Research paper in business information management Essay

Research paper in business information management - Essay Example According to Armstrong (2008), the human resources are the most important ones that the company can have, without which it is impossible to run any business operations. Thus, the human resources are the human work force of an organization that is capable of running the business operations of the company and generate revenue. Human Resources Management (HRM) involves managing the organization’s workforce. It encompasses a wide range of activities involving recruitment of employees, providing with training, compensating for their job work, developing policies to protect and take care of their interest and creating strategies to retain the skilled employees (Barber, 2008). This suggests that managing the human resources involves a series of activities that eventually lead to the welfare of and self-development of the employees. This as a result leads to higher human capital for the organization, which in turn helps to improve overall productivity and efficiency of the organization. Thus, properly managing the human resources is imperative to the organizational success and sustainability. Over time, the function and responsibilities of the human resource department has evolved. Previously, the roles of the HR department (HRD) were to take care of the recruitment process, the employees’ payroll and maintain a steady work force. However, owing to the changing global business market environment, the job role of the HRD has expanded and evolved (Bondarouk, 2011). Now, apart from the recruitment process and managing payrolls, the HR managers also take care of the employee retention by improving their motivational level of the employees. This is mostly because, more than recruiting new employees, retaining the existing ones is quite important. Therefore, increasing their motivational level by offering a favourable working environment, an interesting job role and rewards will not only drive them to work harder but it will also make sure that they will not

Autonomy in Death Essay Example for Free

Autonomy in Death Essay Physician-assisted suicide is a controversial topic with only a few states having legalized it; however, many groups are advocating for its approval. Physician-assisted suicide has ethical limitations that only allow a doctor to prescribe, not administer, a lethal dose of medication for a patient who has been deemed terminally ill with less than six months to live by two physicians. The prescription allows the patient to choose both the timing and setting of death and the physicians only role is provision of medication. This gifts patients with autonomy in their death and relieves the doctor of any moral burden in participation with death keeping this action an ethical practice. Oregon was the first of few states to have legalized physician-assisted suicide but I would like to argue its potential advantages to the entire United States. Ball (2010) said, â€Å"In Oregon the one state in the U.S. where assisted suicide is legal – doctors are allowed to help only state residents who are expected to die within six months† (p.1). Giving terminally ill patients the power to choose a peaceful death demonstrates empathy toward the ill patients and their families. Terminally ill patients without this empowerment face the difficult choice of using limited resources to end their lives if not given the legal freedom to choose how and when they die. The Code of Ethics for Nurses provision 1.4 is the right to self-determination and it states that Respect for human dignity requires the recognition of specific patient rights, particularly, the right to self-determination. Self-determination, also known as autonomy, is the philosophical basis for informed consent in health care. Patients have the moral and legal right to determine what will be done with their own person; to be given accurate, complete, and understandable information in a manner that facilitates an informed judgment; to be assisted with weighing the benefits, burdens, and available options in their treatment; to accept, refuse, or terminate treatment without deceit, undue influence, duress, coercion, or penalty; and to be given necessary support throughout the decision-making and treat ment process. Such support would include the opportunity to make decisions with family and significant others and the provision of advice and support from knowledgeable nurses and other health professionals. Patient should be involved in planning their own health care to the extent they are able to choose to participate (American nurses association, 2001, p.148). Giving this added right to chose physician assisted suicide allows patients the autonomy described in the Nursing Code of Ethics. The purpose of this paper is to argue that physician-assisted suicide is ethical and beneficial because it allows for patient autonomy. â€Å"I would argue that by denying terminally ill people recourse to death with dignity via physician prescribed medication, they are inflicting their own brand of coercion and abuse. The concept of a merciful death needs to be part of this discussion. It is a sad commentary that our society responds to our pets terminal suffering more humanely than to our fellow human beings end-of-life struggles†(â€Å"Death is best approached†, 2012, p. 1). Many feel that denying patients the right to choose is not advocating for their best interest and is a form of abuse. We wouldnt leave our ill family pet alive to suffer so why wouldnt we consider letting our loved ones put themselves out of their misery in a peaceful way? The entire point is to give the public a choice. It would still be up to each individual to decide whether or not to exercise that right if their physician deemed their situation appropriate. The Code of Ethics for Nurses says that â€Å"Respect for human dignity requires the recognition of specific patient rights, particularly, the right of self-determination† (American