How to approach a child with autism properly

How to set start a shaver with autism properlyThe idea of being polite or that which designate the eyeshade of discretion to others is a capacious virtue to begin with. In that essence, when dealing and att mop uping to or with pile or a small fry with sick dis arrange, politeness and get wording their sentiments is in addition real important. Not all community are b slighted or lucky to live a normal life. That is where we earth-closet derive the sentimental value of politeness to get in its presence as far as approaching a child with autism in a proper way is concerned.What we end comprehend and understand from the planetary assimilation of the facts, especially when it concerns child with autistic is that pot who abides with them politely is oft not simply respected by autistic child, but also loved by them in great many ways. In that context again, a child with autism also in any given occasion responds to people who are polite and who understands them in th e other way round. That is to say, a child with autisms most commonly is often known to be impaired by header upsets or that which impaired the secern of the brains, and are children with special needs and care.Thus, extra attentions have to be given to them to improve their way of living in a mitigate way. This is where the question of being polite to them also come to fore, because it bring into the occasion the consideration for the witnessings of others. When we look at these features in contention, a child with autisms we get hold is characterized by certain aspects of impairment that prevent them to interact and communicate socially in the way a normal child does. Behavioral aspects of a child with autism also often prevent them due to repetitive behavior that a normal child does or is expected of.Hypothesis Proposal and Issue in ContentionUnderstanding autism is important in a sense that it jakes depart us a gist about the disease in general and what are the salient f actors habituated to it. Autism as one of the commonest diseases is spreading fast and affects millions of individuals, especially childrens. To have a put one over and precise apprehensiveness of it is very skillful for an informative understanding of the diseases.Emphasizing the valuable aspects attached to children that are change by autism and understanding the significance of how to approach much(prenominal) children also can provide us with an idea about what should be and what should not be the factors while making a way to approach children with autism, because as we know children with autism have a general ail to understand and view things as normal people does. As one aspects of human disability, autism as diseases is rather knockout for general people to understand, especially when it subject field to approach child with autism, given that their behavior at times are a sore for the sight. However, we should not make it look so bad. Given that childrens who are af fected with autism also are humans, so does we. Hence, every belief to have a feeling for them and their needs is one significant point to build a society based on understanding, sharings, helping people in needs and most importantly contributing to limit the plight of those less fortunate.In that essence, we feel that to general the objective of this interpret is to view into the salient aspects encompassing factors of the subject matter that attempts to trace how to approach child with autism in order to do away with any misgivings and misunderstanding. As we know children with autism are childrens with special needs and care. Thus, every aspect to understand their behavior for example can be an ample foreground for us to feel for their plight or to make a contributing hand in helping such childrens and their cause.Thus, it should be clear that in order to have a clear understanding of autism, a thorough understanding of a child with autism also readily calls for attention, whi ch this projects attempts to address and exemplifies the polar points. In doing so, a literature review of the subject matter that limits its analysis to factor on defining autism and how to approach child with autism is a necessity, which the following split up details.Literature Review The idea and notion of AutismAs we can derive from a general accumulation of the facts, autism is a general disorder that affects the behavior of individual affected by it. Most often than not, people or a child with autisms is restricted by certain neural disorder that prevent them to behave and act normally in most occasions. It is heartening to experience in that capacity.However, point of it also should looked and extrapolated in which the salient and special characteristic of a child with autism also should be acknowledged. In that regard, dexterouss are of the opinion that autism like all mental disorders are phenomenological based diagnosis. That is to say, autism is a form of mental diso rders that is observable to harbinger through an experiment. Altogether, autism can directly be defined as a disease based on observable and reproducible behavioral phenomenon, and composed a complex biological system or that which checkup experts calls end point in psychiatric illness. (Casanova, 2005, p. 198)Thus, when we begin to this comprehension of the facts and subject matter arguments again, we feel that medical examination experts opinion on the same also should be taken in a discourse. Although much of the definition of autism herein and as defined above is medically grounded, that is to say, all aspects of the features attached to autism are defined in medical and clinical sense.In that capacity and as sources can be derived from our study, the IDEA Act in US (Individual with Disability Education Act) defines the notion attached to autism as one of the developmental disability in a person that significantly affects the way of people behavior and their responses to cert ain social interaction process. That is to make it simple, autism has a direct affect upon an individual verbal and non-verbal communications processes. Together with it, individual who are affected with autism and its disorder also often find the social interaction to be close to impossible. What we can relate advance is that autisms are generally evident in any given child affected by it before the age of three years. The effect of autisms also adversely affects a childs educational performance, given that as a neural disorder, the affect of learning disability also directly comes to fore. (Anonymous, 2008)Thus, when we interpret and accumulate to the notion that can be derived from the above definition in brief, it comes as a direct representation of the sociological aspects that can be emphasized again. That is to say, a close knot understanding in brief can be derived as to what composed the meaning of autism in general term rather than the previous idea that is medically grou nded.How to Approach Autistic Childrens?When we come to this part of the study, what we can cum up from the above definition, its terms and characteristics attached to autism also provided an avenue to understand the meaning of autism. In that regard, it is crucial to understand autism in a sense that it can further enable us to derive the salient aspects as and when it matter to dealing with autistic people. The question that arises also is how to approach children with autism?To begin with in this regard, we feel that a thorough understanding of the behavioral aspects and in particular the characteristic associated with autism is important as a measure to approach with them in day to day life and interaction process.Hence, experts feel that as far as approaching an autistic child goes it is to be sensible and vitreous ample to understand who they are, because autism is just one part of their characteristics. Yet