Investigating Basic Circuits Essay Example for Free

Investigating Basic Circuits EssayIntroductionWhat is an electrical round? How can you manipulate particles and design a circuit that go out do what you want it to? This guided activity will introduce you to some components, tools, and concepts that be fundamental in electronics. It will allow you to investigate and failWhat are voltage, original, and resistance? How are they related to one another? What are some of the basic components that make up simple circuits and what do they do? What are the important lineaments of a circuit and how do I mea sure enough different parts of a circuit? How do I measure voltage in a circuit?How does the arrangement of components affect the characteristics of the circuit?How do I work safely with circuits?How can I use calculations to design circuits before I start creating one?Equipmentdigital Logic Board (DLB) or breadboard(2) inflame emitting diodes (LEDs)(2) 330 Ohm immunitys (orange/orange/brown/gold or silver)Digital multimeter ( DMM)22 imagine solid wireProcedureFollow the instructions to create different types of circuits. As you create separately circuit, you will be asked to make measurements and record observations to actualize understanding about the circuit and its components. Let us begin by investigating two components that are commonly used in circuits. They are resistors and Light Emitting Diodes (LEDs). Part A Creating a Circuit and Measuring a Circuits Properties 1. A Simple Circuit Arrange the components according to the picture shown. You will need to plug the USB cable from the myDAQ into your computer to provide power to the Protoboard. Notice that the LED has a flat notch on one side. Make sure the notch is ab initio oriented on the bottom as shown in the picture. In this arrangement, the flow of conventional up-to-date is from the top (5V) to the bottom (0V) through the resistor and the LED. What do you think the role is of the resistor in this circuit?(1a) Components on a Breadbo ard (1b) Circuit DiagramIn a circuit, the flow of conventonal current can be described as a positive charge moving through a complete circuit path (VCC to GND). Can you watch the flow of conventional current in both of the above pictures? 2. With the LED illuminated, flip the direction of the LED on the breadboard (notch on top now), and whence flip it back to its original position (notch on bottom). What does your observation tell you about diodes (and LEDs)?3. Using the DMM to Measure Values Making sure that the RED rail is plugged into (V) and the black lead is plugged into (COM) on the Digital Multi-Meter (DMM), turn the DMM on to direct current voltage range 0-600V or first clack (see 3a). Place the RED DMM lead on the top of the resistor, and the black lead on the bottom of the LED. annotating the knowledge on the DMM. Now switch the DMM leads.(3a) Digital Multimeter DMM(3b) Reading voltage across the resistor and LED What did you notice about the value on the DMM when you switched the leads?4. Now place the DMM leads across the circuit as you did initially in picture (3b) and turn the DMM to the next smallest voltage range (0-200V). You may need a classmate to help you. Note the value on the DMM and indeed turn one more click to the next smallest ranges (0-20V). What is happening on the display with each click, as the range you are measuring gets small and smaller?5. Turn one last click of the DMM to read the range (0-2V). What happened and why? What was the most accurate measurement were you able to make of the voltage across the resistor and LED?6. Set the DMM to the range that will give you the most accurate voltagemeasurement and interrelate the lead across the two block offs of the red wire. Note the reading on the DMM. Now touch the leads across the two ends of the black wire. Note the reading.(6a) (6b)Voltage (V=Vf-Vi) is a description of a components potential to do work. (1 volt means the component could do 1 joule of work for every coulomb of charge that passes though it (1V= 1J/1C). In order for a component to do work, there must be a difference in the potential across the component to do work (often called a potential difference). wherefore do you think the reading was the same for both of these sections of the circuit? What you make water just observed is exactly why birds can land on spunky power lines unharmed.7. In Step 3 you measured the voltage across the resistor and the LED combined. Now touch the leads across both ends of the resistor. Note the reading on the DMM. (a) Voltage across LED and Resistor (b) Voltage across Resistor OnlyCan you guess the reading you will see when you touch the DMM leads across the LED only? Were you correct? wherefore did you guess that value?8. You might be asking why we need a resistor in this