Insulin-Dependent Diabetes Mellitus Essay Example for Free

Insulin-Dependent Diabetes Mellitus Essay Etiology of Diabetes Mellitus â€Å"Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels.† (Association, National Center for Biotechnology Information , 2009, p. 1) â€Å"The cause of type 1 and type 2 diabetes remains a mystery. Although genetic factors may play a role†. (Association, Diagnosis and Classification of Diabetes Mellitus, 2010, pp. 562-569) Diabetes mellitus generally results from an insulin deficiency or resistance. Insulin transports sugar into cells for use as energy and storage as glycogen which is a carbohydrate. Insulin also stimulates protein synthesis and free fatty acid storage. Insulin deficiency or resistance compromises the bodies access to essential nutrients for fuel and storage. Several processes called pathogens(capable of causing disease) are involved in the development of diabetes. The reasons of the abnormalities in carbohydrates, fats, and protein metabolism in diabetes is deficient action of insulin on certain tissues in the body. The term Deficient insulin action, results from not enough insulin secretion and/or diminished tissue response to insulin at one or more points in the complex pathways of hormone action (a chemical messenger that transports a signal from one cell to another). If insulin secretion is blocked or impaired, then defects in the insulin action occur in the same patient, and it is often unclear which abnormality, the cause of the hyperglycemia. (Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 1997, pp. 107-109) Type 1 Diabetes Mellitus is defined as an autoimmune disorder or simply put an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body actually attacks its own cells (What-is-Autoimmune-Disease). This form of diabetes is brought on by a viral infection in which certain cells are destroyed which leads to absolute (complete) insulin deficiency and is usually diagnosed in childh ood. Many pediatric patients that have diabetes normally have Type 1 diabetes and therefore a lifetime dependency on insulin. â€Å"Diabetes mellitus (DM) is a chronic metabolic disorder caused by an absolute or relative deficiency of insulin, an anabolic hormone.† (Diabetes-MellitusDefinition-Causes-Symptoms-and-Treatment) In contrast Type 2 Diabetes Mellitus is a more progressive disorder in which the glandular organ in the digestive system and endocrine system known as the pancreas makes less insulin over time. Because the body’s cells have a reduced response to insulin, symptoms arise that include poor control of liver glucose (sugar) output, a decrease in cell function, and eventually cell failure. The true cause of Type 2 diabetes is unknown; however, it usually occurs in adulthood, from heredity, excessive obesity and sedentary lifestyle. These lifestyle choices may play a major role in its development. For both types of diabetes the main feature is chronic high blood glucose (sugar) levels (Ignatavicius, 2006). Risk factors for Diabetes Mellitus include obesity, physiologic or emotional stress, which can lead to an elevation of stress hormone levels. In women sometimes pregnancy, which causes weight gain and increases levels of estrogen and placental hormones, may aggravate insulin output. There is also something called the metabolic syndrome which is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. There are also some medications that can provoke the effects of insulin, including thiazide diuretics, adrenal corticosteroids, and hormonal contraceptives (Mackay, 2004). Classification of Diabetes Mellitus There are several different types of diabetes mellitus; they may differ in cause, clinical course, and treatment. The major classifications of diabetes are: * Type 1 diabetes (insulin dependent diabetes mellitus) is caused by B-cell destruction, usually leading to absolute insulin deficiency a) Immune mediated b) Idiopathic * Type 2 diabetes (previously referred to as non-insulin dependent diabetes mellitus) ranges from those with predominant insulin resistance associated with relative insulin deficiency, to those with a predominantly insulin secretory defect with insulin resistance (Alberti, 2007). Insulin is secreted by beta cells, which are one of four types of cells in the islets of Langerhans (dendritic cells = antigen-presenting immune cells) in the pancreas. Insulin is an anabolic, or storage hormone. When a person eats a meal, insulin secretion increases and moves sugar from the blood into muscle, liver, and fat cells. In those cells, insulin transports and metabolizes glucose for energy. Later it stimulates storage of sugar in the liver and muscle (in the form of glycogen). Following this it signals the liver to stop the release of glucose, then enhances storage of dietary fat in adipose which is a storage tissue. Finally it accelerates the transport of amino acids (derived from dietary protein) into the body’s cells. â€Å"Insulin also inhibits the breakdown of stored glucose, protein, and fat. During fasting periods (between meals and overnight), the pancreas continuously releases a small amount of insulin (basal insulin); another pancreatic hormone called glucagon (secreted by the alpha cells of the islets of Langerhans) is released when blood glucose levels decrease and stimulate the liver to release stored glucose. The insulin and the glucagon together maintain a constant level of glucose in the blood by stimulating the release of glucose from the liver. Initially, the liver produces glucose through the breakdown of glycogen (glycogenolysis). Glycogen is the storage form for glucose in the liver and muscles. Glycogenolysis is the conversion of glycogen into glucose in the liver. After 8 to 12 hours without food, the liver forms glucose from the breakdown of non-carbohydrate substances, including amino acids (gluconeogenesis)† (Hamouda, 2012). Type 1 Diabetes Treatment and Study This form of diabetes is immune-mediated in over 90% of cases and idiopathic in less than 10%. The rate of pancreatic B cell destruction is quite variable, being rapid in some individuals and slow in others. Type 1 diabetes is usually associated with ketosis in its untreated state. It occurs at any age but most commonly arises in children and young adults with a peak incidence before school age and again at around puberty. It is a catabolic disorder in which circulating insulin is virtually absent, plasma glucagon is elevated, and the pancreatic B cells fail to respond to all insulinogenic stimuli. Exogenous insulin is therefore required to reverse the catabolic state, prevent ketosis, reduce the hyperglucagonemia, and reduce blood glucose. Clinical manifestations of all types of diabetes include the â€Å"three Ps†: polyuria, polydipsia, and polyphagia. Polyuria (increased urination) and polydipsia (increased thirst) occur as a result of the excess loss of fluid associated with osmotic diuresis. The patient also experiences polyphagia (increased appetite) resulting from the catabolic state induced by insulin deficiency and the breakdown of proteins and fats. Other symptoms include fatigue and weakness, sudden vision changes, tingling or numbness in hands or feet, dry skin, skin lesions or wounds that are slow to heal, and recurrent infections (Hamouda, 2012, p. para. 8). The onset of type 1 Diabetes may also be associated with sudden weight loss or nausea, vomiting, or abdominal pains. (Association, Diagnosis and Classification of Diabetes Mellitus, 2010) In recent years, there has been increasing interest in the impact of diabetes mellitus on the central nervous system (Lukovits TG, 1999).Clinically and epidemiologically, it has been shown that diabetes mellitus is an important risk factor for cerebrovascular accidents (Kannel WB, 1979), and may underlie many of the neuropsychological and cognitive deficits observed in diabetic patients (CM, 1988). Few studies have sought to establish the pathophysiological mechanisms that occur before these deficits appear, with a view to detecting early subclinical abnormalities that could serve as markers of the risk for stroke in patients who might benefit from preventive treatment. The study I read was performed in 15 insulin-dependent diabetics (eight men and seven women) with no history of central neurological symptoms. Their ages ranged from 27 to 59 years (mean 46 ±8 years) and the mean time since diagnosis of diabetes mellitus was 19 ±6 years. The characteristics of the patients are given in the Table below. The study was been reviewed by the hospitals ethics clinical committee, and before being enrolled each patient gave written informed consent. Characteristics of study subjects No. 15 Gender (M/F) 8/7 Age (years) 46 ±8 Arterial hypertension (yes/no) 5/12 Total cholesterol (mg/dl) 214 ±49 Time from diagnosis of IDDM (years) 19 ±6 Hemoglobin A1C (%) 8.19 ±0.8 Diabetic nephropathy (no/micro/macro albuminuria) 10/1/4 Diabetic retinopathy (yes/no) 7/8 Diabetic neuropathy (yes/no) 7/8 IDDM, Insulin-dependent diabetes mellitus The study dealt with the Cerebrovascular reserve (CVR) which is the capacity of cerebral arteries and arterioles to dilate, thus increasing blood flow in areas of decreased perfusion pressure (WJ, 1991). It is one of the first mechanisms of the brain to be activated in cases of hemodynamic compromise and is an early indicator of its existence (Baron JC, 1981). The chemical Acetazolamide, a carbonic anhydrase inhibitor, induces dilatation of the cerebral microvasculature and has been widely used in assessing CVR in large series of patients with different cerebrovascular disorders. (Julio F. Jimà ©nez-Bonilla, 2001). The study concluded that Insulin-dependent diabetic patients with no clinical history of neurological disorders present baseline abnormalities in cerebral perfusion and a decrease in CVR in extensive areas of the brain. The decrease in CVR and the behavior of baseline subclinical abnormalities after administration of acetazolamide suggested the existence of chronic cerebrovascular disease, the severity of which varied between patients and was better assessed with this technique than with baseline SPET (PET scan). In addition, the introduction of acetazolamide made it possible to classify baseline irregularities as being of probable metabolic origin or of probable ischemic origin. They concluded that the post-acetazolamide brain SPET is a valid tool which, in comparison with baseline SPET, provided additional information on cerebral perfusion in insulin-dependent diabetes. The technique should prove useful in evaluating future preventive strategies aimed at reducing the incidence of complications in diabetics. (Julio F. Jimà ©nez-Bonilla, 2001) The main goal of diabetes treatment is to normalize insulin activity and blood glucose levels to reduce the development of vascular and neuropathic complications. Insulin is indicated for type 1 diabetes as well as for type 2 diabetic patients with insulin openia whose hyperglycemia does not respond to diet therapy either alone or combined with other hypoglycemic drugs. The therapeutic goal for diabetes management is to achieve normal blood glucose levels (euglycemia) without hypoglycemia and without seriously disrupting the patient’s usual lifestyle and activity. There are five components of diabetes management †¢ Nutritional management – teaching the patient to eat properly and manage their diet accordingly. †¢ Exercise †¢ Monitoring – Use of a glucose meter and watching their numbers. †¢ Pharmacologic therapy – medicines that help level off sugars in their system. †¢ Education – finding out all the information they can about the disease so they will be informed as to the preventative measures taken to lead a more normal life. Bibliography Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. (1997). Diabetes Care, 20:1183-97. CITATIONS AND CLINICIANS NOTES: ETIOLOGY, PREDICTION, AND INCIDENCE OF DIABETES. (2005). Current Medical Literature: Diabetes, 22(2), 32-33. Alberti, K. M. (2007). International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabetic Medicine, 24(5), 451-463. doi:10.1111/j.1464-5491.2007.02157.x. Association, A. D. (2009, January). National Center for Biotechnology Information . Retrieved from PMC US National Library of Medicine : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613584/ Association, A. D. (2010, January). Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, pp. 562-569. Baron JC, B. M. (1981). Reversal of focal â€Å"misery-perfusion syndrome† by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. A case study. Stroke, 12: 454-459. CM, R. (1988). Neurobehavioral complications of type I diabetes. Examination of possible risk factors. Diabetes Care, 11: 499-505. Diabetes-MellitusDefinition-Causes-Symptoms-and-Treatment. (n.d.). Retrieved 12 15, 2012, from www.healthguidance.org: http://www.healthguidance.org/entry/7366/1/Diabetes-MellitusDefinition-Causes-Symptoms-and-Treatment.html Hamouda, M. (2012, May 24).

Singapore Education Essay Example for Free

Singapore Education Essay Singapore is one of Asia’s great success stories, transforming itself from a developing country to a modern industrial economy in one generation. During the last decade, Singapore’s education system has remained consistently at or near the top of most major world education ranking systems. This chapter examines how this â€Å"tiny red dot† on the map has achieved and sustained so much, so quickly. From Singapore’s beginning, education has been seen as central to building both the economy and the nation. The objective was to serve as the engine of human capital to drive economic growth. The ability of the government to successfully match supply with demand of education and skills is a major source of Singapore’s competitive advantage. Other elements in its success include a clear vision and belief in the centrality of education for students and the nation; persistent political leadership and alignment between policy and practice; a focus on building teacher and leadership capacity to deliver reforms at the school level; ambitious standards and assessments; and a culture of continuous improvement and future orientation that benchmarks educational practices against the best in the world. 7 SINGAPORE: RAPID IMPROVEMENT FOLLOWED BY STRONG PERFORMANCE 160  © OECD 2010 STRONG PERFORMERS AND SUCCESSFUL REFORMERS IN EDUCATION: LESSONS FROM PISA FOR THE UNITED STATES INTRODUCTION When Singapore became independent in 1965, it was a poor, small (about 700 km2), tropical island with few natural resources, little fresh water, rapid population growth, substandard housing and recurring con? ict among the ethnic and religious groups that made up its population. At that time there was no compulsory education and only a small number of high school and college graduates and skilled workers. Today, Singapore is a gleaming global hub of trade, ? nance and transportation. Its transformation â€Å"from third world to ? rst† in one generation is one of Asia’s great success stories (Yew, 2000). All children in Singapore receive a minimum of 10 years of education in one of the country’s 360 schools. Singapore’s students were among the top in the world in mathematics and science on the Trends in International Math and Science Study (TIMSS) in 1995, 1999, 2003 and 2007. They came fourth in literacy in the 2006 Progress in International Reading Literacy Study (PIRLS). Their excellence is further underlined by the fact that Singapore was one of the top-performing countries in the 2009 PISA survey (Table 7. 1 and Figure 7. 1), the ? rst PISA survey in which it participated. Singapore was rated as one of the best performing education systems in a 2007 McKinsey study of teachers (Barber and Mourshed, 2007), and was rated ? rst in the 2007 IMD World Competitiveness Yearbook (IMD, 2007) for having an education system that best meets the needs of a competitive economy. At the higher education level, the National University of Singapore was ranked 34th in the world and 4th in Asia in the Times  Higher Education Supplement Rankings of World Universities in 2010 (Times Higher Education Supplement, 2010). How has this little red dot on the map, as Singaporeans frequently refer to their country, a nation that is not even 50 years old, evolved from a backwater undeveloped economy into a world economic and educational leader in such a short period of time? What education policies and practices has Singapore employed? And are the lessons from Singapore’s experience relevant for other countries? This chapter attempts to provide some answers to these questions. First, however, we look at the broader context. Table 7. 1 Singapore’s mean scores on reading, mathematics and science scales in PISA PISA 2000 PISA 2003 PISA 2006 PISA 2009 Mean score Mean score Mean score Mean score Reading 526 Mathematics 562 Science 542 Source: OECD (2010), PISA 2009 Volume I, What Students Know and Can Do: Student Performance in Reading, Mathematics and Science, OECD Publishing. 1? 2? http://dx. doi. org/10. 1787/888932366731 Under British colonial rule, from 1819 onwards, Singapore developed as a major seaport at the mouth of the Malacca Straits, on the shipping lanes between Britain, India and China. During this period, it attracted large  numbers of immigrants, primarily from southern China, India and the Malay Archipelago. At independence from Britain in 1959 and then separation from Malaysia in 1965, Singapore had no assets other than its deepwater port. There was no real economy, no defence, and simmering tensions with neighbouring countries. Moreover, it had to import most of its food, water and energy. The Republic of Singapore seemed an unlikely candidate to become a world-class economic and educational powerhouse. The risks facing this nation at birth – the sense of political and economic vulnerability to larger countries and  global changes – created a sense of urgency which in? uences policy to this day. Lee Kuan Yew, Singapore’s ? rst Prime Minister, set out two overarching goals: to build a modern economy and to create a sense of Singaporean national identity. He recruited the best and brightest people into his early government and sought to promote economic growth and job creation. In the 1960s, the emphasis was on attracting labour-intensive foreign manufacturing to provide jobs for its low-skilled workforce. In the 1970s and 1980s, a shift to more skill-intensive manufacturing led to an emphasis on technical ?  