 20,21 ] . The most holds in stomachic voidance happened in those with smaller organic structure surface country [ 22 ] . Gastric emptying clip is associated with adequateness of foods ingestion. Last but non least, psychological factor will besides impact patient ‘s nutrition position. Psychological load causes loss of appetency in CKD patients, ensuing in a diminution of nutritionary position [ 20 ] .2.8 Nutrition Screening2.8.1 Purpose of testingHigh prevalence of CAPD patients with hapless nutritionary position is associated with inauspicious results [ 20 ] . Early sensing of malnutrition patient can diminish the hazard of inauspicious result of hapless nutrition. Therefore, it is critical that a validated and accurate tool used to place those malnutrition patients. Nutritional appraisal acts as an indispensable and introductory clinical process in nutritionary direction [ 4 ] . K/DOQI 2000 recommends nutrition appraisal should be performed routinely with combined method such as anthropometric measurings, organic structure composings measurings, biochemical measurings, dietetic appraisals and subjective appraisals [ 2 ] . However, most of these processs are time-consuming and cumbersome, even when a adept dietician is involved [ 4 ] . Therefore, a simplified and user friendly testing tool is needed for others wellness professional to observe malnutrition among the patients.2.8.2 Introduction of showing toolsThere are entire 6 showing tools will be used in this survey: Malnutrition-inflammation mark ( MIS ) , nutritionary hazard showing ( NRS ) , Malnutrition Universal Screening Tool ( MUST ) , Malnutrition Screening Tool ( MST ) , geriatric nutritionary hazard index ( GNRI ) and modified subjective planetary appraisal ( MSGA ) . The SGA and MIS tools are the gilded criterion showing tools which have proven in many surveies [ 2,23 ] . However, MSGA is used in this survey alternatively of SGA. MSGA is more nonsubjective, easy and practical that utilizing quantitative marking system if compared to SGA which is utilizing semi-quantitative marking system [ 24 ] . Whereas, MIS is validated and proven by Kalantar-Zadeh et. Al ( 2001 ) as a dependable tools to place malnutrition patient particularly in inflammatory province [ 23 ] . A survey by Yamada K. ( 2008 ) obtained the mark from several testing tools such as NRS, MUST, MST, GNRI and Mini nutritionary Assessment-Short Form ( MNA-SF ) and comparing the MIS testing tool as the mention criterion. Among the five showing tools, consequences shown GNRI was the most accurate showing in placing hemodialysis patient at nutritionary hazard. However, this survey did non included CAPD patients [ 4 ] . MSGA is a modified quantitative subjective planetary appraisal which modified utilizing the constituents of conventional SGA by Kalantar-Zadeh and co-workers, 1999. MSGA is a to the full quantitative hiting system with mark from 1 ( normal ) to 5 ( really severe ) . MSGA consists of seven variables including weight alteration, dietetic consumption, GI symptoms, functional capacity, comorbidity, hypodermic fat and marks of musculus cachexia. This survey had shown a relationship between malnutrition mark and the combination of MAMC, BMI, serum albumen and TIBC. MSGA is an nonsubjective, dependable and easy tools which can execute in proceedingss compare to SGA. However, the survey did non include any CAPD patients [ 24 ] . Malnutrition-inflammation mark ( MIS ) was another testing tool developed by Kalantar-Zadeh and co-workers in twelvemonth 2001. It is a utile tool to mensurate nutrition and redness on care hemodialysis ( MHD ) patients. This tools was developed utilizing seven constituents in SGA and added three new elements which are body aggregate index, serum albumen degree and total-iron binding capacity with mark 7 ( normal ) to 35 ( terrible malnourished ) . Kalantar-Zadeh and co-workers proved it is a good tool in foretelling mortality every bit good as nutrition, redness and anaemia in MHD patients. [ 23 ] Nutrition hazard showing ( NRS ) is developed by Kondrup and co-workers in old ages 2002. This tool was designed to steps current possible undernutrition and disease badness patients in order to measure whether tools was capable to separate patients with a positive clinical result from those who non profit from nutrition support. The consequence proved this screening tool is able to separate positive consequence and those who are likely to profit from nutrition support. It scored 0 ( absent ) to 3 ( terrible ) . [ 25 ] Malnutrition Universal Screening Tool ( MUST ) was designed to observe protein-energy malnutrition and the hazard of developing malnutrition in