Brainscapes Case Study Example | Topics and Well Written Essays - 750 words

Brainscapes - Case Study Example Concentration of sodium (Na+) ions in the intracellular and extracellular space of tissues was the major identifier of hippocampus atrophy (with dead neurons). According to this case, brain tissues showing signs of Alzheimer’s disease (AD) had dead neurons and appear smaller than usual by expansion of the extracellular space and shrinkage of intracellular space. 2. Expected Sodium Concentration Changes The change of sodium concentration in the hippocampus region is used to differentiate healthy tissues from diseased ones in that unhealthy tissues have shrunk. It follows then that the hippocampus volume or processes are directly correlated with sodium concentration within and without the extracellular and intracellular space. Decreased volume of the hippocampus can possibly occur when neurons inside have died or are not functioning at their optimum levels. One expected change or difference is a difference in concentration of sodium ions in extracellular space and intracellular space commonly called a gradient difference. This differential concentration of sodium gradient normally occurs due to defects of Na+/K+ ATPase pump which may be blocked. Brain tissues afflicted by AD usually have a smaller volume than normal ones and identified by extracellular space that is expanded as well as shrinkage of the intracellular space. 3. Additional Information from Outside Sources Journal Article: Tissue Sodium Concentration in Human Brain Tumors as Measured with 23Na MR Imaging. Sourced from Radiology Journal Journal article: Brain tissue sodium concentration in multiple sclerosis: a sodium imaging study at 3 tesla. Sourced from National Center for Biotechnology Information database Journal Article: Na+ and K+ ion imbalances in Alzheimer's disease. Sourced from National Center for Biotechnology Information database Journal article: Distribution of Brain Sodium Accumulation Correlates with Disability in Multiple Sclerosis: A Cross-sectional 23Na MR Imaging Study. Sour ced from Radiology Journal 4. Outside Sources Contribution to the case The source (Ouwerkerk, Ronald, et al.) asserts that the concentration gradient difference of Na in tissues can be used to differentiate healthy tissues from affected one. Another source (Inglese, M., et al.) has findings that mechanisms of injury can be diagnosed through Na magnetic imaging. The third source (Vitvitsky V.M.) is of the opinion that failure of previous research come up with findings on cell homeostasis can be a basis of understanding development and progression of AD. Finally the last source (Zaaraoui, Wafaa, et al.) comes up with the finding that tissue injury can be diagnosed with NA imaging. 5. Case Study Finding that is Consistent with other Sources All the sources normally use differential concentration gradient of sodium in the intracellular space and extracellular space to come up with their findings. In this manner, atrophic tissues are identified from healthy ones after imaging. 6. Inconcl usive information with Sodium Concentration Changes Although using differential concentration to assay for atrophic tissues and organs can be very effective, it can also give wrong misdiagnosis especially when movement of sodium ions is impeded by other factors. For example, there can be sodium ions leakage due to a defective Na+K+ ATPase pump. 7. Resolution of the Case Sodium imaging can be a helpful technique

My Career Essay Example | Topics and Well Written Essays - 250 words

My Career - Essay Example ta and information security needs to be preserved not only to survive in the highly competitive global business but also for sustaining competitive advantage in the industry. With my expertise in the information system, I will be able to contribute effectively in ensuring the security of official data and justify my job as Information Security Manager. The job would broadly encompass development and maintenance of comprehensive database of network security with all the support systems like network equipment, hardware and software. The job profile also includes providing administrative and technical support to various departments within the organization in the area of information technology and security and implementing security standard and procedures. My academic qualification has equipped me with expertise in network security, network protocols, Windows, Microsoft office and other such technical software packages that are used within the firm. I would also like my base salary to be around $107,511 as it is the average salary for my job description as per my internet based research (salary wizard, 2011). I sincerely believe that with huge scope in the market for information security, I would be able to get a job that would meet my criteria of salary and job satisfaction. (words:

Economic Evaluation in the National Health Service (NHS)

