Clostridium Difficile Essay Example | Topics and Well Written Essays - 2000 words

Clostridium Difficile - Essay Example The role of CDI in antibiotic-associated diarrhea was recognized in 1970s. In 2000, the emergence of a drug-resistant hypervirulent strain was documented. This strain was associated with severe and recurrent CDI. Between 2000 and 2005, the CDI cases almost doubled, of which majority were older adults (Kee 2011). CDI is characterized by at least three unformed feces, within a 24-hour period, with C. difficile (McCollum and Rodriguez 2012). The presence of infection is examined through histopathologic or endoscopic tests. CDI has been linked to approximately 20% of all cases of antibiotic-associated diarrhea in humans (Carman et al. 2011). From being associated with simple to severe diarrhea, C. difficile is now regarded as the principal cause of various diseases, including sepsis, fulminant colitis, multiorgan failure, toxic megacolon, and even death (Ananthakrishnan and Binion 2010). History and Epidemiology Staphylococcus aureus was commonly linked to antibiotic-associated diarrhea, but in 1974, the cases of clindamycin-associated pseudomembranus colitis were found not caused by S. aureus (Bartlett 2008). These cases were later associated with C. difficile when the link between CDI and antibiotic therapy was elucidated. CDI became more common and severe since the year 2000. From a common cause of nuisance, it evolved into a principal nosocomial cause of mortality and morbidity (McCollum and Rodriguez 2012). ... This percentage increases with age, making the elderly more prone to CDI than the young adults. Older adults may have 10% to 20% colonization rates, depending on the length and frequency of exposure to antibiotic treatments and to C. difficile (Wilcox 2003). Although the vegetative forms of the bacillus die upon exposure to air, its spores may last for months and even years. Hospitals are the major source of C. difficile spores. The bacillus can also be found in farmyards and domestic animals like dogs, cows, cats, horses, and pigs. In developed countries, hospital-acquired diarrhea is likely associated with C. difficile than any other bacteria (Wilcox 2003). In England and Wales, about 18,000 laboratory cases of C. difficile are reported annually (Wilcox 2003). More than 80% of these cases involved patients with ages of over 65 years (Wilcox 2003). The elderly patients tend to acquire severe CDI, though increasing age is not a risk factor for the extent of infection severity. These trends were also observed in the U.S. In fact, the economic cost of CDI cases in the U.S. range from $436 million to $3 billion in a year (Ananthakrishnan and Binion 2010). Clinical and Pathological Features It is often difficult to differentiate the clinical and pathological characteristics of the disease caused by C. difficile from those of other intestinal diseases, such as Crohn’s disease, ulcerative colitis, and chronic inflammatory bowel disease (Knoop et al. 1993). The symptoms may manifest as early as one to two days after an antimicrobial therapy and as late as two to ten weeks after the therapy. C. difficile-associated disease could also occur after a single

Marketing Fundamentals Module (CIM Professional Certificate in Essay

Marketing Fundamentals Module (CIM Professional Certificate in Marketing) - Essay Example Their definition of a successful firm is one, which is able to predict the future accurately, acquire core competences ahead of competition and thereby become the dominant player within an industrial sector. Markets always change faster than Marketing. Today many companies are disappointed over marketing’s inability to produce measurable result. While companies unabashedly declare their wish to get closer to customers, marketing actually losing power to other functions in the corporation. Now to achieve highest level of operations every company needs a strong market plan, which will ensure success to them in the present competitive environment. 2. Marketing plan: The marketing plan operates at two levels strategic and tactical. The strategic marketing plan lays out the target markets and value proposition that will offer, based on an analysis of the best market opportunities. The tactical marketing plan specifies the marketing tactics, including product features, promotion merchandising, pricing, channels and services. The marketing plan is the central instrument for directing and coordinating the marketing effort. Today teams develop marketing plans with inputs and sign-offs from every important organizational function. These plans are then implemented at the appropriate levels of the organization, with management monitoring results and taking corrective action when necessary. The format and contents of marketing plans depend upon the size of the organization, the attitude of the organization the degree of formalization required within the annual planning cycle process and accepted sector conventions. 2.1. Situation review: Within situation review, there should be coverage of the strategic situation facing the organization. This will base on a description of market size, market growth trends, customer benefits