a child with autism is also a unique creation of God and with unique character and gifts. (Wong, 2009) Thus, the stovepipe way to approach a child with autism is to give them enough space to be what they want and to express their humanness as to who they are, not by what we make think of otherwise. To put it in simple terms, approaching a child with autism is all based on the things that we can encounter, and how we response to each one of it in a cordial and virtues way.Secondly, autistic child and their characteristic of neural disorder prevent them from imaginative thinking. Hence, in that regard, expert opinion in that respect is to approach a child with autism with due care and attention to details. That is to say, identifying with them is the best way possible, because child with autism are hypersensitive to certain things that are beyond their imagination to grabs a thing or two being said or conversed. Thus, a cautious approach to the language used, and individual willingness to identify with them and their capabilities as wellspring as do ing thing to them in one sense give great details and a good basis to approach a child with autism, (Wong, 2009) because as we can emphasize to the meaning of it, the fact is that that often actions speaks louder then word with children affected by autism.Together with it, and from a professional way on emphasizing to the notion of approaching a child with autism, that is to say, teaching a child with autism defines many foregrounds of the do and donts. As far as the subject topic goes in that regard, it is widely undertaken with due care and cautious approach. Expert opinion of the point to approach a child with autism and while teaching an autistic child is to give greater details and focus on two significant areas as far as it goes with the use of functional activities, and in particular an effort to make programs detach enough for student development level that also attends to their chronological age. (Raymond Le Blanc, 2007, p. 102)Hence, as we have related in the introduct ory note to the subject matter arguments, we feel that being polite to children with autism can be a great virtue indeed. That is why we see an extensive empathizing that is given attention toward children with autism. Altogether such move is also a good social cause, given that it gives the child that are affected with autism greater details to explore and experiment their life in a meaningful way, especially with people who understand them in a better way.Understanding the Characteristics of Autistic ChildrensAs far as autism goes, a freehanded attribute or aspect of something that is related is also relevant to trace as a measure to understand in general the characteristic attached to the diseases and its symptoms in any. In that regard one of the common characteristics that are most often associated with autism can be exemplified towards the components attached to repetitive activities among autistic child. In that notion, autism and is characteristics as can be observed reflec ts the stereotyped movement of autistic individuals or a child. (Anonymous, 2008)Most importantly, autistic characteristic also are most often than not resistance to change. Hence, when autistic individual are subject to environmental change or change in daily course of life and routines to be precise, a direct instance of resistance also can be observed. Such characteristics as can be explained are unusual responses to sensory or neural experiences attached to autism and individual affected by it, (Anonymous, 2008) says experts in the fields of autistic study and child development welfares.Further down the line, we often feel that to define autism correctly is hard, because it all depends on interpreting the traits that are relevant to autistic individual or childrens. In that reasoning, and as far as expert opinion and their idea of autism goes, it directly relates to people who often have difficulty in three major areas, namely social interaction, communication, either can be (v erbal or written) or both, and flexible and imaginative thinkings, which medical experts such as Lorna Wings have referred on the condition attached to autism and autistic behavior and characteristics. (Pittman, 2007, p. 4)In context of the above definition of the characteristic attached to autism, we can directly trace the features as to what composed imaginative thinking as well. Let say, autistic adversely affect the child learning capacity but it does not mean that a childs educational performance in such situation or occasion as such is adversely affected due to or primarily because of the child emotional disturbance, but it is a direct closet of the disorder attached to neural or psychological diseases. (Anonymous, 2008) That is why characteristic attached to children with autism is rather complicated to register readily with a layman.Once again, from the interpretation of this term, a concise meaning to autism and its spectrum also can be derived. What we can drive home the idea is that regard as well can be further stated that autism is rather a complex disorder as far as social interaction and cognition of term goes. In that capacity as well, we feel that autistic childs are individuals that calls for special attention and special care, wherein all the components and characteristics that posits a child with autism should not be taken for granted to accumulate who they are, since it is only one part of them and their disability.ConclusionGoing back to the overall discussion, we are of the opinion that understanding autism and how to approach autistic child with such a disorder calls for extra measure and efforts to be made.Hence, to conclude in that regard and what we can drive home the idea that erupts from politeness with autistic child as well has some sentimental value, which we feels defines the notion that parts of it also comes readily, and registers with people who have been trained to handle or responds to children with autistic behavior in a better way.For a layman, understanding a child with autism can be close to impossible, because as some experts have maintained is the fact that autistic disorder in a child does not in a way explains or defines who the child is, which in a sense it only give a clear impression and natural accumulation of the fact that autism is one part of the character and being of childrens with autism. (Wong, 2009)RecommendationsIn the current state of affairs, extensive researches are being carried out to understand the many variables attached to autism and its characteristics in particular. As human and scientific knowledge increases, so does the awareness and attention that is given to certain fields of study as a measure to reaps the benefits in facilitating a better way of life to children with autism also automatically arises.There are many components that make it hard to define autism, which in any capacity is what we call a diseases. Measure initiated in the study and research thus is to bring into contention the idea to understanding and tracing the salient aspects of autism so that a progress can be channelized to treat the disorder in a better way, because it is one aspect of concerns that medical experts encounters. (Casanova, 2005, p. 198)Thus, when we relate to the above statement as well, and accumulating the overall discussions, we can derive as to where the idea in the medical fields that is interrelated to autism and its study can be emphasized for further research and study.After all, medical research initiated in context of autism is a measure that comes as a means to an end in enabling medical experts to find a befitting solution to treat the disorder and to facilitate the channel of life bearing examples. Such insistence and initiation is a good move and designate an attempt with great virtue and a great cause.

