Continued Professional Development Essay Example | Topics and Well Written Essays - 250 words - 1

Continued Professional Development - Essay Example On the other hand, PhD is designed to assist nurses to be tangled in research aimed at discovering new knowledge. DNP deals with courses such as evidence based practice and applied statistics, financial management, budget planning, health system transformation whereas on the PhD side courses such as philosophy of science, qualitative research methods chronic illness and care systems For a DNP, one can get health care administration in clinical nurse faculty and preparing nurses in management and health information technology to improve the care given. On the other hand, a PhD holder can work as a nurse scientist in the nursing faculty and carry out research to tackle issues that are arising in nursing discipline. Another difference between the two is the amount of time taken to complete each. A DNP course takes around 5 semesters to finish after a master’s degree whereas a PhD takes around 4-5 years depending on the learning mode of the university. From my point of view I would prefer to take a doctorate of nursing practice (DNP) because of its broad spectrum of finding good jobs and also my passion of helping the patients recover fast (

HRM Case study (giving HR advice) Essay Example | Topics and Well Written Essays - 1000 words

HRM Case study (giving HR advice) - Essay Example Elements of organizational structure Specialization Managers need to decide how much work is to be done by each employee. Less degree of specialization would mean one worker handling many tasks at a time. This works with small organizations. But with a large organization, tasks need to be divided into chunks and each chunk should be handled by the designated worker. This improves productivity which also gives total control on the task (O'Fallon & Rutherford, 2010). Departmentalization Forming departments as per different functions is a logical way to do things in a large organization. It is a practical solution in which two different functions cannot hinder each other as they have been separated by their respective departments (O'Fallon & Rutherford, 2010). Authority An important issue arising is of who is going to take how much authority in his hands. None of the organizations are completely centralized or decentralized. Managers must consider the experience and personality of the s ubordinates when deciding for the management style and strategy of the organization (O'Fallon & Rutherford, 2010). Span of control First and foremost, organizational structure of an organization should be determined. This will determine the nature of responsibilities and authority on each member of the organization. ... A narrow span of control would have fewer people to report directly to the manager. This would add more layers to management and hence communication would be slow between lower employees and top managers. A wide span of control would have more subordinates to report directly to the manager. There is a good flow of communication between its lower level employees and top managers. Few layers are involved in the structure (Thomas, 2011). It has been researched that a small span of management with a taller organization structure would be more expensive to run because of greater number of managers. It would also show communication problems. A wider span of control would is more recommended and proves to be useful in most environments. The reason is more employees report to managers directly which would increase employees’ motivation, morale and productivity (O'Fallon & Rutherford, 2010). Coordination of activities Even if there is departmentalization and specialization, there shoul d be coordination between its activities. Problems arise when there is lack of coordination of activities. There should be a link between the functions of two departments (O'Fallon & Rutherford, 2010). A Functional Organization Mr. John Brown needs to make his hotel a functional organization. A functional organization organizes itself along functional lines, with departments being grouped according to their specific functions. Each department is further sub-divided into further small departments. For instance, if there is Rooms Department in a hotel, it is further subdivided into other smaller departments such as laundry department. This way, specific tasks are performed by employees in a specific pattern and there are fewer chances of errors. A functional organization

Generation Gap Essay Example for Free

Generation Gap Essay Do you know what a generation gap is? Even if you dont know the particular definition, you are aware of this problem, basing on your own experience. Generation gap is a popular term used to describe serious differences between people of two generations. To realize how to deal with it, you should keep in mind that generation gap includes several aspects: children must know as much as possible about their parents and parents — about the world outlook of their children, about relations between brothers and sisters, and also about the attitude to them of close relatives on both sides — fathers and mothers. Children demand a great deal of attention, time and patience, so, if you are not ready to devote all that to your baby, it is better not to hurry There are many families where both parents keep working after giving birth to their baby It is similar to the situation with a single-parent family, when a father or a mother hardly have enough time and neglect their childrens upbringing. In such cases most of the time the child has to spend on his own or with his friends. Due to the fact that he has not got any guidance from his parents he may be involved in some bad companies which commit violence or even crime and become alcohol or drug addicted. When the parents discover that, its usually too late to change anything. On the other hand, there is a different situation when the parents treat their children too strict and dont give them any freedom at all. In this case the children may become pariahs among their peers. Constant bans may increase the risk that the child will grow up insolent and defiant. This causes