nurses association, 2001, p.148). This statement implies that the patient should have the right to make end of life decisions on their own. When terminal patients are in pain and suffering, they may not have the strength or will to fight any longer. It is cruel to prolong a patients pain and suffering and deny their autonomy to make the decision of having a peaceful death. Also, it can be argued that when patients have their mind set on ending their lives, they tend to follow through on their own even if their physician cannot assist them. This may lead to a more traumatic death and a scene that can be quite traumatizing for the family member or friend who finds their loved ones remains. The alternative is a prescribed medicine that the patient may take home, choosing the preferred place to die, to allow the patient to die peacefully without sustaining disfiguring injuries thus allowing them a more dignified burial if the family chooses to view the body one last time. However, in most of the United States, physician-assisted suicide is still illegal so very few Americans are afforded the right to choose to end their life when they are terminally ill. Because physician assisted suicide was brought to the publics attention as an option by the unconventional tactics of Dr. Jack Kevorkian, the idea of legalizing this was tainted from the beginning, making many states hesitant to allow assisted suicide. Miller (2011) notes that â€Å"Jack Kevorkian rose to national prominence as Dr. Death, a physician who insisted that sometimes a doctors first duty to his patient was to help him die. The retired pathologist, who became an assisted suicide advocate claiming to have had a hand in 130 deaths in the 1990s, helped spark a national debate over euthanasia† (p. A5). Jack Kevorkians tactics were questionable because he publicized the deaths of elderly, disabled, and terminally-ill patients using inhaled carbon dioxide or using his self-made suicide mach ine. Although the patients had asked for Dr. Kevorkians assistance to end their suffering by assisting in their suicide, he received a lot of negative attention because he publicized his assistance in this process by encouraging CBS to broadcast a video of himself injecting a cocktail of lethal drugs into a patient suffering from Lou Gehrigs disease (Miller, 2011). After much backlash from the public over the fact that he actually injected patients with lethal drugs, he developed a suicide machine which allowed the patient to press a button that caused the machine to administer a mixture of sodium pentothal and potassium chloride which was first used on Janet Adkins, a 54 year old sufferer of Alzheimers disease (Miller, 2011). The last thing Janet Adkins said was, You just make my case known,' Dr. Kevorkian told the Associated Press† (Miller, 2011, p. A5). Although his tactics were extreme and caused a lot of public controversy, his patients wanted to end their suffering and his act ions caused others to advocate for ethical standards to be put into place for legal physician assisted suicide while at the same time completely turning others away from the concept of legalizing euthanasia. Dr. Goodwin, a general practitioner, said he began advocating for the right to help terminally ill people die after listening to his patients (Miller, 2012). They want autonomy at this time, to be allowed to die at home with the comfort and support of their families, Dr. Goodwin said in a 2001 interview (Miller, 2012, p. 1). Because of the extreme tactics used by Jack Kevorkian, who initiated the debate on legalizing euthanasia, many people view those who advocate for the clients right of physician assisted suicide as cruel or lacking in empathy for patient and families. However, â€Å"Peter Goodwin, a family physician who wrote and campaigned for Oregons right-to-die law in the 1990s, died after taking a cocktail of lethal drugs prescribed by his doctor, as allowed under the legislation he championed. Dr. Goodwin, 83 years old, had been diagnosed with a degenerative brain disorder similar to Parkinsons disease and had been given less than six months to live.†(Miller, 2012, p. 1). Dr. Goodwin believed in a patients autonomy in death so much that he chose to exercise his own rights in the same fashion in order to end his own suffering. In an interview with the Oregonian, the local newspaper in Oregon, Dr. Goodwin said that his health was deteriorating and he would soon end his life. â€Å"His family gathered to bid him farewell. The situation needs thought, it doesnt need hope, he said. Hope is too ephemeral at that time†(Miller, 2012, p. 1). This clearly articulates the feelings of a terminally ill man towards the importance of autonomy in concern of his own death. â€Å"End-of-life decisions are not arbitrary or impulsive. Why shouldnt a person choose to end his or her life with dignity if it is obvious that all options for leading any kind of meaningful life are non-existent? I would think any modicum of compassion would respect such a momentous, personal decision. Suffering, physical and mental, and the anguish it causes should produce empathy for t he patients wishes and desires, even if they run counter to our own sense of rectitude. It is not about us. Its about the patients right of autonomy. We need to understand that it is ultimately his or her decision to make, not ours†(Death is best approached, 2012, p. 1). In this statement, an unknown author expressed the utmost sympathy for those suffering from terminal illness. Physician assisted suicide is ethical as it demonstrates compassion and empathy towards someone elses pain, suffering, and rights. There is nothing cruel about autonomy over the decision to die. These kinds of laws need to be considered using a deep emotional understanding of the terminally ills feelings and problems. Other countries have legalized euthanasia and have less restrictive laws which allow them to provide services for foreigners. Because of this, if all United States citizens arent granted the autonomy