grownup patients. There are three independent standards use in this tool which is BMI, weight loss mark and acute disease consequence mark which mark from 0 to 2. The entire tonss is added and delegate into one out of three classs including 0 ( low hazard ) , 1 ( medium hazard ) and & A ; gt ; 2 ( high hazard ) . Stratton and co-workers concluded that MUST was a speedy and easy performed tool. [ 26 ] Malnutrition Screening tool ( MST ) was developed to observe hospitalized grownup ague patients at hazard of malnutrition by Ferguson and co-workers. It consisted of two inquiries sing appetency and recent unwilled weight loss. The information showed a relationship between patients who are high hazard of malnutrition harmonizing to MST with low average value of nonsubjective nutrition parametric quantities and longer length of infirmary staying. Ferguson and co-workers proposed MST as a simple, speedy, validated and dependable tool to observe malnutrition. [ 27 ] Geriatric Nutrition Risk Index ( GNRI ) was developed by Bouillanne and co-workers in twelvemonth 2005. GNRI was used to observe patients at hazard of malnutrition and related to mortality and morbidity. Nutrition position indexs including albumen, weight and WLo was used to cipher GNRI mark. It had four classs of nutrition related hazard which are no hazard, low hazard, moderate hazard and major hazard categorized by utilizing GNRI mark. This survey showed a strong relationship between albumen and GNRI. It is a simple showing tool for foretelling mortality and morbidity hazard particularly in hospitalized aged patients. [ 28 ]Chapter 3: Materials and Methods3.1 Study designThis research was a cross-sectional survey which done amongst 50 CAPD patients in Hospital Kuala Lumpur ( HKL ) . The research has been approved by the IMU Joint commission Research and Ethics. This research was to place a suited simplified testing tool to observe malnourished patients on CAPD. Six available showi ng tools were tested on patients ‘ nutritionary position. The diagram shows the flow of the survey.3.2 Sample sizeParticipants were chosen by utilizing convenient trying method at the Nephrology unit in Hospital Kuala Lumpur ( HKL ) . The sample size computation was based on the prevalence of malnutrition CAPD patients as reported in National Renal Registry, 2006. ( Z ) 2 P ( 1-p ) e2 Sample size computation, Ns = = ( 1.96 ) 2 ( 0.87 ) ( 1-0.87 ) ( 0.10 ) 2 = 43.4 50 patients Where Z = Z0.95 = 1.96 is read from a standard normal distribution tabular array. Where P = Prevalence of malnutrition CAPD patients = 0.87 ( 87 % ) Where E = Estimated trying mistake = 10 % Therefore, 50 patients were recruited for this survey.3.3 Capable choiceThe inclusion standard of this survey were participants recruited must be above 18 old ages old and undergoes at least 6 months of care dialysis. Participants who admitted in wad or hospitalized were categorized into exclusion standards.3.4 Sampling methodParticipants recruited by utilizing convenient trying method. There were in entire 50 participants in this survey. Participants available at the CAPD unit at informations aggregation period were approached and invited to fall in the survey.3.5 Methodology3.5.1 Questionnaire designThe questionnaire consisted of 8 sectors to obtain information on participants ‘ personal inside informations, socioeconomic background, medical history, drug profile, CAPD prescription, appetite, lifestyle history and dietetic informations. Information was obtained through interview. This is shown in appendix 1. A ) Personal inside informations This subdivision covered inquiries on personal information of the participant ‘s name, gender, age, day of the month of birth, ethnicity, matrimonial position, instruction degree and employment. B ) Medical history Information on cause of kidney failure, intervention history ( continuance, history of kidney graft and parathyroid secretory organ remotion ) and co-morbidities of the participant is obtained. C ) Drug profile This subdivision covered informations on the medicine prescription and besides information of multiple addendum taken and traditional medical specialty. D ) CAPD prescription Information was obtained on figure of exchanges done in one twenty-four hours and the concentration, type and volume of dialysate usage per exchange. Tocopherol ) Appetite Participant ‘s current appetency was questioned by utilizing a graduated table of ranking which included good, just, hapless and really hapless. F ) Physical activity The frequence of exercising and the grounds for non exerting were asked. G ) Dietary Data Food readying, eating wonts and any allergic reaction of nutrients were specified in this portion. H ) Hospitalization Subject ‘s hospitalization ground and surgery history was asked. 