circuit. Is it doing any work? Some components have limitations on how much electrical current can pass through them or how much voltage they should have across them. We can calculate the relationships between Voltage, Current, and Resistance for a component using Ohm Law (V=IR). Lets assume the voltage you saw across the 330 resistor was roughly 3V when the circuit was active. What is the conventional current (measured in Amps) traveling through the resistor according to Ohms Law?In this arrangement, the electrical current has only one path through the components (top to bottom in the picture). These components can be described as being in serial with each other. The inwardness of current flowing through an LED must each be equal in the same path. Warning Do not attempt to hold the current in the circuit at this time using the DMM. While the DMM canhandle this amount of current, you must learn how to use the ammeter portion of the DMM aright to protect it from blowing a fuse. Shorting voltage sources is dangerous and can damage the DMM.Part B Series and Parallel Circuits9. These two identical 330 resistors are in series with each other. There is o nly one path through the circuit from the power source to the ground. In this diagram, the power source is a 9V battery. One end of the battery has 9V of potential to do work (positive terminal-top). The other end of the battery has zero potential to do work (negative terminal/ground-bottom). (a) Based on your observations, what would you appear the voltage read if you touched the DMM across both R1 and R2?(b) Due to the fact that R1 and R2 are identical, what would you guess is the voltage across each resistor is individually? Why?(c) We can actually replace these two resistors with one resistor that would have the same impact on the circuit. (This theoretical resistor is called an uniform resistor). What would the value of this equivalent resistor have to be in Ohms ()?10. Create this series circuit on your breadboard. With both LEDs illuminated, remove one of the LEDs from the circuit path. What happened and why?11. You can refine 3 LEDs in series but none will light up. Why d o you think that is?12. Components in a circuit can to a fault be arranged in double. Create this gibe circuit on your breadboard. With both LEDs illuminated, what happens if you remove one of the LEDS from the circuit path?13. Using the diagram shown to you in Step 9 for series circuit as a reference, can you draw a circuit diagram showing 2 resistors in agree?(Draw circuit below)14. In a series circuit all component have the same current (Amps) flowing them (even if the resistors have different values. That is not the good example for components in parallel with each other. What do components in parallel share in common?15. Based on your observations and what you have learned about parallel circuits, use Ohms Law (V=IR) to calculate the current in each of the 3 resistors?Imagine you add more two more resistors (R4 and R5) in parallel. For each new path to the battery you create, what do you think that does to the total amount of current going into and out of the battery?Conclu sion1. Describe the proper means to place the DMM leads and the steps you use to attain the most precise measurement value for voltage across components using a Digital Multimeter (DMM).2. If the value on the DMM is negative, what does that tell you about the orientation of the DMM leads in relation to the flow of conventional current?3. LEDs and resistors transfer electrical energy into light and thermal energy. What is an important characteristic about LEDs (and diodes) that make it unique compared to a resistor?4. In your own words, describe what it means for components to be in series with each other. What characteristic do components in a series always share in common? (Voltage, Current, or Resistance)5. In your own words, describe what it means for components to be in parallel with each other. What characteristic do components in parallel always share in common? (Voltage, Current, or Resistance)Going Further6. In this investigation you were introduced to the mood of equivale nt resistance (replacing multiple resistors in series with one that does the same job. Equivalent resistance for a series circuits can be shown as a simple mathematical expression. How would you express this relationship to the total resistance in the circuit mathematically?7. A theoretical equivalent resistor can be placed in parallel circuits and shown mathematically as well. This relationship is a little less straight forward than equivalent resistance in series circuits. With a little research, can you determine how the equivalent resistance for this parallel circuit would be expressed mathematically? We will expand our understanding on these concepts in later activities.