elds. From the mid-1990s on, Singapore has sought to become a player in the global knowledge economy, encouraging more research- and innovation-intensive industry and seeking to attract scientists and scienti? c companies from around the globe. The results of the government’s economic policies have been stunning – rapid economic growth to reach developed country levels and a per capita income in 2009 estimated at current market prices to be about SGP 52 000 (USD 39 000). One of the so- called Asian Tigers, Singapore is a free market, business-friendly and globally-oriented economy, shaped by an  active and interventionist government. 7 SINGAPORE: RAPID IMPROVEMENT FOLLOWED BY STRONG PERFORMANCE STRONG PERFORMERS AND SUCCESSFUL REFORMERS IN EDUCATION: LESSONS FROM PISA FOR THE UNITED STATES  © OECD 2010 161 The government of Singapore is a highly ef? cient, honest and ? exible meritocracy with a strong focus on integrated strategic planning and detailed execution. â€Å"Dream, Design, Deliver† aptly characterises its approach to policy development and implementation. Singapore’s small size and political stability (the same People’s Action Party has  ruled Singapore since Independence) have kept the vision of making Singapore a great global city constant, but have also enabled it to be versatile in responding to rapidly changing environments. With a small limited domestic market, Singapore has had to become highly integrated in the global economy. To survive several global recessions and the ever-present uncertainties of the global economy, continuous innovation has been essential. With respect to Lee Kuan Yew’s second goal of nation-building, early race riots led to a profound commitment to creating a multi-racial and multi-ethnic society. At independence, Singapore had multiple religious groups (Buddhist, Muslim, Taoist, Hindu and Christian); multiple ethnic groups (Singapore’s population is about 74% Chinese, 13% Malay, 9% Indian and 3% other); and no common language. Nor did it have a common school system or a common curriculum. A series of measures were gradually put in place to realise the Singapore pledge: â€Å"One united people regardless of race, language or religion†. Singapore recognises and teaches four of? cial languages – Chinese, English, Malay and Tamil – although English is the language of government and, since 1978, the medium of instruction in  schools. 1 Two years of compulsory national service unite different ethnic groups, as does the policy of mixing each group within the government-built housing where most Singaporeans live. This has helped avoid the racial and ethnic segregation that af? icts many countries. Schools play a major role in inculcating Singaporean values and character, and civic and moral education play a major role in schools. Honesty, commitment to excellence, teamwork, discipline, loyalty, humility, national pride and an emphasis on the common good have been instilled throughout government and society. Lacking other resources, human resources were and still are seen as the island republic’s most precious asset. Education was seen, from the beginning, as central to building both the economy and the nation. Its job was to deliver the human capital engine for economic growth and to create a sense of Singaporean identity. The economic goals of education have given education policy a very pragmatic bent and a strong focus on scienti? c and technical ?elds. Singapore’s education system has evolved over the past 40 years in tandem with the changing economy. SINGAPORE’S EDUCATION SYSTEM: THE PATH TO BECOMING A LEARNING NATION. Over the past 40 years, Singapore has been able to raise its education level from one similar to that of many developing countries to match the best in the OECD. The current system did not emerge perfectly-formed, but has developed in three broad phases as it was adapted to changing circumstances and ideas: Survival-driven phase: 1959 to 1978 According to then Prime Minister Lee Kuan Yew, the aim of Singaporean education in its early days was to â€Å"produce a good man and a useful citizen†. This ? rst phase of education has been dubbed the â€Å"survival-driven† phase. In the  late 1950s, 70% of GDP was from port and warehousing activities. This was not enough to sustain, let alone grow, the economy which was suffering from high population growth and signi? cant unemployment. The government decided that there was a need to expand the industrial base and, because of the small size of the domestic market, to make it export-oriented. It set about trying to attract foreign manufacturers who needed low-skilled labour (e. g. textiles, garments, wood products), both to provide jobs and to gain expertise. Prior to independence, only the af? uent were educated. At independence, most of Singapore’s two million people were illiterate and unskilled. Therefore the focus of this â€Å"survival† period was on expanding basic education as quickly as possible. Schools were built rapidly. Teachers were recruited on a large scale. The schools that had been established by different ethnic groups were merged into a single Singaporean education system. A bilingual policy was introduced so that all children would learn both their own language and English. A textbook agency was created to provide textbooks. The expansion was so rapid that universal primary education was attained in 1965  and universal lower secondary by the early 1970s. By the end of the â€Å"survival-driven phase†, Singapore had created a national system of public education. However, the quality of education was not very high. In the early 1970s, out of every 1 000 pupils entering primary grade one, only 444 reached secondary grade four after 10 years. And of these, only 350 (35% of the cohort) gained three or more passes in O-level examinations. A signi? cant report by Dutch economic advisor Dr Albert Winsemius estimated that every year between 1970 and 1975, Singapore would be short of 500 engineers and 1 000 technical  workers and would have a severe shortage of people with management skills (Lee, et al. , 2008). The oil crisis 7 SINGAPORE: RAPID IMPROVEMENT FOLLOWED BY STRONG PERFORMANCE 162  © OECD 2010 STRONG PERFORMERS AND SUCCESSFUL REFORMERS IN EDUCATION: LESSONS FROM PISA FOR THE UNITED STATES of 1973 and the increasing competition from other Asian countries for low-skilled, labour-intensive industry led to a growing realisation that Singapore’s comparative advantage was eroding and that it needed to evolve to a higher-skill economy. However, a large number of policy changes and changes of ministers for education caused  confusion. Teacher morale was low and there was considerable attrition. Although there were attempts to expand vocational education, it had low status and was viewed as a dumping ground. In 1979, a watershed education report highlighted the high dropout rates and low standards and ushered in the next phase of reform (Goh, 1979). Ef? ciency-driven phase: 1979 to 1996 During this phase of education, the focus shifted. The government’s economic strategy was to move Singapore from a third-league, labour-intensive economy to a second-league, capital and skill-intensive country. So in January 1979, a new education system was introduced. Singapore moved away from its earlier one-size-? ts-all approach to schooling that would create multiple pathways for students in order to reduce the drop-out rate, improve quality and produce the more technically-skilled labour force needed to achieve the new economic goals. Streaming (tracking) based on academic ability was introduced, starting in elementary schools, with the goal of â€Å"enabling all students to reach their potential while recognising that all students do not grow academically at the same pace† (Ho Peng,  interview conducted for this report). Students could have more time, for example, to complete different stages of schooling. The multiple pathways included three types of high school: i) academic high schools, which prepared students for college; ii) polytechnic high schools that focused on advanced occupational and technical training and that could also lead to college; and iii) technical institutes that focused on occupational and technical training for the lowest ? fth of students. The Curriculum Development Institute of Singapore was established to produce high-quality textbooks and instructional materials for the different pathways. While streaming was unpopular when it was introduced, drop-out rates did, in fact, decline signi? cantly: by 1986, only 6% of students were leaving school with fewer than 10 years of education. 