Theories of Causal Learning Essay Example for Free

Theories of Causal Learning Essay In the article entitled â€Å"When Learning Order Affects Sensitivity to Base Rates: Challenges for theories of Causal Learning† written by Ulf-Dietrich Reips and Michael R. Waldmann, theories causal learning was put to test, more specifically the causal-model theory and the associative theories. With this, the causal-model theory â€Å"assumes that learners form a representation of causal models regardless of the order in which learning information is presented† (Reips and Waldmann, 2006). As with the associative theories, the researchers decided to take on the Rescorla-Wagner theory of associative learning. Associative learning theories tend to place cues and outcomes simply for the predictive and diagnostic learning (Reips and Waldmann, 2006). Predictive learning entailed the prediction of symptoms based on the disease presented to them while diagnostic learning required the prediction of diseases based on the symptoms given to them. Thus, it can be said that predictive learning is the forecasting of the effects based on the causes. On the other hand, diagnostic learning is the determination of the causes based on the effects. These two causal learning methods were placed against the variable of base rates. The researchers did the study because in general, they wanted to find out whether the use of base rates was affected by the learning order, whether it is predictive learning or through diagnostic learning. Moreover, they wanted to test whether the base rates were encoded and if this was put to use. Also, they wanted to find out whether the increasing complexity of the ideas would affect the use of base rates. The researchers conducted studies on students coming from the University of Tà ¼bingen. They were given a list of fictitious diseases and their corresponding symptoms with other diseases given more likelihood than the other/s that were in the form of an inverted M. Three experiments were done which involved almost the same procedures with a little alteration for each experiment. The first experiment was done with the purpose of â€Å"finding out whether learners have the competency or correctly incorporating base-rate information regardless of the sequence of learning† (Reips and Waldmann, 2006). The purpose of the second experiment was to Results were later on computed using the ANOVA. The number of participants varied for the three experiments but is similar in terms of the school where they came from, which is the previously mentioned University of Tà ¼bingen. For the first experiment, the participants composed of 24 students who were given participation credit or were paid DM 5, where â€Å"half of this group was randomly assigned to either of the two learning conditions, predictive or diagnostic learning† (Reips and Waldmann, 2006). In the second experiment, there were 32 participants composing mostly of students from the same university who were recruited at the cafeteria. Just the same, each of them was given participation credit or was paid DM 8 for their help with the study. The participants were randomly assigned to either of the two learning conditions. With the third experiment, the participants remained at the number 32 and were randomly assigned to either of the two learning conditions and were also paid DM 10 or were given participation credits for their contribution with the study. The procedure varied from one experiment to another. In the first experiment, the participants were given typed instructions written in the German language. After reading such, they were asked to summarize the instructions and recite them. With an error in the instruction, they were asked to repeat it all over again until they were able to get the instructions right. They were asked to proceed as a â€Å"guest in a special clinic for viro-neuronal tropical diseases for one day† (Reips and Waldmann, 2006). Those under the predictive learning conditions will have to predict the symptoms based on the disease given and those under the diagnostic learning conditions will have to identify the disease based on the symptoms given. They were given hypothetical patients’ record on an index card. The card contains two symptoms on one side and one disease on the other where the predictive learning group saw the disease first before the symptoms and the diagnostic learning group saw the symptoms first. The participants were later asked to rate the likelihood of the occurrence of the disease. In the second experiment, they used the same inverted-M disease but added diseases and symptoms to make them into a total of six diseases and nine symptoms. For this experiment, the researches used the aid of the computer for their learning trials with the use of software called Micro Experimental Laboratory (MLE). They received practically the same instructions but with additional directions on how to use the computer and two new types of questionnaire. The test was self-paced and the experimenter would simply have to press a button to display the items that the participant will have to answer. For the third experiment, the general procedure will be a written general instruction, computer instruction, learning phase with feedback, instruction for the test phase, test phase of diagnostic judgments without feedback, rating questionnaire, and frequency questionnaire. The results of the first experiment were in consistence with the causal-model theory which states that â€Å"learners try to correctly represent causal knowledge regardless of the sequence of the learning input† (Reips and Waldmann, 2006). For the second experiment, the results revealed that the â€Å"participants acquired the base rates of the diseases in all conditions but used them differently in probability ratings depending on the learning condition† (Reips and Waldmann, 2006). The results affirmed the associative theories but were in contrast with the causal-model theory. The third experiment reaffirmed the results and findings of the first and second experiment. In addition to this, they were able to find out that â€Å"the use of base rates in the implicit measure is clearly less pronounced in the predictive learning condition than in the diagnostic learning condition† (Reips and Waldmann, 2006). Moreover, there was a â€Å"pronounced difference in base-rate use after diagnostic but not after predictive learning in the diagnostic ratings† (Reips and Waldmann, 2006). A future possible expansion that is adhered to by the researchers is the question on â€Å"whether the competency to acquire flexibly accessible knowledge is based on the learning phase or on the retrieval phase† (Reips and Waldmann, 2006). Due to the fact that none of the two learning theories, the causal-model and associative theories, encompass the findings of the experiments, it can be said that there is a need for further research regarding the topic to formulate a theory that would be able to hold true for the findings of this current research (Reips and Waldmann, 2006). This has an impact particularly on the causal-model theory which has been disproved by the second experiment and the third experiment (Reips and Waldmann, 2006). In addition to this, the same model is challenged by the fact that people encode base rates but do not always put them to use (Reips and Waldmann, 2006). Both theories may be applied but they can not totally encompass or they lack certain things that might explain the findings of the last two experiments to be able to fully contain them (Reips and Waldmann, 2006). The findings of the research is of great importance and use to the field of education. More specifically, it is helpful in determining the â€Å"suitable learning and training contexts in education† (Reips and Waldmann, 2006). Moreover, the information gathered from this research will be of great use to the field of medical sciences since the presentation of information with regard to causes may present deficiencies when this is used (Reips and Waldmann, 2006). The findings of this study will have to enhance the over-all learning process and theories that are in current use. References Reips, U. and Waldmann, M. 2006. When Learning Order Affects Sensitivity to Base Rates: Challenges for Theories of Causal Learning. PLEASE PUT THE PLACE OF PUBLICATION HERE: Hogrefe and Huber Publishers.