Community Health Nursing Essay Example for Free

Community Health Nursing EssayHealthy People provide a 10-year national intention for improving the health of Americans. It has established benchmarks and monitored progress oer time in order to encourage collaborations across the country, empowering individuals toward making knowledgeable health decisions, and measuring the impaction of prevention activities. The vision is for a society in which all people live long and thinking(a) lives. Objectives new to Healthy People 2020 are related to to policies targeting young children through physical drill in childcare settings, television viewing and computer usage, recess and physical education in the Nations public and private elementary schools. Physical legal action is important as it can improve health and quality of life for all, including those with disabilities. Increased physical activity in children and adolescents can improve bone health, cardiorespiratory and muscular fitness, decrease levels of body fat and reduce s ymptoms of depression. at that place is an epidemic of fleshiness among our children today, this is colligateed to the over use of computer games and television. Healthy People 2020 have set an objective that sets limits to screen time. It was rather interesting to me that the pediatrician informed me that my infant, now a yearling should not be watching television at all as recommended by the Journal of Pediatrics. As mentioned in The Journal for Nurse Practitioners, there is a dangerous link found between childhood obesity and asthma (Rance, OLaughlen, 2011). A common assumption is that weight gain occurs because many unhealthy patients avoid exercise since physical activity can trigger their symptoms, though many contributing factors coexist (Rance, et. al., 2011). Interesting enough there has been a shadow that grueling/obesity as a risk factor for developing asthma (Papoutsaakis, Priftis, Drakouli , Prifti, Konstantaki, Chondronikola, Matziou, 2013).Asan adolescent I wa s diagnosed with having chronic asthma, as I was exceedingly active and not an overweight child. Physical activity was a normal part of my daily afterschool routine, I ran track, was a member of the swim team and was on the cheerleading squad. So having asthma one should not exclude physical activity from their life as it helps to prevent obesity and other ailments. A study illustrated that children were to a gr fertiliseer extent adept at identifying healthy foods and explaining their benefits than identifying activities that make their bodies healthy (Lanigan, 2011). This study also discovered that the media was the primary source of childrens health knowledge. Parents need to become much involved and lead by example as it pertains to the health and welfare of their children. This is why I often volunteer for the various optimist clubs in the community, sharing cultivation on the importance of staying active, hydrated and eating a well balanced diet.I keep my kids in extracurr icular activities such as sports, promoting physical activity and a healthy lifestyle. Early-learning professionals and levys need to play a more prominent role in teaching children about the benefits of healthy eating and activity (Lanigan, 2011). There has been a correlation between paternal influences on childrens weight gain, as a review demonstrated fathers who were overweight viewed themselves and their offspring as normal weight (Fraser, Skouteris, McCabe, Ricciardelli, Milgrom, Baur, 2011). The children in this study were more likely to eat fast food, eat at fast pace, eat when bored and were less likely to eat dinner together as a family (Fraser, et al., 2011). As it was hard to discern whether these behaviors are a result of children modeling behaviors displayed by their fathers, although the heavier the fathers were the greater the number of hours their children played out in sedentary activities such as watching television and using the computer (Fraser, et al., 2011). One strategy not mentioned in Healthy People 2020 is mandating parent involvement and modeling, which I consider first line of disproof for prevention of childhood obesity and related disease. The Affordable Care Act (ACA), builds on and strengthens the inception for prevention and wellness established by Healthy People, the nations health promotion and disease prevention aspirations for a healthier nation (Fielding, Teutsch, Koh, 2012). The rent to Community Preventive Services recommends making physical activity the easy choice by creating in our communities accessible parks andrecreation encouraging the kindly norm of walking, bicycling, and climbing stairs where these activities can reasonably substitute for driving and riding elevators or escalators and placing greater emphasis on mass transit and commingle residential and commercial development to encourage greater spatial integration of places where people live, work and shop (Fielding, et al., 2012).In conclusion, comm unity based childhood obesity prevention programs with a school component focusing on both diet and physical activity is more effective at preventing obesity and overweight (Bleich, Segal, Wu, Wilson, Wang, 2013). As previously mentioned one strategy not mentioned in Healthy People 2020 is mandating parent involvement and modeling, which I consider first line of defense for prevention of childhood obesity and related disease.ReferencesBleich, S. N., Segal, J., Wu, Y., Wilson, R., Wang, Y. (2013). Systematic review of community-based