another big problem — lying. The child is forced to lie to the parents because of the fear to be punished. It can be anything from putting on make-up in the girls room at school to stealing. Some children rebel against discipline and family values. They listen to a loud music, wear inappropriate, to their parents mind, clothes, dye their hair in inconceivable colours, have all their bodies pierced and tattooed trying to show their ind ependence and establish their identity. They want to be treated as adults, but they are not ready to take all the necessary responsibilities. It doesnt mean that your child is bad and he will become a criminal. Of course, not! It only means that your child is in his transitional age and he is in need of your understanding and support. But how to handle such behaviour? Parents should become his close friends. First of all they should learn to respect his interests. Try to speak with him as often as possible, offer some parent-child activities like shopping or going in for sports. It is worth involving the child in discussing some family questions, just to show that he is a full member of the family. Moreover, children in their teens are very vulnerable when they are criticized in public, so try to avoid it. Parents should always be honest and sincere with their child; otherwise it would be unfair to require the same from him. Too authoritarian parents cant do any good to their children as well as parents who overindulge all the childs caprices. Overindulgence may lead to the same results as negligence. There are parents who are afraid of hurting the child by banning something when it is necessary. Such parents risk becoming powerless in the family and losing control over their children who may become spoiled and capricious. It demands to make a great effort from both parents and children to reach mutual understanding. There are many different opinions on the question of treating children if they disobey their parents, but every parent should decide for himself what will be best for his child and set him on the right path.

Why is Ethical Considerations Important in a Social Research? Illustrate your answer with examples from real research.

Why is Ethical Considerations Important in a Social Research? Illustrate your answer with examples from real research. In this assignment I will attempt to define ethics and explore its significance when conducting social research. Firstly I will present many different views of ethics in social research by analyzing some common considerations that a researcher must take into account if he/she is to conduct a piece of research properly without breaching ethical principles.   Examples from real research will also be utilized to demonstrate some consequences of unethical procedures in social research. This assignment will then culminate with a critical analysis of why ethical considerations are important when conducting social research. Ethics is defined as the values and morals upheld during interaction with others during the collection of data and the dissemination of findings (Merriam, 1988).   Some ethical considerations include an over-involvement of the researcher, confidentiality of data, the need to preserve the anonymity of participants and problems emerging from a misinterpretation of findings.   As in any research, the researcher should take responsibility for ensuring that guidelines and regulations are followed.   Where there is an extensive analysis of participants behavior and interaction over a period of time, the well-being, confidentiality, privacy and safety of individual participants must take precedence at all times. In addition to this, the British Sociological Association code of ethics states: à ¢Ã¢â€š ¬Ã‹Å"Guarantees of confidentiality and anonymity given to research participants must be honored, unless there are clear and overriding reasons to do otherwise (British Sociological Association, 1996). Homan (1991) contends that during the process of designing and implementing a piece of research one needs to consider the ethical implications on undertaking the research. Homan also note that ethics is the science of morality: those who engage in it determine values for the regulation of human behavior, collecting information about people, raise ethical issues in the focus of attention, chosen methods adopted and in the form and use of the findings. In such a contextualized situation, the researcher must seek to cultivate a high degree of trust without influencing the behaviors of participants.   The researcher therefore must ensure that the true identity of the participants is not revealed and that any documents used are kept confidential at all times. Douglas (1979) notes that the development of ethics in social research provides something of a safeguard against the researcher encroaching on freedom of speech and the outcome of the research. Douglas also believes that ethical guidelines serve to remind the social researcher about their obligation in the conduct of their work. According to Bell (2006) research ethics is about the nature of the agreement that the researcher has entered with the research participants or contacts. Bell further added that ethical research involves getting the informed consent of those you are going to interview observe or take materials from. It also involves the agreements reached about the use of this data and how the analysis will be reported and disseminated. Then adding to all of this is an obligation of the researcher to adhere to the agreements when they have been reached. When carrying out social research, the researcher should take into account ethical considerations, policies and guidelines. Alcock et al (2008) stated that ethical considerations underpin all social policy research. For example, it is unacceptable to conduct research that would harm the participants or place the researchers themselves into danger. Data must be collected and stored in a place where it is secure and which will protect the anonymity of participants. Participants should give their informed consent to taking part in the research rather than being coerced, bribed or misled. There are ethical codes and protocols for conducting research in social policy, other research frameworks and it is very important that these are adhered to in all enquires. It would be seen as an indicator of the quality of social research study where there is evidence that ethical procedures have been followed.   