diary of anne frank :: essays research papers

*New Buddy* The book I read is called The Diary of Anne Frank by Anne Frank The book is a true story about a thirteen year old girl who receives a diary on her thirteenth birthday. The book is a short autobiography In her diary Anne tells Kitty (her pretend friend) everything that happens in her life. The interesting factor in the book is that the time of Anne’s preteen years is the time of the rise of Hitler who oppressed the Jews. Anne’s family is forced into hiding into a secret apartment on top of a factory store in which one of the Frank’s friends works. Meep, the friend brings food up to the Franks. Anne and her family stay in hiding for four years. Just when the Franks are almost ready to leave a man working in the factory rats the Franks out to the Nazis. Anne’s diary begins on her thirteenth birthday and ends shortly after her fifteenth .In the book she writes of her friendships with other girls and her performance in school. The school Anne goes to is called the Lycelium for Jews. Anne also has a sister. Her name is Margot. Margot is 17 years old and very mature. Anne gets along well with her sister. Her father comes from a wealthy family. Anne gets along nicely with him. Anne’s mother is not spoken of too much in the book., mostly because she does not have a good relationship with her. When Hitler was first taking power the Jews were forced into all Jewish schools. It was there that Anne met a good friend. Her name was Joy. Anne and Joy became friends but only for a short while before Anne was forced into hiding. Anne and her family hid from the Nazi’s for two and a half years. The Franks stayed with three other people. They had a woman named Meep bring food to them. The rise of Hitler grew worse as the years passed. The Nazis were then taking Jews to camps where they would kill them. The Franks got into many arguments with the people in the house and Anne was between it all. During this time Anne was beginning to like one of the boys she was staying with in the house.