childhood obesity prevention studies. Pediatrics, 132(1), e201-e210. doi10.1542/peds.2013-0886 Fielding, J. E., Teutsch, S., Koh, H. (2012). Health reform and healthy people initiative. American Journal of Public Health, 102(1), 30-33. doi102105/AJPH.2011.300312 Fraser, J., Skouteris, H., McCabe, M., Ricciardelli, L. A., Milgrom, J., Baur, L. A. (2011). Paternal influences on childrens weight gain a system review. Fathering, 9(3), 252-267. doi10.3149 /fth.0903.252Lanigan, J. D. (2011). The substance and sources of young childrens healthy eating and physical activity knowledge implications for obesity prevention efforts. Child Care, Health Development, 37(3), 368-376. doi10.1111/j.1365-2214.2010.01191.x Papoutsaakis, C., Priftis, K. N., Drakouli, M., Prifti, S., Konstantaki, E., Chondronikola, M., Matziou, V. (2013). Childhood overweight/obesity and asthma is there a link? a system review of recent epidemiologic evidence. Journal of The Academy of Nutrition and Dietetics, 113(1), 77-105. doi10.1016/j.jand.2012.08.025 Rance, K., OLaughlen, M. (2011). Obesity and asthma a dangerous link in children an integrative review of the literature. Journal for Nurse Practitioners, 7(4), 287-292. doi10.1016/j.nurpra.2010.06.011

Television broadcast Essay Example for Free

Television broadcast Essay1. The hale announced on last nights television weather broadcast was 29.92. Explain how this was measured and give the units. Would this be con inclinered an unusually large or low storm value? A pressure announced on the weather forecast of 29.92 is an average measurement. It is measured with a barometer and in the United States the units of measure are inches of mercury, or inHg. This is what meteorologist are referring to in their forecasts. 29.92 inHg is a measurement within the normal range. This may be referred to as air pressure, atmospheric pressure or barometric pressure. They are all the identical thing. Low pressure readings are associated with stormy weather and precipitation, while luxuriously pressure readings are indicated by clear and calm weather. Here is Portland, Oregon, where it rains 9 months of the year, we be normal pressure readings of 29.92 inHg or slightly higher or put down. It only changes when we have exceptionally wo rse or better weather.2. If the earth did not rotate, how would you forebode winds to blow with respect to high and low pressure centers? With no earth rotation, winds would blow in straight lines. They would move from a huge high pressure region, the side in direct sunlight, to the lowest pressure region. This would be the dark side of the earth. The side the sun never touches. Cold air from the dark side would then be pulled back to the sunny side in straight lines to be warmed and then pushed back again. The dark side would be in a constant state of stormy weather, while the sun side would experience beautiful clear, calm, sunny days. If it didnt get cooked by the sun, that is.3. If the pressure incline force remained the same but the earths rate of rotation decreased slightly, would you expect the speed of the geostrophic wind to increase, decrease or remain about the same? If pressure gradient winds remained the same but the earths rotation slowed geostrophic winds would incr ease. The Coriolis force is a force based on the earths rotation. Because the earth spins objects in the atmosphere do not move in straight lines. The earths rotation causes them to veer of course. This is the CF. Pressure gradient winds (PGF) along with CF balance out geostrophic winds. If the earth slowed, the CF would decrease, so geostrophic winds would have to increase to maintain this balance.4. Explain why it is much more difficult to measure nose candy amount than rainfall amount. Rain is measured by the amount of runniness contained in the measurement device. Whatever is amount of liquid is in the device, is themeasurement. However snow, has unhomogeneous factors that can impact its measurement. First of all snowfall measurement is based on how much liquid there would be if the snow was melted into liquid form. There are several factors that can impact how much snow is measured in a device. Wind can move snow from high points to low points and vice versa. The surface on which the snow is falling onto can also impact a measurement. The length of time the snow has been on the foundation and how compact it is can also effect measurements. Measuring in several places and then using an average can give a more correct total. Meteorologists usually forecast snow amounts giving a range of totals due to these factors which make it challenging to give an exact forecast.5. Would you expect to find a remittance upending to be associated with high or low pressure? What effects might a subsidence inversion have on weather conditions at the ground? Subsidence inversions happen in areas of high pressure. A mass of cold air sinks slowly and is heated by adiabatic compression lower in the atmosphere. This causes this type of inversion. Subsidence inversions are high in the atmosphere and never reach the bottom because of turbulent mixing. The wind of a subsidence inversion can usually be indicated by a smoky or dusty looking layer that has a distinguishable line . This line marks the top of this inversion. Effects can include low visibility and poor air quality.ReferencesAhrens, C. D. (01/2014). Essentials of Meteorology An Invitation to the Atmosphere, 7th Edition VitalSource Bookshelf version. Retrieved fromhttp//online.vitalsource.com/books/9781305439733

