Avian Influenza Essay Example

Avian Influenza Essay Example Avian Influenza Paper Avian Influenza Paper Essay Topic: The Wild Duck Avian Influenza Introduction Bird flu in most cases begins with discomfort of lower respiratory ways and in unusual casesfrom upper respiratory air-ways. Elevated viral titer is isolated from pharynx but not from nose. Initial symptoms of the H5N1 influenza are: high grade fever, mild cold, cough and shortness of breath. Practically all patients develop viral pneumonia complicating to secondary bacterial infection, mild to severe respiratory distress, diarrhea, vomiting and abdominal pain. Conjunctivitis is entity. Sometimes gastrointestinal disorder develops earlier than respiratory symptoms. Avian influenza viruses are shed in respiratory secretions and feces of birds. Infected ducks, for example, shed virus for at least 30 days. Influenza virus from the feces of waterfowl can be recovered from surface water. Avian species develop infection that ranges from asymptomatic to lethal. Avian influenza has caused major outbreaks in poultry farms.   Influenza virus can undergo genetic mutations in hemagglutinin or neuraminidase (antigens on the surface of the virus) that can lead to epidemics. Much less commonly, a completely new hemagglutinin or neuraminidase emerges- with the new genetic material coming from animals. This genetic shift typically leads to pandemics. Early chronology: 1929 Last evidence (serologic) of circulation in humans of a swine-like influenza virus 1930 Isolation of an influenza virus from swine 1933 First isolation of an influenza virus from humans Until 1995, only three of the 15 influenza hemagglutinins that had been identified were known to cause infections in humans. Birds have all 15 identified hemagglutinins and nine neuraminidases. New influenza viruses often emerge from southern China, a region characterized by a large, densely settled human population and abundant pigs and ducks living in close proximity to humans. Until events in Hong Kong in 1997, scientists thought that avian influenza posed no direct threat to humans. In 1997, after causing influenza outbreaks on chicken farms, avian influenza (H5N1) spread to humans (Claas et al. 1998). Eighteen human cases were confirmed, six of them fatal. Infection was concentrated in children and young adults, unlike the pattern in most outbreaks where morbidity and death are most common in older adults. The virus recovered from humans was identical to that found in birds (Subbarao et al. 1998). Epidemiological studies suggested that there had been multiple independent introductions of the influenza virus into the human population from birds, but that very limited person-to-person spread occurred. At the time of the human cases, there were estimated to be 300–600 live bird markets in Hong Kong, where mixing of different avian species (ducks, chickens, pheasants, pigeons, wild birds) was possible. When the Hong Kong live bird markets were studied , 10% or more of birds were found to be shedding H5N1, in multiple avian species (geese, chickens, ducks). The birds (more than one million) were killed, and no additional human cases of H5N1 have been documented. In 1999, human infection with H9N2, another avian influenza strain widespread in Asia, was also documented for the first time in humans, at a time of enhanced surveillance (Peiris et al. 1999). The events in Hong Kong have led to heightened global surveillance for influenza in humans and animals. There was reason to be concerned about the events in Hong Kong, a densely populated city with extensive links to the rest of the world. In 1993, there were an estimated 41.4 million passenger movements (boat, train, car, airplane) and from Hong Kong. The influenza viruses that afflict humans are divided into three types: A, B, and C. Influenza A is responsible for the epidemics and infects not only man but also pigs, horses, seals, and a large variety of birds. Indeed, influenza A has been isolated worldwide from both domestic and wild birds, primarily waterbirds including ducks, geese, terns, and gulls and domesticated birds such as turkeys, chickens, quail, pheasants, geese, and ducks. Studies of wild ducks in Canada from 1975 to 1994 indicated that up to 20 percent of the juveniles were infected, and fecal samples from their lakeshore habitats contained the virus. These birds usually shed the virus from five to seven days (with a maximum of thirty days) after becoming infected even though they show no sign of the disease. Obviously, this virus and its hosts have adapted mutually over many centuries and created a