Economic Evaluation in the National Health Service (NHS) The National Health Service is built on the Benthams concept of utilitarianism of maximising utility for greatest number (Lockwood,1988), enabling risk sharing across the entire population by confronting moral hazard and adverse selection. This can be linked to the microeconomic theory of supply and demand (Frank, 1994). Supply and demand underlies the allocation of limited resources or commodities used to achieve maximum health output. In this situation, demand refers to both willingness and ability to pay, and supply is the willingness and ability of potential sellers to produce and sell a particular commodity (Schafermeyer, 2000). Consumers subject to their individual income constraints, maximise their individual utility through their purchasing of particular goods. As such, health in this respect has both aspects of an investment good and a consumption good. The demand for health care services is very different to that of food. Health, unlike other resources, cannot be traded over time. It is a derived demand, in which consumers have a demand for health but cannot directly purchase it (Ringel, 2002). Like a capital good, health is capable of depreciation over time and as such; its demand is a time-dependent variable, which changes with exogenous and endogenous factors. Therefore, one could suggest there is unlimited health care demand that will always exceed limited supply due to the overall burden of ill health being impossible to anticipate due to changing constantly. As such, health care in an important determinant of health but the demand for it is often unpredictable (timing, frequency, intensity, costs) and therefore, expensive. Markets favour consumers with purchasing power. The food industry is a free market, dictated by consumer choice and demand, the emergence of new suppliers and the exit of under performing suppliers. Within the food market, elasticity is driven by the premise of consumer sovereignty, in which consumers have information about every product, therefore can choose an enormous range of options and exactly how much of any given thing we want to purchase. In a free market, no one producer can manipulate the market price of a product. Producers are incentivised to satisfy consumer wants and produce efficiently to gain maximum profit. Economic theory suggests that under certain circumstances a free market promotes the optimal outcome for consumers and providers. As such, equilibrium in price and quantity are eventually met. While markets may be efficient, the allocation of resources by markets may not result in equity Do we have purchasing power as consumers in health care? In simple terms, we can predict when we will be hungry but we cannot predict when we are going to be ill and we know how to treat hunger but not all the eventualities of ill health. It is likely that without a national insurance system like the NHS an oligopolistic market would exist as there would be a few dominant sellers capable of influencing the overall market price of a commodity due to great market power.The universal NHS exists to meet this variable demand and ensure equity by providing a comprehensive, high quality service available on the basis of clinical need and not ability to pay; ensuring individuals arent victims of the market forces that could be derived from a market in which access to services is driven by the law of demand. It exists under a command market with no competition ensuring horizontal equity in distribution. In health care, consumers dont have the necessary information for driving a perfect market . To have perfect information they would need to know their current health status, prospective health status, available treatments and the cost of treatments. We rely upon doctors acting as agents (principal-agent relationship) or gatekeepers to assist in our decision making and to purchase healthcare based on their knowledge. In the Grossman Model based on a human capital approach to health (Grossman 1972; Grossman 2000) demand for health care is derived from the demand for health. In this model, it is recognised that consumers have imperfect information about their health and therefore may be subject to adverse selection problems. For a perfect market to exist within Health Care Services there is a need for prefect competition. For perfect competition to exist, asymmetry of information between consumers and producers should not exist, there should be uniformity in product and producers should be able to freely enter and exit the market. Rational purchasing decisions are often diff icult if not impossible to the non-medical population. Consumers are often unable to make an informed decision regarding whether treatment is required and, if so, which therapies are most effective. Markets in health care are not efficient, mainly because consumers do not have good information. In making resource decisions, allocation efficiency is also important. The concept of allocative efficiency takes account the efficiency with which outcomes are distributed among the community. Question 2 What are the disadvantages and advantages of using quality adjusted life years (QALYs) in economic evaluation? (800 words maximum) Within the National Health Service, according to Morris, Devlin and Parkin (2007), economic evaluation is used for the following reasons: To maximise the benefits from health care spending. To overcome regional variations in access. To contain costs and manage demand. To provide bargaining power with suppliers of health care products. QALYs are a type of health status index, based on population-level information that measure health gain (Spencer, 2003 p.1) to allow for economic evaluation of different health interventions. A single QALY is the arithmetic product of life expectancy, weighted by a measure of the quality (utility) of the remaining life-years to reach a single index value (Prieto and Sacristà ¡n, 2003). The utility value is 0 for dead and values one year of perfect-health life expectancy to be equal to one. These values are derived from scales, namely, the rating scale; time trade-off; or standard gamble. Each is subject to forms of bias. The QALY model offers consistency and limits budgetary waste, allowing for the greatest good to be achieved for the greatest number, so called distributive justice. It also allows for direct comparison of interventions in a common currency regardless of clinical discipline. This is because the cost per QALY does not confer the price of treatment but the price of the outcome that results, may that be in years or quality gained or lost. Phillips and Thompson (2001) summarise this as an expensive treatment may have a low cost per QALY if it brings significant benefit to patients; likewise, a cheaper treatment may have a high cost per QALY if the degree of benefit is relatively low. There are however specific criticisms held as to the generalisability of this model, the lack of consideration for baseline health status and whether QALYs perpetuates the issue of health inequalities (Wagstaff, 2002). The use of QALYs implicitly assumes that there are no other objectives to health care than health maximization. QALYs are considerably crude measurements, leaving vulnerable the question what exactly constituted the quality for which life years are adjusted. The utility measurement instruments each hold inherent bias as they are subjective aggregation of values. Individuals do not place the same value on each year of life. As such, the QALY model is inherently flawed as a health state utility of 0.6 is the same as three extra years of life at a health state utility of 0.2. As such, concerns have been