Change Management And Organizational Culture Management Essay

Change Management And Organizational Culture Management try out1. INTRODUCTIONThis assignment discusses on two major pitch management issues, which are stopping channel and lead, pertaining to a ethnic figure. The nature of cultural neuter pull up stakes be discussed in two parts which are the different begines to viewing cultural exchange in an disposal leading to its implications and two reasons why cultural change is ingested. Culture and leadership are essential in a cultural change beca use they are fundamentally conceptually intertwined (Section 3). In elaboration, we volition be discussing the different perspectives of how culture is divided up which leads to the issue on subcultures and change resistivity. Furthermore, different firees to effect a cultural change will be discussed as well. In leadership, theories on effective leadership meanss will be looked into together with guidelines on how to effect a cultural change. field studies and recommendati on will be pose out for each issue. Beginning with the end in mind, change agents leading a cultural change will have a deeper understanding of its master(prenominal) issues and recommendations for an effective and successful change.2. THE NATURE OF CULTURAL limitingThe scientific draw near views culture as an object or a thing that organisations have. McKinsey 7s framework (Peters Wa destinationan, 1982) illustrates culture, shared values, as star of the several components (strategy, skills, module, system, structure etc) of an organisation. Thus, cultural change is defined as unlike another(prenominal) forms of organisational change, it is the change of shared beliefs, values and behaviours of organisational members rather than entirely focusing on the systems and structures within which people work (Waterhouse Lewis, 2004353).However, the anthropological set about sees culture as what an organisation is or is being. Anthropologist suggests that if cultures in societies are regarded as something societies are, should non organisations be view in the equivalent way likewise? In support of this view, one suggests that, since organisation ultimately resides in the heads of the people involved, effective organisational change implies cultural change (Morgan, 1986138).There are two implications resulting from the idea that organisational change is cultural change. The first is that since cultural change is organisational change, no distinction made in the midst of a strategy for cultural change and a strategy for organisational change (Bates, 1994). The second is that cultural change is not about what we study, rather the way one looks at an organisation. Therefore, in a cultural change, one must think culturally rather than to think about culture (Bate, 1994).Although there is no tall(prenominal) and fast rule when it comes to deciding which approach is right, one must therefore take balanced view that the anthropological approach is good for sy stems sake turn the scientific approach is helpful for practise.Two main reasons for a cultural changeThe first reason lies in the header, what cause organisations to change if cultural change implies organisational change? One main answer is that the environment is ever-changing thus methods used today whitethorn not be relevant and successful for tomorrow. Now, base assumptions shared among members are considered as methods and litigatees in an organisational of how people work and solve problems. Thus the change in methods implies change in radical assumptions which means a cultural change.The second reason lies in the perception that there is a relationship between an organisations performance and its culture (Kotter Heskett, 1992). Furthermore, researchers argue that this positive link will exist only if the culture has the ability to adapt to changes. Therefore, changing culture can result in higher performance in an organisation.3. TWO CHANGE MANAGEMENT ISSUES Organisa tional Culture LeadershipCulture and leadership are the non-negotiables in cultural change as they are conceptually intertwined (Schein, 1992 pg2). Culture begins with leaders who infix values and assumptions on an organisation which in time are taken for granted if proven to be successful. In this case, the culture now defines leadership (Schein, 1992 pg2).Case in tiptop Richard Branson, CEO of Virgin Corporate, is famous for his radical, charismatic and unconventional leadership style. In 2007, he pulled out a publicity stunt during the erect of Virgin America by jumping off the Palms Casino Hotel in a bungee rope (Yaqoob, 2007). The point is- the reason to Virgins phenomenal culture is generally rooted in Bransons leadership. Thus, one may also understand his leadership style by examining Virgins culture.Since cultures begin with leaders, developing and transforming culture has to begin with leaders besides and this justifies the need to examine culture and leadership as th e two major change management issues in whatever cultural change of an organisation.4. ORGANISATIONAL CULTUREAlthough numerous writers have associated organisational culture as an organisations climate (Schneider, 1990), embedded skills (Argyris Schon, 1978), habits of thinking (Hofstede, 1980) and shared meanings (Geertz, 1973), they just seem unable to hit it on the nail. They are merely descriptions of what culture is but not its definition and as Schein puts it, none of them are the culture of an organisation (Schein, 1992 pg10).In