reservoir that ensures perpetuation of the virus. Duck virus has been implicated in outbreaks of influenza in animal s such as seals, whales, pigs, horses, and turkeys. Extensive analysis of the viruss genetic structure, or nucleic acid sequences, supports the hypotheses that mammalian influenza viruses, including those infecting man, may well originate in aquatic birds. (Suarez DL, Spackman E, Senne DA, 2003) Subtypes of influenza A, the various strains of these avian viruses can be classified as either highly pathogenic or as of low pathogenicity, based on their genetic features and the severity of illness they cause in birds. There are currently 27 potential forms of the three subtypes of avian influenza viruses differentiated by variations in the neuraminidase surface antigen. Thus, H5, H7, and H9 avian influenza viruses, so named for their hemagglutinin surface antigen, can each be matched with nine possible neuraminidase surface antigens, N1, N2, N3, etc. Thus, there could be H5N1 through H5N9, H7N1 through H7N9, and H9N1 through H9N9 strains. H9 viruses appear to be of low pathogenicity, while H5 and H7 viruses can be highly pathogenic for birds. However, low pathogenic forms of these viruses seem to be the cause of most outbreaks among poultry causing only mild or imperceptible illness and low mortality rates. Nonetheless, both H5 and H7 can develop high levels of pathogenicity in which case mortality rates in poultry flocks can reach 100%. The natural history of avian influenza viruses is characterized by spread through infected nasal, respiratory and fecal material, and a reservoir state in healthy birds. (Pascal James Imperato, 2005) www.springerlink.com/index/H6427776HH34G857.pdf Pathogenesis The pathogenesis of avian influenza A (H5N1) virus in humans has not been clearly explained. Apoptosis might also play a vital part. Apoptosis has been observed in alveolar epithelial cells, which is the major target cell type for the viral replication. Many apoptotic leukocytes were observed in the lungs of patients who died on day 6 of illness. Apoptosis may play a major role in the pathogenesis of influenza (H5N1) virus in humans by destroying alveolar epithelial cells. This pathogenesis causes pneumonia and destroys leukocytes, leading to leucopenia, which is an outstanding clinical feature of influenza (H5N1) virus in humans. Whether observed apoptotic cells were a directly related to viral replication or outcome of an over activation of the immune system needs further studies. (Uiprasertkul M, 2007) www.cdc.gov/EID/content/13/5/708.htm Infected birds were the major source of the H5N1 influenza virus among humans in Asia. Mainly humans became infected by eating infected birds, by poor hygiene procedures when cooking infected birds, or by close contact with infected poultry. (Reina J, 2002). Certain birds, particularly water birds, act as hosts for influenza viruses by carrying the virus in their intestines and shedding it. Infected birds shed virus in saliva, nasal secretions, and feces. Susceptible birds can become infected with avian influenza virus when they have contact with contaminated nasal, respiratory, or fecal material from infected birds. Fecal-to-oral transmission is the most common mode of spread among birds. Most often, the wild birds that are the hosts for the virus do not get sick, but they can spread influenza to other birds. (CDC, 2006) www.cdc.gov/flu/avian/gen-info/spread.htm At present spread of the H5N1 influenza from human to human by air born route has not been registered, but enduring monitoring for identification mutation and adaptation of H5N1 influenza virus to human is needed. Most studies performed in avian viral strains elucidates that virulence is a polygenic phenomenon. However, hemagglutinin and neuraminidase and the genes codifying these substances (genes 4 and 6) play a vital role in viral pathogenesis. (Gu J, Xie Z, Gao Z, Liu J, Korteweg C, Ye J, Lau LT, Lu J, Gao Z, Zhang B, McNutt MA, Lu M, Anderson VM, Gong E, Yu AC, Lipkin WI, 2007). Avian strains can be classified as virulent or avirulent according to the capability of hemagglutinin to be triggered by endoproteases of the respiratory tract merely or by proteases from other tissues. This ability is based on the ever going mutations that lead to the substitution of the normal amino acids at the point of hemagglutinin hydrolysis by the other basic amino acids that determine the amplifi cation of the spectrum of hydrolysis and activation. Neuraminidase contributes in the acquisition of virulence through its ability to attach to plasminogen and by escalating the