Rheumatoid Arthritis Exercises Essay Example | Topics and Well Written Essays - 1250 words

Rheumatoid Arthritis Exercises - Essay Example The onset of the disease is most frequent in fourth and fifth decades of life (Luqmani et al., 2006). The aetiology of the disease is not specifically known and has been suggested to be multifactorial. The class II major histocompatibility complex allele HLA-DR4 and related alleles are known to be major genetic risk factors for RA. It has been suggested that RA might be a manifestation of the response to an infectious agent in a genetically susceptible host. Activation of autoimmune mechanisms is the key aetiologic event in sustaining the chronic inflammatory process so characteristic of RA (Scott et al., 2000). The main event in pathophysiology is inflammatory synovitis. Subsequently through a cascade of multiple immune events through mediation of a host of immune cells, the synovial fibroblasts are activated. Added to cartilage degradation, osteoclasts are activated that leads to erosion of bone. The chemokines and cytokines lead to synovitis, cartilage and bone damage, and systemic manifestations of RA (Luqmani et al., 2009). Altman (2008) notes that these immunologic abnormalities arise from various immune complexes, which originate from the inflamed synovial cells that serve as a target for such immune injuries. The plasma cells that are recruited produce antibodies known as rheumatoid factors. These actively contribute to these complexes which ultimately lead to joint destruction. With further inflammation chemotaxis ensues leading to recruitment of macrophage cells with associate vasculitis. Primarily CD4+ lymphocytes infiltrate the synovial cells. These together produce inflammatory cytokines and chemokines, namely tumor necrosis factors, granulocyte-macrophage colony stimulating factors, interleukins, and gamma-interferon. These are known inflammatory mediators leading to further joint inflammation and systemic manifestations of the disease. When the disease is chronic, the synovial membrane is very much thickened and is projected into the joint cavity. The synovium is the seat of inflammation, which produce collagenase and stromelysin leading to further degeneration of joint cartilage. Interluekin-1 and tumor necrosis factor-alpha contribute to this process and stimulate osteoclasts, thus leading to bone erosion. Prostaglandins are released. With the maintenance of inflammation, fibrous tissue is deposited within the joint. The synovial tissue appears very much proliferates and highly vascular, leading to pannus which further potentiates release of inflammatory chemokines leading to all round erosion of the joint structures such as cartilage, bone, articular capsule, and the periarticular ligaments. Most of the inflammatory cells are neutrophils. In some patients rheumatoid nodules develop (Altman 2008). Clinical Features Clinically RA presents as chronic polyarthritis of symmetrical synovial joints of hands, wrists, knees, and feet with an insidious onset of fatigue, generalised weakness, and vague musculoskeletal symptoms for weeks or months. Pain, tenderness, and swelling in the affected joints get aggravated with movement. Generalised stiffness of joints noted in the mornings for about duration of greater than 1 hour is invariable. Swelling and tenderness in the joints lead to motion limitation and hence impairment of physical function. These lead to fibrous or bony ankylosis of the joint leading to fixed deformities (Scott et al., 2000).

Professional Application Essay Example | Topics and Well Written Essays - 1500 words

Professional Application - Essay Example Nevertheless, Houston represents a booming market for Steve Madden with a high proportion of working population with higher incomes. The paper reviews the internal and external situational factors affecting Steve Madden. The insights offered by this research can provide a basis for further in-depth research regarding the competitive position of Steve Madden. Keywords: Steve Madden; positioning; target market; marketing efforts Introduction The small business chosen for the purpose of this essay is Steve Madden which has a strong retail presence in Houston, Texas. Steve Madden enjoys a strong foothold in the footwear industry and is primarily known for the novelty of its products at a reasonable price. This paper discusses the competitive and marketing landscape for Steve Madden along with the economic, social, technological and demographic factors affecting the business. Part 1: Situation Analysis Product/Service Overview – strengths, weaknesses Steve Madden offers an assorted range of accessories and shoes for men, women and children. It enjoys high brand equity by virtue of its cutting edge styles and fashion statements (Zappos.com, 2013). Another strength is that the products are sold through the company’s own stores, department stores as well as company website, thereby increasing availability of its products. Furthermore, the price matches quality thereby offering value for money for customers. However, the products remain beyond the reach for majority of the customers. Also, repetitive styles result in monotony. Current positioning in the market Steve Madden has positioned itself on the bridge between high-end and mid-range fashion. It currently enjoys a dominant market position with Steve Madden being ranked second to Nike as the customer’s preferred footwear brand (from 2002-2007) (Piper Jaffray Companies, 2013). Target Market Steve Madden targets a broad range of customers. Its core market for women ranges from 16-45 years whereas the sub brand â€Å"Stevies† is focused on girls aged 6-12 years (T. Sloan, personal communication, September 02, 2013). The target market for men includes those aged 20-40 years (T. Sloan, personal communication, September 02, 2013). These individuals are primarily fashion conscious individuals with high annual incomes but do not want to splurge in expensive, high-end fashion. Less expensive knock-offs are offered for such customers. Current marketing efforts (traditional, interactive, etc.), messages and effectiveness The company’s marketing efforts can best be described as both traditional and interactive. It has partnered with Katy Perry under â€Å"Steve Madden Music† campaign which also featured live performance by Shwayze, a rapper. The company is actively engaged in mobile marketing as well as digital marketing through Facebook where customer feedback is taken via comments on videos, pictures and other content posted by the company. Google ad words and T witter are also used to broaden sharing of Steve Madden’s content and deepening relationships with customers. Part 2: Competition The three major competitors for Steve Madden are BCBG, Nike and Nine West. These shall now be analyzed one by one. BCBG- Product/Service Overview – strengths, weaknesses Primarily known for its high quality, fashionable apparel, BCBG has increased its offerings to include handbags, shoes and accessories thereby offering high product variety. The mid-range price points appeal to a broad range of