expressed about the appropriateness of using QALYs calculations to inform resource allocation decisions (Dolan et al, 2008) as they are attempting to make subjective conce pts explicit numerically when there really is no consensus, leaving ambiguity in assessing overall improvement or detriment in health. Criticism has been expressed about the discriminatory aspects of the QALY model. The model favours those with more treatable conditions and those with greater potentials for health- be it in terms of functioning or longevity (Nord et al, 2009). Question 3 Outline the main methods to remunerate general practitioners (GPs) in the United Kingdom. (300 words maximum) GPs are self-employed providers, which under the 2004 GMC negotiated contract are paid by mixed payment remuneration, consisting of salary based on weighted capitation, fixed allowances, QOF and fee for service. Individual GP practices are allotted a practice income under the contract, from which expenses and staffing costs are funded. This payment, representing the largest part of their income, is a capitation fee per enrolled patient adjusted for age, gender, morbidity and mortality, with additional fixed allowances for maintaining particular services. GPs working in underserved geographic areas receive additional payments. Distribution to individual GPs within a practice is dependent upon seniority, practice efficiency and maintenance of operational costs through cost containment. GPs can also receive additional payments based on the quality of services provided in designated areas such as child health, maternity, family planning, and chronic diseases as part of a quality enhancin g framework (DH, 2004). The Quality and Outcomes Framework (QOF) is a voluntary, evidence-based framework spanning four domains: clinical, organisational, patient experience and additional services (DH, 2003). GPs are challenge to meet a range of evidence-based indicators within these domains from which they can accumulate points based on the breadth and depth of quality. As a result, payments are awarded according to the level of achievement. Practices receive about  £125 per point for an average sized practice with a maximum of 1000 points available to them. QOF is often revised to reflect changing population priorities, clinical advancements and best evidence to remain a pragmatic funding model. Thirdly, practices can enter into so called Enhanced Service agreements, based on the fee for service model. In Enhanced Service agreements, payments are awarded for meeting targeted requirements, such as flu and childhood immunisations and providing other specific services. ii) Compare and contrast 2 of these methods outlining advantages and disadvantages of each. (300 words maximum) Different financial incentives given to GPs might affect their behaviour and treatments plans for individual patients. Fees for service compensation is awarded based on a service being given to an individual patient. Care is clearly linked to payment and each service that is delivered has a specific payment rate. It has been argued that such a system of compensation induces GPs to put quantity, over quality of care in a bid to get increasing numbers of patients through their practice door and allows for unnecessary, potentially more lucrative, treatments to be performed at a financial benefit to the GP. This compares quite dramatically to the capitation system, which remunerates practices based on the population demography, regardless of the health status of the population. This means GPs have better budgeting capabilities, as each payment is fixed regardless of case mix meaning it is an equitable system for all patients. Capitation removes the need for GPs to see a high volume of patients within an allotted time frame but places incentives upon general practioners to enrol large numbers within their practice. As such, Capitation comes with the added risk of the potential to have a difficult case-mix due to increased numbers and allows for cream skimming to take place in which GPs exercise the potential to choose patients that are easier to care for, leading to health inequalities in certain demographics, i.e. the elderly. Outline the equity implication of patient co-payments for primary care services. (300 words maximum) Concern with equity implies the availability of some goods, including health care, should not be based, or based solely, on willingness to pay. Indeed, equity is an ethical concept built on the principle of distributive justice. In health, it is considered to be the absence of systematic disparities in health between groups with different levels of underlying social advantage/ disadvantage (Braveman, 2003, p1). Co-payments are flat fees or means tested payments, based on the willingness to pay model that a patient pays for a named health care service, such as a GP visit, dental treatment or prescription. Basing health care treatments on being able to pay is contentious. Co-payments have the potential to widen the equality gap by discouraging or restricting people from seeking important treatments or forcing individuals from lower socio-economic groups into making decisions about their health care based on price not their need. Equity assumes equal utilisation (use) for equal need. References Braveman P Gruskin S. (2003) Deà ¯Ã‚ ¬Ã‚ ning equity in health. Journal of Epidemiology and Community Health 57 pp. 254-58 Department of Health (2003) Investing in General Practice; The New General Medical Services Contract, Department of Health, London Department of Health (2004) Updated version of the QOF guidance and evidence base, Department of Health: London; 2004. Dolan, P (2008). Developing methods that really do value the Q in the QALY. Health Economics, Policy Law;3 pp.69-77. Dolan P. Kahneman D. (2008). Interpretations of utility and their implications for the valuation of health. Economic Journal; 118 pp. 215-234 Frank, R (1994): Microeconomics and Behavior. New York: W.W. Norton Company Goddard M. Smith p (2003) Equity of access to health care services: Theory and evidence from the UK, Social Science Medicine 53 (9) pp. 1149-1162 Grossman, Michael (1972a), The Demand for Health-A theoretical and Empirical Investigation. New York: National Bureau of Economic Research. Grossman, M. (1972b), On the Concept of Health Capital and the Demand for Health, The Journal of Political Economy, 80 (2) pp. 223-255. Grossman, Michael. (2000), The Human Capital Model, in Handbook of Health Economics, 1, pp. 347-408 Lockwood, M. (1988). Quality of Life and Resource Allocation. Royal Institute of Philosophy Supplement, 23, pp 33-55 Morris S, Devlin N, Parkin D.  (2007) Economic analysis in health care. John Wiley Sons, Ltd. Pinto-Prades, JL. Loomes, G. Brey, R. (2009)Trying to estimate a monetary value for the QALY ,Journal of Health Economics, 28 (3) pp. 553-562 Phillips, C. Thompson, G. (2001) What is a QALY? [online] at: http://www.evidence-based-medicine.co.uk/ebmfiles/WhatisaQALY.pdf Prieto, L Sacristà ¡n, J.A. (2003) Problems and solutions in calculating quality-adjusted life years (QALYs) Health Quality Life Outcomes; 1 pp. 80 Ringel, J ( 2002) The elasticity of demand for health care: a review of the literature and its application to the military health system, United States. Department of Defense, National Defense Research Institute (U.S.) Schafermeyer KW (2000) Health Economics I: Basic Economic Principles, Journal of Managed Care Pharmacy 43-50 Spencer, A. (2003) A test of the QALY model when health varies over time, Social Science Medicine; 57, (9) pp. 1697-1706 Wagstaff, A (2002) Inequality aversion, health inequalities and health achievement,  Journal of Health Economics, 21(4) 627-641