concentration of activating proteases. Adaptation to the host, by recognition of the cell receptor, is an additional factor determining the virulence and interspecies spread of avian strains. (Reina J, 2002) Transmission to mammals Influenza A viruses from aquatic birds grow poorly in human cells, and vice versa. However, both avian and human influenza viruses can replicate in pigs. We have known that pigs are susceptible to influenza viruses that infect man ever since the veterinarian J. S. Koen first observed pigs with influenza symptoms closely resembling those of humans. Retrospective tests of human blood indicate that the swine virus isolated by Shope in 1928 was similar to the human virus and likely responsible for the human epidemic. Swine influenza still persists year-round and is the cause of most respiratory diseases in pigs. Interestingly, in 1976, swine influenza virus isolated from military recruits at Fort Dix was indistinguishable from virus isolates obtained from a man and a pig on a farm in Wisconsin. The examiners concluded that animals, especially aquatic birds and pigs, can be reservoirs of influenza virus. When such viruses or their components mix with human influenza virus, dramatic geneti c shifts can follow, creating the potential of a new epidemic for humans. The influenza virus continually evolves by antigenic shift and drift. Early studies in this area by Robert Webster and Graeme Laver established the importance of monitoring influenza strains in order to predict future epidemics. Antigenic shifts are major changes in the structure of the influenza virus that determines its effect on immune responses. Of the viral proteins, the hemagglutinin (H), a major glycoprotein of the virus, plays a central role in infection, because breakdown of hemagglutinin into two smaller units is required for virus infectivity. (Suarez DL, Spackman E, Senne DA, 2003). Shifts in the composition of the hemagglutinin (H) or neuraminidase (N), another glycoprotein, of influenza virus were observed in the 1933, 1957, 1968, and 1977 epidemics: 1933: H1N1 1957: H2N2 (Asian flu) 1968: H3N2 (Hong Kong flu) 1977: reappearance of H1N1, called the Russian flu The reappearance in 1977 of the Russian flu, a virus first isolated in 1933, raises the uneasy possibility that a return of the 1918-19 influenza epidemics with its devastation of human life is possible and perhaps likely. In March of 1997, part of influenza virus nucleic acid was isolated from a formalin-fixed lung tissue sample of a twenty-one-year-old Army private that died during the 1918-19 Spanish influenza pandemic. Since the first influenza viruses were not isolated until the 1930s, characterization of the 1918-19 strain relied on molecular definition of the viruss RNA. Chemical evidence indicated a novel H1N1 sequence of a viral strain that differed from all other subsequently characterized influenza strains and that the 1918 HA human sequence correlated best with swine influenza strains. Once the entire sequence is on hand, a virulent marker for the influenza virus associated with killing over 675,000 Americans from 1918 to 1919 may be uncovered and a vaccine planned that might abort the return of this virus form of influenza.   When such antigenic shifts occur, the appearance of disease is predictable. Therefore, surveillance centers have been established all over the world where isolates of influenza are obtained and studied for alterations, primarily in the hemagglutinin. According to the evidence from these centers, isolates identified in late spring are excellent indicators of potential epidemics in the following winter. Both avian and human influenza viruses can replicate in pigs, and genetic reassortants or combinations between them can be demonstrated experimentally. A likely scenario for such an antigenic shift in nature occurs when the prevailing human strain of influenza A virus and an avian influenza virus concurrently infect a pig, which serves as a mixing vessel. Reassortants containing genes derived mainly from the human virus but with a hemagglutinin and polymerase gene from the avian source are able to infect humans and initiate a new pandemic. In rural Southeast Asia, the most densely populated area of the world; hundreds of millions of people live and work in close contact with domesticated pigs and ducks. This is the likely reason for influenza pandemics in China. Epidemics other than the 1918-19 catastrophes have generally killed 50,000 or fewer individuals, although within a year over one million people had been infected with these new strains. Conclusion Three major hypotheses