this view, Schein defines culture as a shared pattern of (1) basic assumptions that a exceedn group has invented, discovered or developed (2) in learning to cope with its problems of external adaptation and internal integration, and that have (3) worked well ample to be considered valid and, therefore, to be taught to natural members as the correct way to perceive, think, and feel in relation to those problems (Schein, 1992 pg12).4.1 Dimensions of Organisational CultureThe understanding of what organisational culture is leads one to question, What constitutes to an organisations culture? To answer this, there are two models of cultural dimensions. The first is the cultural web model (Johnson Scholes, 1992) which lays out six dimensions (stories, symbols, power, structure, controls and rituals) constituting culture. The second is the trains of culture model (Schein, 1992) which describes cardinal dimensions in degrees of depth1. Artefacts (surface level) This refers to the physical architecture of the organisation, the mannerisms, attire and even gossips/stories of the organisation (Schein, 1992 pg17).2. Espoused values (middle level) They are strategies, goals and philosophies of the organisation.3. Basic assumptions This refers to the way things are done in the organisation (e.g. processes of solving issues) that are taken for granted, changing these requires much time and can be very difficult and anxiety provoking (S chein, 1992).Iceberg conceptThe companionship of what constitutes to an organisations culture provides a clear, comprehensive and deep understanding of it. Furthermore, one can derive from this knowledge a clear direction of what needs to be changed and worked on in a cultural change.When managing a cultural change, one must be mindful of not falling into the error of the Iceberg concept (Watson, 2002). heathenish changes are often reflected only at the top of the iceberg (e.g. physical appearances, attires, vision etc) while the processes and basic assumptions among the members have not changed or are not changing.Therefore, it is our recommendation that change agents look into the dimensions of the organisations culture (maybe as a checklist) ensuring every aspect are taken into account of for a successful change.Case in point (http//www.income.com.sg/aboutus/releases/2009/aug28.asp) Since the start of a cultural revolution led by Mr Tan Suee Chieh, CEO of Income cooperative, m any aspects of the Incomes culture have been changed. At the surface level (Artefacts), Incomes logo was re-designed, particular(a)ly from red to orange, to give a smell out of relevance and vibrancy. At the deeper level, philosophies and strategies are re-constructed from a work-life balanced perspective to a competitive point one. Basic assumptions have been changed to encourage members to be take initiatives rather than wait for a top- raze post.4.2 SubculturesSpeaking of shared shared basic assumptions, an important question one must consider is, to what extent are they shared? To answer this, Martin suggests that there are cardinal perspectives to view it (Martin, 2002).The Integration perspective refers to a consentaneous consensus of the organisations culture shared across every level and department with no room for ambiguity. Differentiation perspective refers to a certain level of ambiguity and repugnance in interpretation resulting in a collection of subcultures. Me mbers who have shared norms and beliefs gravitate together forming subcultures. Subcultures may or may not be from the same subgroups or divisions of an organisation and the norms and beliefs they share often arise from changing demands. Subcultures may also be a place to express common unhappiness and conflicts. fragmentation/ambiguity perspective has a high level of ambiguity and unclear consistent or inconsistent manifestations. Subcultures are unbounded and are highly dynamic.In other words, organisations can either only have single cultures with no subcultures or a collection of subcultures with a/no overarching culture. It is useful to understand this when overcoming resistance as subcultures can be a resistant to change.4.3 ResistanceUnfortunately, change resistance are inevitable and often begins at the initial leg when do members to change. Subcultures, fears, anxieties, uncertainties, misunderstandings and the inertia to change can contribute to change resistance result ing in a stall in the change process.Case in point (Madslien, 2010) Lufthansa and British Air ways found hard to persuade members to accept operational changes as they could not win the hearts and minds of their ply. The contributing factor is plausibly that there is a peachy inertial in members to change.We recommend change agents six ways to overcome resistance to change (Kotter Schlesinger, 1979)1. Education and persuasion- Provide information for the need for change.2. Participation and involvement- Empowering members with the sense of ownership in the change.3. Facilitation and support- Provide counselling and coaching.4. Negotiation and agreement- Embrace the give and take spirit.5. Manipulation and cooptation- Distort information forcing them to accept change.6. Direction and reliance (coercion)- akin to the aggressive approach where it commands/directs members to change if not they have to face certain consequences.Change agents may also use the expectancy theory model ( Vroom, 1964) to trip members to change. The key is that members would be more motivated to change (if there is a reward/benefit