Wednesday, November 27, 2019

Bird Imagery In Portrait Of The Artist free essay sample

As A Young Man Essay, Research Paper Bird Imagery in A Portrait of the Artist as a Young Man The plants of twentieth-century Irish author James Joyce resound vividly with a alone humanity and mastermind. His novel, A Portrait of the Artist as a Young Man, published in 1916, is a convincing journey through the interior head and spirit of Stephen Dedalus. Portrayed with unbelievable eloquence and pragmatism, imagination guides the reader through the fleet current of growing touchable in the juvenile hero. Above all heavy imagination in the novel is the repeating bird motive. Joyce uses birds to finally associate Stephen to the Daedelus myth of the? hawklike adult male ; ? nevertheless, these images besides represent Stephen? s day-to-day experiences, and hankering for true freedom ( page169 ) . By utilizing imagination of birds as threatening, images of beauty, and images of flight, the reader can unite the work and better understand Stephen? s disruptive journey through life. We will write a custom essay sample on Bird Imagery In Portrait Of The Artist or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The opening scene of Chapter one portrays a conversation between a really immature Stephen and Dante, Stephen? s nursemaid. She scolds him for an unconventional idea, warning him that? the bird of Joves will come and draw out [ your ] eyes? ( 8 ) . This evidently in writing image suggests to Stephen the endangering presence of bird of Joves that are minding all his ideas. Joyce? s color with such ghastly imagination has a existent consequence on Stephen ; he repetitions Dante? s cautiousness in his childish vocal, intonation: ? Pull out his eyes, Apologize? ( 8 ) . A playful, yet sensitive Stephen must instantly conform Pfeiffer 2 even his guiltless irregular actions in fright of the threatening apparition bird of Joves to salvage the effects they will convey. His ideas are threatened once more by birds when he meets an familiarity named Heron when walking down a dark street. Stephen instantly notes the peculiar image of Heron? s? bird face every bit good as a bird? s name? ( 76 ) . Through descriptive images of Heron? s? nomadic face, beaked like a bird? s? and his ? close set outstanding eyes which were light and inexpressive, ? Joyce enables the reader to non merely visualize his birdlike features but besides adds penetration to Stephen? s ideas toward his unchaste equals ( 76 ) . Heron twits Stephen, sarcastically calling him a? theoretical account young person? who? doesn? T coquette and doesn? T darn anything or curse all? ( 76 ) . This blazing comment by the bird-like male child is an obvious verbal menace to Stephen? s character. Continued as Heron and his friend viscously chide Stephen for his esteem for Byron? s poesy, Joyce? s bird imagination bears in this scene a restraint of Stephen? s singularity by endangering his self-expression. As Stephen mentally develops in the patterned advance of the novel, he begins his hunt for the? free dom and power of his psyche, as the great inventor whose name he bore? would hold done ( 170 ) . Stephen is now at the beach, chew overing his new sense of adulthood as he grows? near to the wild bosom of life? ( 171 ) . Walking down a bouldery incline, he takes notice to a miss? entirely and still, staring out to sea? ( 171 ) . Stephen watches her, and awed by her? similitude of a unusual and beautiful sea-bird, ? he realizes she is the prototype of all that is? the admiration of mortal beauty? ( 171 ) . Painted by Joyce? s beaming imagination of the? darkplumaged dove? he sees before him, this rationalisation is the footing of Stephen? s internal epiphany ; she is, to Pfeiffer 3 Stephen, ? an minister plenipotentiary from the just tribunals of life? ( 171, 172 ) . This wholesome bird-like miss with? long slender bare legs ( that ) were delicate as a Crane? s, ? gives Stephen a perceptual experience of a true virtuous beauty he has neer known before, and a naming to? animate life out of life, ? as is the function of the true creative person he aspires to be ( 171, 172 ) . A few old ages subsequently on the stairss of a library stripling Stephen bases, inquiring? what birds are they? as he watches tonss of birds fly free above him, their? fliting quaking organic structures winging clearly against the sky? ( 224 ) . Now more restless and philosophical, he wonders at their images. Joyce? s genuinely hearable imagination of the birds? ? call ( that ) was shrill and clear and all right and falling like togss of silken visible radiation? is, for Stephen, ? cold clamor [ comforting ] his ears? ( 224 ) . Stephen Dedalus sees consolation in the birds? ? waver of wings ; ? they are the cardinal symbol of the freedom he is ready to hold for his ain ( 224 ) . He wishes to hold their release from the society he knows as he reflects on: ? The correspondence of birds to things of the mind and of how the animals of the air have their cognition and cognize their times and seasons because they, unlike adult male, are in the order of their life and have non perverted that order by ground? ( 224 ) . In order to seek true emancipation, Stephen? must travel away for they were birds of all time traveling and coming # 8230 ; of all time go forthing the places they had built to wander? ( 225 ) . Stephen resolves to go forth his Irish fatherland ; free and wild as his images of the birds. Pfeiffer 4 The properties which mold Stephen Dedalus? turning unity and life determinations stem from the actions which surround him. The reader associates Stephen by the images he encounters and his reaction to them. In James Joyce? s A Portrait of the Artist as a Young Man, Stephen? s connexion with bird imagination helps to specify his hunt for a function in his society, and helps readers define and place with his pursuit. 371

Saturday, November 23, 2019

Cascade Volcanoes essays

Cascade Volcanoes essays The Pacific Northwest is home to the Cascade Volcanoes. Between Southern British Columbia and Northern California is where the Cascades thrust out of the earth. All along the range majestic peaks climb towards the sky. The Gorda, Juan de Fuca, and Explorer plates are being pulled down into the Cascadia subduction zone and beneath the North America plate. As a result of this the Cascade range was formed, and is still being changed to this day by the interaction of these plates. Because of this specific type of interaction between the plates the Cascades are volcanic. Within the range there are varying types of volcanoes. Major peaks like Mt. Ranier and Mt. Hood are composite volcanoes. Lassen Volcanic National Park has good examples of many types of volcanoes. The peak we see today is a plug dome volcano. However, there are shield volcanoes, and cinder cones found throughout Lassen Volcanic National Park. Crater Lake is a great example of a caldera. All through the Cascade mountain range one can find all sorts of examples of different types of volcanoes. Volcanoes have no regard for human life, and they will erupt, change, and vent whenever it is necessary. The eruption of Mt. St. Helens in the early 1980s is a very good example of an extremely violent eruption. Surrounding forests were devastated and mudflows brought havoc to the lower laying areas around St. Helens. If St. Helens was near a major metropolitan area, or even a modest sized city, the damage would be almost immeasurable. Many Cascade Volcanoes are still very active. Mt. Ranier is near Seattle, and Mt. Hood is just east of Portland. If either of these volcanoes were to erupt the cities below would be directly in the warpath. ...

Thursday, November 21, 2019

Analyzing HR Policies of Tesco Essay Example | Topics and Well Written Essays - 1750 words

Analyzing HR Policies of Tesco - Essay Example All these policies are closely knitted with one another. Human resource management components cannot be separated from each other and they together denote effectiveness of the approach. Tesco employs approximately 310,000 people in its UK branch. The company witnessed certain challenges in terms of declining sales margin and falling share price value. This aspect greatly affected employee base and it was essential to boost up their morale. In this report, drawbacks in HR policies of the company shall be highlighted along with some recommendations to be implemented in the system. HR practices and policies revolve around various theoretical frameworks. These frameworks basically state the need for human resource management strategies. Employees should be motivated in every sphere of workplace simply because they are the most valuable asset of an organization. Recruitment and selection procedure are basic methods through which a pool of talent is structured within an organization. These initial methods are then followed by the training and development approach. Learning plays an important role in organizational success (Torrington, Hall and Taylor, 2014). A learning organization is always more productive in comparison to other firms. Kolb’s learning cycle includes different components that are generally focused on by HR practitioners. Figure1 further elaborates this cycle. As per figure1, the first phase of this learning cycle is to identify probable learning need. On basis of this need, learning opportunities are appropriately designed. This eventually leads to influencing candidates so that they are able to opt for these opportunities. The last phase of this cycle is critical since it denotes effectiveness of entire learning program (Bonnici, 2011). Evaluation phase helps a team leader to analyze overall impact of learning program on employees.