Brown (1997) in Gross (2001, 2005) made the point that, although à ¢Ã¢â€š ¬Ã‹Å"protection of participants is one of the specific principles in the Ethical Principles, theyre all designed to prevent any harm coming to the participant, or the avoidance of overt à ¢Ã¢â€š ¬Ã‹Å"sins. This view is reinforced by Cohen et al (2007) who stated that whatever the specific nature of their work, social researchers must take into account the effects of the research on participants and in such a way to protect their dignity as human beings. There are several instances where ethical principles are lacking in some social research and result in unethical practices. An example of this is in an extreme case of deception: In an experiment designed to study the establishment of a conditioned response in a situation that is traumatic but not painful, Campbell et al (1964) in Cohen (2007) induced through the use of drugs a temporary interruption of respiration in their subjects. The subjects reports confirmed that the experiment was a à ¢Ã¢â€š ¬Ã‹Å"horrific experience for them. All the subjects thought they were dying. The subjects, male alcoholic patients who volunteered for the experiment when they were told that it was connected with a possible therapy for alcoholism, were not warned in advance about the effect of the drugs, since this information would have reduced the traumatic impact of the experience. In relation to the case presented in the above paragraph it could be argued that the researcher could have given more thought to the ethical consideration of informed consent. Frankfort and Nachmaias Nachmaias (1992) suggest that informed consent is particularly important if participants are going to be exposed to any stress, pain, invasion or if they are going to lose control over what happens. An important example is in drug research; such informed consent requires full information about the possible consequences and dangers. Cohen et al (2007) argue that the principle of informed consent arise from the subjects right to freedom and self determination. Being free is a condition of living in a democracy and when restrictions and limitations are placed on that freedom they must be justified and consented to, as in research. Also, as part of the right to self determination, the subject has a right to refuse to take part or to withdraw once the research has begun. Thus informed consent also implies informed refusal. There are several other reasons why ethical considerations are important when conducting social research. Although the use of deception has already being explored in the previous paragraph it appears to be a very common way of breaching ethical principles in social research. The use of deception resulting in particularly harmful consequences would be another occasion where ethical considerations would need to be given priority.   An example here would be the study by Festinger et al (1956) in Bryman (2008) of a religious cult; it is quite likely that the fact that the researchers joined the group at a crucial close to the projected end of the world fuelled the delusions of group members. Frankfort and Nachmaias Nachmaias (1992) explains that conducting research that may violate the rights and welfare of the research participants should neither be the intent or of major interest of the social scientist. They further argue that the underlying objective of research is to contribute to the development of systematic, verifiable knowledge. These ethical considerations help to guarantee that the researcher can be held accountable to the public.   Cohen (2007) agrees that the researcher has responsibilities to the research community, for example, not to jeopardize the reputation of the research community (e.g. the university) or spoil the opportunities for further research. Thus, a novice researcher working for a higher degree may approach a school directly, using a clumsy approach, with inadequate data collection instruments and a poor research design and then proceeds to publicize the results as though they are valid and reliable. Cohen (2007) also believes that such a r esearcher , at the very least, should have sought and gained advice from the supervisor, modified the research as necessary, gained approval for the research, made suitably sensitive overtures to the school, and agree rights of disclosure. The quality and integrity of research is very important to the public and when ethical considerations are applied public support is more than likely to be achieved. Bryman (2008) argues that possibly one of the most interesting developments in connection with ethical issues is that the criterion of the ethical integrity of an investigation is its quality. To add to this is the government involvement with the conduct of research. Bower (1979) indicated that the government plays an instrumental role in taking responsibility for subjects involved in research it sponsors but also its accountability in light of the vast amount of public monies on social research. Finally, lapses in ethical considerations in research can significantly harm human, researcher and the public in general. Some examples here could be a researcher who fabricates data in a potentially harmful experiment and may harm or kill participants similarly a researcher who fails to adhere to strict regulations and guidelines relating to safety may jeopardize his health and safety and the health and safety of all those who are involved in the research.   An example of where this actually happened is where the participants in the Milgram (1963) experiment on obedience to authority, experienced high levels of stress and anxiety as a consequence of being incited to administer electric shocks. It is against things like these happening why ethical considerations are so important. Punch (2005) explained that a thorough research proposal will have anticipated the ethical issues involved, and will show how they will be dealt with.