they desire in their own country they will still be able to get the results they so desperately want but the outcome may be more painful to family members whose loved ones would end up dying in other countries and in less desirable conditio ns. Mr. Minelli, who is head of Dignitas, a Swiss company that provides euthanasia services only to foreigners, said that â€Å"a memory of his seriously ill grandmothers pleading in vain with her doctor to help her die left him with a particular interest in Switzerlands growing right-to-die movement, and he joined one of the main groups. In 1998, he quit to found Dignitas†(Ball, 2010, p. 2). In 2008, his neighbors complaints forced Dignitas out of his rented apartment that he had been using to conduct the assisted suicides and Zurich city officials refused permission for a new venue. In response to this Mr. Minelli organized suicides in cars, a hotel room, industrial sites, and his own home which drew the attention of local officials. Someone who is used to a five-star hotel cant come to Dignitas and expect the same, says Mr. Minelli†(Ball, 2010, p. 2). Is it really beneficial to force terminally ill patients into a foreign country to a harsh environment to grant them the freedom to end their own lives? If terminally ill patients really want a physician assisted suicide, they will find another setting in which they can achieve one but allowing patients to have one in their own country optimizes the setting and allows for more family support near the time of death. It also saves the family the trouble of getting the body of a loved one from a foreign country after t he time of death and allows the family to begin funeral arrangements sooner so that they can go through the stages of grieving that they need to in order to move forward with their own lives. This act of ending the life sooner also spares the family the pain of watching their loved one suffer longer than they want to. Another benefit to approving physician assisted suicide is that just know that the option is available can be therapeutic for terminal patients. â€Å"Mr. Minelli argues that making assisted suicide available removes a taboo around suicide, helping people who want to kill themselves open a dialogue and seek help. About 70% of people who get the green light from Dignitas for an assisted suicide never contact the group again, proving the palliative effect of knowing help is available, he says†(Ball, 2010, p. 2). This clearly proves that just knowing that euthanasia is an option is enough to help patients carry on with terminal illness. Even if a patient chooses never to exercise the right to a physician assisted suicide, the knowledge that they have an option for a way out of their suffering is comforting in itself. Craig Ewert was a retired university professor who suffered from Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrigs disease. He decided to end his life because he wanted to make this decision before he lost the ability to decide his own fate, overcoming the resistance of his doctors (Ball, 2010). When youre completely paralyzed and cant talk, how do you let someone know you are suffering? he told a television interviewer before his death in September 2006. This could be a complete and utter hell (Ball, 2010, p. 3). Mr and Mrs. Ewerts were from the U.K. but they traveled to Switzerland and chose Mr. Minellis group, Dignitas, because it accepts foreigners. Mrs. Ewert said that had she not been able to travel to get her husband the assisted suicide services that he desired she may have been forced to help her husband die and she worried that she wouldnt have known exactly what to do (Ball, 2010). She defended Mr. Minelli saying Sure, there have to be some protections for people, but I think were going way beyond what there needs to be, I admire Minelli for being willing to take the heat (Ball, 2010, p. 3). Because Craig Ewert was allowed to make his own decision to die, his wife was spared the pressure that he may have put on her to help him end his life. Furthermore, had he been denied the right to make his own decision and his wife Mary had been coerced to help him commit suicide, there would have been extreme emotional and possibly even legal consequences to her action despite the fact that it was her husbands wish. This is a situation that may Americans are also threatened with because physician assisted suicide is illegal in most of the country. All United States citizens should be afforded the right to choose a physician assisted suicide if they have been deemed terminally ill because this freedom shows compassion and empathy towards the patients suffering. If patients arent allowed to legally choose death here, they may travel to another country to receive services or chose to carry out suicide on their own. If patients chose to take matters into their own hands this would be harder on the patient as the death would probably not be as peaceful as the lethal injection that the physician would prescribe and if would also be harder on the patients loved ones. If patients decide to go to another country to achieve the death they desire they would lose the privilege of dying in their own comfort zone and the distance would make the death harder on the family to make funeral arrangements and move on with their own lives. The Code of Ethics for Nurses stated that â€Å"Respect not just for the specific decision but also for the patients method of decision-making is consistent with the principle of autonomy† (American nurses association, 2001, p.149). Regardless of whether or not we understand an individuals motivation for seeking a physician assisted suicide, nurses should support the autonomy that patients needs to make this choice on their own. Giving terminally ill patients autonomy in their death, by making physician assisted legal for every United States citizen, is only giving patients additional rights that they may or may not chose to exercise and is the most compassionate way to show empathy for those who are dying.