Wednesday, November 20, 2019

How the Anthropocene is related to my major Business Management Research Paper

How the Anthropocene is related to my major Business Management Explain through McDonalds especially their Beef Hamburgers - Research Paper Example Their production activity requires meat from animals, yet livestock production is one of the human practices that results in adverse changes in the environment. Subsequently, the current sorry state of the environment marked by degradation and depletion of essential resources is attributed to anthropogenic activities. Moreover, scientists believe that there is a new wave of anthropogenic activities that started in a particular period, a concept referred to as anthropocene. Being business management student, understanding the concept of anthropocene and environmental degradation is important, as it helps in finding solutions to the issue. McDonalds is one of the biggest fast food restaurants in the world. The restaurant was established in 1955 in Illinois USA and has more than 30000 outlets located in 120 countries globally that serve more than 54 million customers daily. McDonalds is famous for producing delicious and tasty beef hamburgers that attract many customers every day. As a result, the company is growing day by day, and the customer base is equally rising, which translates to increased consumption of beef hamburgers, and thus production of more of meat by farmers. The primary source of meat is nature. Therefore, increased demand for beef is among the anthropogenic activities that results in adverse effects on the environment and natural resources. The continuous and enormous use of natural resources disturbs the balance in the ecosystem resulting in numerous problems that cause environmental problems. One of the adverse effects of production and consumption of beef hamburgers is the depletion of the natural resources in the environment. The main ingredient of McDonald’s hamburgers is meat from animals. Halden and Schwab states, â€Å"Finally, but growing more urgent every day, industrial agriculture may be a significant contributor to climate change, as the production of greenhouse gases from

Sunday, November 17, 2019

Carbon, Phosphorus and Nitrogen Cycles Essay Example for Free

Carbon, Phosphorus and Nitrogen Cycles Essay The carbon cycle starts with the reservoir of the carbon dioxide in the air, the carbon atoms move from carbon dioxide through photosynthesis into atoms of organic molecules that form the plants body. These carbon atoms are then further metabolized and are eaten and turned into tissue that all organisms in the ecosystem use. Half of the atoms are respired by the plants and animals and half are deposited back into the soil in the form of dead animal and plant matter, which are eaten by decomposers and transformed back into carbon dioxide. Humans impact this cycle because we are removing so much of the photosynthetic efforts of the plants in order to support our enterprises, we are â€Å"diverting 40% of the photosynthetic productivity of land plants to support human enterprises,† (pg 67). Two examples of our harmful tendencies are burning fossil fuels which has increased atmospheric carbon dioxide â€Å"35% over preindustrial levels,† (pg. 67) and logging. These both are being used naturally by the ecosystem and the lack of these resources causes stress and strain to keep the balance. At the rate it is going carbon to complete its cycle from the atmosphere through one or more living organism and back to the atmosphere happens about every 6 years. The phosphorus cycle includes the cycle of all the biologically important nutrients found in the natural minerals. These elements include iron, calcium, potassium found in the rock and soil minerals in the lithosphere. Over time a rock breaks down and releases phosphate (PO43-) and other ions which replenish phosphorus that is lost due to runoffs and leaching. The phosphate is absorbed by plants and turned into compounds that are moved through the food chain. Humans impact this cycle because we are using the phosphorus to make fertilizers, animal feeds, detergents or other products and mining these locations. Our water systems are being damaged because â€Å"human applications have tripled the amount of phosphorus making it to the oceans,† (pg 68). This is a problem because it causes over fertilization or eutrophication of the aquatic ecosystem. The waterborne phosphorus cannot be returned to the soils this causes too much bacteria or algae in the water and kills of the fish and other water mammals. The nitrogen cycle is similar to the carbon and phosphorus cycles; because it has a gas phase like carbon and can also be a limiting factor such as phosphorus. The main form of nitrogen is in the air â€Å"which is about 78% nitrogen gas (N2),† (pg 68). The plants change the nitrogen into organic compounds which are necessary like proteins and nucleic acids. Humans impact this cycle because many of our crops are legumes or nonleguminous. Legumes like peas, beans provide the bacteria a place to live and a source of food and receive nitrogen in exchange, where it enters the food web. Nonleguminous crops such as corn, wheat, potatoes and cotton have to be heavily fertilized with nitrogen’s from industrial fixations. The over fertilization of nitrogen into the soils are destroying lakes, ponds and forests. However our actions are more than doubling the rate which nitrogen is moved from the atmosphere to the land, â€Å"nitric acid has destroyed thousands of lakes and ponds and caused extensive damage to forests,† (pg 70). Humans have a great impact on all three cycles. If it continues the way that we are using fossil fuels, and destroying the land as we are currently are. We are depleting our resources at a faster rate than we can sustain naturally which is causing harmful living conditions which we may not necessarily feel the repercussions of immediately.