The Autoimmune Hemolytic Anemia Biology Essay

The Autoimmune Hemolytic Anemia Biology Essay Autoimmunity is a disorder in which an organism loses its ability to recognize the self and non-self antigen, which would further lead to immune response against its own cells and tissues. Diseases that results from such abnormal immune responses are termed as autoimmune diseases. Autoimmune hemolytic anemia (AIHA) is an autoimmune disorder in which endogenous antibodies are directed against the red blood cells and upregulated leading to erythrocyte death. This review article focuses on the types of AIHA based on the classification of the antibodies and the temperature at which they are active i.e warm AIHA, cold AIHA and mixed AIHA , based on the age of its occurance i.e adult or pediatric AIHA, causes, diagnostic techniques, diseases which may cause AIHA as a secondary disorder, treatment and its aftereffects, current and future prospectives of its studies. Abbreviations: AIHA Autoimmune hemolytic anemia, WAIHA Warm autoimmune hemolytic anemia, CAIHA Cold autoimmune hemolytic anemia, RBCs Red blood cells, DAT Direct antiglobin test. INTRODUCTION: Autoimmune hemolytic anemia (AIHA) is a disorder in which the auto-antibodies are directed against the persons own red blood cells (1). It is a relatively uncommon but not a rare disorder. It has an estimated incidence of 1 to 3 cases per 100,000 population per year (1). There are three types of AIHA based on the temperature of activity of the autoantibodies i.e warm AIHA, cold AIHA and mixed type AIHA of which warm AIHA has the most common occurance (more than 70%) followed by cold AIHA (about 20%) and mixed type has least occurance (2). Further AIHA is classified on the basis of age of the patient suffering from the disorder i.e pediatric AIHA and adult AIHA. Pediatric AIHA is from the age group of 1 to 16 (or 18) years and mostly has no underlying causes (2). Adult AIHA is from 18 years and above and is mostly associated with some underlying primary diseases. Sometimes AIHA is caused due to administration of some drugs and is called drug induced AIHA. AIHA may also be of secondary or idiopathic type. The further description of the different types of AIHA is explained below. TYPES OF AIHA: Based on the temperature at which the auto-antibodies are active: Warm autoimmune hemolytic anemia (WAIHA) It the most common type of AIHA. Warm auto-antibodies are usually IgG. It is called warm autoimmune hemolytic anemia because the antibodies have their peak activity at 370C. IgG effectively binds to the FC receptor of phagocytic cells. Hence the destruction of RBCs takes place mostly by phagocytosis. IgG may or may not fix complement. Hemolysis of RBCs also takes place in spleen. WAIHA may be idiopathic i.e when there is no primary infection causing the disorder or secondary to lymphoproliferative diseases, autoimmune diseases, viral infections, immune deficiency etc (1)(2)(3)(6). Cold autoimmune hemolytic anemia (CAIHA) Cold auto-antibodies are usually IgM antibodies. Rarely IgG or IgA antibodies can act as cold auto-antibodies. It is so called because the antibodies have their peak activity at temperature ranging from 0-40 C (1)(2)(3)(6). IgM antibodies are potent classical complement pathway activators. Hence causes complement mediated lysis of RBCs. Paraxysmal cold hemoglobinurea a form of CAIHA, is caused by cold active IgG hemolysin. It was usually associated with some underlying diseases like syphilis, measles, mumps or other viral diseases (1)(2)(6). Mixed autoimmune hemolytic anemia Both warm auto-antibodies and cold auto-antibodies are present the blood. It is more fatal than the WAIHA and CAIHA. Detection and diagnosis is also more difficult than the earlier types (1)(2)(3)(4)(6). Based