2 The range of efforts to raise standards also yielded results: performance in the O-level English examinations went from a 60% failure rate to a 90% pass rate by 1984, and by 1995 Singapore led the world in mathematics and science on TIMSS. As Singapore sought to attract companies with a more sophisticated technological base (e. g. silicon wafers, computers), a major goal of this second phase was to produce technical workers at all levels. Concerned about the low status of blue-collar jobs, from 1992 Singapore invested signi? cantly in the Institute for Technical Education (ITE; Box 7. 2). With a number of campuses around the city, the ITE provides high-quality technical and vocational education, with high-tech facilities and amenities that are comparable to those of modern universities elsewhere. Each technical ? eld is advised by industries in that sector to keep it current with changing demands and new technologies. New programmes can be built for multinational companies looking to locate in Singapore. There has been strong market demand for ITE graduates, and it is possible for the top graduates from the ITE to go on to polytechnics and then to university. As a result of these changes, the image and attractiveness of vocational education vastly improved. At the top end of the technical workforce, the number of university and polytechnic places was also expanded during this period to increase the pool of scientists and engineers. Ability-based, aspiration-driven phase: 1997 to the present day By the early 1990s, the ef?ciency-driven education system had yielded clear results. But, as became clear during the Asian ? nancial crisis of 1997, the world economy was shifting to a global knowledge economy. The competitive framework of nations was being rede? ned and national progress would increasingly be determined by the discovery and application of new and marketable ideas. The growth of the global knowledge economy required a paradigm shift in Singapore’s education system towards a focus on innovation, creativity and research. A key instrument as Singapore intentionally navigated towards the global knowledge economy has been the  government Agency for Science, Technology and Research (A* Star), which provides generous funding for research and aims to attract top scientists and scienti? c companies. One million foreign nationals with scienti? c, technical or managerial skills have been encouraged to work in Singapore in international corporations and in higher education. Singapore’s three universities, and especially the National University of Singapore and Nanyang Technological University, have research partnerships with leading universities around the world with a focus in selected ? elds,  including bioinformatics, information sciences and medical technologies. At the school level, Singapore created a new educational vision, â€Å"Thinking Schools, Learning Nation†. This major milestone in Singapore’s education journey recognised Prime Minister Goh Chok Tong’s belief that â€Å"A nation’s wealth in the 21st century will depend on the capacity of its people to learn† (Goh, 1979). â€Å"Thinking Schools 7 SINGAPORE: RAPID IMPROVEMENT FOLLOWED BY STRONG PERFORMANCE STRONG PERFORMERS AND SUCCESSFUL REFORMERS IN EDUCATION: LESSONS FROM PISA FOR THE UNITED STATES  © OECD 2010 163 represented a vision of a school system that can develop creative thinking skills, lifelong learning passion and nationalistic commitment in the young. Learning nation is a vision of learning as a national culture, where creativity and innovation ? ourish at every level of society† (Lee et al. , 2008). Thinking Schools, Learning Nation encompassed a wide range of initiatives over a number of years that were designed to tailor education to the abilities and interests of students, to provide more ? exibility and choice for students and to transform the structures of education. Career paths and incentives for teachers were revamped  and teacher education upgraded, as described in more detail later. Curricula and assessment changes put greater emphasis on project work and creative thinking. A major resource commitment, involving three successive master plans, was made to information and communication technology (ICT) as an enabler of new kinds of self-directed and collaborative learning. A broader array of subject matter courses was created for students and a portfolio of different types of schools has been encouraged, specialising in arts, mathematics and science, and sports, as well as a number of independent schools. â€Å"We need a mountain range of excellence, not just one peak, to inspire all our young to ? nd their passions and climb as far as they can,† explained Tharman Shanmugaratnam, then minister for Education (cited in Lee et al. , 2008). Major changes were also made in the management of schools. Moving away from the centralised top-down system of control, schools were organised into geographic clusters and given more autonomy. Cluster Superintendents – successful former principals – were appointed to mentor others and to promote innovation. Along with greater autonomy came new forms of accountability. The old inspection system was abolished and replaced with a school excellence model. It was felt that no single accountability model could ? t all schools. Each school therefore sets its own goals and annually assesses its progress towards them against nine functional areas: ? ve â€Å"enablers†, as well as four results areas in academic performance (Ng, 2008). 3 Every six years there is an external review by the School Appraisal Branch of the ministry of Education. Greater autonomy for schools also led to a laser-like focus on identifying and developing highly effective school leaders who can lead school transformation. This is also described in more detail later. In 2004, Prime Minister Lee Hsien Loong introduced the idea of â€Å"Teach Less, Learn More† as the next step under the Thinking Schools, Learning Nation umbrella. Its aim was to open up more â€Å"white space† in the curriculum to engage students more deeply in learning. Despite the system’s widely-recognised successes, learners were still seen as too passive, overloaded with content, driven to perform, but not necessarily inspired. Teach Less, Learn More aims to â€Å"touch the hearts and engage the minds of learners by promoting a different learning paradigm in  which there is less dependence on rote learning, repetitive tests and instruction, and more on engaged learning, discovery through experiences, differentiated teaching, learning of lifelong skills, and the building of character through innovative and effective teaching approaches and strategies. † (Ho Peng, interview conducted for this report) Further moves in this direction were made in 2008 with an envisioning exercise that led to Curriculum 2015. According to Ho Peng, Director General of Education in the Singapore ministry of Education, this review asserted that the Singapore education system had strong holding power and important strengths in literacy, mathematics and science, and that these should remain. However, it needed to do better on the soft skills that enable future learning. In addition, â€Å"the overload of information has put a premium on the ability to do critical analysis. Working across cultures will require language skills and a larger world view† (Ng, 2008). A review of primary schools in 2009 focused on the question of how each child’s learning can be driven by their innate curiosity and love of play. Art, music and physical education (PE) are also being enhanced in the curriculum. Finally, Curriculum 2015 re-emphasises that education must be rooted in values: â€Å"Without a moral and ethical compass, all learning will come to nought. We must rebalance content, skills and character development to achieve a more holistic education,† (Ng, 2008). Current structure In Singapore’s education system today, students receive six years of primary education, and four to ? ve years of secondary education, followed by two years at junior college, polytechnic or the Institute for Technical Education. (Figure 7. 1). 4 Primary education consists of a four-year foundation stage during which all students follow a common curriculum that emphasises English, mother-tongue language and mathematics. Science is introduced from primary 3. Other subjects taught in primary school are civics and moral education, social studies, health, physical education, art and music. 7 SINGAPORE: RAPID IMPROVEMENT FOLLOWED BY STRONG PERFORMANCE 164  © OECD 2010 STRONG PERFORMERS AND SUCCESSFUL REFORMERS IN EDUCATION: LESSONS FROM PISA FOR THE UNITED STATES Source: Singapore Ministry of Education website: www. moe. gov. sg/education/. †¢ Figure 7. 