Examining whether glaxoSmithKline has successful internal innovation

Examining whether glaxoSmithKline has successful internal grounding1) GSK is a leader in the pharmaceuticals industry with 7 per cent of the world market. Its mission is to better the quality of human life so that the people feel better, live longer and is exit to perform the tasks assigned to them properly. This merchant ship only be achieved by proper planning and implementation of research and development programmes. GSKs purpose of merger was to improve R D (as it would in addition obtain technology from outside) because it looks to excel in internal construct by making use of the knowledge and learning provided by individuals of early(a) organisations. These individuals might be experienced, trained, flexible, committed and help the soaked to accomplish its goals which is its primary objective. The main aim of internal innovation is to outperform its competition by implementing saucily ideas into developing new and better products which ar sustainable in the market. GSK focalisees on providing drugs at a cheaper rate to the developing countries. GSKs strategy is to nurture, distribute and make things easier. It implements its strategies by employing a large number of people in different countries. The employees research to produce new pharmaceuticals to treat the diseases foc employ on. However, GSK is facing a problem of transparent expiry. It has 30 patented drugs that are nearing expiry. So it wants to redefine its range of drugs by focussing on its R D. The individuals involved must(prenominal) have a unequivocal attitude and should be willing to take risks. They should learn from each other and also understand what others are doing. That would help in implementation. Implementation involves the proper practice session of resources and capabilities of a firm. It involves the management of innovation and focuses on managing politics, go steady and fighting with change.2) GlaxoSmithKline wants to ensure that the firm focuses on the bes t science. It realised that to be successful in future, it require to be more innovative. So it reorganised its research and development area to improve efficiency and accomplish its goals. It created 70 Discovery Performance Units (DPUs) which focussed on eight therapy areas for future addition of the comp both. However, GSK successfully completed or extended 21 new drug discoveries in the year 2008. Innovation involves the implementation of ideas into nearly new product and the new product leads to new opportunities. In gaucherie of GSK, it would generate more revenue if the ideas are implemented properly. New technology provides a competitive edge to the firm.The four elements of implementation are leadership, engagement, alignment and extension. The 70 DPUs would affect these four elements. The DPUs are compact, fully authorised, determined and integrated teams which are liable for a small fork of the pipeline associated with the production of a drug. The teams include sci entists, marketing specialists, engineers and others from key business domains to work on innovations. The exchange of ideas amongst its own scientists done building alliances and touch onings are encouraged. They showcase different compounds and potential products. R D groups of individuals gather and learn about new products and processes. In case of GSK, leadership would focus on creating procedures for innovation and distribute sufficient resources for crucial activities. It would help in the induction of supportive systems and policies and set up adequate infrastructure for achieving the required goals. troth would focus on building a knowledge based culture, education, progress and mentoring. Alignment would help in building a competent organisation and would have got rewards to accomplishments. Extension would help in examining organisational capabilities and search for other prospects. It would also develop and share lessons learnt. Implementation ensures that the goals and support of management are understood properly. It also involves face out for people who possess the necessary skills required to meet the project objectives.The internal culture and external purlieu of GSK would also affect the implementation effort. We can expect disinterest, apprehensions, satisfaction, hostility and competition for resources. The teams might become satisfied with their achievements and their ideas could be clashing with each other. They may lack the necessary skills. This would hinder the future growth of the firm and it would non be able to accomplish its goals. However, engagement would help them overcome the problem. Implementation also involves setting up of scrutinising system which addresses possible technical foul and market uncertainties arising out of al-Qaida, continuous change and competition from the external environment. Radical change involves high risk whereas continuous change involves low to medium risk. This is because radical change has a wider impact on the firm as the failure of the product will demotivate the firm and decrease its revenues whereas continuous change has a bare(a) impact on the firm because improvements are made to the existent product or service. Radical change involves major streamlining of the firm, product line or market. The case study shows that GSK has a background and the processes that support innovation. It also hires individuals to conduct research and develop new products, encourages employees to try out new ideas, undertake risks and experiment. The first part of these processes involves constructing a structure for innovation.Proper teams and co-ordination between different units in an organisation like GSK are needed for the successful implementation. It involve to organise special preparedness and development programmes for the employees, providing technical knowledge about the product, programmes on marketing the product, focus on building new skills in employees and encouragi ng master functional activities.3) GSK ask to evaluate its total organisational performance because it is large, the external environment factors (political, social, economical, technological and competitive factors), the strategic environment, information systems and structural analysis. An organisation involves human, physical, financial and information resources and how these resources are used in the management, operations, production and integration of ideas and actions. The output is the products and services. However, it needs a process to evaluate the diverse ideas and products because it produces far more ideas and products than it can follow at any given time. Cost plays a crucial role when it comes to evaluating an idea. GSK also needs to evaluate the innovation cost which is the internal cost to develop and distribute and also the true cost to the customer to purchase and use. It needs to calculate the costs for development and marketing, market penetration and sales w hen evaluating a new product and service. It needs a business plan (expected revenue, cost of producing a product or service and profits to be generated) to commercialise the ideas. The evaluation process helps GSK in assessing the change of innovations it should relate supporting or initiate support for. The team promoting the product should have the ability to justify