on the age of the patient suffering from the disorder AIHA is classified as: Pediatric AIHA Affects the age group of 1-16 years, with a higher incidence of occurance in the first four years of life (1). It may spontaneously resolve on its own. It shows a good response to the steroid treatment. It has a severe onset and less morbity rate. Males are more prone to pediatric AIHA (2). Adult AIHA Affects the age group of 18 years and above. It is more often associated with the underlying lymphoproliferative, autoimmune and infectious diseases. Treatment is steroid therapy or spleenectomy. Has higher morbity rate compared to adult AIHA because of the difficulty or inability in treating the underlying disease (2). Based on the cause of its occurance, following are the types of AIHA: Secondary AIHA It is mainly caused due to some underlying diseases like bacterial, fungal or viral infections. The primary underlying diseases that may cause secondary AIHA are Sjogrens syndrome (10), lymphoproliferative and autoimmune diseases (2).Treatment of the secondary AIHA would also include the treatment of the underlying primary disease, for its complete remission (1). Idiopathic AIHA Has no particular underlying causes like infections or primary diseases for its occurance. Mortality rate is comparatively less than that of secondary AIHA (1). Drug induced AIHA Cause of occurance are drug molecules that binds to the surface of the RBC membrane, acts as non-self antigens, thus inducing the autoantibodies against the RBCs and further leads to hemolysis (2). Examples of the drugs that cause drug induced hemolytic anemia are Ibuprofen, Diclofenac, L-dopa, Procainamide (6). CAUSES In majority of the cases AIHA is caused due to some primary underlying diseases like lymphoproliferative, autoimmune and infectious diseases (2). For example, after the M.suis infection in pigs, warm IgG autoantibodies are directed against the RBCs and destroys it. In this case actin was the active component that played a vital role in inducing an autoimmune response. Actin acted as a target protein for the autoreactive antibody during the acute phase of the M.suis infection. The autoreactive antibody production is induced by a misguided upregulation of the naturally occurring B cells specific for self antigens, appearance of previously cryptic antigens, occurance of altered self antigens, tolerance to self antigens due to molecular mimicry. The autoimmune epitopes (in this case actin) on the RBCs may be due to contact with the proteolytic enzymes. Cytoskeleton of the RBCs gets modified by the attachment and invasion of the infectious agent. Also the infectious agent causes damage to the RBCs making the hidden cytoskeletal proteins of the RBCs accessible for the circulating antibodies. Due to all the above mentioned reasons the antibodies recognizes them as non-self and elicit an immune response (3). There are several other causes which may lead to AIHA other than due to a primary infections. For example higher incidence of occurance of AIHA after allogenic hematopoetic stem cell transplantation in adult patients. Further studies proved that the chances of development of AIHA is more in patients with HSCT from unrelated donors and also that they develop chronic extensive graft versus host disease (GVDH). In such cases it was observed that AIHA was never the primary cause of death, rather it was due to infection of GVDH (5). In some rare cases, liver transplantation or solid organ transplantation leads to the development of AIHA (11)(14)(15). DIAGNOSIS: The destruction or removal of red blood cells from the circulation before their normal life span of 120 days is called Hemolysis. Hemolysis manifests itself as acute or chronic anemia, reticulocytosis or