1 †¢ Singapore’s education system organisation Specialised Schools For students who can bene? t from a more customised and practice-based curriculum Privately- funded Schools determine their own curriculum and provide more options for Singapore students (4-6 years) Universties (3 4years for undergraduates) Workplace GCE â€Å"A† Level/Other Quali? cation Polytechnics (3 years) (Diploma) Alternative Quali? cations Integrated Programme combines Secondary and JC education without an intermediate national examination (4-6 years) Junior Colleges/ Centralised Institute. (2-3 years) (GCE â€Å"A† Level) Intitutes of Technical Education (1-2 years) (Nitec/Higher Nitec) Special Education Schools provide EITHER Mainstream curriculum whith programmes catering to students’ special needs OR Customised special education curriculum (4-6 years) Direct Admission to JCs/Polytechnics JCs and polythechnics have autonomy in admitting some students GCE â€Å"O† Level Sec N (A) GCE ’N’ Level Secondary: Express course (4 years) Government/Government-aided Schools †¢ Mainstream schools †¢ Autonomous Schools whith enhanced niches programmes †¢ Independent Schools whith greater autonomy in  programmes and operations Specialised Independent Schools For students with talents in speci? C areas Privately-funded Schools Priovide more options for Singapore students Special Education For students with special needs Direct Admission to Secondary Schools Independent Schools, Autonomous Schools, mainstream schools whith niches of excellence, and schools offering the Integrated Programme have autonomy in admission of some of their students Specialised Independent Schools and Privately- funded Schools have full autonomy in students admission Primary School Leaving Examination (PSLE). Primary Schools (6 years) All students follow a broad-based mainstream curriculum. Some schools offer niche programmes such as in aesthetics, sports and gifted education Specialised Independent Schools with specialised programmes to develop students’ talents in speci? cs areas (4-6 years) Secondary: Normal (Academic) Course [N(A)] (5 years) Secondary: Normal (Technical) Course [N(T)] (4 years) Vocational Course (1- 4 years) 7 SINGAPORE: RAPID IMPROVEMENT FOLLOWED BY STRONG PERFORMANCE STRONG PERFORMERS AND SUCCESSFUL REFORMERS IN EDUCATION: LESSONS FROM PISA FOR THE UNITED STATES  © OECD 2010 165. Streaming, which was a key feature of the Singapore education system, was designed to allow students to progress at their own pace from primary 5 onwards. However, in 2008, streaming was replaced with subject-based banding. At the end of primary 6, all students sit for the Primary School Leaving Examination in English, mathematics, mother- tongue language and science. Based on the results of this examination, students are admitted to an express (60% of students), normal academic (25%) or normal technical (15%) course in secondary school. Students in the express course follow a four-year programme culminating in the general certi?  cate of education (GCE) O-level exam. Students in the normal academic course follow a four-year course to GCE N-level and may sit for O-levels in year ? ve (Figure 7. 2). The normal technical programme prepares students for technical higher education, jobs or the postsecondary ITE after a four-year programme leading to the GCE-N level. In recent years, more choice has been offered to students in secondary school, with a wider range of subjects at O-level and elective modules. Students who are clearly of university calibre may study in Integrated Programme Schools where they can  skip O-levels; this arrangement allows them to engage in broader learning experiences that develop their leadership potential and capacity for creative thinking. There is now more horizontal mobility between courses, and students who do well are allowed to transfer between streams. The ratio among streams is further enhanced with students being able to follow subjects from a different stream. Schools specialising in sports, art and mathematics and science are also available, as well as a small number of independent schools. After 10 years of general education, students go to post-secondary education, either junior colleges (31% of  students), polytechnics (43%) or ITE (22%). Academically inclined students can take A-levels during this period and then proceed to university. Students may also take diploma courses in technical or business subjects at polytechnics. Many polytechnic graduates who have done well also go on to university. Students with GCE O- or N-levels can take skill-based certi? cates in technical or vocational subjects at ITE. Outstanding ITE graduates can also go on to polytechnics or universities. About 25% of a cohort goes on to university in Singapore (the number of places will rise to 30% in 2015). Many students also go abroad to university. SINGAPORE’S SUCCESS IN EDUCATION Singapore has pursued its vision of a high-quality education system over a long period of time and has accomplished signi? cant improvements at each stage of its journey. What are some of the key features that have helped Singapore become so successful? A forward-looking, integrated planning system In modern Singapore, education has consistently been the building block for economic and national development. As Prime Minister Goh Chok Thong famously stated: â€Å"The wealth of a nation lies in its people. † Since the founding of the republic, the high value placed on education as the key to economic development and national cohesion in a country with no natural resources is evident in the statements of Singapore’s senior leaders. But the statements about â€Å"nurturing every child† are not just political rhetoric. They have been accompanied by willingness at each stage to invest considerable ? nancial resources in education. Education spending rose to 3. 6% of GDP in 2010, approximately 20% of total government expenditure and second only to defence (Annex 7. A). The linkage to economic development is tight and is driven from the top of the government. As Singapore evolved from an economy based on port and warehousing activities, through a low-wage, labour-intensive manufacturing economy, and then to a more capital and skill-intensive industry and ? nally to its current focus on knowledge- intensive industrial clusters, the education system was expected to ramp up the quality of its education and the supply of speci? c skills needed to make Singapore globally competitive. Singapore has a uniquely integrated system of planning. The Manpower ministry works with various economic agencies (such as the Economic Development Board) responsible for promoting speci? c industry groups to identify critical manpower needs and project demands for future skills. These are then fed back both into pre-employment training and continuing education and training. In other countries, labour and education markets make these adjustments slowly over time, but the Singapore government believes that its manpower planning approach helps students to move faster into growing sectors, reduces oversupply in areas of declining demand more quickly, and  targets public funds more ef? ciently for post-secondary education. The ministry of Education and the institutions of higher and post-secondary education then use these skill projections to inform their own education planning, especially for universities, polytechnics and technical institutes. 7 SINGAPORE: RAPID IMPROVEMENT FOLLOWED BY STRONG PERFORMANCE 166  © OECD 2010 STRONG PERFORMERS AND SUCCESSFUL REFORMERS IN EDUCATION: LESSONS FROM PISA FOR THE UNITED STATES In short, the ability of the government to successfully manage supply and demand of education and skills is a major  source of Singapore’s competitive advantage. As Singapore seeks to become a global scienti? c hub, it is bringing together all aspects of the government – the ? nance ministry, economic development board, manpower ministry, education ministry, urban and environmental planning bodies, housing and immigration authorities – to create the next platform for Singapore’s growth. Singapore demonstrates strong alignment among policies and practices. One of the most striking things on visiting Singapore is that wherever one visits – whether the ministries of manpower, national development, community  development, or education or the universities, technical institutes, or schools – he or she hears the same clear focus on the same bold outcomes: careful attention to implementation and evaluation, and orientation towards the future. â€Å"Milestone† courses bring together top of? cials from all the ministries to create a shared understanding of national goals. And a focus on effective implementation is shared throughout government. Because of the value placed on human resource development and the understanding of its critical relationship to economic development, Singapore’s government provides a very clear vision of what is needed in education. This means that the ministry of Education can then design the policies and implement the practices that will meet this vision. Close links between policy implementers, researchers and educators At the institutional level, both policy coherence and implementation consistency are brought about by the very close tripartite relationship between the ministry of Education, the National Institute of Education (NIE, the country’s only educator training institution), and the schools. The ministry is responsible for policy development, while NIE conducts research and provides pre-servic.