Important Of Sight For The Purpose Of Survival Biology Essay

Important Of Sight For The Purpose Of Survival Biology Essay The importance of sight has been one of the most taken for granted systems in the human body. Sight, like the other four senses, plays an important role in the survival of an individual. In primitive humans, a loss of vision would make predator avoidance and food gathering difficult. Hence, there is an evolutionary pressure to maintain vision even when the eye sustains injury. While the eye is highly developed, certain post trauma mechanisms have evolved in such a way that our visual axis will not be altered, which would normally lead to instant blindness. Damage done to any normal part of the body usually leads to some sort of immunological response, including inflammation caused by the lymphocytes. Due to the physiology of the ocular system of mammals, the cornea cannot sustain inflammation, which can lead to the changing of the visual axis, thus leading to blindness. In primitive man, blindness could potentially lead to the individuals death. In order to prevent this, certain immu nological responses are suppressed in the cornea, allowing vision to remain. Keratitis is the clinical diagnosis of inflammation of the cornea, which if left untreated, can lead to blindness of the patient. This paper will use the Darwinian Medical approach and the Adaptationist Program to discuss the implications of the suppressed immune response in development and treatment of keratitis and the various microbial and mechanical causes thereof. In order to understand topics covered in this paper, a basic explanation of structures of the eye, their functions, as well as mechanisms and associated pathogens must be explained. Keep in mind, what will be mentioned is a buildup all to save the visual axis. The main anatomical focuses of the eye for this paper are the cornea and the anterior chamber. Concluding this will be a brief description of Darwinian Medicine and the Adaptationist Program. The cornea has two main functions and is composed of five layers. It acts as a protective membrane for the eye. The five layers consist of the following, in order from anterior to posterior, an external stratified squamous epithelium, an anterior limiting membrane (Bowmans membrane, the basement membrane o the stratified epithelium), the stroma, a posterior limiting membrane (Descemets membrane, the basement membrane of the endothelium), and an inner simple squamous endothelium. 1. The main functions of the cornea are to act as a protective membrane as well as to be the transparent window that allows light to enter through the eye to the retina. This unique transparency is due to the uniformity of the cell structure, being devoid of blood vessels, and being in a constant state of dehydration. If the epithelium is damaged, there is only a temporary regional build up of watery fluids in the stroma. However, if trauma is severe enough to expose any corneal layer below the epithelium, the cornea then becomes susceptible to infection of a variety of pathogens. These include, but are not limited to the following: bacteria, fungus, amoeba, and herpes virus.2. Without medical intervention, the basic stages of corneal infections are as followed: trauma, entrance of pathogen, inflammation of the cornea, ulceration, loss of vision, and even possibly loss of the eye. Located between the endothelium of the cornea and the iris, is a fluid filled cavity called the anterior chamber. The anterior chamber of the eyeball is filled with thick liquid-like substance called the aqueous humor. Its primary function is to maintain a normal intraocular pressure as well as provide nutrition for the tissues with no veins attached to them. In the anterior chamber, specifically the aqueous humor, there is a presence of a wide variety of immunoglobulins, as well as a wide variety of immunosuppressive substances such as transforming-growth-factor- Ã‚ ¢ and macrophage-migration-inhibitory-factor. A theory deemed Anterior-chamber associated immune deviation will be discussed later in this paper alongside with ocular-immune privilege. 3. The Darwinian Medical approach looks at both proximate, biological causes, as well as the ultimate, evolutionary causes to explain a disease or an immune function such as a fever. Ultimate causes are usually more complex in their explanations, which include defense, infection, novel environment, genes, design compromise, and evolutionary legacy all of which are evolutionary driven by four forces: natural selection, mutation, gene flow, and genetic drift. Evolutionary causes of an excessive and uncontrolled defense mechanism can affect the risk of the disease. Other risk factors include losing the evolutionary arms race, the preservation of an allele that is harmful, and the result of evolutionary constraints. While keratitis is classified as an infliction, it is actually an immune response related to the infiltration of a pathogen in the cornea. As stated above, keratitis is the inflammation of the cornea. Symptoms include mild to sever pain in the eye, redness of the eye, opaque cornea, photosensitivity, and tearing. Clinical diagnosis of keratitis is done through examination using a slit lamp and proper illumination, Fluorescein stain to detect superficial corneal lesions, and laboratory examinations of corneal scrapings to detect pathogens. 