have been put forth to explain antigenic shifts. First, as described above, a new virus can come from a reassortant in which an avian influenza virus gene substitutes for one of the human influenza virus genes. The genome of human influenza group A contains eight RNA segments, and current wisdom is that the circulating influenza hemagglutinin in humans has been replaced with an avian hemagglutinin. A second explanation for antigenic shifts that yield new epidemic viruses is that strains from other mammals or birds become infectious for humans. Some believe that this is the cause of the Spanish influenza virus epidemic in 1918-19, with the transmission of swine influenza virus to humans. A third possibility is that newly emerging viruses have actually remained hidden and unchanged somewhere but suddenly come forth to cause an epidemic, as the Russian H1N1 virus once did. H1N1 first was isolated in 1933, then disappeared when replaced by the Asian H2N2 in 1957. H owever, twenty years later the virus reappeared in a strain isolated in northern China and subsequently spread to the rest of the world. This virus was identical in all its genes to one that caused human influenza epidemics in the 1950s. (Gu J, Xie Z, Gao Z, Liu J, Korteweg C, Ye J, Lau LT, Lu J, Gao Z, Zhang B, McNutt MA, Lu M, Anderson VM, Gong E, Yu AC, Lipkin WI, 2007) Where the virus was for twenty years is not known. Could it have been inactivated in a frozen state, preserved in an animal reservoir, or obscured in some other way? If this is so, will the Spanish influenza virus also return, and what will be the consequences for the human population? In addition to antigenic shift, which signifies major changes in existing viruses, antigenic drift permits slight alterations in viral structure. These follow pinpoint changes (mutations) in amino acids in various antigen domains that relate to immune pressure, leading to selection. For example, the hemagglutinin molecule gradually changes while undergoing antigenic drift. Such mutations allow the virus to escape from attack by antibodies generated during a previous bout of infection. Because these antibodies would ordinarily protect the host by removing the virus, this escape permits the related infection to remain in the population. With these difficulties of antigenic shift and, drift and animal reservoirs, it is not surprising that making an influenza vaccine as effective as those for smallpox, pohovirus, yellow fever, or measles is difficult to achieve. Another complication is that immunity to influenza virus is incomplete; that is, even in the presence of an immune response, influenza can still occur. Nevertheless, the challenge of developing vaccines based on surveillance studies has been met. A chemically treated, formalin-inactivated virus has been formulated in a vaccine that is 30 to 70 percent effective in increasing resistance to influenza virus. The vaccine decreases the frequency of influenza attacks or, at least, the severity of disease in most recipients, although protection is not absolute. In addition, the secondary bacterial infections that may accompany influenza are today treatable with potent antibacterial drugs previously unavailable. Nonetheless, of the plagues that visit humans, influenza is among those that require constant surveillance, because we can be certain that some form of influenza will continue to return. References: CDC. Spread of Avian Influenza Viruses among Birds; Journal of Environmental Health, Vol. 68, 2006.www.cdc.gov/flu/avian/gen-info/spread.htm Claas, E. C. J., A. D. M. E. Osterhaus, R. van Beek, J. C. De Jong, G. F. Rimmelzwaan, D. A. Senne, S. Krauss, K. F. Shortridge, and R. G. Webster. 1998. Human influenza A H5N1 virus related to a highly pathogenic avian influenza virus. Lancet 351:472–477. Gu J, Xie Z, Gao Z, Liu J, Korteweg C, Ye J, Lau LT, Lu J, Gao Z, Zhang B, McNutt MA, Lu M, Anderson VM, Gong E, Yu AC, Lipkin WI. H5N1 infection of the respiratory tract and beyond: a molecular pathology study; Lancet Sep 29; 370(9593):1106-8, 2007 Pascal James Imperato. The Growing Challenge of Avian Influenza; Journal of Community Health, Vol. 30, 2005. www.springerlink.com/index/H6427776HH34G857.pdf Peiris, M., K. Y. Yuen, C. W. Leung, K. H. Chan, P. L. S. Ip, R. W. M. Lai, W. K. Orr, and K. F. Shortridge. 