jaundice. Intravascular hemolysis refers to the destruction of red blood cells in the blood with the release of contents into plasma. This is then followed by direct membrane degradation and cell destruction caused by mechanical trauma from a damaged endothelium, complement fixation and activation on the cell surface. On the other hand, extravascular hemolysis refers to the removal and destruction of red blood cells with membrane alterations by the macrophages of the spleen and liver. The hemolysis can be categorized broadly into the following types: HEMOLYTIC ANEMIA HEREDITARY (6) ACQUIRED (6) ( Due to infections (6) Microangiopathic (6) Autoimmune (6) Autoimmune (6) Alloimmune (6) Drug induced (2) (6) Paroxysmal (1)(2)(6) Mixed (1)(2)(3) (4)(6) Cold (1)(2) (3)(6) Warm (1)(2) (3)(6) Immune complex or Auto-antibody (6) Drug absorption (hapten induced) (6) Delayed transfusion reaction (6) Acute transfusion reaction (6) Flow chart 2: Broad classification of autoimmune hemolytic anemia. Since all the above said categories of hemolytic anemias have many similar symptoms and expressions, efficient diagnostic techniques should be developed to detect the correct category of hemolytic anemia for its appropriate treatment. DIAGNOSTIC TESTING Basic diagnosis for hemolysis on the basis of laboratory and peripheral smear findings: Hematologic tests Reticulocytosis which is the normal response of the bone marrow to the peripheral loss of blood cells is an important characteristic laboratory feature of hemolysis. Checking for the presence of reticulocytosis can be used for diagnosis of hemolysis. Review of the peripheral blood smear with an assessment for pathognomic red blood cell morphologies (spherocytes or schistocytes) along with examination of WBCs and platelets is very important for the evaluation of any anemia (6). Chemistry tests Increased unconjugated bilirubin, increased lactate dehydrogenase, and decreased haptoglobin levels are characteristic feature of the distruction of RBCs and thus can be used for diagnosis of hemolysis (6). c) In addition to the above tests, urinary tests are also be performed (6) After diagnosis of the basic hemolysis, its etiology is determined by performing further diagnostic tests. This review article focuses on the diagnostic techniques specific for AIHA. Microspherocyte on a peripheral smear and positive direct antiglobin test (DAT) is a characteristic feature of AIHA (1). The direct antiglobin test ,is also known as direct Coombs test (8). It demonstrates the presence of antibodies or complement on the surface of red blood cells which is the hallmark of autoimmune hemolysis (8). In this technique, the patients red blood cells are mixed with rabbit or mouse antibodies against human IgG or C3. The test would give a positive result if an agglutination reaction between the patients antibody or complement coated red blood cells by anti-IgG or C3 is observed. RBC agglutination with anti-IgG serum indicates warm AIHA and RBC agglutination with anti-C3 indicates the cold AIHA. However further efficient and very specific diagnostic techniques should be developed to distinguish mixed AIHA and paraxysomal cold hemoglobinuria from the other types. Also the present diagnostic techniques many a times failed to give an errorless distinction between these two types of AIHA (4). The three types of drug induced anemia based on their mechanism of their mechanism of action can be detected by a positive DAT and its type can be identified by the intravascular or extra-vascular hemolysis that it produces (6). TREATMENT: Treatment mainly depends upon the type of AIHA i.e warm antibody type, cold antibody type, mixed antibody type or paraxysomal cold hemoglobinuria and also on the secondary or the idiopathic forms. The following