3.5.2 Anthropometric informations ( Appendix 3 )3.5.2.1 Height and weightParticipant ‘s tallness and weight was obtained from the medical record. Three measurings of participant ‘s station dialysis weight were recorded at first hebdomad for 3 old months from December 2010 to February 2011. The 3-month weight informations provides the information of topic ‘s weight position ( weight addition or weight loss ) for testing tool constituent. Body Mass Index ( BMI ) will be calculated from topic ‘s tallness and weight, utilizing the undermentioned expression: BMI = Body weight ( kilogram ) / Height2 ( M2 ) *KDOQI 2000 recommended that the BMI of care dialysis patient to be at least 24-28 kg/m2. Table 3.1: Categorization of BMI cut off point for grownupCategorizationBMI ( kg / M2 )Underweight & A ; lt ; 18.50 Normal 18.50 – 24.99 Corpulence 25.00 Corpulent 30.00 Beginning: Adapted from WHO, 1995, WHO, 2000 and WHO 2004.3.5.2.2 Mid arm perimeter ( MAC )Mid arm perimeter was performed with mensurating tape ( preciseness  ± 0.1 centimeter ) . Landmarking was done on the center of acromiale and radiale. Cross manus technique was used to mensurate the perimeter.3.5.2.3 Tricep skinfold ( TSF )Triceps skinfold was performed with Harpenden Skinfold Caliper ( John Bull, British Indicators Ltd. England ; preciseness  ± 0.1 centimeter ) . Landmarking was carried out prior to skinfold measuring.3.5.2.4 Mid arm musculus perimeter ( cAMA )Mid arm musculus perimeter is a computation derived from mid arm perimeter ( MAC ) and Tricep skinfold ( TSF ) : MAMC ( centimeter ) = MAC ( centimeter ) – [ ? – TSF ( centimeter ) ] Calculate mid arm musculus country ( cAMA ) provides a more accurate appraisal of musculus mass by gauging bone-free arm musculus country, corrected with gender differences. Calculate mid arm musculus country, cAMA = [ ( MAC ( centimeter ) – ? – TSF ( centimeter ) ) 2 ] / 4 ? – 10.0 ( work forces ) = [ ( MAC ( centimeter ) – ? – TSF ( centimeter ) ) 2 ] / 4 ? – 6.5 ( adult females ) Table 3.2: Cut off point of arm musculus perimeter ( AMA )PercentileClass 5th Wasted & A ; gt ; 5th but ? 15th Below norm & A ; gt ; 15th but ? 85th Average & A ; gt ; 85th but ? 95th Above norm & A ; gt ; 95th High musculus Beginning: Frisancho AR. 1990. Anthropometric criterion of the appraisal for growing and nutritionary position. 3.5.3 Biochemical informations ( Appendix 4 ) Serum albumen, serum beta globulin, serum Total Fe binding capacity ( TIBC ) , serum cholesterin, serum creatinine, Kt/V and serum carbamide were obtained from participant ‘s latest blood trial consequence. Table 3.3: Cut off point biochemical value Biochemical constituents Normal scope Serum albumen & A ; gt ; 4.0 g/dl Serum Tranferrin Serum TIBC Serum Cholesterol Serum Creatinine Serum Urea Kt/V & A ; gt ; 1.7 3.5.4 24 hours dietetic callback ( Appendix 5 ) Dietary consumption was obtained utilizing 24 hours dietetic callback. Participant ‘s dietetic consumption of 1 weekday and 1 weekend were recorded. Dietary appraisal tools ( bowls, spoon, matchbox and cup ) were shown to the topic at the first interview subdivision. The subsequent information aggregation was done through phone call. Food functioning size recorded was converted to unit gm and analysed via Nutrient composing of Malayan Food ( Tee E Siong, 1997 ) and Nutritionist Pro. Programme.3.6 Screening toolA sum of 6 showing tools were used in this survey.3.6.1 Modified Subjective planetary appraisal ( MSGA )This tool was designed by Kalantar-Zadeh group in twelvemonth 1999. This testing tool was developed by utilizing the constituent of conventional SGA and consists of seven variables: weight alteration, dietetic consumption, GI symptoms, functional capacity, co-morbidity, hypodermic fat and marks of musculus cachexia. Each constituent was scope from 1 ( normal ) to 5 ( te rrible ) . The entire mark used to find the nutrition position of the patient.3.6.2 Malnutrition-inflammation mark ( MIS )MIS was developed by Kalantar-Zadeh et. Al 2001 based on 7 constituents of SGA method and 3 extra constituents of BMI, serum albumen and serum TIBC. The medical history buttockss weight loss during the predating 6 months, dietetic consumption, GI symptoms, functional capacity ( nutritionary related functional damage ) , and co-morbidity including figure of old ages in Dialysis ; while physical scrutiny assesses loss of hypodermic fat and musculus cachexia. Each constituent was scored from 0 to 3, the entire mark of all 10 constituents ranged from 0 to 30 ( higher figure indicates more terrible ) .3.6.3 Nutrition hazard showing ( NRS )Nutrition hazard showing ( NRS ) was developed by Kondrup and co-workers in old ages 2002. The concluding tonss were categorized into absent, mild, moderate or terrible malnourished with a entire mark 0-6. It contain of two testing c onstituents, initial and concluding showing. There were four variables included in initial screening- BMI, recent weight loss, alterations in nutrient consumption and wellness status. In concluding showing, two chief constituents were tested by each hiting 0 ( absent ) to 3 ( terrible ) . The entire mark was added and one extra mark for participant above 70 old ages old.3.6.4 Malnutrition Universal testing tool ( MUST )MUST was developed for multidisciplinary usage by the Malnutrition Advisory Group of the British Association for Parenteral and Enteral Nutrition. MUST consists of 3 independent constituents which are current weight position measured by BMI ( mark: 0 to -2 ) , unwilled weight loss ( mark: 0 to -2 ) , and acute disease consequence bring forthing no nutritionary consumption for & A ; gt ; 5d ( mark: 0 or 2 ) . The amount of these 3 tonss was calculated.3.6.5 Malnutrition testing tool ( MST )The MST was developed by Ferguson et. Al 1999 had been used for acute infirmary patients ; it incorporates 3 constituents which are weight loss ( mark: 0 or 2 ) , sum of weight lost ( mark: 1-4 ) , and hapless nutrient consumption or hapless appetency ( mark: 0 or 1 ) . The entire mark was calculated for each patient.3.6.6 Geriatric nutrition hazard index ( GNRI )The GNRI was developed by modifying the nutritionary hazard index ( NRI ) for aged patients. This index was calculated from the serum albumen and organic structure weight by utilizing the undermentioned equation: GNRI = [ 1.489 – albumen ( g/dL ) ] + 41.7 – ( organic structure wt/ideal organic structure wt ) ]3.7 Statistical AnalysisAll the information was analysed by utilizing Statistic Merchandises and Services Solution, SPSS ver. 18.0. Each variable is presented as the mean  ± Standard Deviation ( SD ) . Descriptive frequence trial was used to prove the distribution of the variables among gender. T-test was besides used to show the correlativity between the variables. P & A ; lt ; 0.05 was considered as statistically important. Sensitivity, specificity, positive prognostic value ( PPV ) and negative prognostic value ( NPV ) were used between testing tools and nonsubjective variables. Crosstab was used to transport out the sensitiveness and specificity trial. Formula of computation: Sensitivity = true positives/ ( true positives + false negatives ) Specificity = true negatives/ ( true negatives + false positives ) Positive prognostic value ( PPV ) = true trial positives/all trial positives Negative prognostic value ( NPV ) = true trial negatives/all trial negatives

Symbols in Scarlet Letter essays

Symbols in Scarlet Letter essays In the novel The Scarlet Letter, Nathaniel Hawthorne used symbolism to show the importance of or the meaning of many things. It is demonstrated throughout the entirety of the novel. Henry James, a famous American novelist, said, ...there is, I think, too much. It is overdone at times, and becomes mechanical; it ceases to be impressive, and grazes triviality. One may feel as if Hawthorne did not overuse symbolism, but I agree with Jamess opinion. There are many cases in the novel that involve symbolism, which is overused. These cases include the letter A, Pearl, and the scaffold. The first major form of symbolism, and the most obvious, is the letter A, which appears in various places in the novel. The main example of the letter A is the scarlet letter, which is worn by Hester Prynne. The scarlet letter was the letter A, which was to be embroidered onto Hesters clothing. It symbolized Hesters sin, adultery. There are many instances that describe the A as it appears on Hesters dress. Hawthorne first describes it by saying, -was that SCARLET LETTER, so fantastically embroidered and illuminated upon her bosom. (p. 51) Another usage of the letter A that appears in the novel appears in chapter 12. While Hester, Dimmesdale, and Pearl were out at night, a meteor appears in the sky in the shape of an A. The reader may consider this to be symbolism because Hawthorne describes this instance by saying, We impute it, therefore, solely to the disease in his own eye and heart, that the minister, looking upward to the zenith, beheld there the appearance of an immense letter,the letter A,marked out in lines of dull red light.(p. 143) In this case, the A may symbolize guilt that the minister may have, as well as symbolize sin. Lastly, another example of the A&apos...