Friday, November 15, 2019

Effect of Calpain-calpastatin System in Meat Tenderness

Effect of Calpain-calpastatin System in Meat Tenderness 1.0 Introduction Meat quality is the freshness of the meat. This is the most crucial things which supplier always find and think in order to fulfill the high demand from the customer. This shows researcher play an important role in increasing the quality of meat because of the high demand from the wholesalers or consumer. The critical point of appraisal of meat quality occurs when the consumer eats the products and they comment on the colour, nutritional value, and price determines the decision to repurchase (Boleman et al., 1997).In addition, consumer evaluation of eating quality is the most determination of meat quality as tenderness, juiciness and flavor of meat are the most important elements (Tarrant, 1998; Bindon Jones, 2001). The variability in tenderness cause by a lot of factors before post mortem, like the feeding types and the environment (French et al., 2001) and after post-mortem, like temperature, pH, sarcomere length and proteolysis (Charlotte Maltin et al., 2003). In this study it focusing majorly on the role of genetic traits which play an important function in order to get the high quality of meat (Williams, 2008). Interest of this study is to identify the relationship between the microsatellite repetition and the calpastatin type1 promoter region effects in meat tenderness. In mid 1980s (Mullis Faloona, 1987; Saiki et al., 1985) as the advent of Polymerase Chain Reaction(PCR), microsatellites were detected in eukaryotes genome and they are the most promising PCR-based markers. Microsatellites are simple sequence tandem repeats (SSTRs) of variable length that distributed throughout the eukaryotic nuclear genome in both coding and non-coding region (Jarne Lagoda, 1996). This can be amplify and identify by the PCR method (Sunnucks, 2000, Strassmann et., 1996, Shriver et., 1995). Due to the high mutation rate of microsatellites, they are potentially the most informative marker with advantages of easy and low-cost detection. Thus, the microsat ellites repeat in calpastatin can influence the tenderness of meat because of the different types can produce with different role. The aim of this findings is to characterise the expression of microsatellite repeat in calpastatin type I promoter region in bovine, to identify the  regulation of CAST gene inhibitory calpain system in affecting the tenderization of meat and to develop a mechanism that can control the calpastatin gene in maintaining the tenderization of meat. 2.0 Literature review 2.1 Meat Quality and consumer perception Meat quality is a term used to describe a range of attributes of meat. Those factors such as post mortem factors, pH, temperature, proteolysis, sarcomere length, and the most important elements is tenderness and juiciness that affect the consumer to repurchase the meat (Warris, 2000). Besides that, meat quality also determine by color, flavor and texture which influence the consumer to enjoy the meat product (Glitsch, 2000). However, the main cause of failure of consumer complain to repurchase is the variability in eating quality, especially in tenderness. Some of the consumer that has more knowledge will concern on the safety of consuming meat. They will think of the health implication like the composition of the polyunsaturated fat and saturated fat, and the microbial contamination especially during handling the meat products. According to the statistical of meat consumption in Ninth Malaysian Plan, the Malaysian government targets to increase the production of beef in order to reduce the import dependence. As per capita consumption which 0.5 kg in 2003 of mutton is very low, more attention is paid to the beef market which increased from 2.3 kg to 5.8 kg (FAO, 2007). Due to the high demand, the qualities of meat need to be increased in order to make sure consumer will repurchase. Anderson and Ferguson (2001) emphasize that quality as the top priority in making decision to buy and consume more meat. Similarly , factors that effect the consumer to repurchase red meat other than economic one is meat quality (Taljaard et al., 2006). 2.2 Tenderness Tenderness is a primary factor that influencing the consumers reaction (Glitsch, 2000).Tenderness is an integrated textural property made up of mechanical, particulate and chemical components (Paerson and Young, 1989).The appreciation of tenderness when eating is not explained by the force required to cut through a piece of meat, but is affected by the way the muscle fibers breakdown and the release of juices and flavor while chewing. Several independent studies have identified a locus on bovine chromosomes 29 with affect on tenderness. The caplain1 (CAPN 1) gene that codes for a calcium dependent protease involved in meat tenderization post- mortem. According to the research Miller et al., 2001, meat tenderness (texture) is the most important organoleptic characteristics that influence the acceptability for consumer. Tenderness is the consequences of postmortem physicochemical and biochemical changes in muscle of myofibrillar. After slaughtering, muscle is extensible and elastic until the onset of the rigor mortis, when the energy for muscle relaxation is depleted (Alberle et al., 2001). 2.3 Tenderization phase 2.3.1 Pre-rigor phase The duration of pre-rigor phase is dependent on the animal species. After the slaughtering of animal, blood, oxygen and nutrient supply are cut to the muscle and these triggers the pre-rigor phase to start (Lawrie, 1998).For chicken is less than 0.5 to 1.0 h and for beef 4 to 6 h (Aberle et al., 2001). The muscle will becomes gradually stiff and its tension reaches maximum on the completion of rigor. This is due to the formation of an irreversible actomysin complex in muscle which lead to the shorten sarcomere length. This will cause the toughening of muscle at the beginning of the post-mortem process (Koohmaraie et al., 1996). 2.3.2 Rigor phase At this phase, muscles maintain the homeostasis by metabolize muscle glycogen by aerobic glycolysis. Thus, it will continue supply of ATP. During this phase, the depletion of ATP will increase the concentration of calcium ion in sarcoplasma. Sarcoplasma reticulum functioning in removing of calcium ion across the membrane utilizing the calcium ATPase pump and dependent on ATP for this active process (Robbins et al., 2003). In the meat process, anaerobic glycosis is take place in order to maintain the production of ATP. From this the lactic acid will produced and decrease in pH value and lead to the depletion of creatine phosphate because of lack of ATP. Thus, the availability of substrate required to maintain the contractile proteins actin or myosin in relaxation state. The irreversible cross bridge and rigor mortis occur because of actin and myosin and these will made the muscle reaches to the maximum toughness as the consequences of shortening the sarcomere length (Goll et al., 1995 ). 2.3.3 Post-rigor phase In the post-rigor, the proteolytic enzyme system are responsible in continuing the tenderness (Kemp et al., 2010; Koohmaraie et al., 1996). This phase started about 24 hours to 14 days of meat storage. The rate change is variable due to the proteolytic degradation of myofibrillar and cytoskeletal proteins cause the loss of structural integrity of myofibrils which enhancing the meat tenderization (Koohmaraie et al., 1996). The calpain/calpastatin(calcium-dependent), proteosomal and lysosomal systems have been extensively investigated for their involvement in post-rigor proteolytic degradation and meat tenderization (Kemp et al., 2010; Koohmaraie et al., 1996). 2.4 Factors that affect the meat tenderness 2.4.1 Muscle pH After the bovine is being slaughter, they need to maintain their homeostasis. So, the muscle will undergoes anaerobic respiration and regenerate the production of ATP by aerobic respiration. The amount of ATP produced is less than normal. During anaerobic, the glycogen is metabolized into pyruvate and then converts into lactic acid. The lactic acid will gradually decrease the pH value of the muscle tissue (Maltin et al., 2003).This level of of pH will give varies effects on glycogen level, ATP turn over and the metabolic characteristic of muscle tissue (Lawrie, 1998). The high level of pH which is greater than 7.5 , typically dark and easy to bacteria to survive on it. This will shorten the shelf life of the meat and this bring to the variability if the tenderness as the low of glycogen substrate (Watanabe et al., 1996). 2.4.2 Temperature Temperature during the pre-rigor and post-rigor phase will affect on the metabolism of the muscle tissue of meat(Hertzman et al., 1993).Meat toughness will increase during the higher temperature (Bruce and Ball, 1990). The declination of muscle temperature will lead to the shortening of muscle. This is because of the reduced calcium sequestering ability by the sarcoplasmic reticulum as a result of the depletion of energy compounds which cause the muscle to contract and increase the toughness of meat (Huff Lonergan et al., 2010). There are a researched found that, at 15 Celsius is the best temperature for maintaining meat tenderization (Geesink et al., 2000). 2.4.3 Juiciness Juiciness is defined as the feeling in the mouth of moisture from cooking meat and chewing. The juiciness is closely related to the attribute of flavor as this latter attribute is also affected by the level of IMF in the meat. The high the intramuscular fat content (IMF) , the higher the meat quality (Kerry et al., 2002). 2.4.4 Proteolysis Proteolysis is a conversion of muscle to meat entrains changes in tenderness due to changes in the properties of muscle fibre and connective tissue. The steps are toughness increase into rigor, proceed with proteolysis and last the rigor is resolve. Proteolytic system is divided into four which, first, cathepsin-lysomal system second, ATP-dependent ubiquitin –proteasome system, third, calpain-calpastatin system and last is matrix Metalloproteinases (MMP) (Thompson and Palmer, 1998). Tenderization increasing during ageing and it is primarily a result of calpain-mediated degradation of myofibrillar and cytoskeleton proteins. Most of researcher doing the investigation on proteolytic system and the have a A1QWdebate on these. But most of the studies agreed that the calpain system has play the major role in post-mortem tenderization (Boehm et al., 1998; Koohmaraie.1992b; Taylor et al., 1995a). Proteolysis involve calpain occurs between 3-14 d post mortem when activity of  µ-calpain low ,  µ-calpain maybe bound to the myofibril and inactivated during post mortem storage but the m-calpain active when the level of calcium arise. Calpain is calcium-dependent which function in softening the muscle tissue of the meat. In proteolysis it involve the calpain proteases and caplain-specific inhibitor, calpastatin. When the low level of calpastatin produce, the more calpain protease produce .Then, the tenderness of meat will increase. 2.5 Microsatellite Microsatellites are simple sequence tandem repeats (SSTRs).The repeat units are generally di-, tri-, tetra- or pentanucleotides (Powell et al., 1996) .Like repetition in birds is ACn, where it`s means two nucleotides A and C are repeated in bead-like fashion a variable number of times. The n could be range from 8 to 50.This always occur on a non-coding region of DNA. On the each side of the repeat unit are flanking regions which consist of unordered DNA. This flanking region is dangerous because they will allow the development of locus-specific primers to amplify the microsatellites with PCR. By having a forward and reverse primer on each side of microsatellites it will be able to amplify a fairy short (100 to 500bp) locus-specific microsatellite region(Sunnucks, 2000, Strassmann et., 1996, Shriver et., 1995). Microsatellites were designed for generative neurology disease in human but it shows a great applicability in other species. Microsatellites act as markers was classified based on the number of bases like short repeats are microsatellites while longer repeats are minisatellites. Besides that, it also classified by the type of repeated sequence present whether it is perfect, imperfect or composite. Imperfect means the repeated sequence was interrupted by different nucleotides which are not repeated while composites when two or more different motifs in tandem (Selkoe Toonen, 2006).In addition, microsatellites is co-dominant and it is widely distributed throughout the genome and transferable between species. These features provide their successful function in these fields (Chistiakov et al., 2006). 2.5.1 Microsatellites mutation Microsatellites are useful genetics markers because they tend to be polymorphic. Normally, human microsatellites with 20 or more alleles ad heterozygosities. This is because their mutation occurs different from the â€Å"classical† point mutations, where the substitution of one nucleotide to another occurs. The mutation in microsatellites occur through slippage replication where two strands could slip relative position a bit but still manage to get the zipper going down the beads. One strand can be lengthened or shortened by the addition or excision of the nucleotides. So, the repeat unit can be one longer and the other is shorter than the original (Selkoe et., 2006). 2.6 Calpastatin Study of calpastatin gene promoter activity had been done by some of the researcher .Calpastatin is proteinase inhibitor for calpain which family of calcium-activated neutral proteases that regulate the of Ca2+. It is encoded by single gene in mammal which produces proteins isoforms through the alternating splicing, There are four types of CAST which are Type I, Type II, Type III has been characterized in porcine with the study of the three promoters directing expression(Parr et al., 2004) while in bovine calpastatin transcripts including Type IV had been characterized with the studied of four functional promoters in the gene (Raynaud et al., 2005).This four types of CAST can bind to the calpain and inhibit proteolytic activity. A single calpastatin can inhibit several caplain molecules in vitro. Several isoforms of calpastatin exist due to the alternative promoter usage and differential splicing (Parr et al., 2001; Raynaud etal., 2005).Increasing response on calpastatin expression to ß- adrenergic stimulation has been associated with skeletal muscle hypertrophy in livestock (Parr et al., 1992; Killefer and Koohmaraie, 1994) and related inversely with the tenderization rates(Koohmaraie, 1996). ß- adrenergic stimulation act by the cyclic adenosine monophosphate (cAMP) responsive elements in calpastatin promoter regions(Cong et al., 1998a, b).three types of promoters located in the 5 region of gene upstream of exons 1xa, 1xb, and 1u generate calpastatin mRNA transcripts the types I, II, and III respectively (Takano et al., 2000; Parr et al., 2004).In pig, these promoters have putative motifs for another transcription factors that will imply other signaling pathways of calpastatin expression(Parr et al., 2001; Raynaud etal., 2005). 2.6.1 The types of calpastatin genes From the previous studies, there were found calpasatin has four types of repetitive-inhibitor domains which are Type I, Type II, Type III and Type IV. The isolated cDNAs from the various mammalian species have conspicuous differences in the regions encoding the N-terminal sequences. These four different types has different function and from the different sources. The Type I and Type II in mouse and bovine respectively also differ from each other in the uttermost N-terminal sequences, possess longer domain L sequences than those of rabbit, pig and human inhibitors which are Type III.The previous obtained mouse calpastatin cDNA is encoded by as many as 31 exons including the first exon. The other three additional exons specifying the N-terminal sequences of the types were identified in the mouse genomic DNA sequence. The mRNAs for Type I and Type III were expressed in the liver, the Type II high in heart and skeletal muscle .Besides , the Type IV abundance in testis. These findings sho w that the calpastatin isoforms possessing different N-terminal sequences are generated by the alternative transcription initiation from their own promoters and skipping of the mutually exclusive exons (Takano et al., 2000). Cong et al. (1998), reported cAMP-dependent transactivation of the bovine calpastatin gene whose promoter located on the upstream of exon .They identified a sequence GTCA which was important for the cAMP responsiveness and corresponded to the half site of the full CRE(a consensus palindromic cAMP-responsive cis-element; TGACGTCA).They demonstrated that mutation of GTCA at -76 nt to ATCT completely abolished the dibutyryl-cAMP .Comparison of the nucleotide sequences of the mouse and bovine genomic DNAs did not show a high similarity but little similar sequence GTGCGGTGTCAGCCGG (identical residues are underlined) containing GTCA was found. The differential expression patterns of the type I, II, III mRNAs among different animal suggests that the presence of different transcriptional regulatory elements upstream of the respective promoters. Besides that, the differences in N-terminal sequences might affect the intracellular distribution of the action calpain-calpastatin system in stimula tion of meat tenderness (Takano et al., 1999). 2.7 Calpain Calpain were intracellular calcium-dependent cysteine proteinases which present in all mammalian(Goll et al., 2003; Sorimachi et al., 2001).In catalysing the limited proteolysis of cytoskeletal and membrane protein , the calpain were play a big role.This regulation occur with help of specific protein inhibitor calpastatin.In striated muscle, the calpain/calpastatin system has been proved in regulation protein turnover especially in meat texture development (Sensky et al., 2001). 2.8 The effect of calpain-calpastatin system in meat tenderness The calpain and calpastatin proteolytic enzyme system is believed to be the main contributor to the tenderness of meat at post mortem.The present of calpastatin in meat influence the calpain by acting as inhibitor. Calpastatin is a marker in order to determine the tenderness of meat. The researcher found the activity of the calpastatin in meat at 24 hours was highly related to shear force value after 14th day after post mortem. It showed that an early event after the animal being slaughter could be predictive of ultimate shear force because of the low activity of calpastatin (Whipple et al., 1990). The findings was repeated in pork. The higher level of calpastatin after 2 hours of post mortem is increasing the toughness (parr et al., 1999).We can conclude that the activity of calpastatin was responsible in variation of tenderness of meat by the differences in proteolytic rate of the animals. A more complex study is performed by the Shackleford et al.(1994) that correlate between both calpastatin level and meat toughness and the possibility of using these for selection purposed to improve the meat quality.