1999. Human infection with influenza H9N2. Lancet 354:916–917. Reina J. Factors affecting the virulence and pathogenicity of avian and human viral strains (influenza virus type A)] Enferm Infecc Microbiol Clin; 20(7):346-53 (ISSN: 0213-005X) Hospital Universitario Son Dureta, Palma de Mallorca, Espaà ±a, 2002 direct.bl.uk/research/48/44/RN119578176.html Suarez DL, Spackman E, Senne DA. Update on molecular epidemiology of H1, H5, and H7 influenza virus infections in poultry in North America; Avian Dis. 2003; 47(3 Suppl): 888-97 ncbi.nlm.nih.gov/sites/entrez Subbarao, K., A. Klimov, J. Katz, H. Renery, W. Lim, H. Hall, M. Perdue, D. Swayne, C. Bender, J. Huang, M. Hemphill, T. Rowe, M. Shaw, X. Xu, K. Fukuda, and N. Cox. 1998. Characterization of an avian influenza A (H5N1) virus isolated from a child with a fatal respiratory illness. Science 279:393–396. Uiprasertkul M. Apoptosis and Pathogenesis of Avian Influenza A (H5N1) Virus in Humans Emerg Infect Dis; 13(5):708-12 (ISSN: 1080-6040) Mahidol University, Bangkok, Thailand.2007 www.cdc.gov/EID/content/13/5/708.htm

Saudi Arabia water problem Term Paper Example | Topics and Well Written Essays - 1250 words

Saudi Arabia water problem - Term Paper Example According to Bragg and Bragg (2005), the oceans contain about 97% of the entire water on the earths’ surface; in Saudi Arabia, water has been supplied in three forms, mainly surface water, which accounts for about 10%, the underground aquifers that provide the majority percentage of more than 80%, and the various desalination plants, which provide about 5% of water. The availability of essential water supply continued to deplete and the water resources become limited, prompting the adoption of desalination plants. Natural resources define all the resources that occur freely within the environment that exist in a natural form, such as natural forests, minerals, water, and natural gases. 1. Background Desalination refers to the several processes of conversion of salt water to fresh water through the removal of salt and other minerals. Several approaches are used to treat seawater including thermal evaporation of seawater and use of modern desalination plants, osmosis in reverse. Nanomembranes are filters made from organic polymers with less thickness that are used to separate the liquids and gases at the molecular levels. Such technology is also used in desalination of seawater, purification of polluted water, and the removal of carbon dioxide and other pollutants from exhaust gases. The modern technology adopted in Saudi Arabia has enabled the exploitation of underground water by companies such as Saudi Aramco, an oil company, and hence increasing availability of water in the country. 2. Desalination process In Saudi Arabia, there has been water scarcity because of the rising population, which led to the adoption of desalination technology through the development of modern polymer materials producing semi-permeable membranes, which allow selective passage of water and other ions. The technology is categorized according to content extracted (water or salt from the main stream), separation process, and the energy used in the entire process (Anon, 1997). Eva porative processes have been used for extraction of fresh water from the mainstream. Such evaporative desalination processes consist of various methods. Multi stage flash (MSF) method involves the evaporation of seawater in chambers with low pressure as compared to the vapor pressure. The low-grade steam from the turbines heats the tubes within the distiller, which heat the seawater intake. The heated seawater then passes into low-pressure vessels, and boils into steam. The steam is condensed on heat exchanger tubes, which are cooled by the incoming water, feed to the heater. The conversion of seawater to steam depends on the pressure maintained within the vessel. In multiple effect distillation (MED), condensing steam heats tube bundles, resulting into evaporation. The vapor produced is used as steam in the next chamber operating at low pressure and temperature (Micale, Cipollina and Rizzuti, 2009). B. Nano membrane technology

Plot and Character Analysis of The Story of An Hour by Kate Chopin Essay

Plot and Character Analysis of The Story of An Hour by Kate Chopin - Essay Example special attention given to just how the story is to be told, authors can open the story to a variety of interpretations illustrating the complexities of life during a particular period in history. A close examination of Kate Chopin’s short story â€Å"The Story of an Hour† illustrates how the written word can be a powerful representation of the weight of social constraints on women during this period in time. In this very short story, Chopin shows how her main character, Louise Mallard, was effectively dehumanized by the expectations of role fulfillment imposed upon her by her husband and her society. The story begins by illustrating