are the treatment options for AIHA. However each treatment stratergies has its own advantages and disadvavtages. Warm antibody autoimmune hemolytic anemia i) CORTICOSTEROIDS The initial therapeutic agent used for treatment of WAIHA patients are the corticosteroids. There is a rapid onset of response. This therapy is usually maintained for 1-3 weeks, however sudden ceasation of therapy may result in prompt relapse of hemolysis. The adverse effects of long term use of corticosteroids as a therapeutic agent would include pulmonary aspergellosis, central nervous system hemorrhage (2), osteoporosis, avascular necrosis, susceptibility to infection, abnormalities in glucose and lipid metabolism and growth suppression in children (7).The gluocorticoids may inhibit antimicrobial activity of macrophages thus showing side effects when treated with it (2). In cases of pediatric anemia, prednisolone along with folic acid supplementation was used for therapy which showed a positive response in 81% of the patients (8). ii) SPLENECTOMY Splenectomy is mainly considered in patients who donot respond to the corticosteroid therapy. The main advantage of splenectomy is that it has a potential for a complete and long term remission. The adverse effect of spelectomy would include overwhelming postspelectomy infection (OPSI) which may result in serious morbity or mortality in a small percentage of patients after spelectomy (2)(7)(8). iii) IMMUNOSUPPRESSIVE DRUGS This is the third therapeutic option after both corticosteroid therapy and spelectomy. Examples of the immuno-suppressive drugs would include azathioprine, cyclosporine (8), rituximab (9)(11) etc. iv) DANAZOLE It is an attenuated androgen with good responses and comparatively lesser side effects (2)(7). v) INTRAVENOUS IMMUNOGLOBIN In patients who doesnot respond to the corticosteroids, it is used as a second line therapy. However, intravenous immunotherapy is expensive (2)(7). vi) PLASMA EXCHANGE Used for acute reversal of severe hemolysis along with other therapeutic agents. Cold antibody autoimmune hemolytic anemia The simplest and the possible way for reducing the severity of CAIHA is avoidance of cold. Plasma exchange showed a temporary benefit in a small percentage of patients. Any other therapeutic options involved more potential risks than probable benefits. Paroxysmal cold hemoglobinuria In most of the cases hemolysis terminates spontaneously and hence only supportive care is required. Sometimes transfusion of RBCs and corticosteroid therapy may have a positive impact on the treatment. Atmost care should be taken in case of secondary autoimmune hemolytic anemia i.e the underlying diseases like chronic lymphocytic leukemia, systemic lupus erytromatous, lymphomas etc should be treated for complete remission from AIHA (7).Combinational therapy was used in some cases of AIHA as secondary infection. Example, a case in which AIHA was found in association with Plasmodium vivax infection was treated with chloroquine and primaquine (for P.vivax infection), prednisolone and transfusion of least incompatible RBCs (for AIHA) (12). CONLUSION This review article gives a very short explanation about autoimmunity as a disorder. It mainly focused on auto-immune hemolytic anemia which is a subset of autoimmunity. The types of AIHA, causes, diagnosis and possible treatment stratergies were discussed. The future area of research under this topic is in finding out more efficient and specific diagnostic techniques to detect mixed and paroxysmal cold hemoglobinuria and treatment options with maximum results and minimum side-effects. Drugs like Bortizomib (13), Alemtuzumab (humanized monoclonal antibody targeting CD52 antigen) etc are still under research for the treatment of hemolytic anemia (16).