Family theories Essay

In this answer, I am going to discuss about the conjugal relationship in modern industrial societies. This means I will assess the claim that conjugal relationships are based on equality in modern industrial societies. I plan to structure my answer from housework and childcare, power and money management. The hours worked between husband and wife become more equal by the increased participation by women in the labour market have led to more equality in modern family life. This view is highly supported by many sociologists like Young and Willmott who suggest that the family is becoming more symmetrical and therefore, is in fact becoming more egalitarian via a ‘march of progress. ’ They suggest that the family is gradually improving in terms of equality as there has been a trend away from segregated conjugal roles and more of a shift towards joint ones. This they argue is due to major social changes in that women are more financially dependant with employment opportunities and so there is less of a need to rely on extended kin. This is further explained by Gershuny who suggests that because women have these employment opportunities, they are more likely to do less domestic work. This is shown by the item as it suggests that ‘men were making more of an effort to do housework when their wives were in full-time employment. By this change of position for women, it has meant that men are now more responsible for different household tasks therefore suggesting that equality within modern family life is evident and so this view seems correct. He emphasises the change in social values as a reason for this which is also supported by Sullivan’s study (2000) which found an increase in equal division of labour. This supports Young and Willmott’s ‘march of progress’ view that conjugal roles are becoming more symmetrical; thus suggesting that the view of equal gender roles and relationships is likely. Also, due to post-modern society, there are better living conditions compared to those during industrialisation and so this has drawn the men back into the family and thus has enabled them to help with housework and childcare as well as providing leisure time; enhancing equality in relationships. The social changes have meant that equality is becoming evident and so the statement seems highly likely. However, the functionalist view of equality in modern family life has been highly criticised particularly by feminists like Ann Oakley (1974). Oakley rejects the ‘March of progress’ view described by Young and Willmott as she suggests that this is simply exaggerated as we still live in a patriarchal society where women do most of the housework. She suggested that the methodology used by Young and Willmott was hardly convincing as their questions lacked in detail. In Oakley’s research, she found only 15% of husbands had a high participation in housework, showing how the statement is flawed as this clearly does not show evidence of equality in relationships and gender roles. Despite Gershuny suggesting that paid work entitled equality for women, Oakley suggested that this was only an extension of the housewife role. Therefore, unlike Parsons claim of a ‘natural’ role, feminists argue that this was socially constructed to enforce dependence on men which became worse with industrialisation as it forced women to stay within the home. Thus, it is clear that joint conjugal roles are not as ‘joint’ as functionalists initially suggested they were as the social changes have only exacerbated the role of women suggesting this so called equality does not exist. Besides, other feminists like Elsa Ferri and Kate Smith (1996) suggest that the changed position of women in terms of employment has only created a dual burden as they now have to undertake paid work as well as the unpaid housewife role. Ferri and Smith suggest that unlike Gershuny, increased employment has had little impact of the domestic labour as fewer than 4% of families had a father responsible for childcare. Therefore, women still remain responsible for the children as well as their employment responsibility; clearly suggesting that modern family life is not as equal as it seems. The dual burden is also supported by Dunscombe and Marsden’s theory of a triple burden in that women are expected to do the double shift of housework and paid work but also the caring of the emotional welfare of the family. This clearly disputes Gershuny’s idea that women are more equal due to employment as the triple burden means that they in fact gain more responsibilities than losing them. Next, feminists ‘point to inequalities of power and control that persist in modern family relationships’ as a key reason for inequality; again challenging the statement. Allan suggests that ideological factors limit women’s power in that they are ‘disadvantaged from the start. ’ This suggests that the family is always going to be founded on inequality; thus suggesting that the view of equality is limited. This is supported by Barrett and McIntosh who suggest that men gain far more from women’s domestic work than they give in financial support and that in turn this support often comes with ‘strings’ attached. Also, men are usually the ones who make decisions about finances despite some families being dual-earners. This is due