the perceived condition of Louise’s health as she reportedly has a weak heart. â€Å"It was her sister Josephine who told her, in broken sentences; veiled hints that revealed in half concealing† (Chopin). What her sister Josephine told her was that Louise’s husband was killed in a recent railroad accident, information that had been confirmed by a close family friend. Louise’s reaction to the news is remarked as somewhat surprising, but takes on greater significance later in the story. â€Å"She wept at once, with sudden, wild abandonment, in her sister’s arms† (Chopin). From this point, there isn’t a great deal of physical action to the story. Louise retires to her room alone and sits in a chair looking out the window. As she reflects upon the news she has just received, Louise begins to see the remainder of her life in ways that might have been highly unexpected at the time. Instead of feeling that he r life was over because her husband is dead, Louise begins to see her life as just beginning. She will finally have a chance to make some of her own decisions. Although her life has been turned upside down, Chopin demonstrates through Louise’s thoughts that her world had already been upside down under the external conditions she’d been forced to accept and only now, with the death of her husband, was it righting

Lucent technology supply chain summary Essay Example for Free

Lucent technology supply chain summary Essay Lucent Technologies is a multinational telecommunication company which was spun off from ATT in 1996. Before restructure, as an integrated telecommunications services and equipment company, ATT had been primarily U. S. -centric market and more than half of income was generated by services in U. S. However, the restructure made Lucent focused on communications equipment globally. When Lucent expand into global market, its flagship product, the5ESS ® digital switch, was a market leader in worldwide telecommunication infrastructure equipment. While the 5ESS ® digital switch provided the company’s more competitive edge in global market. This custom configured, engineered-to-order product made only a portion of its assemblies could be built to stock. Moreover, 5ESS ® digital switch orders from Asian market had continued to grow rapidly, and Asia became an important part of Lucent’s business. U. S. -centric Supply Model Before Lucent’s independence from ATT, it established some joint ventures in four Asian countries to meet the increasing telecommunication equipment demand in Asian market. But this marketing entry mode just provided access to these markets. Most manufacturing continued to be done in Oklahoma City. The Asian joint ventures only performed final assembly and testing. It was believed that Lucent would benefit from the cost saving from economies of scale in manufacturing in US. However, as tremendous demand growth and intense competition arose from these countries, the delivery costs and lead time became two critical issues in this industry. The long distance inhibited the instant response. Delay means market losing. What’s more, increasing local content by having locally purchased parts would lower the costs and made product more locally attractive. Asian-centric Supply Model After 1996, asset management, product lead time and supply chain efficiency became more and more important for this new independent manufacturing firm. The primary market shifted from U. S to Asian market required a redesign of the Asian supply chain. First of all, it took a â€Å"hub-and spoke† model. Taiwan was the hub of the Asian supply chain. Custom engineering and manufacturing of Asian orders would be manufactured in Taiwan rather than Oklahoma City, and Asian orders were placed with Taiwan rather than U. S. Low volume assemblies remained in U. S. Secondly, different supply modes (inshore or outsource) were decided by different product volumes. And then it used local components (direct procurement) and local suppliers (local procurement). Last but not least, it insisted a strict quality control. Products manufactured by Asian joint ventures had the same quality standards. There were also some barriers for the redesign of supply chain. For example, the new manufacturing center in Asian mean losing job in U. S. The transfer of production to joint venture may reduce Lucent’s profits. And also the sales organization worried about the sales decreased because of losing â€Å"Made in USA† label. All of these barriers were addressed when the benefits of redesigning outweighed the costs. The redesign decreased the lead time, and customer satisfactions had improved a