Tuesday, November 12, 2019

Nursing Practice

My nursing practice has been characterized by a marked transition from the general wards to the intensive care unit. Nevertheless, my values have remained intact. Initially, I must admit, I believed that patients had no role in determining the medication or intervention they receive. However, since I came to know about it, in a nursing class, the value of decision-making independence has guided my practice. I learnt the value in class, thus, my definition of the term is influenced by Fahrenwald et al., who defined decision-making autonomy as the act of allowing patients to make their own decisions regarding diagnosis and treatments, albeit after receiving all relevant information (2005). The value of decision-making autonomy and working with patients under intensive care have shaped my understanding of person-centered care and its relevance to nursing, as a profession and a practice. In the ICU, it is easy to view the person as just a patient. However, I have deliberately chosen to consider them people who are just momentarily inconvenienced by illness. As a nurse, I am in agreement with Ross, Tod, & Clarke's (2015) observation that the definition and use of person-centered care has been fluid and varies in distinct research, guidance, policy and daily practice. Still, I concur with the definition offered by the American Geriatrics Society; eliciting individuals' preferences and values and, once expressed, letting them guide all healthcare aspects, and supporting their practical life and health goals (2015). However, I find an earlier definition by McCormack, Dewing, & Breslin (2010) quite relevant to practice. They define person-centered care as an approach to nursing practice that is created by forming and fostering therapeutic relationships between patients, care providers and other people who are significant to the patients' lives. Drawing from the two definitions, I believe person-centered care is viewing patients as persons with social networks and accomodating their beliefs and values in the provision of care, while developing relationships that enable the attainment of healthcare as well as life goals. In adherence to the value of decision-making autonomy, I always communicate to patients their diagnosis and suggested interventions. To attain the goals associated with the value, one needs excellent communication and people skills, which is one of my strengths in practice. More specifically, I have demonstrated empathy, which is a person-centered communication skill. In the course of my practice, I try to comprehend and share into the perspectives, current situation and feelings of the persons under my care. That creates a bond of trust, social support and mutual understanding. The informed patients then get to decide whether they agree with the diagnosis, and whether they are willing to receive the suggested interventions. In case of the ICU, I consult with the patients' families and let them make the decisions. Human dignity is another value that has influenced most of my decisions in my professional and personal life. As a nurse, I believe it is important to respect all individuals, including the patients, their families and the entire society. In line with the value of human dignity, I respect patients' belief systems and consider their natural human values during my interactions with them and their families. However, at times, it is difficult to know some patients' beliefs, especially in the ICU. Although it is possible to get information about patient beliefs from their families and close friends, I consider it my duty to ensure that the informants do not pass out their own belief systems as the patients'. Trustworthiness and honesty are important strengths that have enabled me uphold human dignity in my practice. Without being trustworthy, patients and their families would not reveal their secrets to me. Many a times, the secrets are critical to the formulation of interventions. Human dignity also dictates that I protect patients' confidentiality during clinical interactions. For instance, I always ensure that I cover all exposed body parts of patients. What's more, I demonstrate my respect for human dignity through respectful communication with patients' families and keeping their secrets confidential. Respecting human dignity calls for mindfulness, which is another person-centred communication skill I believe I possess. Hafskjold et al., (2015) define mindfulness as the art of drawing unique variations by being present in interactions. By being mindful, I am able to observe the happenings and act according to what I notice. Research shows that mindfulness by nurses leads to more satisfied patients (Ross, Tod, & Clarke, 2015). My practice has also been guided by altruism. My own conceptualization of altruism is in line with the definition of the term offered by Shahriari et al., (2013); focusing on patients as human beings, while striving to promote their health and welfare. In nursing practice, the ICU is ostensibly the most tasking department to work in. It requires working without losing concentration, whether one is on a day shift or night shift. I have often found myself standing next to patients' beds throughout the night just to make sure they are fine. Despite the tough requirements, I believe I have exhibited devotion and selflessness the entire time I have attended to patients in the ICU, and even before. Undeniably, sometimes I have felt exhausted by the demands of the job, but my altruistic tendencies have always reminded me that nursing is not just a job, but a calling that requires me to give my all towards the healthcare and welfare of others. To reflect on my professional practice, I use two different strategies; the Gibbs model and John's reflective framework. The Gibbs (1988) Model has six stages; description of event, feelings, evaluation, analysis, conclusion and action. On its part, John's framework has three important elements; bringing the mind home, experience description and reflection (Palmer, Burns, ; Bulman, 1994).Part 2 Wanda formulated a reflection model that requires students to follow a five-step process during reflective practice, also known as the 5Ds structured reflection model (2016). The 5Ds stand for Doubts/differences, Disclosure, Dissection, Discover and Decision. The learner reflects on whether s/he has any doubts in his/her practice, or whether there are any differences between what s/he did in a clinical setting and what is found in literature. Disclosure entails writing about the experiences or situation on the topic discussed in the doubts section, while the dissection section considers why it happened and the impact. Discover involves finding additional information from relevant literature and the decision part describes a future plan.5Ds model of structured reflection (Wanda, 2016) The Rolfe model enables students to reflect on their experiences based on three questions; what, so what and now what (Rolfe, Freshwater, ; Jasper, 2001). The first question allows students and nurses to describe the situation, while the second question gives students room to discuss what they learnt, while the answers to the last question identify what the person should do to develop learning and improve future outcomes. The 5Ds Structured reflection The two models have various similarities and differences. For starters, the two reflective models allow students to explore their experiences while being guided by something. However, in the Rolfe model, students are guided by the questions, while in Wanda model (2016); students are guided by the 5Ds expressed earlier. A key strength of the 5Ds reflection model is that it focuses on the student as an individual (Wanda, 2016). Consequently, it enables students to decide what they need to learn more about, which makes them more self-directed in their learning. Secondly, it has a positive impact on students' ability to self-evaluate during clinical practice (Wanda, 2016). When used by students, it improves their ability to assess their own performance in clinical practice.Despite the apparent strengths, the model also has some limitations. To begin with, the effectiveness of the model can be restricted by students' characteristics (Wanda, 2016). For instance, the less motivated students are not suited to the reflective model. As a result, the model is not an effective learning tool for all students. What's more, the use of the 5D model requires consistent supervision, which is sometimes not possible because faculty members might have workloads that limit their time (Sicora, 2017).Grant, McKimm, & Murphy (2017) posit that the analysis part of the Rolfe et al. framework considers not just the technical-rational knowledge but also other forms of knowledge that might inform the comprehension of a particular situation. This is one of the strengths of the reflective model since it allows learners explore all knowledge points. However, it runs the risk of leading to superficial reflections (Sicora, 2017). At times, the students might just result to answering the three questions in short answers. That would not help in yielding a comprehensive reflection that would help them learning about their achievements and shortcomings that can help improve their practice. At a personal level, I prefer the 5Ds model. My preference for the model is informed by my desire to identify my doubts in practice as well as the tasks I perform in a way that is different from dictates of literature. That would help me refine my skills and procedures in practice, while making me a more confident practitioner, particularly in the ICU. BibliographyFahrenwald, N., Bassett, S., Tschetter, L., Carson, P., White, L., & Winterboer, V. (2005). Teaching core nursing values. Journal of professional nursing , 46-51.Gibbs, G. (1988).Learning by doing: a guide to teaching and learning methods. Oxford: Oxford Polytechnic.Grant, A., McKimm, J., & Murphy, F. (2017).Developing Reflective Practice: A Guide for Medical Students, Doctors and Teachers. Hoboken, NJ: John Wiley & Sons.Hafskjold, L., Sundler, A. J., Holmstrà ¶m, I. K., Sundling, V., Dulmen, S. v., & Eide, H. (2015).A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol. BMJOpen , 1-10.McCormack, B., Dewing, J., & Breslin, L. (2010).Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people. International Journal of Older People Nursing , 93-107.Palmer, A., Burns, S., & Bulman, C. (1994).Reflective practice in nursing. Oxford: Blackwel l Scientific Publications.Rolfe, G., Freshwater, D., & Jasper, M. (2001). Framework for Reflective Practice. London, United Kingdom: Palgrave.Ross, H., Tod, A., & Clarke, A. (2015).Understanding and achieving person-centred care: the nurse perspective. Journal of Clinical Nursing , 9-10.Shahriari, M., Mohammadi, E., Abbaszadeh, A., & Bahrami, M. (2013).Nursing ethical values and definitions: A literature review. Iranian journal of nursing and midwifery research , 1-8.Sicora, A. (2017). Reflective Practice. London, United Kingdom: Policy Press.Smith, K. (2016).Reflection and person-centredness in practice development. International Practice Development Journal , 1-6.The American Geriatrics Society . (2015).Person?Centered Care: A Definition and Essential Elements. Journal of the American Geriatrics Society , 15-18.Wanda, D. (2016). The development of a clinical reflective practice model for paediatric nursing specialist students in Indonesia using an action research approach. Open Pu blication of UTS Scholars , 1-288.Wanda, D., Fowler, C., & Wilson, V. (2016).Using flash cards to engage Indonesian nursing students in reflection on their practice. Nurse Education Today , 132-137.