Free Essays on A Mother

Economic Status and the Maternal Figures in No Matter What and â€Å"A Mother† From as early as the days of ancient Rome and Greece your economic status and place in society determined what kind of life you and in turn, your family would lead. It also determined the expectedness of the offspring of the family. In â€Å"A Mother† by James Joyce and No Matter What by Mary Saracino both of the matriarchal figures are on different spectrums of economic status. Mrs. Kearny in â€Å"A Mother† does not have to worry about where the grocery money is going to come from as Marie does in No Matter What. â€Å"I need grocery money. Don’t be cheap this time.† (Page 94) Economic stress can lead to many things in a person’s life. Economic stability has a lot to do with the happiness and comfort ability of ones life. Mrs. Kearny came from an economically comfortable background and therefore entered into a marriage with which she would again be economically comfortable. â€Å"She had been educated in a high-class convent where she l earned French and music.† (Page 139) Marie Giov! anni came from a poor economic background and consequently married into another poor economic family. In my essay, I will compare the lives of Mrs. Kearny and Marie Giovanni and the effects that their economic status has on their lives. When one does not have the extra worry of money to think about, life can almost seem a little easier. Financial issues in a family can lead to major problems, especially between husband and wife. Financial issues are actually one of the leading causes of divorce. In No Matter What, Marie is very unsatisfied with her economic status in life. Marie always dreamed of being something more than she became. â€Å"Mama says her life isn’t what she wanted it be.† (Page 74) Besides other problems Marie might have with her husband, Paulie, she feels that life with her lover, Patrick, will take her out of the economic poverty th... Free Essays on A Mother Free Essays on A Mother Economic Status and the Maternal Figures in No Matter What and â€Å"A Mother† From as early as the days of ancient Rome and Greece your economic status and place in society determined what kind of life you and in turn, your family would lead. It also determined the expectedness of the offspring of the family. In â€Å"A Mother† by James Joyce and No Matter What by Mary Saracino both of the matriarchal figures are on different spectrums of economic status. Mrs. Kearny in â€Å"A Mother† does not have to worry about where the grocery money is going to come from as Marie does in No Matter What. â€Å"I need grocery money. Don’t be cheap this time.† (Page 94) Economic stress can lead to many things in a person’s life. Economic stability has a lot to do with the happiness and comfort ability of ones life. Mrs. Kearny came from an economically comfortable background and therefore entered into a marriage with which she would again be economically comfortable. â€Å"She had been educated in a high-class convent where she l earned French and music.† (Page 139) Marie Giov! anni came from a poor economic background and consequently married into another poor economic family. In my essay, I will compare the lives of Mrs. Kearny and Marie Giovanni and the effects that their economic status has on their lives. When one does not have the extra worry of money to think about, life can almost seem a little easier. Financial issues in a family can lead to major problems, especially between husband and wife. Financial issues are actually one of the leading causes of divorce. In No Matter What, Marie is very unsatisfied with her economic status in life. Marie always dreamed of being something more than she became. â€Å"Mama says her life isn’t what she wanted it be.† (Page 74) Besides other problems Marie might have with her husband, Paulie, she feels that life with her lover, Patrick, will take her out of the economic poverty th...