Main Objective Is Profit Maximization Commerce Essay

Main Objective Is Profit Maximization Commerce Essay In this assignment I am looking at profitable organizations which have main objective is profit maximization. I am going to look at this in the context of starting a small firm. I will be looking at the problems and requirements when aiming to begin a business either in manufacturing or in the tertiary sector. I will future explain that why plan is important for baseness? Also I will right about types of businesses, sectors, of businesses and I will talk about some businesses. Market analyzing mission and vision statement also are very important for a success business. Introduction In this assignment I am going to write about the business plan. What are the important factors for a new business? I will write about the requirement of the business, types of the business, business sector and then I will explain each business sector advantages and disadvantages. 2. Business Definition Business is an economic or financial activity, which is associated with permanent and regular production and sharing of goods and services for fulfilling human needs .Stephenson defines business as, The regular production or purchase and sale of goods undertaken with an objective of earning profit and acquiring wealth through the satisfaction of human wants. According to Dicksee, Business refers to a form of activity conducted with an objective of earning profits for the benefit of those on whose behalf the activity is conducted. (KALYAN CITY LIFE, 2011) A business plan is the arrangement for the business, clarifying that what it exists, for and what products, services it provides to society. Rebecca Jones wrote in Information Outlook. A business plan is a roadmap for the organization, showing the destination it seeks, the path it will follow to get there, and the supplies and wherewithal required to complete the journey. almost every succeed company needs a business plan. Due to Lack or upland of proper planning is one of the most frequently cited reasons for business failures. So business plans helpful for companies identify their goals and objectives also provide them with channels and strategies to reach those goals. (Reference for Business, 2012) There are main three types of business one primary, secondary and Tertiary. à ¢Ã¢â€š ¬Ã‚ ¢ Extractive (primary) à ¢Ã¢â€š ¬Ã‚ ¢ Manufacturing (secondary) à ¢Ã¢â€š ¬Ã‚ ¢ Services (tertiary 3. Deferent Types of Businesses Sectors We have three type of businesses sectors one is public sector 2nd is private sector and 3rd is voluntary sector/ non profitable but I will discuss about private sector. 3.1 Public Sector Public sector can be defined in the different way, Public sector in owned and run by the Government for the people. Government collect money by taxes and this money are used to finance most of the public sector. Central or local government or public corporations are Involves. The government makes all decisions in this sector Shareholders have LIMITED LIABILITY. A board of directors run the business and must have the words public limited with the company name or letters PLC. Accounts must be published. Main aims of public are to use recourses well for the benefit of the community. Some example is royal mail in the UK and BBC TV channel. 3.2 Private Sector A company owned by at least 2 shareholders and shares are sold privately. Profits are shared with shareholders dividends and Shareholders have LIMITED LIABILITY. Private sector has a board of directors to run the business. Name must be end with the word Limited or letters Ltd. Private sector business are owned and run by private individual. 3.2.0 Types of Private Sector: We have many types of private business but the most common are bellow. à ¢Ã¢â€š ¬Ã†â€™ 3.2.1Sole Trader Business of this sector has owned and controlled by one person Money is usually provided by the owner. This means that legally the owner and the business are the same. Sole trader has unlimited liability. There is not much legal paper work. Funding for business will be from owner side, banks, credit card, and bank overdraft. Power and right will be on one hand, profit will on one share low VAT and tax. 3.2.2 Partnership When 2 or more than 2 people running a business which aims to make a profit is called partnership. The maximum number of partners is usually 20. Money is provided by partners. They are easy to set up but may have a Deed of Partnership and will share their profit and loss according to their agreement. They are unincorporated. Easy to start, funding is same like sole trader also from partners. 3.2.3 Franchise It is an agreement between a franchisor and a franchisee and allows the use of a business name to franchise. Franchisee must provide the money to start their business and franchisor provides materials, training and advice. Franchisee must make regular payments to the franchisor. Main aims of private sector are profit, growth, increased market share and maximize sales. 4. Legal requirement For a new business you should know the legal requirement of the business and must register the company companies act 2006 in the UK. For example the business should be legal and register with company registrar. If the business is partnership then must submit partners all agreement paper with registrar without registration of the company no one can start the business in the UK.4. Legal requirement For a new business you should know the legal requirement of the business and must register the company companies act 2006 in the UK. For example the business should be legal and register with company registrar. If the business is partnership then must submit partners all agreement paper with registrar without registration of the company no one can start the business in the UK. 5. Funding Options For business funding is the most important fact without money no one can start business and fund will never have enough, so shortage can be serious at firs stage. Depending on the structure of Business, business will have different sources of funding or finance. Some resources are: à ¢Ã¢â€š ¬Ã‚ ¢ Loans from Banks and Financial Institutions à ¢Ã¢â€š ¬Ã‚ ¢ Shareholders à ¢Ã¢â€š ¬Ã‚ ¢ Some banks provide our draft à ¢Ã¢â€š ¬Ã‚ ¢ Some time government provide loans for some business such in Pakistan for agriculture à ¢Ã¢â€š ¬Ã‚ ¢ Sale shares à ¢Ã¢â€š ¬Ã‚ ¢ Partners Some other resources are shareholders and partners, depending on the organization legal structure of firm. 6. Compliances 7. Protecting your Intellectual Property IPR main benefits are to save the company products and services from your Oppositions or competitors and prevent unauthorized users and action. If you have branded a only one of its kind product then you must patent it. This means registering the manufactured goods and its design to put a stop to others from doubling it. If dont, then the competition can just steal the product design from you, and will cost you a lot. Example of a patent shielding a firm from any more business copying its product was when apple clime that Samsung copy their product and the court still on process for more detail ( http://news.cnet.com ). Patenting is an expensive or valuable, though, and it must be done correctly. So IPR is very important for a company to register other hand it will cost a lot to the company. 7.1 Trademark A trademark is a brand name. A trademark includes any name, word, sign, device, or any combination, used or intended to be used to identify the organization such as MacDonald, HP computers, coca cola. http://www.bitlaw.com 7.2 Copyrights Copyright is the ownership of the of intellectual property (IP) The select right to make copies, and otherwise exploit a literary, musical, and artistic work, even audio, printed, video. It should register under copyright law act January 1, 1978, is protected for the duration of the author or inventor and for 50 years period of after his or her death. For example Adam Smith is the right person for his book Wealth of Nation no one can write this book or print it by other name. 7.3 Industrial Designs Manufacturing Design is concerned with all the human being aspects of machine-made goods and their bond to people and the environment. The designer is responsible for these products and their impact on society and nature. Such as apple I pone 5, 7.4 Patents The protection a person or a company a new product or way of doing something by stopping anyone else from copying or using it for a particular period of time. For example any Madison formula. 8. Contracts An agreement between two or more parties to avoid the future problem and it is written and enforceable by law. For new business you have to sign many corrects like with Employment, Shareholders, Agency, Vendors, with other business, banks and financial institutes. Every things should be clear and must be Confidential also it must include Term, Confidential information, representations and warranties, indemnity, limitation of liability, assignment protection of intellectual property. 