2. Inflammation caused by pathogens is potentially harmful leading up to corneal ulceration, loss of the visual axis, and potentially blindness. The inflammation however is the lesser of two evils, for without having this immune response, the sight of the infected would be doomed to blindness. While this is true, an eyes last-ditch effort to remove the pathogen leads to over-inflammation and ulceration of the cornea. At that point, unless a corneal transplant is done alongside with medicine to kill the pathogen, the eye has given up and the host goes blind. To regulate inflammation and prevent ulceration, it has been hypothesized that there is design compromise called ocular immune privilege in the eye that regulates inflammation up to a certain point. This will be discussed later. The epidemiological qualities of keratitis fluctuate etiologically as well as geographically. Keratitis has risen in both developing countries as well as modernized countries, afflicting people worldwide with no restrictions based on economic status. Thousands of patients each year are diagnosed with some form of pathogenic keratitis, having each pathogen found in particular environments found worldwide. Anyone involved in agriculture is usually at risk for fungal keratitis. Anyone wearing contacts are at an even higher risk for not only fungal keratitis, but also bacterial and amoeba induced keratitis. However, anyone who has any sort of ocular trauma led to lesions in the cornea is susceptible to any form of microbial keratitis. 2. The evolutionary legacy of ocular immune privilege is the result of evolutionary constraints and design compromises. In order to preserve the function of the eye, inflammation is regulated by the hosts adaptive immunity, specifically called ocular immune privilege. Immune privilege has been recognized in only three organs; the testes and ovaries, the brain, and the eye. 5. Coincidentally, these are some of the most important organs in the body related to survival and spreading of ones genome. Adaptive immunity is compromised of lymphocytes that throughout life generate unique receptor molecules that recognize with extraordinary specificity molecules expressed by invading pathogens. 3. (pg 11). It is important to understand this concept to elucidate the mechanisms of ocular immune privilege and ACAID. Ocular Immune privilege was first described about 130 years ago. However, its importance was not recognized until the early 1940s by P.B. Medawar and his colleagues. During the 1970s, it was discovered that ocular immune privilege was caused by anatomical, physiological, and immunoregulatory processes, which prevent the introduction and expression of immune-mediated inflammation. Many ophthalmological researchers agree that ocular immune privilege is an adaptation for reducing immune-mediated injury to ocular cells that have limited or no capacity for regeneration.6. The three major mechanisms of ocular immune privilege are as followed: (1) there are anatomical, cellular, and molecular barriers in the eye; (2) eye-derived immunological tolerance (ACAID); and (3) immune suppressive microenvironment in the eye. 5. Anterior chamber-associated immune deviation, or ACAID, is directly related to the ocular immune privilege theory. ACAID is characterized by impaired antigen-specific delayed -type hypersensitivity and reduced production of complement fixing antibodies. 3. It is an observable fact that allows the antibody response but not the cellular responses mentioned above. 5. The discovery happened when there was a prolonged survival of genetically different transplanted tissue survived in the anterior chamber of the eye. The failure of the immune system to bring forth an immunological response composes the characteristics of immune privilege. This is the reason why corneal transplants are one of the most successful, and least rejected tissue transplant clinically practices. Most tissue transplants are rejected due to inflammation however, the cornea has a weaker immune response caused by low antigenicity, the difference between corneal versus other tissue grafts. 7. The mechanisms of ACAID involve both the eye and the spleen. Transforming Growth factor TGF- Ã‚ ¢2 and thrombospondind TSP-1 located in the anterior chamber are involved in the initiation of mediation of ACAID. Through this, there is an attraction of regionally located natural killer T cells, which bind to CDQd molecules to present the antigens. When these cells come in contact with marginal zone B cells, clusters are formed which then differentiate into ACAID-inducing regulatory T cells. 5. A recent discovery made by Molly E. Skelsy and colleagues, concluded that  Ã‚ Ã‚ ¤ T cells are needed for ocular immune privilege and corneal graft survival. The study used mice treated with anti- Ã‚ Ã‚ ¤ Ab failed to develop ACAID concluding the injection of spleen cells. It was concluded that these T cells were required for the creation of regulatory T cells. By blocking the creation of  Ã‚ Ã‚ ¤ T cells, Skelsey showed that there was a profound increase in corneal transplant reje ctions. 8. Another recent discovery was that thymocytes, cells created by thymus that generate into T lymphocytes, are also necessary for the induction of ACAID. Thus the sustainment of immune privilege in the eye is done through the mutual aid of various cells from organs other than the eye itself. 5. The adaptive immunity is expressed in the form of humoral immunity mediated by antibodies produced by B lympocytes, and in the form of cellular immunity mediated by T lymphocytes. 3. (pg 15) Clearly, ocular immune privilege isnt something that just arose out of nowhere. It has been an evolutionary legacy, because whatever beneficial implications it had, leading up to ACAID, must have been immediately beneficial for it to exist throughout the evolution of many mammals such as humans and even mice. In 2008, Xiaoyong Yuan and colleagues did a study to compare the gene expression patterns in uninfected and fungus-infected mouse corneas at the onset of Candida albicans fungal keratitis. Candida ablican related corneal infections cause an inflammatory response, which has been known to permanently impair vision in half of all eyes affected, including those with therapy. Infected eyes were observed and corneal transcriptomes were categorized to suggest pathways contributing to corneal inflammation during Candida related keratitis. Through the use of gene microarray, the hosts gene expression during the early stages of this keratitis was also observed in mouse models. RNA isolated from the corneas one day after inoculation were used for reverse transcription of the RNA which