Sunday, November 10, 2019

Patient Recording System Essay

The system supplies future data requirements of the Fire Service Emergency Cover (FSEC) project, Fire Control, fundamental research and development. Fire and Rescue Services (FRSs) will also be able to use this better quality data for their own purposes. The IRS will provide FRSs with a fully electronic data capture system for all incidents attended. All UK fire services will be using this system by 1 April 2009. Creation of a general-purpose medical record is one of the more difficult problems in database design. In the USA, most medical institutions have much more electronic information on a patient’s financial and insurance history than on the patient’s medical record. Financial information, like orthodox accounting information, is far easier to computerize and maintain, because the information is fairly standardized. Clinical information, by contrast, is extremely diverse. Signal and image data—X-Rays, ECGs, —requires much storage space, and is more challenging to manage. Mainstream relational database engines developed the ability to handle image data less than a decade ago, and the mainframe-style engines that run many medical database systems have lagged technologically. One well-known system has been written in assembly language for an obsolescent class of mainframes that IBM sells only to hospitals that have elected to purchase this system. CPRSs are designed to review clinical information that has been gathered through a variety of mechanisms, and to capture new information. From the perspective of review, which implies retrieval of captured data, CPRSs can retrieve data in two ways. They can show data on a single patient (specified through a patient ID) or they can be used to identify a set of patients (not known in advance) who happen to match particular demographic, diagnostic or clinical parameters. That is, retrieval can either be patient-centric or parameter-centric. Patient-centric retrieval is important for real time clinical decision support. â€Å"Real time† means that the response should be obtained within seconds (or a few minutes at the most), because the availability of current information may mean the difference between life and death. Parameter-centric retrieval, by contrast, involves processing large volumes of data: response time is not particularly critical, however, because the results are us ed for purposes like long-term planning or for research, as in retrospective studies. In general, on a single machine, it is possible to create a database design that performs either patient-centric retrieval or parameter-centric retrieval, but not both. The challenges are partly logistic and partly architectural. From the logistic viewpoint, in a system meant for real-time patient query, a giant parameter-centric query that processed half the records in the database would not be desirable because it would steal machine cycles from critical patient-centric queries. Many database operations, both business and medical, therefore periodically copy data from a â€Å"transaction† (patient-centric) database, which captures primary data, into a parameter-centric â€Å"query† database on a separate machine in order to get the best of both worlds. Some commercial patient record systems, such as the 3M Clinical Data Repository (CDR)[1] are composed of two subsystems, one that is transaction-oriented and one that is query-oriented. Patient-centric query is considered more critical for day-to-day operation, especially in smaller or non-research-oriented institutions. Many vendors therefore offer parameter-centric query facilities as an additional package separate from their base CPRS offering. We now discuss the architectural challenges, and consider why creating an institution-wide patient database poses significantly greater hurdles than creating one for a single department. During a routine check-up, a clinician goes through a standard checklist in terms of history, physical examination and laboratory investigations. When a patient has one or more symptoms suggesting illness, however, a whole series of questions are asked, and investigations performed (by a specialist if necessary), which would not be asked/performed if the patient did not have these symptoms. These are based on the suspected (or apparent) diagnosis/-es. Proformas (protocols) have been devised that simplify the patient’s workup for a general examination as well as many disease categories. The clinical parameters recorded in a given protocol have been worked out by experience over years or decades, though the types of questions asked, and the order in which they are asked, varies with the institution (or vendor package, if data capture is electronically assisted). The level of detail is often left to individual discretion: clinicians with a research interest in a particular condition will record more detail for that condition than clinicians who do not. A certain minimum set of facts must be gathered for a given condition, however, irrespective of personal or institutional preferences. The objective of a protocol is to maximize the likelihood of detection and recording of all significant findings in the limited time available. One records both positive findings as well as significant negatives (e.g., no history of alcoholism in a patient with cirrhosis). New protocols are continually evolving for emergent disease complexes such as AIDS. While protocols are typically printed out (both for the benefit of possibly inexperienced residents, and to form part of the permanent paper record), experienced clinicians often have them committed to memory. However, the difference between an average clinician and a superb one is that the latter knows when to depart from the protocol: if departure never occurred, new syndromes or disease complexes would never be discovered. In any case, the protocol is the starting point when we consider how to store information in a CPRS. This system, however, focuses on the processes by which data is stored and retrieved, rather than the ancillary functions provided by the system. The obvious approach for storing clinical data is to record each type of finding in a separate column in a table. In the simplest example of this, the so-called â€Å"flat-file† design, there is only a single value per parameter for a given patient encounter. Systems that capture standardised data related to a particular specialty (e.g., an obstetric examination, or a colonoscopy) often do this. This approach is simple for non-computer-experts to understand, and also easiest to analyse by statistics programs (which typically require flat files as input). A system that incorporates problem-specific clinical guidelines is easiest to implement with flat files, as the software engineering for data management is relatively minimal. In certain cases, an entire class of related parameters is placed in a group of columns in a separate table, with multiple sets of values. For example, laboratory information systems, which support labs that perform hundreds of kinds of tests, do not use one column for every test that is offered. Instead, for a given patient at a given instant in time, they store pairs of values consisting of a lab test ID and the value of the result for that test. Similarly for pharmacy orders, the values consist of a drug/medication ID, the preparation strength, the route, the frequency of administration, and so on. When one is likely to encounter repeated sets of values, one must generally use a more sophisticated approach to managing data, such as a relational database management system (RDBMS). Simple spreadsheet programs, by contrast, can manage flat files, though RDBMSs are also more than adequate for that purpose. The one-column-per-parameter approach, unfortunately, does not scale up when considering an institutional database that must manage data across dozens of departments, each with numerous protocols. (By contrast, the groups-of-columns approach scales well, as we shall discuss later.) The reasons for this are discussed below. One obvious problem is the sheer number of tables that must be managed. A given patient may, over time, have any combination of ailments that span specialities: cross-departmental referrals are common even for inpatient admission episodes. In most Western European countries where national-level medical records on patients go back over several decades, using such a database to answer the question, â€Å"tell me everything that has happened to this patient in forward/reverse chronological order† involves searching hundreds of protocol-specific tables, even though most patients may not have had more than a few ailments. Some clinical parameters (e.g., serum enzymes and electrolytes) are relevant to multiple specialities, and, with the one-protocol-per-table approach, they tend to be recorded redundantly in multiple tables. This violates a cardinal rule of database design: a single type of fact should be stored in a single place. If the same fact is stored in multiple places, cross-protocol analysis becomes needlessly difficult because all tables where that fact is recorded must be first tracked down. The number of tables keeps growing as new protocols are devised for emergent conditions, and the table structures must be altered if a protocol is modified in the light of medical advances. In a practical application, it is not enough merely to modify or add a table: one must alter the user interface to the tables– that is, the data-entry/browsing screens that present the protocol data. While some system maintenance is always necessary, endless redesign to keep pace with medical advances is tedious and undesirable. A simple alternative to creating hundreds of tables suggests itself. One might attempt to combine all facts applicable to a patient into a single row. Unfortunately, across all medical specialities, the number of possible types of facts runs into the hundreds of thousands. Today’s database engines permit a maximum of 256 to 1024 columns per table, and one would require hundreds of tables to allow for every possible type of fact. Further, medical data is time-stamped, i.e., the start time (and, in some cases, the end time) of patient events is important to record for the purposes of both diagnosis and management. Several facts about a patient may have a common time-stamp, e.g., serum chemistry or haematology panels, where several tests are done at a time by automated equipment, all results being stamped with the time when the patient’s blood was drawn. Even if databases did allow a potentially infinite number of columns, there would be considerable wastage of disk space, because the vast majority of columns would be inapplicable (null) for a single patient event. (Even null values use up a modest amount of space per null fact.) Some columns would be inapplicable to particular types of patients–e.g., gyn/obs facts would not apply to males. The challenges to representing institutional patient data arise from the fact that clinical data is both highly heterogeneous as well as sparse. The design solution that deals with these problems is called the entity-attribute-value (EAV) model. In this design, the parameters (attribute is a synonym of parameter) are treated as data recorded in an attribute definitions table, so that addition of new types of facts does not require database restructuring by addition of columns. Instead, more rows are added to this table. The patient data table (the EAV table) records an entity (a combination of the patient ID, clinical event, and one or more date/time stamps recording when the events recorded actually occurred), the attribute/parameter, and the associated value of that attribute. Each row of such a table stores a single fact about a patient at a particular instant in time. For example, a patient’s laboratory value may be stored as: (, 12/2/96>, serum_potassium, 4.1). Only positive or significant negative findings are recorded; nulls are not stored. Therefore, despite the extra space taken up by repetition of the entity and attribute columns for every row, the space is taken up is actually less than with a â€Å"conventional† design. Attribute-value pairs themselves are used in non-medical areas to manage extremely heterogeneous data, e.g., in Web â€Å"cookies† (text files written by a Web server to a user’s local machine when the site is being browsed), and the Microsoft Windows registries. The first major use of EAV for clinical data was in the pioneering HELP system built at LDS Hospital in Utah starting from the late 70s.[6],[7],[8] HELP originally stored all data – characters, numbers and dates– as ASCII text in a pre-relational database (ASCII, for American Standard Code for Information Interchange, is the code used by computer hardware almost universally to represent characters. The range of 256 characters is adequate to represent the character set of most European languages, but not ideographic languages such as Mandarin Chinese.) The modern version of HELP, as well as the 3M CDR, which is a commercialisation of HELP, uses a relational engine. A team at Columbia University was the first to enhance EAV design to use relational database technology. The Columbia-Presbyterian CDR,[9],[10] also separated numbers from text in separate columns. The advantage of storing numeric data as numbers instead of ASCII is that one can create useful indexes on these numbers. (Indexes are a feature of database technology that allow fast search for particular values in a table, e.g., laboratory parameters within or beyond a particular range.). When numbers are stored as ASCII text, an index on such data is useless: the text â€Å"12.5† is greater than â€Å"11000†, because it comes later in alphabetical order.) Some EAV databases therefore segregate data by data type. That is, there are separate EAV tables for short text, long text (e.g., discharge summaries), numbers, dates, and binary data (signal and image data). For every parameter, the system records its data type so that one knows where it is stored. ACT/DB,[11],[12] a sys tem for management of clinical trials data (which shares many features with CDRs) created at Yale University by a team led by this author, uses this approach. From the conceptual viewpoint (i.e., ignoring data type issues), one may therefore think of a single giant EAV table for patient data, containing one row per fact for a patient at a particular date and time. To answer the question â€Å"tell me everything that has happened to patient X†, one simply gathers all rows for this patient ID (this is a fast operation because the patient ID column is indexed), sorts them by the date/time column, and then presents this information after â€Å"joining† to the Attribute definitions table. The last operation ensures that attributes are presented to the user in ordinary language – e.g., â€Å"haemoglobin,† instead of as cryptic numerical IDs. One should mention that EAV database design has been employed primarily in medical databases because of the sheer heterogeneity of patient data. One hardly ever encounters it in â€Å"business† databases, though these will often use a restricted form of EAV termed â€Å"row modelling.