Information security management Essay Example | Topics and Well Written Essays - 2500 words - 1

Information security management - Essay Example Taking a step back, there is value in situating a risk assessment process for Accounting Company in the context of a cycle for managing risks. The chart below situates this particular exercise for Accounting Company in terms of a cycle that includes the (1) assessment of risks and determination of needs; (2) the implementation of controls and policies; (3) the promotion of awareness; and (4) monitoring and evaluation; all occurring within the context of a central point of focus (United States General Accounting Office 6): Meanwhile, a compilation of risk assessment approaches for information security that is taken from best practices of many different top organizations in the US has distilled the most important elements of an effective security risk assessment as follows: (1) the identification of threats that could significantly impair crucial assets and operations; (2) estimation of the likelihood of the occurrence of such identified threats; (3) the identification and prioritization of assets and operations in order to determine the most crucial assets and operations to protect in cases of the occurrence of the identified threats; 4) the estimation of probable losses in the event of the occurrence of the threats, to included losses from the costs of recovery, for the most important assets and operations (5) the identification of interventions for risk mitigation, where the emphasis is on the cost-effectiveness of such interventions; and (6) the documentation of the results and the development of a plan of action (General Accounting Office 6). To be sure, while the above outlines a generic information security risk assessment approach that is the common denominator for all kinds of effective, best practice, approaches, the literature actually details many different kinds. Including a matrix approach (Goel and Chen), and many other different best practice

Quantitative analysis Research Paper Example | Topics and Well Written Essays - 1000 words

Quantitative analysis - Research Paper Example History confound defines events that occur during the data collection process to influence the dependent variable without effects from independent variable. The events may increase effects of the independent variable or reduce them and therefore compromises validity of data. Maturation confound however defines transitions in research participants’ cognitive or physical properties towards different rationale by the same person. A longitudinal study may involve change in age that associates with improved rationale and physical characteristics that may change an individual’s perception. Other factors such as education, stress, and physical strain may also influence a person’s rationale into different perspectives during a study. Test confound is another challenge to quantitative research and defines differences in results because of a research participant’s previous experience with the test instrument and the experience influences results from values that wou ld be observed on first encounter with the same test. Interactive effect is another threat to quantitative research and defines association between two or more confounds in a study. Interaction between treatment and history is an example results in different values from actual effects of a study’s independent variables (LoBiondo & Haber, 2013). Challenges of quantitative research are evident and offer a basis for differentiating between quantitative and qualitative research. Their understanding are therefore important, not only for development and implementation of qualitative research initiatives, but also for understanding differences between the two research methods in order to ensure development of a suitable research methodology for a study (Allwood, 2012). History confound is a significant threat to quantitative research because of its potential to alter results in a study. History can occur in a study’s internal or external environment and this defines the exten t to which it may be significant to a study. In a study to investigate effects of lecturers’ appearance on effectiveness of learning process, an independent forum on learning skills that averts students’ attention from a lecturer’s appearance is an external historic factor to the study. A seminar to lecturer’s on how to improve their lecturers is however, an external historical factor and both offer significant potential to shifting the relationship between lecture’s appearance and effectiveness of lecturers. The extent of such an impact on results further depends on effectiveness of the history factor. The challenge is based on factors beyond rationale of research participants and therefore defines independence from bias, unless the history event is selective to influence a proportion of research participants and their associated data. In the absence of bias, history has uniform impacts on phenomenon of study and therefore ensures reliability of c ollected data because of a possible uniform shift in relationships. Consistency in measures will therefore be attained in a historically confounded study but validity will be compromised because of lost accuracy on the effects of independent variables on the subject dependent variable. Possible existence of reliability but not validity in a data