American Attack on Omaha and Utah Beaches During D Day :: World War II History

American Attack on Omaha and Utah Beaches During D Day It was 1944, and the United States had now been an active participant in the war against Nazi Germany for almost three and a half years, nearly six years for the British. During that period occurred a string of engagements fought with ferocious determination and intensity on both sides. There is however, one day which stands out in the minds of many American servicemen more often than others. June 6, 1944, D-Day, was a day in which thousands of young American boys, who poured onto the beaches of Utah and Omaha, became men faster than they would have ever imagined possible. Little did they know of the chaos and the hell which awaited them on their arrival. Over the course of a few hours, the visions of Omaha and Utah Beaches, and the death and destruction accompanied with them formed a permanent fixation in the minds of the American Invaders. The Allied invasion of Europe began on the 6th of June 1944, and the American assault on Utah and Omaha beaches on this day played a critical ro le in the overall success of the operation. (Astor 352) An extensive plan was established for the American attack on Utah and Omaha Beaches. The plan was so in-depth, and complex, its descriptions detailed the exact arrivals of troops, armor, and other equipment needed for the invasion, and where exactly on the beach they were to land. Before the landings were to begin, the coastal German defenses had to be adequately prepped, and softened by a combination of a massive battering by United States ships, and bombing by the United States Air Force. Between the hours of 0300 and 0500 hours on the morning of June 6, over 1,000 aircraft dropped more than 5,000 tons of bombs on the German coastal defenses. As soon as the preliminary bombing was over, the American and British naval guns opened fire on the Normandy coastline (D' Este 112). A British naval officer described the incredible spectacle he witnessed that day: "Never has any coast suffered what a tortured strip of French coast suffered that morning; both the naval and air bombardments were unparalleled. Along the fifty-mile front the land was rocked by successive explosions as the shells of ships' guns tore holes in fortifications and tons of bombs rained on them from the skies. Through billowing smoke and falling debris defenders crouching in this scene of devast ations would soon discern faintly hundreds of ships and assault craft ominously closing the shore.