would then be used in a quantitative real-time RT-PCR to multiply the amount of DNA created. Gene expression levels were calculated for both the experimental group and the control group. When comparing the two groups, a total of 45,102 genes were detected. Of those genes, 3,977, roughly 8.82% of the infected corneas were significantly regulated. Of those genes, 1987 were upregulated and 1,990 were down-regulated. A total of 3.71% were differentially expressed, 1,075 being upregulated and the other 597 being down-regulated. Specifically, there were 30 different genes being upreglated more than 100 fold. These genes were categorized as chemokines, metalloproteinases, interleukin cytokines, leukocyte chemotaxis and surface molecules, Ig recept ors, Neuro-hormone mediatiors and many others. Simply stated, these gene expressions suggest that microbial keratitis involves the synchrony of various host processes that affect inflammatory and immune responses, intercellular communication, and cellular metabolism in other words, ocular immune privilege and ACAID. 9. Keratitis is a microbial infliction occurring globally. Bacteria, parasites, virus, and fungus cause the four main microbial causes for infection. These microbes are currently winning the at arms race due to an increased virulence and re-infection after treatment. At the same time, because there have been changes in mans history, various novel environments have been associated with the etiology of all these infections. Looking at a study in a referral centre in South India from September 1999 through August 2002, MJ Bharathi and colleagues observed and calculated the statistics of keratitis in that referral centre. Of 3183 corneal scrapings evaluated, 1095(34.4%) were fungal related, 1043(32.77%) were bacterial related, 33(1.04%) were acanthamoeba related and 76(2.39) were both bacterial and fungal related. Of the 1043 bacterial related infections, the predominant isolated bacteria were Streptococcus. Males were 56.76% of cases and females were 43.24%, thus showing that sex doesnt af fect the infiltration rate. In the study, 60.2% patients were over the age of 50 were affected significantly more than patients under the age of 50. Roughly 16.97% of corneal injuries were due to soil/sand, compared to the 11.03% caused by other materials, showing a statistical significance between the two. Seasons also affected the rate of infections showing a lower incidence of bacterial keratitis from the months of June to September. 10. The epidemiology of bacterial keratitis varies based on geography. One could acquire keratitis from numerous gram-positive or gram-negative bacteria, such as Serratia, Pseudomonas, and Staphylococcus. Once the bacteria has touched base with the cornea, it colonizes the hosts cells by using adhesins at the surface of the epithelium. The adherence of these three bacteria to the corneal epithelium is significantly higher than any other bacteria, which explains their high frequency of isolation. Several bacteria have also displayed adhesins on pili and nonfimbriae structures to recognize carbohydrates on host cells. Recently, there have been emerging cases of resistance among pathogens, requiring the emersion of a stronger antibacterial to eradicate it. 11. The advent of contact lenses has created a novel environment for the infiltration of many bacterial pathogens. In the United States, there are approximately 25,000 cases of infectious keratitis annually. There are roughly 2-4 infections per 10,000 soft contact lenses users, and 10-20 infections per 10,000 extended-wear contact lenses users. 14. A study done by T. Bourcier and colleagues has identified predisposing factors of bacterial keratitis. After analyzing 300 cases, contacts were the main risk factor, occurring in 50.3% of the study group, with 83% of bacteria being gram positive, and 17% being gram negative. 12. Another study of a case report done by Konstantinos Tsaousis and colleagues concluded that the incidence of bacterial keratitis can be reduced by maintaining high standards of lens hygiene and following the recommended guidelines to safely wearing contacts. 13. In the past, fungal keratitis has been a major ophthalmological problem in the tropical regions of the world. 16. Of all of the fungus related to keratitis, there are two classifications of infiltrates yeast and filamentous fungi. The three main isolates of fungus in fungal keratitis are Aspergillus, Fusarium, and Candida. While the most common of isolate reported has been Aspergillus, ranging from 27-64%, Fusarium comes to a close second (6-32%). Like bacterial keratitis, contact lenses wearers are at a higher risk of fungal infection. In recent news, on March 8, 2006, the CDC began an investigation of the use of Bausch Lomb ReNu contact lens solution. The solution had been related to a series of 130 confirmed cases of Fusarium Keratitis, which resulted in 37 corneal transplant surgeries. Most fungal related incidences however are usually related to agriculture. Since fungus are found in soil and on plants, the probability of infection after ocular trauma increases if one is tendi ng to their crops. Once the fungus accesses the corneal stroma, they multiply and cause tissue necrosis leading to the onset of keratitis and the loss of stromal opacity. 