9. Insurance 10. Mission statements: Mission statements are targeted at external and internal stakeholders its means that the statements must be suitable for a wide range of audients or readers. A mission statement is a idea or guiding hand, which provides a shared direction and focus for the firm internally so its mean that mission statement are meant to encourage and motivate everybody. The mission statement should: à ¢Ã¢â€š ¬Ã‚ ¢ Show the direction and aiming that the business to head in à ¢Ã¢â€š ¬Ã‚ ¢ Give some sort of statement of success -what the business wants to do and achieve à ¢Ã¢â€š ¬Ã‚ ¢ Classify the way in which the business is aiming to develop over a period of time à ¢Ã¢â€š ¬Ã‚ ¢ Allow the business to use the mission statement for the growth of specific goals and objectives to reach their aims. these should be relevant for all levels of the organization à ¢Ã¢â€š ¬Ã‚ ¢ Provide inspiration to employees to work towards achieving the goals and objects or vision set out by the statement. (mindtools, 2012) 11. Vision statements While a mission statement shows the way on which a business wants to head now and is of immediate relevance to all stakeholders, a vision statement is a more common statement looking at where the business or organization wants to be in the future. A vision statement essentially outlines what a company wants to be in the future and it may well be related to some sort of future outcome. (mindtools, 2012) http://www.diffen.com/difference/Mission_Statement_vs_Vision_Statement à ¢Ã¢â€š ¬Ã†â€™ 12. Market analyzing Market analyzing will assist to the business and some benefits are below à ¢Ã¢â€š ¬Ã‚ ¢ Understand the market and give you a bug picture à ¢Ã¢â€š ¬Ã‚ ¢ Attract the customers and beat the competitors à ¢Ã¢â€š ¬Ã‚ ¢ Market size à ¢Ã¢â€š ¬Ã‚ ¢ Who is your customers and who is your competitors à ¢Ã¢â€š ¬Ã‚ ¢ What customers need Best way to understand the market is market research. Market analyzing will help to understand the market and give you a big picture to you organization by analyzing the market will understand the behavior of end users and will beat the competitors because you know that what customers wants. Market research will give lots of information about the competitors. Try to make the products different from your competitors and this different will stand the business out from crowd and for competition there are three main things are very important 1. Quality issues 2. Customer services 3. High price 12.1 Segmentation Customers Its mean grouping of customers by their age, gander, stander, location by segmentation will easily target the customers so we can segment it by 1. Demographic ( how old they are) 2. Socio-Economical (who much they want to spend ) 3. Geographic ( where the live ) 13 PEST Analysis 14. Planning a new business For this section I have a profitable business plan and I will recommend a Dominos franchise which is much better than other businesses. If we start a sole trade business or partnership business it is very difficult for as to competition with big business. So there is a big chance to failure of the business. We will run business under the banner of an already established business I mean Dominos Pizza. We also take advantages of their brand, ideas, operating techniques and much more which already tested and tried. Brand name we can use Dominos pizza is well know brand in the market and have much demand in the all over the globe. à ¢Ã¢â€š ¬Ã†â€™ 14.1 Capital investment For Dominos pizza franchise total investment is  £290000 + (VAT approx  £49000. VAT will claim back/ Constriction cost (shop fitting and project management fee) approx  £130000 Equipment cost approx  £ 80000 Legal/ Planning / Architects approx  £17000 Opening cost approx  £ 25000 Fees (training fees approx  £ 45000 Total approx  £ 290000 + VAT More detail available in appendix 14.2 Funding In assignment question the say that dont worry about money but any way in case we face to the shortage of funding we can use alternative way like loan from banks, bank overdraft, credit card, and loan from financial institute. 14.3 HR and Training In one franchise approximately 25 jobs we can create so we will advertise it in local news paper and we will select right candidate for training. After the selection we have to do contract with our employees for minimum 2 years. à ¢Ã¢â€š ¬Ã†â€™ Conclusion From above discussion it is clearer that planning is very fore a business. Without planning no one can achieve their goals effectively. Also invest the capital on the right business because everyone wants to invest their money for profit and other important thing is we should do business on legal way. If you want to be a success business man you have to create image in the society like Apple, MacDonald and, Dominos. Policies and procedure should clear to employees and customer and Health and safety environment provide to employees and customer. Franchise is more profitable the other business because we can use their logo, trademark also it is well known in the market,.

Epogen :: Science Biology Papers

Epogen Epogen is produced by the company Amgen. Amgen located atThousand Oaks, California, is a global biotechnology company. It discovers, develops, manufactures, and markets human therapeutics based on advanced cellular and molecular biology. Amgen, founded in 1980, is now the largest biotechnology company in the world. It has 4,200 employers around the world and 2,700 of the 4,200 workers, work at the headquarters in Thousand Oaks. Amgen has centers of research in "Boulder, Colorado and Toronto, Canada; clinical research centers in Cambridge, England and Melbourne, Australia; the international distribution center in Louisville, Kentucky, fill and finish facility in Junco, Puerto Rico; and European regional headquarters in Lucerne, Switzerland. Amgen has other international offices that are located in Austria, Australin, Belgium, Canada, China, France, Germany, Italy, Japan, the Netherlands, Hong Kong, Portugal, Spain, and the United Kingdom." (Amgen 1996) Amgen's first product, Epogen was approved in June 1989 for use in the United States. Neupogen (filgrastim) Amgen's second product, received approval for use in February 1991, is used for preventing infections in cancer patients that receive chemotherapy for bone marrow and peripheral blood progenitor cell transplantation patients and treatment for chronic neutropenia, which is a rare blood disorder. Amgen has research in the areas of hematopoiesis, neurobiology, inflammation/autoimmunity, and soft tissue repair and regeneration. Products from the research, in the four areas mentioned from above, may, sometime in the future, be used in treating conditions characterized by disorders of blood and bone marrow, neurodegenerative diseases such as ALS, Parkinson's, Alzheimer's, or traumatic nerve injury. Epogen Epoetin Alfa recombinant Epogen, or Epogen, has 3,000 units of recombinant Epoetin Alfa, 2.5 mg Albumin (Human) in sterile buffered solution (pH 6.9 +/- 0.3) of sodium citrate (5.8mg), sodium chloride (5.8mg), citric acid (0.06mg), in Water for injection. Its uses are stimulating the body to make red blood cells, treatments of anemia (loss or reduction of red blood cells) associated with chronic renal failure or anemia caused by AZT (zidovudine) in HIV-infected persons. Before Epogen was produced or used, blood transfusions and male hormone therapy was used in treating anemia, which was caused by chronic renal failure. Epogen Studies Studies on Epogen are available from Amgen, Food and Drug Administration (FDA), and the Journal of the American Society of Nephrology. One study by Amgen was "to establish the safety and efficacy of EPOGEN in pediatric patients" (Amgen 89), the second study from FDA, was about erythropoietin, which is

Analysis of Langston Hughes On the Road :: On The Road essays

Analysis of Langston Hughes' On the Road In life, we are often confronted with boundaries created by society and ourselves. In our limited understanding of what those boundaries represent, we find ourselves confined by our ego. Racism and prejudices have plagued society for many years, and many of us have been judged and condemned for expressing our true selves. How long must it take for us all to be accepted as beautiful beings, all perfectly capable of greatness and joy? Langston Hughes', "On the Road," uses beautiful symbolism and imagery. He offers a gift to his readers: Open your heart and life will provide unlimited abundance. During this literary analysis, we will take a look at how Hughes uses nature to demonstrate his main character's unwillingness to participate in life. Another point we'll examine is the use of anger and survival and how it can be used as a powerful force in breaking down racial barriers. Next, we'II look at Jesus Christ as a metaphor for how we experience life and how traditional church values contradict each other when it comes to the acceptance of human beings. Finally, we'll briefly take an historic look at how the Depression gave blacks an even playing field with whites. To begin with, Hughes uses nature to demonstrate a distinct relationship amongst blacks and whites. His use of snow and night convey a point simple enough, but through the use of these metaphors, he enables the story to be less invasive and more appealing to everyone that experiences "On the Road". Hughes' main character, Sargeant, is left doubting the goodness of life. "Sargeant didn't see the snow, not even under the bright lights of the main street, falling white and flaky against the night. He was too hungry, too sleepy, too tired" (Hughes 1). For almost two hundred years white people have suppressed the black population. Hughes' use of snow and night give us perfect example. Sargeant was tired of fighting, tired of surviving, tired of hoping, and most of all tired of the white people who've suppressed and tormented his life. On the other hand, Hughes reminds us that if combined, the beauty of both night and snow create a perfect harmony.