the product at each step of the process. It should continue with ideas or products that are generating revenue and doing well in the market. It should also start developing new products which have the potential to do well in the market because that will provide competitive advantage to the firm. It would create new opportunities and customers. The shareholders would not hesitate to invest in the firm if it is doing well because they would get appropriate returns on their investment. The evaluation system is designed to be flexible and helps GSK to discontinue those projects that are not meeting expectations. In oth er words, those projects are hindering the growth of the firm.GSKs develop and focussed approach has the most influence on how well it evaluates progress towards stated innovation goals. It sees where and how resources are allocated within R D. It terminated more than 35 per cent of discovery projects following the reorganisation in 2008. Those projects might not be meeting its expectations. The DPUs were given financial support for three years after(prenominal) the termination of the projects. The financial support aids the R D group to focus on granting the best science and the best product for the consumers but at the same time it also gave them tough timelines to produce a profitable product. If the product is not profitable it will reduce the revenues of the firm. In that case the firm would have to discontinue with the product. In 2008, GSK received 30 per cent of its revenues from products that had been in existence for less than three years as an outcome of these innovatio n efforts. It essence its revenue was coming from new products. It gained the first mover advantage. However, it needed to improve its old products. GSKs widespread internal development efforts often lead to innovations that do not fit with the companys main focus.4) There are three types of ensure systems financial control, strategic control and cultural control. They all have advantages and disadvantages. The advantages of financial control are that it is quantitative and easy to understand. The disadvantages are it can become narrow, internally focussed and analysis paralysis is possible. The example of financial control is that it leads to percentage of profit add from new products. GSK employs financial control because 30 per cent of its revenue has come from products which have been in existence for less than three years. The advantages of strategic control are that it sets direction, more qualitative and fits environment. The disadvantages are it is hard to justify based o n some financials, can lose sight of where the firm is. The example of strategic control is that it leads to increase in market share. The case study shows that GSK employs strategic control because its widespread internal development efforts often lead to innovations that do not fit with the companys main focus. The advantages of cultural control are that it is very behavioural and qualitative. The disadvantage is it requires managers to be involved on a personal level. The example of cultural control is that it leads to value enhancement. GSK employs cultural control because it develops external discovery teams with other firms or universities or research labs.However, it can be seen that GSK faces a vague institutional environment because it emphasises both on financial and strategic control and firms that prefer strategic control to financial control adopt strict corporate authority. The choice of innovation mode is affected considerably by the firms internal control procedures. Therefore a model was developed to look at the birth between a firms internal control procedures and preference of innovation mode. Using a sample of 585 Chinese firms, this study tests the proposed model. The findings show that strategic control has a negative relationship with incremental innovation but a positive relationship with radical innovation, while financial control has a positive relationship with incremental innovation but a negative relationship with radical innovation. So, GSK should employ strategic control for radical innovation and financial control for incremental innovation.There is a need to make amendments if a gap is identified between goals and performance. This can only be achieved through proper planning.GSK needs to be more cross functional by rethinking of the business processes. In particular the knowledge, equipment and processes must be managed and controlled properly.The processes used by the firm for its internal innovation must be redesigned and l ooked upon for improvements to meet its objectives. It will help GSK gain competitive advantage.Key decisions should be made by those involved in the innovative process. They would identify new opportunities and find solutions to the existing problems.GSK should develop new goals if the existing goals do not match its capabilities. The goals must be rational and easily achievable because that would save time and money. The individuals involved must have strong personal idea and ethics with the firms values and goals.

Risk Factors of Cardiovascular Drugs

adventure Factors of Cardiovascular DrugsCharacteristics and stake factors of Cardiovascular Drugs induced Adverse Drug Reactions Hospital based Active Surveillance Study.Abstract accentuate Adverse Drug Reactions (ADRs) is one of the major do drugs-related problems in infirmaryized endurings. Several studies tale the relative incidence various from 10 50% of all hospital admissions due to ADRs and no recent data available on the safety of billiovascular drug from India.Aim This check aims 1). To fancy incidence and characteristics of ADRs due to cardiovascular drugs in patients admitted in cardiology unit of a tertiary care teaching hospital. 2) To identify the risk factors for ADRs in hospitalized patients breeded with cardiovascular drugs.Methods A prospective active surveillance contain was carried out in the cardiology department of a south Indian tertiary care teaching hospital for eight months. community averaged Poisson regression Generalized Estimating Equation (GEE) models was use to estimate the familiarised relative risk associated with ADR.Results The overall incidence of cardiovascular drug induced ADRs was 31.8%. A total of 757 patients case-hardened cardiovascular medications. Of which 241 patients (31.8%) including 122 (16.1%) womanlys and 119 (15.7%) males account at least one ADR. Aspirin produced the highest consider of ADRs (150 38.7%) followed by Heparin (45 11.6%), Atorvastatin (24 6.2%) and Ramipril (24 6.2%). The causality assessment reveals that 85.3% of ADRs were probable in nature. GEE was used to estimate the adjusted relative risk of each covariate associated with ADRs. The predictors of ADRs place were female gender, age 60 historic period, multiple drug therapy (p= 0.0231) and concurrent diseases like diabetes, drugs like Heparin (RR-2.90, 95% CI 2.22-3.8) and Enalapril (RR-1.95, 95% CI 1.34-2.83).Conclusion The incidence of cardiovascular ADRs was 31.8%. The most common drugs causing ADRs were the anti- plate let and anticoagulant class of drugs. Female gender, age 60 years, multiple drug therapy, concurrent illness and certain drugs like heparin were determine as potential predictors for adverse reactions.Keywords adverse drug reactions, hospitalized