† Examples of row modelling are the tables of laboratory test result and pharmacy orders, discussed earlier. Note also that most production â€Å"EAV† databases will always contain components that are designed conventionally. EAV representation is suitable only for data that is sparse and highly variable. Certain kinds of data, such as patient demographics (name, sex, birth date, address, etc.) is standardized and recorded on all patients, and therefore there is no advantage in storing it in EAV form. EAV is primarily a means of simplifying the physical schema of a database, to be used when simplification is beneficial. However, the users conceptualisethe data as being segregated into protocol-specific tables and columns. Further, external programs used for graphical presentation or data analysis always expect to receive data as one column per attribute. The conceptual schema of a database reflects the users’ perception of the data. Because it implicitly captures a significant part of the semantics of the domain being modelled, the conceptual schema is domain-specific. A user-friendly EAV system completely conceals its EAV nature from its end-users: its interface confirms to the conceptual schema and creates the illusion of conventional data organisation. From the software perspective, this implies on-the-fly transformation of EAV data into conventional structure for presentation in forms, reports or data extracts that are passed to an analytic program. Conversely, changes to data by end-users through forms must be translated back into EAV form before they are saved. To achieve this sleight-of-hand, an EAV system records the conceptual schema through metadata – â€Å"dictionary† tables whose contents describe the rest of the system. While metadata is important for any database, it is critical for an EAV system, which can seldom function without it. ACT/DB, for example, uses metadata such as the grouping of parameters into forms, their presentation to the user in a particular order, and validation checks on each parameter during data entry to automatically generate web-based data entry. The metadata architecture and the various data entry features that are supported through automatic generation are described elsewhere.[13] EAV is not a panacea. The simplicity and compactness of EAV representation is offset by a potential performance penalty compared to the equivalent conventional design. For example, the simple AND, OR and NOT operations on conventional data must be translated into the significantly less efficient set operations of Intersection, Union and Difference respectively. For queries that process potentially large amounts of data across thousands of patients, the impact may be felt in terms of increased time taken to process queries. A quantitative benchmarking study performed by the Yale group with microbiology data modelled both conventionally and in EAV form indicated that parameter-centric queries on EAV data ran anywhere from 2-12 times as slow as queries on equivalent conventional data.[14] Patient-centric queries, on the other hand, run at the same speed or even faster with EAV schemas, if the data is highly heterogeneous. We have discussed the reason for the latter. A more practical problem with parameter-centric query is that the standard user-friendly tools (such as Microsoft Access’s Visual Query-by-Example) that are used to query conventional data do not help very much for EAV data, because the physical and conceptual schemas are completely different. Complicating the issue further is that some tables in a production database are conventionally designed. Special query interfaces need to be built for such purposes. The general approach is to use metadata that knows whether a particular attribute has been stored conventionally or in EAV form: a program consults this metadata, and generates the appropriate query code in response to a user’s query. A query interface built with this approach for the ACT/DB system[12]; this is currently being ported to the Web. So far, we have discussed how EAV systems can create the illusion of conventional data organization through the use of protocol-specific forms. However, the problem of how to record information that is not in a protocol–e.g., a clinician’s impressions–has not been addressed. One way to tackle this is to create a â€Å"general-purpose† form that allows the data entry person to pick attributes (by keyword search, etc.) from the thousands of attributes within the system, and then supply the values for each. (Because the user must directly add attribute-value pairs, this form reveals the EAV nature of the system.) In practice, however, this process, which would take several seconds to half a minute to locate an individual attribute, would be far too tedious for use by a clinician. Therefore, clinical patient record systems also allow the storage of â€Å"free text† – narrative in the doctor’s own words. Such text, which is of arbitrary size, may be entered in various ways. In the past, the clinician had to compose a note comprising such text in its entirety. Today, however, â€Å"template† programs can often provide structured data entry for particular domains (such as chest X-ray interpretations). These programs will generate narrative text, including boilerplate for findings that were normal, and can greatly reduce the clinician’s workload. Many of these programs use speech recognition software, thereby improving throughput even further. Once the narrative has been recorded, it is desirable to encode the facts captured in the narrative in terms of the attributes defined within the system. (Among these attributes may be concepts derived from controlled vocabularies such as SNOMED, used by Pathologists, or ICD-9, used for disease classification by epidemiologists as well as for billing records.) The advantage of encoding is that subsequent analysis of the data becomes much simpler, because one can use a single code to record the multiple synonymous forms of a concept as encountered in narrative, e.g., hepatic/liver, kidney/renal, vomiting/emesis and so on. In many medical institutions, there are non-medical personnel who are trained to scan narrative dictated by a clinician, and identify concepts from one or more controlled vocabularies by looking up keywords. This process is extremely human intensive, and there is ongoing informatics research focused on automating part of the process. Currently, it appears that a computer program cannot replace the human component entirely. This is because certain terms can match more than one concept. For example, â€Å"anaesthesia† refers to a procedure ancillary to surgery, or to a clinical finding of loss of sensation. Disambiguation requires some degree of domain knowledge as well as knowledge of the context where the phrase was encountered. The processing of narrative text is a computer-science speciality in its own right, and a preceding article[15] has discussed it in depth. Medical knowledge-based consultation programs (â€Å"expert systems†) have always been an active area of medical informatics research, and a few of these, e.g., QMR[16],[17] have attained production-level status. A drawback of many of these programs is that they are designed to be stand-alone. While useful for assisting diagnosis or management, they have the drawback that information that may already be in the patient’s electronic record must be re-entered through a dialog between the program and the clinician. In the context of a hospital, it is desirable to implement embeddedknowledge-based systems that can act on patient data as it is being recorded or generated, rather than after the fact (when it is often too late). Such a program might, for example, detect potentially dangerous drug interactions based on a particular patient’s prescription that had just been recorded in the pharmacy component of the CPRS. Alternatively, a program might send an alert (by pager) to a clinician if a particular patient’s monitored clinical parameters deteriorated severely. The units of program code that operate on incoming patient data in real-time are called medical logic modules (MLMs), because they are used to express medical decision logic. While one could theoretically use any programming language (combined with a database access language) to express this logic, portability is an important issue: if you have spent much effort creating an MLM, you would like to share it with others. Ideally, others would not have to rewrite your MLM to run on their system, but could install and use it directly. Standardization is therefore desirable. In 1994, several CPRS researchers proposed a standard MLM language called the Arden syntax.[18],[19],[20] Arden resembles BASIC (it is designed to be easy to learn), but has several functions that are useful to express medical logic, such as the concepts of the earliest and the latest patient events. One must first implement an Arden interpreter or compiler for a particular CPRS, and then write Arden modules that will be triggered after certain events. The Arden code is translated into specific database operations on the CPRS that retrieve the appropriate patient data items, and operations implementing the logic and decision based on that data. As with any programming language, interpreter implementation is not a simple task, but it has been done for the Columbia-Presbyterian and HELP CDRs: two of the informaticians responsible for defining Arden, Profs. George Hripcsak and T. Allan Pryor, are also lead developers for these respective systems. To assist Arden implementers, the specification of version 2 of Arden, which is now a standard supported by HL7, is available on-line.[20] Arden-style MLMs, which are essentially â€Å"if-then-else† rules, are not the only way to implement embedded decision logic. In certain situations, there are sometimes more efficient ways of achieving the desired result. For example, to detect drug interactions in a pharmacy order, a program can generate all possible pairs of drugs from the list of prescribed drugs in a particular pharmacy order, and perform database lookups in a table of known interactions, where information is typically stored against a pair of drugs. (The table of interactions is typically obtained from sources such as First Data Bank.) This is a much more efficient (and more maintainable) solution than sequentially evaluating a large list of rules embodied in multiple MLMs. Nonetheless, appropriately designed MLMs can be an important part of the CPRS, and Arden deserves to become more widespread in commercial CPRSs. Its currently limited support in such systems is more due to the significant implementation effort than to any flaw in the concept of MLMs. Patient management software in a hospital is typically acquired from more than one vendor: many vendors specialize in niche markets such as picture archiving systems or laboratory information systems. The patient record is therefore often distributed across several components, and it is essential that these components be able to inter-operate with each other. Also, for various reasons, an institution may choose to switch vendors, and it is desirable that migration of existing data to another system be as painless as possible. Data exchange/migration is facilitated by standardization of data interchange between systems created by different vendors, as well as the metadata that supports system operation. Significant progress has been made on the former front. The standard formats used for the exchange of image data and non-image medical data are DICOM (Digital Imaging and Communications in Medicine) and HL-7 (Health Level 7) respectively. For example, all vendors who market digital radiography, CT or MRI devices are supposed to be able to support DICOM, irrespective of what data format their programs use internally. HL-7 is a hierarchical format that is based on a language specification syntax called ASN.1 (ASN=Abstract Syntax Notation), a standard originally created for exchange of data between libraries. HL-7’s specification is quite complex, and HL-7 is intended for computers rather than humans, to whom it can be quite cryptic. There is a move to wrap HL-7 within (or replace it with) an equivalent dialect of the more human-understandable XML (eXtended Markup Language), which has rapidly gained prominence as a data interchange standard in E-commerce and other areas. XML also has the advantage that there are a very large number of third-party XML tools available: for a vendor just entering the medical field, an interchange standard based on XML would be considerably easier to implement. CPRSs pose formidable informatics challenges, all of which have not been fully solved: many solutions devised by researchers are not always successful when implemented in production systems. An issue for further discussion is security and confidentiality of patient records. In countries such as the US where health insurers and employers can arbitrarily reject individuals with particular illnesses as posing too high a risk to be profitably insured or employed, it is important that patient information should not fall in the wrong hands. Much also depends on the code of honour of the individual clinician who is authorised to look at patient data. In their book, â€Å"Freedom at Midnight,† authors Larry Collins and Dominic Lapierre cite the example of Mohammed Ali Jinnah’s anonymous physician (supposedly Rustom Jal Vakil) who had discovered that his patient was dying of lung cancer. Had Nehru and others come to know this, they might have prolonged the partition discussions indefinitely. Because Dr. Vakil respected his patient’s confidentiality, however, world history was changed.