to the fact that women are statistically still paid on average less than men; enhancing male economic power. Therefore you can question the extent of equality in modern family life. Resources are also said to be shared unequally like Kempson’s (1994) study among low-income families. This leaves women in poverty and so restricts their power in the family which creates an atmosphere of inequality in conjugal relationships. This is further explained by feminists Pahl and Vogler (1993) who focused on the effects of decision making within the family through ideas like ‘pooling’ and ‘allowance systems. They found a 31% increase in pooling where both partners have joint decision responsibility as well as a decline in allowance systems. However, it was still evident that men usually made huge financial decisions. Edgell also supports this as the levels of decision making are not equal due to the male economic power that still exists. Therefore, women have less say in the decisions and thus it is obvious that the view that gender roles and relationships are becoming more equal is incorrect as inequality in pay and decisions still exist. Similarly, this inequality of power has led to domestic violence which clearly shows how inequality is evident in that relationships are being gender dominated. Radical feminists like Millett and Firestone (1970) use domestic violence as a way to show that society is primarily founded on patriarchy and that men oppress and exploit women. They suggest that the inequality of power within the family maintains men’s power and so domestic violence is inevitable. Similarly, Dobash and Dobash suggest that marriage legitimises violence against women as it provides the male with power and the women with dependency, therefore evidently showing no signs of equality. Thus, this disputes the statement of gender roles and relationships becoming more equal with 1 in 4 women being assaulted in their lifetime according to Mirrlees-Black. Finally, childcare which is essentially about exercising responsibility for another person who is not fully responsible for herself and it entails seeing to all aspects of the child’s security and well-being, her growth and development at any and all times. Mary Boulton ( 1983 ) argues the exaggeration in the extent of men’s involvement in childcare and she denies that questions about who does what give a true picture of conjugal roles. She also claims that although men might help with particular tasks, it is their wives who retain primary responsibility for children. It is the wives who relegate non-domestic aspects of their lives to a low priority. This shows that there is still inequality in terms of childcare in conjugal relationships. In addition, Elsa Ferri and Kate Smith provide some empirical support for Boulton by conducting a study based on National Child Development Survey. The survey found it was still very rare for fathers to take primary responsibility for childcare. In both the sample of mothers and the sample of fathers it was very rare in dual-earner families, no-earner families or families where only the mother worked, for the man to be normally responsible for the children or to look after them when they were ill. In almost every category the man was the main carer in 4 percent or less of families. This is also supported by the radical feminist idea of ‘gender scripts’ in that there are expected norms in terms of gender roles and so patriarchal relationships are inevitable. Therefore, they suggest that equality without burdens will only be reached through same-sex relationships as this eliminates the ‘gender script’ idea. Thus, this enhances the inequality of the family, and suggests that the view that conjugal relationships are becoming more equal is in fact incorrect as the inevitability of patriarchal relationships means that equality cannot be established. In conclusion, I have discussed and assessed the view that conjugal relationships are based on equality in modern industrial societies by evaluating three sections which are hours worked, power and childcare. With all of the statement, I believe that conjugal relationships in modern industrial societies are not based on equality.

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Nursing At The 21st Century - 1347 Words

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As a knowledge worker, a nurse moves from the role of a â€Å"data gatherer, information user, knowledge user, and knowledge builder, respectively† (McGonigle Mastrians, 2015, p. 114). It is in the role of a knowledge user that the nurse starts to take â€Å"notice of the trends in a patient’s clinical data and determines whether the clinical data fall within or outside the normal data range† (p. 114). In measuring the final outcome of the patient as suggested by O’Grady and Malloch (2003) Not only should we empower patients, but also we simply don’tShow MoreRelatedClinical Nursing Practice in the 21st Century Essay1368 Words   |  6 PagesMaryville University | Clinical Theory Practice of the 21st Century | Assignment 4.1 | | Sally Fandek | 9/1/2012 | [Type the abstract of the document here. The abstract is typically a short summary of the contents of the document. Type the abstract of the document here. 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