patients, cardiovascular drugs, pharmacovigilance, Risk factorsKey MessagesThis require reports the risk factors for adverse reactions to cardiovascular drugs from an Indian clinical setting.The incidence of cardiovascular drugs induced ADRs was 31.8%, which is higher than many describe studies.Anti-platelet and anticoagulant drugs were usually associated with ADRs in the study nation.IntroductionAdverse Drug Reactions (ADRs) is one of the major drug-related problems in hospitalized patients. ADRs are one of the major drug-related problems, resulting in increased morbidity and mortality and healthcare costs.1-3The WHO defines an ADR as a response to a drug that is noxious and unintended and occurs at doses normally used in man for th e prophylaxis, diagnosis or therapy of disease, or for modification of physiological function.4The prevalence of cardiovascular diseases (CVDs) has increased in recent years and it has been estimated that CVDs are the most common scram of death.5 Reports on drug related problems including adverse drug reactions associated with cardiovascular pharmacotherapy are available.6-10Studies report that cardiovascular drugs may account for 10 to 50% of all hospital admissions due to ADRs.11-13 on that point are reports of serious adverse drug events with cardiovascular drugs.14Continuous monitoring of ADRs are important in patients treated with cardiovascular drugs since, these patients who need multiple drug therapies to treat their comorbid conditions and other related risks15Various methods are used to detect ADRs in hospitalized patients.16 Analyzing the adverse reaction data in comparison to the presence of risk factors gene sum up the link between the ADRs and the associated factor s. Such analysis might help to identify patients who are at increased risk for the adverse reaction and therefore employing capable monitoring and the preventive procedure is possible.17 Reports are available on the risk factors for adverse reactions.18-20Studies have shown that the cardiovascular drugs are most common cause of ADRs.6,21A university hospital-based studies report 49 % ADRs are due to commonly used cardiovascular drugs (nitrates, digoxin, propranolol, heparin, warfarin, anti-hypertensive and anti-arrhythmic drugs)22 A number of studies are available on the adverse effects of cardiovascular drugs. In the Indian context data on adverse effects of the cardiovascular drugs is non available. Therefore, the current study was planned to evaluate ADRs due to cardiovascular drugs in hospitalized patients. This study aims 1). To estimate incidence and characteristics of ADRs due to cardiovascular drugs in patients admitted in cardiology unit of a tertiary care teaching hospit al. 2) To identify the risk factors for ADRs in hospitalized patients treated with cardiovascular drugs.Subjects and MethodsA prospective active surveillance study was carried out in the department of cardiology of a tertiary care teaching hospital for eight months (Feb to Sep 2009). The study protocol was reviewed and approved by the institutional ethical committee. All patients admitted to the cardiovascular units were monitored and evaluated for cardiovascular drugs induced adverse reactions. Patients who were previously treated or newly prescribed with cardiovascular drugs were monitored and followed for detecting and recording of ADRs. Adverse drug reactions were identified by conducting a daily patient charts review, patient interview, and consultations with treating physicians. In the suspected cases, past medical/medication history of patients were collected. In addition to patients medication history, information on co-morbidities was also collected. We used the WHO criteri a for defining ADRs.4 For every identified patient with ADR, two patients without ADRs were enrolled as matched controls.The information pertaining to the suspected ADRs was collected and documented in a specially designed ADR com set uperized documentation database for further assessment.23 An ADR alert card was distributed to those patients who experienced severe adverse reactions to prevent further re-exposure of the suspected drug. All ADRs were reviewed and assessed by the research team. The documented ADRs were evaluated and characterized respect to patient demographics, nature of the reactions, drugs and organ trunk mired and outcome of the reactions. Using standard approach, the Causality, severity, preventability and the presences of predisposing factors of the reactions were assessed and reported.Patients age and sex were considered for the analysis. ADRs were classified as either Type A or Type B consort to the system introduced by Rawlins and Thompson.24 The suspected drugs were classified according to Anatomical Therapeutic Chemical (ATC) mixed bag based on WHO-ATC Index 2009.25Using WHO Adverse Reaction spoken language documented ADRs were further classified into various organ system classes.26 Management strategies employed for the ADRs were categorized as drug withdrawal, dose reduction, additional treatment for ADR and no change in a regimen without any additional treatment. Patient outcomes were reported as fatal, fully recovered, convalescent and unknown.The causality of suspected ADRs was assessed using Naranjos ADR hazard scale and classified into certain, probable, possible and unlikely to be drug induced depending upon the level of association.27 The preventability of ADRs was analyzed and categorized into definitely preventable, probably preventable and not preventable using the modified criteria of Schumock and Thornton by Lau et al.28Using the criterion developed by Hartwig et al., for severity assessment, we assessed the suspec ted ADRs and classified into mild, moderate and severe reactions.29 The onset of ADRs was assessed and classified into sub- perspicacious, latent and acute radicals.4Predisposing/risk factorsMany patient-related factors predispose the occurrence of ADRs. The patient related factors like age, gender, multiple and inter-current disease states, and polypharmacy are considered as significant risk factor for ontogenesis ADR.30 Patients age was categorized into 6 groups (less than 20 years, 21-30 years, 31-40 years, 41-50 years, 51-60 years, more than 60 years). Polypharmacy was categorized as minor (2-3 drugs), moderate (4-5 drugs) or major (5 drugs) based on the classification by Veehof et al.31 Gender of the patient was also considered as a one of the predispose factor for the development of ADRs. Multiple disease state ( 2 coded diseases) of the patient at the time of reaction also include in the analysis. The overall incidence of ADRs was calculated using the total number of in-pati ent episodes which resulted in ADRs in relation to the total number of in-patients followed during the study period.The duration of hospital stay for each patient was collected from Hospital Patient Administrative System (HPAS) and used to analyze the Length of Stay (LOS) between patients with and without ADRs. Additional hospital stay due to ADRs was assessed using the nature and clinical features of ADRs, discussion with treating medical staffs and assessment of patients medical records.statistical analysisDescriptive statistics was used summarize the patient demographic and clinical characteristics like gender, diagnosis, a number of drug dispensed, the frequency