Friday, November 8, 2019

Free Essays on Iago Shrewdly Directs This Play

The main distinguishing point between Shakespeare’s Othello and his other works is the role of villainous Iago. Iago articulates the plot while he plays a key role in the play, seemingly as a puppeteer, subtly directing most (if not all) of the other characters, most notably Othello, the noble Moor, in this play. Othello seems, above all other characters, a subject to the play’s focal character, Iago. Iago cleverly forges Othello to see, among other things, false infidelity of his young and beautiful wife, Desdemona, with his rival, Lieutenant Michael Cassio. Not only is illusion and the stretch between appearance and reality a central theme of the play, it overlaps a theme of patriarchy and the political state, labeling characters with military ranks. As the story unfolds, Iago claims credit as the story’s mastermind. So Iago’s character draws many emotions in readers, as he serves as an undistinguished stage director. His most important characteristic is his escalating ability throughout the play to cleverly manipulate. Iago calls forth many emotions in readers. Few of the emotions he draws are that of trust, then deception, and next impertinence, then hypocrisy. From the book’s opening, Iago justifiably earns the reader’s acceptance and trust. For the trust he builds, Iago tells Roderigo, â€Å"I am not what I am† (I. 1. 64). Roderigo softens as he listens to Iago confide in him. And by demonstrating how Roderigo trusts him, Iago simply puts his integrity so far in question so as not to leave any doubt of his complete honesty in the mind of the reader. We trust Iago until Roderigo’s gullibility shines through, at about the point that they both confront Brabantio. As Roderigo informs Desdemona’s father of a marriage he disapproves of, he assures Roderigo that with either man, â€Å"Some one way, some another† (174), he would disapprove. Then Roderigo fails to reinstate himself as a worthy candidat... Free Essays on Iago Shrewdly Directs This Play Free Essays on Iago Shrewdly Directs This Play The main distinguishing point between Shakespeare’s Othello and his other works is the role of villainous Iago. Iago articulates the plot while he plays a key role in the play, seemingly as a puppeteer, subtly directing most (if not all) of the other characters, most notably Othello, the noble Moor, in this play. Othello seems, above all other characters, a subject to the play’s focal character, Iago. Iago cleverly forges Othello to see, among other things, false infidelity of his young and beautiful wife, Desdemona, with his rival, Lieutenant Michael Cassio. Not only is illusion and the stretch between appearance and reality a central theme of the play, it overlaps a theme of patriarchy and the political state, labeling characters with military ranks. As the story unfolds, Iago claims credit as the story’s mastermind. So Iago’s character draws many emotions in readers, as he serves as an undistinguished stage director. His most important characteristic is his escalating ability throughout the play to cleverly manipulate. Iago calls forth many emotions in readers. Few of the emotions he draws are that of trust, then deception, and next impertinence, then hypocrisy. From the book’s opening, Iago justifiably earns the reader’s acceptance and trust. For the trust he builds, Iago tells Roderigo, â€Å"I am not what I am† (I. 1. 64). Roderigo softens as he listens to Iago confide in him. And by demonstrating how Roderigo trusts him, Iago simply puts his integrity so far in question so as not to leave any doubt of his complete honesty in the mind of the reader. We trust Iago until Roderigo’s gullibility shines through, at about the point that they both confront Brabantio. As Roderigo informs Desdemona’s father of a marriage he disapproves of, he assures Roderigo that with either man, â€Å"Some one way, some another† (174), he would disapprove. Then Roderigo fails to reinstate himself as a worthy candidat...