America Underclass Essay -- essays research papers fc

It is believed that there is a tension between social classes in America. Typically, people of lower classes choose to imitate those of higher social status. As a result, advertisers have a tendency to take advantage of this tension in order to profit from people of the lower and middle classes. In â€Å"The American Upper Class,† G. William Domhoff says that â€Å"exhibiting high social status†¦ is a way of exercising power† (Domhoff p.34),† which is something important to all social classes. According to Judi Puritz Cook, author of â€Å"Consumer Culture†¦Sales Discourse,† advertisements in print as well as in visual media seem to create â€Å"the promise of status mobility through consumption (Cook p.373).† In the article, Puritz explains how television programs on channels such as the Home Shopping Network are examples of how the media exploits the anxiety caused by social standing. It is believed that American people in the lower and middle classes have needs for status mobility. For example, when browsing through a fashion magazine, one can find numerous sections that are dedicated to creating ways to look like the featured model or actress for half the price. The intention of the article, in most cases, is to give others the impression that you are of high social status. In addition, advertisers often use people in the entertainment business to model their products so that the viewer may purchase the product. For example, when mimicking the purchases of hotel heiress, Paris Hilton one may believe, â€Å"If I buy this, I’ll look cool just like Paris Hilton!† The fact that this method is usually successful is a product of the anxiety felt by lower and middle class families. For those reasons, it is likely that Domhoff’s statement that the upper class â€Å"creates respect, envy, and deference in others,† is true. It seems that many o f America’s lower and middle class families would like to create those same feelings of respect and envy in others. When flipping through Vogue, a well-known high fashion magazine, one can see that almost all the advertisement scream wealth and status. The magazine’s beautiful models as well as its expensive brands are major characteristics of the famous magazine. Members of the middle class skim through the magazine thinking, â€Å"Wow, if only I could look like this!† In Gregory Mantsios’ article â€Å"Class in America,† he says, â€Å"We are, on occasion, presented... ...consciously imitate† (Domhoff p.166). Various advertisers use the desperate need of people of the lower and middle classes to appear â€Å"rich† as a weapon. Domhoff’s statement is an explanation of why many people choose to emulate people of high social status. According to Domhoff, showing signs of high social status is one of the many reasons that the upper class generates feelings of envy and deference in those of lower social status. This seems to be the reason for the craze involving the imitation of celebrities as well as the wealthy. It is also believed that the lower classes attempt to look as much like the people in higher classes because of the feeling of significance that comes with the expensive clothes etc. As a result, advertisers use the tension between social classes to sell the idea of luxurious style. Works Cited Cook, Judi Puritz. â€Å"Consumer Culture †¦Ã¢â‚¬  Mass Communication and Society 3.4 (2000): 373-392. Domhoff, G. William. â€Å"The American Upper Class.† Great Divides: readings in social   Ã‚  Ã‚  Ã‚  Ã‚  inequality in the United States 2nd edition (2001): 159-167. Mantsios, Gregory. â€Å"Class in America: myths and realities.† Privilege (2003) 33-47.

Creating Tension and Presenting the Themes in A View from the Bridge Es

Creating Tension and Presenting the Themes in A View from the Bridge Miller uses the climax of act 1 to create tension for the audience through the acting and the situation the characters are in, and to present the key themes of the play to the audience. Firstly, he uses dramatic irony to give the audience an insight into how the story is going to end, which creates frustration and tension for them, as although they can see how the story is developing, the characters can’t, this ties in with the theme of a Greek tragedy where there is a predestined conclusion. He uses the fact that in the 1950’s and especially in dockside and urban households, masculinity and being the ‘man of the house’ was a huge part of family life. He combines this with Eddies desire to control and obsession with authority, to put the audience on a knife-edge, as to when one of the characters will lose control and lash out. Miller also expands on the situation of relationships in the play, both within the family, and outside. This ties in with Eddie’s apparently incestuous feelings for Catherine, and this creates suspense and tension throughout the audience, as they don’t know what is going to happen about it. Stage Directions, play a large part of ‘A View From The Bridge’, as they give it the final touches which create tension for both the characters and the audience, they help show what a character is feeling, which allows the audience to empathize with the character, making it all the more believable and therefore creating more tension as they want to know what will happen. Alfieri’s monologue is also a main contributing factor to the tension, which slowly builds throughout the entire scene. The audience share Alfieri’s perspectiv... ...the play, just over there to send money home, but now it seems like he is taking an active part, and defending Rodolfo against Eddies slanderous onslaught. In conclusion, I feel that Arthur Miller creates tension in the climax to Act 1 in â€Å"A View From The Bridge,† in many different ways. These include the exploration and presentation of many of the key themes that Miller has sewn throughout the play, comprising mainly of: masculinity, incest, Greek tragedy, jealousy, pride and obsession. He uses surprise, and a ‘factor of the unknown’ to keep the audience in suspense as to when Eddie will lose control, but never in doubt to the fact that he will. All in all Miller uses a variety of techniques and themes to create tension for the audience and keep them in suspense for the whole play, and successfully draws on this to build huge climaxes at many points.