The Pancreas :: essays research papers fc

The pancreas is located in the middle of the abdomen. It’s surrounded by the stomach, small intestine, liver and spleen. It’s about six inches long and shaped like a thin pear, wide at one end. It has three sections: wider right end is the head, the middle is the body and the left end is the tail.   Ã‚  Ã‚  Ã‚  Ã‚  The pancreas has two functions; to make enzymes that help digest fats and proteins and the other, to produce insulin that controls the blood sugar level called glucose. It consists of Islet cells (1 of 3 types), which are endocrine glands. This means the Islet cells secret the insulin directly into the blood stream. The pancreas contains many more of these Islet cells than the body needs to maintain a normal insulin level. Even when half of the pancreas is removed, the blood sugar level can still remain normal. The pancreas is also made up of exocrine glands, which produce enzymes for digestion.   Ã‚  Ã‚  Ã‚  Ã‚  When the blood sugar levels aren’t normal, it’s a disease called diabetes. Diabetes (diabetes mellitus) is a deficiency of the hormone insulin or the inhibition of its action with the cells. The insulin acts like a bridge between the glucose and the cells. In the US there are about 16 million people who suffer from diabetes. It is the seventh most common cause of all deaths. Diabetes is most common in Native American females over 45 years of age.   Ã‚  Ã‚  Ã‚  Ã‚  There are two main types of diabetes. The firsts is insulin-dependent diabetes mellitus (IDDM). In IDDM the body either doesn’t produce diabetes or produces very small amounts. The symptoms usually occur in teenagers under 20, usually around puberty. Untreated IDDM affects the metabolism of fat. Since the body can’t convert glucose into energy, it is broken down into fat and stored for energy. This also increases the amounts of ketone bodies in the blood, which interfere with respiration. The second type is called is non-insulin-dependent diabetes mellitus (NIDDM). This is when the body doesn’t make enough insulin or is unable to use it. NIDDM is the most common of all diabetes; it makes up 90 to 95 percent of all cases. Scientists believe that in some people weight gain or obesity is what triggers their diabetes because 80 percent of people with diabetes are over weight.   Ã‚  Ã‚  Ã‚  Ã‚  Another problem people have with the pancreas is pancreatic cancer. Each year about 29,000 Americans and 3,000 Canadians are diagnosed with it.

Obtaining Mental Health Services

Being a probation officer is not easy.   It requires a lot of knowledge, skills, and experience to be an effective probation officer.   Having a golden heart is fine – believing that these offenders can change their lifestyle, supporting them in their intention to function in the community, and making sure that the people within the community where these offenders are staying would be safe from any danger.   However, objectivity should always come first since many lives are dependent on the probation officer’s ability to supervise and monitor these offenders’ performance. A probation officer also uses his resources in the community to assist his client, the offender in seeking employment or services such as medical care, alcohol treatment, mental health treatment, and the like.   The probation officer explains all the terms to the offender’s temporary release and the consequences for violating them under probation.   Everything is made clear. In the case of this 22-year-old man who have been convicted four times in two years straight for driving while under the influence of alcohol, thorough investigation should be done.   This man may be telling his substance abuse counselor that he is clean.   He may be present in all his counseling appointments.   Nevertheless, these claims do not prove that he has stopped alcohol consumption.   Furthermore, having eccentric ideas and opinions – this man telling you that his neighbors are monitoring his breathing through the television – proves that there is something terribly wrong about this person.   So, what do I plan to do about the matter? First, researching and investigating about this man’s personal history , such as his family to start with, would be a good start.   Knowledge about his childhood, his relationship with his co-family members, and his plight during his growing-up years are vital information in knowing how and why he acquired such behavior, vices, and even beliefs that he still carry on up to this day. A background check of his life three to five years prior the present date could also come in handy.   Past relationships usually contribute to a person’s perspective and sanity.   Another background check would be his scholastic and interpersonal performance in school given that he went into one.   Based from his interaction with these people, I might find clues to some grounds as to why and how this person came to be the way he is. Second, talking with this man would give me hints and clues about the way he thinks, the way he answers questions – may it be rational, practical or not, and the way he views the world.   Upon acquiring his personal background, a brief interview about his family and previous relations with others would somehow prove if this man is reliable or not.   This would be necessary because inconsistencies on his statements would prove irregularity of his character, therefore making him a threat, somehow, to the community. Third, I would discuss with his substance abuse counselor all my findings so we could come up with proper procedures needed to prove his mental capability or incapability.   I would suggest that the substance abuse officer gives my client some intellectual tests because my client is showing signs of a paranoid schizophrenic or of a person just having paranoid reactions that may be due to depression or trauma Fourth, I would require my client to undergo not only the psychological tests that his substance abuse counselor would give him but also a series of physical exams for instance urinalysis, blood tests, and the like to see if he really is clean or if he went back to alcohol or worse took other substances and mixed it with alcohol altering the effects of the alcohol-intake alone. Fifth, I would reiterate to my client the sanctions that he might be subjected to if his tests prove that he is positive of alcohol and/or substance intake.   Such are necessary actions for me to accurately and objectively assess him and propose certain measures. References Civil Service Associations, Inc. (August 2000). Examination Preparation Booklet.. Principles and Practices in the Treatment of the mentally Ill/Emotionally Disturbed, Problems of the Mentally Ill/Emotionally disturbed, booklet #10. pp. 4-5. Retrieved October 10, 2007, from http://www.csea9200.com/pdfs/TestPrepBks/TreatMIllBook10.pdf Court and Community.   (January 2003). Probation Officers. p2, numbers 4 – 6 . Retrieved October 10, 2007, from