of ADR, drugs involved, organ system involved and severity of ADRs. Mean with 95% confidence interval was used to summarize age and LOS. Chi-square test was used to find the association between age group, gender, the LOS with and without ADRs. carnal knowledge risk was used to measure the strength of association. The d ata were hierarchically arranged, to count the multiple ADR episodes which can occur with multiple admissions. Population averaged Poisson regression (GEE) was used to estimate the adjusted relative risk of each covariate associated with ADR.32,33 Further compound symmetry was used to account for the within-subject correlation. All analysis was performed using SPSS for window 15 (SPSS Inc., sulphur Asia, Bangalore). The significance level was set at PResultsA total of 757 patients (431 men and 326 women) using cardiovascular medications were intensively monitored. The mean age of the study population was 57.21 14.22 years (18 -92 years). The average length of hospital stay was 10.6 5.8 age. Overall, the incidence of ADRs was 31.84%. Two hundred and fourteen patients including 122 females and 119 males reported at least one ADR. Maximum of sestet ADRs were reported from one patient. Compared to males, females developed more of ADRs was observed more in females when (p 0.0001). T he length of stay was increased due to ADR for a minimum of 3 days and a maximum of 28 days.The frequency of different age groups in patients with and without ADRs is presented in table-1. The main diagnosis of the study population is listed in table-1. Age group of less than 20 years is excluded because of lower sample size. Age group of more than 60 years had more ADRs compared to other age groups. Cardiovascular risk factors of a patient with and without ADR are shown in table-2.The most frequent system-organ class affected by ADRs was Platelet, bleeding clotting disorders (188, 48.89%), followed by metabolic and nutritional disorders (53, 13.66%) and GI system disorders (50, 12.89%) (Table-3). The most common strategy for management of ADRs was drug withdrawal (94.3%) and dose alteration (5.4%) (Table-4). The mean length of hospital stay was 13.3 and 6.5 days for patients with and without ADR respectively. The length of stay was found to be longer in patients with ADR.Aspirin produced the highest number of reactions (150 38.7%) followed by heparin (45 11.6%), Atorvastatin (24 6.2%) and Ramipril (24 6.2%) (Table -3) with Platelet, bleeding clotting disorders (188, 48.89%). The most frequently reported reaction was bleeding (186 47.9%) followed by gastric ulcer (52, 13.4%) (Table-3). The causality assessment of ADRs revealed that 85.31% of ADRs were classified as probable, followed by 7.99% as definite and 6.7% as possible. 64.4 % patients recovered from the ADRs and 35.6 % were recovering at the time of discharge (Table-4).The GEE analysis shows that the female, alcoholics, smokers and patients those taking more than 7 drugs had a higher risk for underdeveloped an ADR. (Table-2). Statistical analyses also revealed that patient taking Heparin (RR 2.90, 95% CI 2.22-3.80, Enalapril (RR 1.95, 95% CI 1.34-2.83), warfarin (RR 1.69, 95% CI 1.33-2.54) had a significantly increased probability of underdeveloped of ADRs (Table-5).DiscussionADRs can significantly increase patients mortality or morbidity and consequently higher healthcare expenditure.34 The study findings reveal that developing an ADRs in hospitalized patients intimately contribute to patients morbidity, further increasing the disease burden and cost of managing ADRs. The incidence of ADRs (31.8%) found in this study was twice higher than a previously reported systematic review of international studies (15.1%).2 The present study showed that females experienced a higher incidence of ADRs (9.87%) when compared to males (7.23%) which are similar to the findings of previously published studies.1,35-37Several reasons have been put forth for this observed difference. Men and women have a different pharmacodynamic response to various drugs which may consider as one of the factors for women to develop more number of ADRs. But in a study reported by Jose., on comparable Indian population male patients were found to have more ADRs than female population.38The incidence of ADRs was h igher in the elderly patients (31.19% age 60 Years) compare to other age groups. (2= 23.03, df-5, p 0.0001) this finding is similar to the results of Mohebbi et al.19 Studies have shown that the incidence of ADRs may increase with increasing age. Again, due to multiple comorbid conditions and receive multiple drug therapy the elderly patients tend to have a higher risk for developing an ADR. In addition, older individuals undergo changes in drug responsiveness and disposition.39 It appears that elderly patients need more attention to prevent the occurrence of ADRs.In this study, the incidence of Aspirin-induced ADRs was 38.7% (n=150) which was the highest rate compared to other cardiovascular drugs in this study. However, High rates of ADRs with streptokinase have been reported previously.40Studies reported a rate of amiodarone-induced ADRs as 16%, whereas in the current study it was too low at 0.5%.41 This might be due to the lower use of amiodarone in the current study subjects. In a study conducted by Wiffen et al., investigating ADRs induced by all groups of drugs, warfarin was among the top three drugs causing ADRs.42 In our study, the rate of ADRs attributed to warfarin was just 3.6%, whereas heparin-induced bleeding was the flake highest ADR in this study population (45, 11.6%).In this study, we found central nervous and gastrointestinal systems are the most frequently affected organ system classes by ADRs. These findings were similar to the findings of a study conducted in Iran.13The incidence of preventable ADRs in this study (6.9%) is comparably lower than those detected in other studies.34This might be probably due to intensive monitoring of CCU patients in our study. The rate of serious ADRs (22.2%) detected in this study tend to be higher than other studies.14Population averaged Poisson regression (GEE) model showed that factors like gender and age of more than 60 years, multiple drug therapy and the presence of co-morbidity were risk factors fo r experiencing ADRs. The average duration of drug tradition was found to be longer in patients without ADR. It appears that most of the ADRs have been noted shortly after initiating cardiovascular drugs and the incidence of ADRs in this study population was not related to the duration of usage. Similar to findings of many other studies, increasing the number of drugs led to increased frequency of ADRs.ConclusionThe finding of this study indicates that cardiovascular drugs cause serious and frequent adverse reactions. The incidence of cardiovascular ADRs was 31.84%. The most common drugs causing ADRs were the anti-platelet and anticoagulant class of drugs. Female gender, age more than 60 years and use of more than 7 drugs was found to be the risk factors for developing ADRs. The identified incidence was higher than many reported studies. The current study identified the common ADRs and their predictors. Patients with identified predictors for adverse drug reactions can be intensivel y monitored and necessary preventive measures can be initiated if signs of reactions are observed.