lot. Meanwhile, Taiwan joint venture reengineered its factory to improve the productivity. The increasing productivity and decreasing costs means the firm became more profitable. Also, support of Asian joint ventures helped Lucent win more business in Asia, and the huge capacity of Asian joint ventures can support Lucent’ global customer demand. So the all improvement by redesigning the supply chain made Lucent more competitive in global market. Summary and Recommendations Despite its success in the later 1990s, new challenges have arisen. How to response the changing demand in this complex business environment and how to expand its capacity in other emerging markets? The internet and IT tools caused fundamental changes in business models and traditional customer-supplier relationships. Contract manufacturing company in Asian provides new opportunity for the firm to outsourcing its manufacturing and logistics responsibility. In my view, outsourcing its assembly and component is a better way for Lucent to cope with new challenge. Because 5ESS ® digital switch was reaching its mature period in the product life cycle, and the intensive competition and changing environment forced telecommunication industry to devoted more time to new product research and marketing strategy. In its initial stage, the core product is the key to success and the supply chain redesign facilitate its further success. But nowadays, the product life cycle is shortening and the industry is changing at ever-increasing rate. Lucent has to improve researching, marketing strategy and supply chain management at the same rate to cope with the changing market. In addition, Lucent can use merging and acquisition strategy to integrate available resources to expand its business. Questions for group As Lucent shift its main supply chain from U. S to Asian market, how to compete with domestic rivalry Cisco? As more and more local telecommunication company grew up, how to cope with fierce industry competition with local firms, and some multinational telecommunication firms now target at Asian market, how to compete with them in global market? Should Lucent insist its in-source strategy or use outsourcing for the future supply chain management? Because its flagship products had reached its mature period, is it necessary for Lucent to build a main RD center in the emerging market like Cisco did?

Sundowing And Alzheimers Disease Essay -- Alzheimers Disease Essays

SUNDOWNING AND ALZHEIMER'S DISEASE Sundowning, or sundown syndrome are terms that have been used for over 20 years to describe the reversal of day and night which often occurs in Alzheimer's and other dementing illnesses. (2) Those who are impacted are often called Sundowners and they act as if their biological clocks have reversed their day and night cycles. Some are able to function on little sleep throughout their 24-hour day cycle. Some individuals stay up all night and will then continually doze off during the day. This alteration in the sleep-wake cycle is not necessarily permanent and they may revert to earlier patterns of sleep, or may sleep for increasing periods of time. (1) Those suffering from acute or chronic confusion increasingly become highly agitated, confused, suspicious, active and restless, combative and disoriented late in the day, especially after dark. (2,3) They may see, hear and believe things that are not real. Patients become more impulsive and respond to their own ideas of reality, often in ways that can that get them in trouble. The confusion is often worse after a move or change in routine and can happen in any setting, whether they are living at home or in a facility. The behavior may be totally out of character for the person. And, the change is drastic. You may see them in the morning and the person seems mentally competent and alert. The same individual may not recognize you or other family members, seem lethargic, become easily agitated, confused, or disoriented late in the afternoon or evening. (1) There is currently no conclusive evidence about the reasons for these changes in the sleep-wake cycle. (2) However, in the online articles "Sundowning and Sleeping" and "The Sundown Syndrome" there are some theories identified about the cause. 1) The decreasing levels of light may be disorienting. The lower light provides fewer clues as to the person's surroundings and shadows may be frightening. 