Antihypertensive and antilipidemic medications Essay

Antihypertensive and antilipidemic medications - Essay Example 7. Follow up will include Re-appointment in one month for repeat labs and then in three months for follow up. Labs to repeat will be renal panel, liver panel and Hgb. as well as K. If patient is diabetic HA1c. 8. Special education should include diet and exercise. However, adverse reactions are often chronic headache, dizziness, abdominal pain and nausea and URI symptoms. The patient will need to be aware of these. 10. He will need to keep his appointments as scheduled, follow diet and exercise, change position slowly, and drink adequate amounts of fluid during the day. He will need to take this drug for a lifetime, unless told by a primary provider to discontinue. Do not use any nonprescription drugs that might increase blood pressure. Do not drink alcohol. 11. Hypertension if left uncontrolled can cause stroke or heart attack. Chronic hypertension often causes renal failure and the need for dialysis. Untreated hypertension works the heart harder and contributes to atherosclerosis 12. Not all antihypertensives work equally well in any given patient. Vasodilating activity occurs with this class of drug. Postural or orthostatic hypotension may occur in some patients causing falls. 2.

Management Final Project Essay Example | Topics and Well Written Essays - 1000 words

Management Final Project - Essay Example The project showed the new shopping cart concepts that embedded the issues including shopping behavior, maneuverability, cost maintenance, and child safety. These concepts aimed at improving the management skills where both the business and the customers were the centers of interest (Kelly, 1999). As the business was reducing the loss of its fixed assets (the cart trolleys), the customer values and interest were also considered whereby despite the crewed developing in the shaping both the cost and customer safety were never compromised. Moreover, the show concentrated on the design process of the IDEO that reflected multidisciplinary team brainstormed, prototyped, and research the gathered the feedback from those who used the design. These applications deployed by the design indicated that good managerial skills that included teamwork as well as the incorporating the end users in the development and improvement of services and products (Kelly, 1999). Teamwork allows acquiring extensi ve knowledge and skills in design products and services that will meet the end users’ desire. Moreover, teamwork allows extensive innovation thereby increasing the production and sale of the intended service or product in the market line. Seeking for the views of customers within the intended product and service line is also an effective business management skill since it allows the business to design products and services that will meet the needs and wants of customers (Kelly, 1999). Notably, meeting the needs of customers within every product and service line often improves sales and profitability in the same sense (Kelly, 1999). Moreover, seeking and using feedback from the targeted customers is essential in that it is a means of improvement of services and products especially in areas that customers feel unsatisfied. It should be noted that the current business management skills are customer centered; the production of goods and services are to meet the needs of the custo mer. In this sense, the application of this design in businesses will improve businesses applying the same since they will be having an extended and elaborate market (Kelly, 1999). Additionally, every proper business management skill usually values the safety of its customer in line with production and service delivery and the IDEO’s design have ensured that child safety is a factor in their production and service delivery in the cart shopping. Another essential management skill demonstrated in case video clip, the continual improvement. Every business must give room for product and or service improvement. In the case of IDEO’s shopping cart design, the continual improvement is demonstrated where it is vivid that the design lacks some steel frame bottom and side to detect theft. However, it substituted plastic baskets thereby increasing shoppers’ flexibility and helped in protecting goods as well as providing a means of promoting the brand awareness (Kelly, 1999 ). The design also incorporated the auxiliary services that usually aim at maintaining customers to the services and products offered or acting as a means of customer attracting other customers to such news services and products. The dual child seat with a swing up tray provides a play surface and a secure spot for placing a bunch of carnations or cup of coffee. Additionally, seeking for the addition information through secondary research enable the IDEO shopping cart des

Laboratory Report Essay Example | Topics and Well Written Essays - 500 words

Laboratory Report - Essay Example Question 4: In this example of the elbow flexion unloading response (i.e. the task performed during the laboratory), state the muscle from which the data from sheet 1 was recorded, and whether the weight was removed unexpectedly or was self-removed by the subject. What was the latency of the response Answer: The data from sheet 1 showed the elbow flexion unloading response of the biceps. The weight was self- removed as we observed the reduced EMG activity of the biceps, starting before the onset of the unloading. The latency time is about 50 milliseconds. Question 5: Based on evidence from the laboratory and/or the literature, explain the major reflex pathway that causes the reduction in agonist EMG in the unexpected unloading response. Include the series of neural events from just prior to the release of the weight until the end of the first agonist (biceps) response. Answer: Anticipation in the postural domain is an example of the ability of the CNS to predict the consequence of the mechanical effect of movement on posture and helps minimize a forthcoming disturbance. A classical example was provided by the pioneer work of Belenkiy et al. (1967). They showed that, during arm raising while standing, the prime mover activity in the biceps brachii was preceded by an activation of a leg muscle, the biceps femoris, starting 100 ms before the movement onset.