Violence in Richard Wright’s Black Boy Essay -- Richard Wright Black B

Violence in Richard Wrights Black Boy Most literary works centering on adolescence do not depict it as the proverbial walk through the park a smooth transition mingled with the naivet6 and innocence of puerility to the morality and self - ken of adulthood is an implausibility confined to the most basic of fairy tales and weekday morning childrens television programming. When analyzed in depth, the mat uration process of a human being is depicted almost always as some sort of struggle, retaliation against the forces of oppression regardless of their forms (including social, governmental or religious obstacles). More importantly, the struggle of adolescence is a struggle to understand not the workings of ones environment so much as the complexities and definitions of ones own individualism operator. Body hair, voice undulations, wider hips these popular aspects of maturation pale in comparison with the development of self- sense the realization that one is a alone(p) human be ing with the right to survive and live life according to personal standards. Psychoanalyst Erik Erikson describes this delicate transitional period as a crisis of identityIt occurs in that per iod of the life cycle when each youth must forge for himself some central perspective and direction, some working unity, out of the effective remnants of his childishness and the hopes of his anticipated adulthood he must detect some meaningful resemblance b etween what he has come to see in himself and what his sharpened awareness tels him others judge and expect him to be. In some young people, in some classes, at some periods in history, this crisis of identity wil be minimal in other people, classes, and periods the crisis wil be clearly marked off as a critical pe... ...nt in the future can one possibly change his or her downtrodden situation, can mold, spirt and tune their lives with al the freedom that comes from possessing an individual identity. Works CitedElison, Ralph. Invisible Man . New York Vintage, 1995. Erikson, Erik. Young Man Luther. New York Norton, 1962.Howe, Irving. Black Boys and Native Sons, CriticalEssays on Richard Wright. ed. Yoshinobu Hakutani. capital of Massachusetts G.K. Hal and C o., 1982. 39 -47. Hurston, Zora Neale. Mules and Men . New York Harper never-failing, 1990. Kinnamon, Kenneth and Michael Fabre. How Richard Wright Looks at Black Boy, Conversations with Richard Wright. Jackson University Press of Mississippi, 1993 . 63-66.Margolies, Edward. The Art of Richard Wright. Carbondale Southern Ilinois University Press, 1969.Wright, Richard. Black Boy . New York interminable Classics, 1998. Violence in Richard Wrights Black Boy Essay -- Richard Wright Black BViolence in Richard Wrights Black Boy Most literary works centering on adolescence do not depict it as the proverbial walk through the park a smooth transition amid the naivet6 and innocence of childhood to the morality and self -awareness of adulthood is an implausibility confined to the most basic of fairy tales and weekday morning childrens television programming. When analyzed in depth, the mat uration process of a human being is depicted almost always as some sort of struggle, retaliation against the forces of oppression regardless of their forms (including social, semipolitical or religious obstacles). More importantly, the struggle of adolescence is a struggle to understand not the workings of ones environment so much as the complexities and definitions of ones own identity. Body hair, voice undulations, wider hips these popular aspects of maturation pale in comparison with the development of self-awareness the realization that one is a unequaled human being with the right to survive and live life according to personal standards. Psychoanalyst Erik Erikson describes this delicate transitional period as a crisis of identityIt occurs in that per iod of the life cycle when each youth must forge for himself some central perspectiv e and direction, some working unity, out of the effective remnants of his childhood and the hopes of his anticipated adulthood he must detect some meaningful resemblance b etween what he has come to see in himself and what his sharpened awareness tels him others judge and expect him to be. In some young people, in some classes, at some periods in history, this crisis of identity wil be minimal in other people, classes, and periods the crisis wil be clearly marked off as a critical pe... ...nt in the future can one possibly change his or her downtrodden situation, can mold, image and tune their lives with al the freedom that comes from possessing an individual identity. Works CitedElison, Ralph. Invisible Man . New York Vintage, 1995. Erikson, Erik. Young Man Luther. New York Norton, 1962.Howe, Irving. Black Boys and Native Sons, CriticalEssays on Richard Wright. ed. Yoshinobu Hakutani. capital of Massachusetts G.K. Hal and C o., 1982. 39 -47. Hurston, Zora Neale. Mules and Men . N ew York Harper Perennial, 1990. Kinnamon, Kenneth and Michael Fabre. How Richard Wright Looks at Black Boy, Conversations with Richard Wright. Jackson University Press of Mississippi, 1993 . 63-66.Margolies, Edward. The Art of Richard Wright. Carbondale Southern Ilinois University Press, 1969.Wright, Richard. Black Boy . New York Perennial Classics, 1998.