Lost Worlds

In his article â€Å"Lessons from Lost Worlds†,   Jared Diamond briefly relates the environmental issues facing the world today.   He compares drought issues in Southern California to those of the ancient Anasazi or the Four Corners area of the American southwest, deforestation issues to the collapse of Polynesian societies and the interdependence of cultures to the collapse of island cultures as well/   Diamond points out that many of the countries causing political unrest around the world are among the most environmentally devastated and overpopulated in the world. He argues that it took the calamity of September 11, 2001, to make most Americans aware of their relationship with the rest of the world and that globalization means that we can be affected by global events far beyond the American borders. Diamond is a professor of geography and public health at the University of California, Los Angeles, and a director of the World Wildlife Fund. Both speak to his predisposition to seeing global climate change as a serious evil, even though he begins his article by saying that he had not considered the ramifications of environmental issues until his children were born.   He also uses himself and the Anasazi chieftains as an example of why people should care about the environment. The argument that it doesn’t affect me may not be true, as in the case of the last Anasazi’s, or it may be our children that will live with the consequences of our actions. Diamond takes it as a given that parents want the world to be a better, or at least as good, place for their children.   However, he blames the lack of will to change our own lives for what we are doing to the planet. The argument that the worst environmentally destroyed nations and most over-populated are political hotbeds is very convincing. I read recently that Pakistan fights a constant battle with mass immigration from India and because of it, the two countries are always on the brink of war. The main issue is that the India is well-overpopulated and has insufficient water for its people, so they leave trying to find another place to get their basic needs. People who cannot get enough food and water rightly resent those who appear to have everything and terrorists and those who support them develop as a result. I agree with Diamond’s observations that if we take more time to correct global climate issues, we may in fact be fixing some of our political issues as well.

Reaction Paper on “Matilda” Essay

â€Å"If you’re not having fun, you’re not learning†, this quote is taken form the movie â€Å"Matilda†. This is very meaningful to me because it is placed in the classroom of Miss Honey and it contradicts the school’s ambience of not being a conducive place (or even a fun place) learn. This of course is reinforced with the meanest principal on Earth, Miss Trunchbull, who is in fact hates children. I do agree with the quote because if you’re not having fun with what you are doing, then it would not be fun and it would not be even meaningful. I also think that having that fun environment will have a positive effect on the learner. The movie has parts that the class really enjoyed. The most thrilling parts for me were: 1) Matilda discovered her power; 2) Matilda was adopted by Miss Honey. I like the first one because I’m always fascinated about supernatural powers and mysticism. My reading preferences are always of a mystical genre, full of witches, spell, and supernatural beings and such. When I was a child, I have a very wide imagination and I will always imagine myself as a warlock casting spells or an extraordinary being that have powers like telekinesis, invisibility, shape shifter and many more. I also like the second one because I believe that every child deserves the best home possible. A child should have a home and a family that will encourage and enhance their mind. The movie, â€Å"Matilda†, is a very good movie about reading and about togetherness in the family. In the movie, reading for me is depicted in two ways. First, reading is a privilege skill that only the sophisticated people can practice fully. This is half true because nowadays the prices of book are too expensive for the poor people or even some of the middle-class people. Even some of the books that are published here in the Philippines are too expensive. But thanks to the very famous Book Sale, we can afford international or even local books that have a very good authority and storyline. The second is reading as a very powerful tool in battling simple to complex situations. There was one video I watched there the librarian said that â€Å"If knowledge is power, then I am in charge of an arsenal.† The books are powerful arsenals; they’re like bullets and our mind (while reading them) is the gun. Matilda is a very wide and complex reader. Wide in a way that she reads books from different genres and different eras. Complex in a way that she reads books that are way passed her capability or understanding as a child. I can really relate to Matilda in a way that I want to read so many books so badly but due to some circumstances I cannot. I can also relate to Matilda’s eagerness in reading. I too am eager in reading, mist especially when I like the book. I always try to read book from different genres and eras, just like Matilda. Reading that widely can enhance your knowledge and other skills like communication and social skills. All in all, â€Å"Matilda† is a very good movie with a lot of lessons like overcoming an obstacle is to face it wholeheartedly and don’t underestimate others. The parents are the ones who will instil the very rewarding skill of reading to their children. And I quote from one Emilie Buchwald, â€Å"Children are made readers on the laps of their parents.† We should all be Matilda, a very wide and complex reader and a very enthusiastic one too. Not being a stereotypical child who just plays outside. Lastly, I quote from one Frederick Douglass, â€Å"Once you learn to read, you will be forever free.†