15. Acanthamoeba related keratitis is usually derived from standing water or mud, with an increased risk in contact users. Incidence per million contact lens users includes 333 in Hong Kong, 1 in USA and 149 in Scotland 14. The abnormally high incidence in Scotland is due to the fact that there are many water towers, holding standing water, a novel environment for the acanthamoeba. Survival in the wild is not only based on ones ability to escape a predator, but also ones ability to detect the predator. The up keeping the visual axis is one of the most important abilities of the eyes immune abilities for without sight, many mammals would be at disadvantage. Keratitis, the inflammation of the cornea, has probably been around since the dawn of man, and more specifically, the dawn of agriculture. If injury to the eye were to be sustained, the cornea would become inflamed. Normally, corneal cellular layers would be impaired, leading to a loss of the visual axis. However, it has been observed that there is a key mechanism that has developed over time in order to save ones sight. There is an ocular immune privilege, considered to be an evolutionary legacy as well as a design compromise, in the anterior chamber of the eye, which limits certain immune functions to prevent the loss of vision. The microbial pathogens cause these infections ranges from bacterial, to funga l, viral, and amoebic have been detected around the world, causing countless keratitis infections. Novel environments, such as contact lenses, have created the perfect environment for these pathogens to culture on especially if proper care protocols havent been taken. While most of these infections are treatable, in the long term, the microbes are winning the at arms race. With increase resistance to anti-bacterials/fungals, pathogens will only become more virulent. From an epidemiological standpoint, microbial keratitis poses a serious threat for future infected patients, occurring world-wide. Mescher, Anthony L. PhD. (2010). Junqueiras Basic Histology: Text Atlas, 12e. In accessmedicine. Retrieved 10/1/10, from http://www.accessmedicine.com/content.aspx?aID=6183284searchStr=cornea#6183284. Biswell, Roderick MD. (2008). Vaughan Asburys General Ophthalmology, 17e. In accessmedicine. Retrieved 10/1/10, from http://www.accessmedicine.com/content.aspx?aID=3090961searchStr=cornea#3090961. Streilein, J.W. et al, 1999: Immune Response and the Eye. Karger, Switzerland Nesse, R. M. and Williams, G.C. 1994: p.x, Why We Get Sick. The New Science of Darwinian Medicine, Vintage, New York Junko Hori. (July 16, 2008). Mechanisms of immune privilege in the anterior segment of the eye: what we learn from corneal transplantation. In PubMed Central Journal List. Retrieved 10/1/10, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802514/?tool=pubmed. Niederkorn, Jerry Y. PhD, Streilein, Joan. PhD. (January 2010). History and Physiology of Immune Privilege. In Informa healthcare. Retrieved 10/1/10, from http://informahealthcare.com/doi/abs/10.3109/09273940903564766. Junko Hori, MD, PhD1, Vega, Jose L. MD, PhD2, Sharmila Masli, PhD3. (October 2010). Review of Ocular Immune Privilege in the Year 2010: Modifying the Immune Privilege of the Eye. In Informa healthcare. Retrieved 10/1/10, from http://informahealthcare.com/doi/abs/10.3109/09273948.2010.512696. Skelsey, Molly E., Mellon, Jessamee., Niederkorn, Jerry Y. . (2001). {{gamma}}{{delta}}T Cells Are Needed for Ocular Immune Privilege and Corneal Graft Survival. In The Journal of Immunology. Retrieved 10/1/10, from http://www.jimmunol.org/cgi/reprint/166/7/4327. Xiaoyong Yuan, Mitchell, Bradley M., and Wilhelmus, Kirk R. (September 18, 2008). Gene profiling and signaling pathways of Candida albicans keratitis. In PubMed Central Journal List. Retrieved 10/1/10, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562425/. Bharathi MJ, Ramakrishnan R, Vasu S, Meenakshi R, Shivkumar C, Palaniappan R. Epidemiology of bacterial keratitis in a referral centre in South India. Indian J Med Microbiol 2003;21:239-45 OBrien, T P . (February 2003). Management of bacterial keratitis: beyond exorcism towards consideration of organism and host factors. In Cambridge Ophthalmological Symposium. Retrieved 10/1/10, from http://www.nature.com/eye/journal/v17/n8/full/6700635a.html. Bourcier T, Thomas F, Borderie V, Chaumeil C, Laroche L . (January 10, 2003). Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases. In PubMed Central Journal List. Retrieved 10/1/10, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1771775/?tool=pubmed. Tsaousis K.T., Sakkias G., Kozeis N., Tahiaos P. . (July 19, 2010). A Management Dilemma: Infectious Keratitis Associated with Soft Contact Lens Use and Dubious Treatment Compliance. In PubMed Central Journal List. Retrieved 10/1/10, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935133/?tool=pubmed. Trevor John Mills, MD, MPH. (December 2, 2009). Corneal Ulceration and Ulcerative Keratitis. In Emedicine from WebMD. Retrieved 10/1/10, from http://emedicine.medscape.com/article/798100-overview. Daljit Singh, MBBS, MS, DSc. (June 12, 2008). Keratitis, Fungal. In Emedicine from WebMD. 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Business Plan for New Airline Essay examples -- Essays Papers

Business Plan for New Airline HausAir Mission Statement HausAir fixed base operation will provide the highest quality of flight instruction and comfortable charter services to the public; without compromising an ounce of safety, at a price lower than the competition. Human Resources/ Management Functions Breakdown of initial staff to begin at HausAir. (1) Manager/Owner Jason Bushouse (1) Assistant Manager Jeff Doyle (5) Receptionist/Clerical Jason Henderson (Full Time) Julie Vanek (Full Time) Roseanne Francis (Full Time) Pamela Laurie (Full Time) Art Wegner (Part Time) (6) Flight Instructors (Chief) Adam MacDonald (Full Time) Brent Ivey (Full Time) Janessa Luncford (Full Time) James Bushouse (Full Time) Ron Hallaux (Full Time) Randy Renolds (Full Time) (4) Pilot (Chief) Jason Bushouse Tim Dolenz Trevor Blackmer Dwayne Clemmens (4) Mechanics (Chief) Greg Radd (IA; Full Time) Lee Coss (A&P; Full Time) Joan Laukner (A&P; Full Time) Miguel Sanchez (A&P; Full Time) (4) Line Attendents Josh Hodny (Full Time) Mara Kennelly (Full Time) Brett Carlson (Part Time) Tommy Snellings (Part Time) (1) Sales Personnel Mike Campea FBO Organizational Chart Flight Office Service Finance Sales Job Description: Flight Instructor The HausAir flight instructors will follow some basic guidelines. They will be responsible for: - Student training for appropriate licenses - Maintaining proficiency in maneuvers - Proficiency required flight knowledge - Proficiency instructional techniques - Promoting a positive image