2) The person may feel they are supposed to "go home" around this time. 3) The person may be fatigu... ...dence regarding the reasons for these changes, some theories have been identified about the cause. This syndrome can be exhausting for the caregiver. Some measures have been identified that may lessen the effects. It is important to realize with sundown syndrome, as in any behavior related to Alzheimer's Disease, that the person does not have control over their behavior and that it is a result of the brain tryng to sort out a confusing environment. REFERENCES 1. Alzheimers.com. Sundown Syndrome and the Elderly. Alzheimers.com feature story. [On-Line] Avaialble: http://www.alzheimers.com/L3TABLES/L3T-428.HTM. 2. Crystal, H. (1998). Sundowning and Sleeping. Northern Virginia Chapter of Alzheimer's Association. [On-Line]. Available: http://www.alz-nova.org/sundown.htm. 3. Davis, M. (1997). Light in the Darkess. Perspectives Magazine. [On-line]. Available: http://www.siu.edu/worda/persp/sp97/alz.html. 4. Nitram, R. (1997). The Sundown Syndrome. The Arizona Daily Star Online. Availabnle: http://www.azstarnet.com/~rnitram/sundown.html

Gossip Girls

How many times a day do you gossip . . . .Either as a sender or receiver? Although you may think gossip is harmless, it can have some pretty serious consequences. It did for four former employees of the town of Hooksett, Mew Hampshire, who were fired by the city council for gossiping about their boss. They learned the hard way that the gossip can cost you your job. The longtime employees were fired because one of the woman had used derogatory terms to describe the town administrator and because all of them had discussed a rumor that he was having an affair with a female subordinate.All four of the woman acknowledged feeling resentment toward the woman. Who worked in a specially created position and was paid more than two of the employees, despite having less experience and seniority. Despite an appeal of their dismissal by the four employees, the Hooksett council didn’t budge and stated. â€Å"These employees do not represent the best of the town of Hooksett and the false rum ors, gossip and derogatory statement have contributed to a negative working environment and malcontent among their fellow employees.† Despite national media attention and a petition signed by 419 residents, asking for the woman to be reinstated, the city council hasn’t wavered on its decision. An attorney for the four women said that his clients were, â€Å"legitimately questioning the conduct of their supervisor, and whether the female subordinate was getting preferential treatment. It almost cheapens it to call it gossip. It might have been idle, not particularly thoughtful, talk. But there was no harm intended.

VANCL Analysis - 2159 Words

VANCL: Problem Within the period of 2007 to 2009, two major retail companies emerged in China: PPG Apparel (Shanghai) Co., Ltd. and VANCL Technology (Beijing) Co., Ltd. Though both had similar business models, VANCL was able to excel and profit in places where PPG Apparel suffered tremendously. These included creating a successful supply chain with effective quality control, adopting a variety of improvement measures to ensure a positive customer experience, and shifting most of VANCL’s advertising dollars towards internet marketing. Though successful when first established, PPG eventually collapsed in late 2009 due to their inefficiencies in such areas. Owner of VANCL, Chen Nian stated that VANCL has passed its most risky period†¦show more content†¦Market Analysis: VANCL is a leading Chinese internet-based apparel retailer that has successfully established dominance in the e-tailing world. Their approach to elevating the customer experience includes improvement measures such as online commenting threads and try-on activities. VANCL’s services have helped them diminish any skepticisms the Chinese market had in regards to shopping online. Known for its â€Å"fast fashion†, they have expanded their market range to include most kinds of men’s and women’s apparel, specifically casual-wear such as canvas shoes and graphic tees. In China alone they have captured over 25% of market share in the apparel market and are the 6th largest B2C company in China in terms of revenue. VANCL’s channels of distribution are exclusively their online website as well as their small call-center. Because they are only an online retailer, VANCL uses their own logistics company, Rufengda, and other third party companies to ensure speedy delivery of their products. Their apparel is made from top fabric manufacturers such as Luthai Textile and go through countless quality checks to ensure the best apparel for their customers. In China alone th e market for apparel including clothing, shoes, hats, and textiles has grown by a staggering 18.8% in 2009 according to the