Wednesday, November 6, 2019

Gunpowder Facts, History and Description

Gunpowder Facts, History and Description Gunpowder or black powder is of great historical importance in chemistry. Although it can explode, its principal use is as a propellant. Gunpowder was invented by Chinese alchemists in the 9th century. Originally, it was made by mixing elemental sulfur, charcoal, and saltpeter (potassium nitrate). The charcoal traditionally came from the willow tree, but grapevine, hazel, elder, laurel, and pine cones have all been used. Charcoal is not the only fuel that can be used. Sugar is used instead in many pyrotechnic applications. When the ingredients were carefully ground together, the end result was a powder that was called serpentine. The ingredients tended to require remixing prior to use, so making gunpowder was very dangerous. People who made gunpowder would sometimes add water, wine, or another liquid to reduce this hazard since a single spark could result in a smoky fire. Once the serpentine was mixed with a liquid, it could be pushed through a screen to make small pellets, which were then allowed to dry. How Gunpowder Works To summarize, black powder consists of a fuel (charcoal or sugar) and an oxidizer (saltpeter or niter), and sulfur, to allow for a stable reaction. The carbon from the charcoal plus oxygen forms carbon dioxide and energy. The reaction would be slow, like a wood fire, except for the oxidizing agent. Carbon in a fire must draw oxygen from the air. Saltpeter provides extra oxygen. Potassium nitrate, sulfur, and carbon react together to form nitrogen and carbon dioxide gases and potassium sulfide. The expanding gases, nitrogen and carbon dioxide, provide the propelling action. Gunpowder tends to produce a lot of smoke, which can impair vision on a battlefield or reduce the visibility of fireworks. Changing the ratio of the ingredients affects the rate at which the gunpowder burns and the amount of smoke that is produced. Difference Between Gunpowder and Black Powder While black powder and traditional gunpowder may both be used in firearms, the term black powder was introduced in the late 19th century in the United States to distinguish newer formulations from traditional gunpowder. Black powder produces less smoke than the original gunpowder formula. Its worth noting early black powder was actually off-white or tan in color, not black! Charcoal Versus Carbon in Gunpowder Pure amorphous carbon is not used in black powder. Charcoal, while it contains carbon, also contains cellulose from incomplete combustion of wood. This gives charcoal a relatively low ignition temperature. Black powder made from pure carbon would barely burn. Gunpowder Composition There is no single recipe for gunpowder. This is because varying the ratio of the ingredients produces different effects. Powder used in firearms needs to burn at a fast rate to quickly accelerate a projectile. A formulation used as a rocket propellant, on the other hand, needs to burn more slowly because it accelerates a body over a long period of time. Cannon, like rockets, use a powder with a slower burn rate. In 1879, the French prepared gunpowder using 75% saltpeter, 12.5% sulfur, and 12.5% charcoal. The same year, the English used gunpowder made from 75% saltpeter, 15% charcoal, and 10% sulfur. One rocket formula consisted of 62.4% saltpeter, 23.2% charcoal, and 14.4% sulfur. Gunpowder Invention Historians believe gunpowder originated in China. Originally, it was used as an incendiary. Later, it found use as a propellant and explosive. It remains unclear when, exactly, gunpowder made its way to Europe. Basically, this is because records describing the use of gunpowder are difficult to interpret. A weapon that produced smoke might have used gunpowder or could have used some other formulation. The formulas that came into use in Europe closely matched those used in China, suggesting the technology was introduced after it had already been developed. Sources Agrawal, Jai Prakash (2010). High Energy Materials: Propellants, Explosives and Pyrotechnics. Wiley-VCH.Andrade, Tonio (2016). The Gunpowder Age: China, Military Innovation, and the Rise of the West in World History. Princeton University Press. ISBN 978-0-691-13597-7.Ashford, Bob (2016). A New Interpretation of the Historical Data on the Gunpowder Industry in Devon and Cornwall.  J. Trevithick Soc.  43: 65–73.Partington, J.R. (1999). A History of Greek Fire and Gunpowder. Baltimore: Johns Hopkins University Press. ISBN 978-0-8018-5954-0.Urbanski, Tadeusz (1967),  Chemistry and Technology of Explosives,  III. New York: Pergamon Press.

Sunday, November 3, 2019

Nursing managment Essay Example | Topics and Well Written Essays - 250 words - 2

Nursing managment - Essay Example Upon having received all of the data, it was necessary for head officials at the hospital to adjourn and discuss the results—in order to see if the scores on the assessment could be improved at all. The outcome of such wonderful reflection is a hospital system that works better for all involved—both patients and care providers. Brief Summary of Activity: Conducted by varying individuals, surveys were given not only to the patients, but to the staff as well in order to take a comprehensive overview in the hopes that this information could be used to overhaul the hospital’s overall performance. This would cover a wide range of areas and thus help the hospital’s management be smoother and more effective, rendering changes made by hospital officials—in the form of recommendations, garnered by the study. Thusly, quality of care, food service, and wait times were to be improved upon based on the surveys, and consequentially the score on the

Friday, November 1, 2019

The Current State of the Post-Recession Global Economy Research Paper

The Current State of the Post-Recession Global Economy - Research Paper Example Additionally, there is always a shift in supply and demand. The needs of nations and individual differ making it complex to preserve the steadiness of the economy. An ideal situation can never exist in the world economy making recession inevitable. Consequently, the recession that took place in 2008 was expected. Recession has significantly influenced the global economy as apparent in trade, unemployment and relationship amid countries. The current state of the global economy after recession According to Foroohar & Schneiderman (2010), recession refers to a situation when the economy has experienced inflation for quite a long period. Recession affected most nations in the Western hemisphere in 2008. Before the recession began, Japan and the US were controlling most part of the global economy. Consequently, countries in the West were experiencing a boom in the property market. The rates of unemployment were at the lowest level for a long period, and banks were charging lower interest rates for loans. The decrease in lending rates contributed to the increase in investments. However, the gains came to a halt after the recession in 2009. Presently, the United States and Japan have limited control on the activities taking place in the global market. The two countries no longer influence trade directly because they are facing competition from China. The influence they had has shifted to countries like China, Brazil and South Korea. However, the US is still the global economic powerhouse. According to Avantika (2011), countries like India and Brazil are beginning to exert their influence on trade globally. As a result, growth is on the decline in Japan and America. This is making investors shift their plans by investing in developing economies. It is clear that Malaysia and Singapore are formulating innovations to counter the dynamics of trade. Concurrently, the US in coming up with policies to correct the decline of their economies. Consequently, the recent president ial debate in America focused on measures for reviving the global economy. According to Avantika (2011), there is stagnation in the growth of the economy of China at 7 per cent. This is a decline from the double-digit growth realized in the same time last year. This is an indication that the global economy is unpredictable. Schaeffer (2009) adds that uncertainties in the global economy have made nations readjust their plans. For instance, South Korea is deploying their resources towards energy production to avert the energy crisis. This is because most of the economic activities in the global economy are dependent on fossil fuels. Developing economies in Asia are opting to trade with African countries. This is affects global trade by reducing the demand of commodities from developed economies. Indeed, African nations have increased their demand for products from the markets in Asia. Besides, China is encouraging domestic consumption to reduce their dependency on exports. Moreover, C hina has reformed their pension scheme to cater for the needs of the middle-class citizen who constitute the majority in the populace. According to Neumark & Troske (2012), it is necessary to review trade policies for economies of Asian countries. New policies will bring changes in the healthcare and the education sector in developing eco