of general aviation - Perform duties assigned by chief pilot - Maintaining safe and professional habits The position requires a minimum commercial multi-engine land instrument airplane and CFI certificate and those without a CFII will be expected to obtain the certificate within 6 months of start date. Instructors must be able to train a student from wherever their current ability level is to proficiency to the practical test standards for the certificate desired. Instructors will be required to follow HausAir flight training syllabus unless there is prior approval from the chief flight instructor. Instructors will be expected to give biannual flight reviews, checkouts to customers planning to rent aircraft an... ...n income of $5480 with a profit of 2200 a month. Fuel will be stored and fueled by the fuel truck. Line service will fuel all incoming aircraft, regardless of size. Supplies HausAir will carry a wide selection of supplies and keep current with charts, approach plates, books and other aviation publications. We can make between 40-60% profit but will charge what competitors like sportys pilot shop charge. We will match their price and work prices around that range. Insurance Insurance is an important protection for this FBO. Due to the high amount of risk involved in aviation it will be important to hold monthly safety meetings, and have rotating safety officer schedule that will change every day. There are many different kinds of insurance that we must purchase. Some of the insurance coverage that is required: Aircraft hull Aircraft liability Passenger liability Hangar liability Product liability Fire and Natural disaster coverage Auto full coverage Comprehensive public liability Bibliography http://www.airplane.com/be58.htm Richardson, Rodwell, & Baty (1995) Essentials of Aviation Management. Dubuque, IA: Kendall/Hunt Publishing Company.

A journey by bus

It is generally said that a Journey by bus is not as thrilling as one by train or rear plane is. However, I had quite a pleasant experience of the Journey by bus which I undertook few months ago. It was the month of January. My annual examination was over. I had recess for some days. My parents decided to go to my uncle's house at Smaller by bus. Hearing the news my heart danced with Joy. It was 15th January 2014. We got into the bus at Subtotal bus terminal in due time. It was winter. There was pleasant sunshine. The sun started punctually Just at 6 a. M.I sat beside a window and was looking outside. The sun was rising with all its splendid beauty. Within an hour our bus began running leaving the urban areas at a high speed along the road with green fields on both sides. I was looking at the houses, trees, and meadows through the window with a cheerful mind. Things came to my vision and vanished in the twinkling of an eye. Everything on either side seemed running swiftly to the oppo site direction. When the bus was running through the forest of ‘Modular gear', the tall trees with green leaves gave a nice view.I was really charmed at the green beauties of Nature. It filled my heart with great Joy. The bus ran continuously for three hours. It then stopped at a place named Plash. There was a restaurant by the roadside. We got down from the bus and had light refreshment there. After a few minutes the bus began Its Journey again crossing the green fields on both the sides of the road. This time we saw bare-bodied youngsters tending cattle and grown up people working In the field. Occasionally we saw village women and girls bathing and washing clothes In the ponds. At about 12 noon we reached Smaller.Thus our Journey came to an end. The Journey by bus was really a pleasant one. I can hardly forget the sweet memory of this Journey. The scene of the Journey peeps Into my mind when I become tired of the monotonous urban life. Words- 361 a journey by bus By brandie d After a few minutes the bus began its Journey again crossing the green fields on both grown up people working in the field. Occasionally we saw village women and girls bathing and washing clothes in the ponds. At about 12 noon we reached of this Journey.

Urban Segregation essays

Urban Segregation essays Since urbanization began in European cities, there has always been segregation, either by class, socio-economic status, political affiliation, etc. In modern American cities stratification is most heavily linked to class or race. There are many reasons that segregation in cities take place, and we will explore the more prevalent ideas of social stratification. When urban centers in America were beginning to take shape, people moved in droves to these industrial metropolises to find work and success. We studied earlier the effects of this mass immigration to cities and saw the horrid living conditions that people endured to find work. The overcrowding of cities made ghettos obvious and wealth was not directly associated with the masses of people moving in. Through the years, urban areas grew with new suburban towns encircling the city. Wealthier people inhabited these suburban areas with the ability to move in and out of cities at their own will. Cities became a melting pot of cultures in a small area. People of the same ethnic background often moved into neighborhoods in which their own culture was dominant as to fit in and feel more at home. These areas are obvious in places such as Chinatown, or Little Italy. Southie, in Boston is dominated by the working class Irish people that came to the American cities as many others did: looking for work, and the American Dream. These social groupings are one way that cities become segregated. This segregation is not the discriminatory term that we usually attribute to the phrase, but the separation of social groups. The city in the 1920s was often a battleground as various groups within the population struggled for social and cultural authority. New laws in urban centers gave way to a new cultural group as well: criminals. Organized crime in the 1920s was widespread; In New York, Chicago, Detroi ...