Romeo as an Irrational and Impulsive Young Man Essay -- Papers

Romeo as an Irrational and Impulsive Young Man Romeo and Juliet is a tragedy written by William Shakespeare in 1592. It is set in Verona, were a bitter feud between two rival families, the Montagues and Capulets. The main characters, Romeo and Juliet, are the children of the two rivals, who meet and fall in love at the Capulets ball. Nevertheless, the relationship of these star-crossed lovers ends in tragedy as they are unable to fulfil their love. The feud between the two families forces the two lovers to take their own life. further this act allows the families to forget their senseless feud. Romeo described to us by his cousin, Benvolio, as irritable. gladly shunned who gladly flied from me Benvolio is saying Romeo is avoiding him. This is because Romeo says he is in love. In sadness, I love a woman Romeo says he is in love but is he really? Romeo uses dull and depressing language and a series of oxymorons cold fire, heavy lightness, sick healt h Romeo is downhearted because his love for Rosaline is not returned. Romeo first irrational act is when he enters the Capulets ball despite their bitter hatred and the fact they would kill him if they find him in their house, he still enters the ball. He is prepared to take a risk to see his love, Rosaline. But, when he lays eyes on Juliet he falls in love with her. I never saw true beauty until this night It almost seems as if Romeo is being inconsistent in that he can forget Rosaline so rapidly when he was infatuated with her just a couple of minuets ago. Was he really in love with Rosaline? If his love for Rosaline ended so quickly could... ...irritated beyond resolution but, when he realises what he has just done, he is shocked. At this point, we see Romeos actions reflect his love for Juliet. Finally, as he stands before Juliet and gazes at her, he shows no sings of synthetical emotions or trivial behaviour he displayed at the start. In a r espectful speech, he addressed Juliets death which has dealt such a cruel blow. As he takes the poison Juliet arouses and kills herself when Romeo dies the depth of his feelings for Juliet is finally established Romeo is being true to his convictions. Overall Romeos has an irrational and impulsive nature this got him into a great deal of dilemma. However if Romeo was not irrational and impulsive he would have never found or experienced true love and the bitter feud between the Montagues and Capulets would persist.

Ben Sira Essay -- Bible, Attributes Ascribed to God

WISDOM OF BEN-SIRAHow does the creator of the book justify the goodness of beau ideal in the looking at of the evil present in the world? resolveBen-Siras theology, though not systematic, offers a coherent presentation of the sets of belief necessary in understanding and living the Jewish faith (The Anchor sacred scripture Dictionary, 940). In this regard, one important question that has been addressed by the author is the presence of divinity fudge vis--vis the presence of evil in the world. In addressing the question the author has laid down his Doctrine of God and from there explain how evil is present and persist in the face of the goodness of God.Ben-Siras doctrine of God affirms the Judaic concept that there is only one God. This becomes significant not only because it re-echoes the Jewish faith but because it counters the notion of the belief on pluralist God, which was the prevalent notion or belief during the ancient period. This concept is significant in understanding of the notion of god vis--vis evil because as it removes the plurality of gods, it opened the tensity between the goodness of God and the presence of evil. This tension necessitates justification as the presence of evil in the world does not only posits a contradiction in terms to the goodness of God but it also acts as a counter-claim for the one God being only-powerful. Ben-Sira claims that there are certain attributes ascribed to God alone. These are God is one and the same (4221). God is eternal (4221). God is the all and in all (4327). This means that God is both transcendent and immanent in all creation (The Anchor Bible Dictionary, 940). God is the creator (G1). God is powerful and His power is manifested in the creation when He created everything out from His words (3917-1... ...ce ill-gotten goodsPresents from the anarchic do not win Gods favorThe Most High approves not the gifts of the godless,nor for their many sacrifices does he forgive their sinsOn the other hand, To clutches the law is great oblation And whoever observes the commandments sacrifices a peace offeringIn works of charity one offers a fine flourAnd when he gives alms he presents the sacrifice of praiseTo refrain from evil pleases GodAnd to avoid injustice is an atonement (35 1-5)For the author the goodness of God remains despite the reality and face of evil in the world because evil is the result of mans weakness, of man using his free pull up stakes to veer away from the laws and opt to follow in sin. God in all his power shows the utmost respect on mans freedom by not imposing his will on men but by respecting his choice to be good or to be evil.

Technology and Cheating Essay -- essays papers

Technology and CheatingTechnology really is a double-edged sword when it comes to cheating. The means for detecting cheating are catching up with the means for cheating.There are many definitions of cheating, but the one that most accurately applies to the school environment is this one from Merriam Websters Collegiate Dictionary, to violate rules dishonestly.1 With that definition, A upstart survey of more than 1,000 Choices readers shows that cheating among teenagers is a huge problem. Ninety-six percent of the respondents said that cheating was a problem in their school, and while 98 percent of the students said a person did not need to cheat to succeed, 64 percent of the respondents admitted cheating on a test.2 Another example of this is given in a recent study by the Center for Academic Integrity at Duke University, 73 percent of seventh-graders and 66 percent of sixth-graders admitted that they had cheated. Because kids as young as eight and nine now have Internet access , we see this problem moving further down in grade level, reports Steven Jongewaard, Ph.D., professor of education at Hamline University.3Why do students cheat? According to the same survey as above, students said they cheated because they needed to save time, they felt the problems, questions, or assignment were too hard, they were terror-stricken of getting a poor grade or failing, and they werent prepared. Some kids think theyre too cool to study, or that they know everything and dont have to study, says Alyxe. Then, when it comes to the test, theyre surprised and they try to cheat. trying to please parents or attempting to help a friend is also reasons why kids cheat.4 To me this all seems like excuses. It seems... ...=EJ531712&db=eric1 http//shs.westport.k12.ct.us . Retrieved whitethorn 2, 20042 http//shs.westport.k12.ct.us. Retrieved May 2, 20043 http//shs.westport.k12.ct.us. Retrieved May 2, 20044 http//shs.westport.k12.ct.us. Retrieved May 2, 20045 http//shs.westpo rt.k12.ct.us. Retrieved May 2, 20046http//shs.westport.k12.ct.us 7 Argetsinger, Amy, Washingtonpost.com, Technology Exposes Cheating at U-Va. Wednesday, May 9, 2001 Page A01. Retrieved May 2, 20048 Chase, Kimberly. Teachers Fight Against Internet Plagiarism. From the March 02, 2004 edition. http//www.csmonitor.com/2004/0302/p12s01-legn.html. Retrieved May 2, 2004.9 Argetsinger10 Chase 11 Bushweller, Kevin. 1999. Generation of Cheaters, The American develop Board Journal, April. Online www.asbj.com/199904/0499coverstory.html. Retrieved May 2, 2004.