at the end) by integrating all three aspects1. Valence- The willingness members to change for a particular outcome.2. Instrumentality- The effort members must put in to achieve a particular outcome. This must be weighed with the reward/benefit (equity) piped from change.3. Expectancy- The capability undeniable of an individual to accomplish the task/s.Case in point (www.osl.ltd.co.uk) Joseph, general sales manager of Universal Property Agency Ltd, decided to propose a sales contest to motivate his staff for better sales. He believed that members would be motivated to bring in more sales by rewarding them with exchange rewardsMembers may feel that the effort they must produce is more than the reward, although they may seem attractive. Thus, we recommend that change agents take in to account all three aspects of the expectancy model together in order to m otivate members to change.4.4 Two types (strategies) of cultural changeDevelopmental change focuses on strategies to maintain order and persistency of an organisations culture while transformational change seeks for change and discontinuity. To avoid a Castalian tragedy, we recommend change agents to integrate some(prenominal) strategies linking each strategy to a different point in the cultural development cycle (CDC) (Bate, 1994).Case in point (http//www.income.com.sg/aboutus/brands/index.asp) Income underwent a cultural revolution of both developmental and transformational change. It is developmental because the point of cultural change is for Income to remain to its cause by being relevant and competitive. It is transformational because the logo of Income is changed and the values and basic assumptions among members are re-constructed.In order for a comprehensive unified strategy, one must consider the following1. The existing culture- Nature of present culture to be changed. 2. Origins trajectory through time- A telescopic perspective to gain a complete picture.3. The CDC the stage an organisation has reached- The life cycle of its culture and stage where the organisation is at.4. The environmental context- The context outside the organisation where the culture is situated.5. The native dimension- The culture envisaged after change.4.5 Four approaches to effect cultural changeAggressive approachThe aim is to cause disruption of traditional values, fears and panic among members as a clear intention that change is on its way regardless how members feel or prefer. It is like someone barging into the meeting room forcing a change down the throats of everyone.Case in point (T. Nakajo T. Kono, 1989) Japanese Brewery, Asahi, threw the idea of capitalism out of the window taught members the idea of communism. Food ration were reduced to anyone who resisted the change.Aggressors deed of conveyance to use this approach only as the last resort for survival w here radical times demand radical remedies (Dunphy Stace, 1988321). In other words, it is being cruel to be kind (Bate, 1994177).Furthermore, aggressors argue that unlike democracy that allows the opposition to sip in, they should take the initiative and have a single say where there is no chance for duologue but only complete submission.This approach is dangerous as it may backfire caused by increase in segmentation of unhappy members. Secondly, the aggressor may be too self-centred and motivated by selfish desires that the change may sidetrack off its intended purpose.Conciliative approachConciliative approach believes that mutuality is key as it promotes incremental changes quietly without offending either the proposition or opposition. Conciliatives see resistors as being reasonable and believe that both parties are able to work things out amiably.Conciliative use this approach because they feel they have a lack of power to compel members to change.Case in point (Mayo, 1989) A lthough Peter Bonfield, chairman of ICL, saw the need for a total cultural change he did not dare to impose it as he did not feel empowered to effect the change.Also, conciliatives use this approach because they want to avoid conflict. They believe it is always better to collude than to collide with members who object the ways things are done. Lastly, conciliatives believe in promoting continuity for cooperative relations rather than discontinuity which breeds resistance. It is an attempt to avoid opposition through gradual continuous development (Renfrew, 1979).However, this approach may be time wasting as conciliatives are always afraid of conflict thus it is difficult to move on (Bate, 1994). Also, one need to critique whether revolutionary changes possible through evolutionary change.Corrosive approachAs the name implies, this approach sees cultural change as a political process and aims to incrementally corrode the oppositions power until they become either submissive or irrele vant (Bate, 1994187). This is achieved through networking and deviously manipulating relationships.They argue that cultural change has to involve networking as it is at the core of cultural development and change (Bate, 1994) empowering individuals which in turn will collaborate with other individuals to effect a cultural change (Brass, 1984). Furthermore, they claim to focus on actions instead mouthing change it is a concept of pulling rather than pushing for change.This can be dangerous as it can subtly move from change-directed to order-directed and relationships formed are considered as informal which may shift frequently.Indoctrinative approachThis approach sees cultural change as a learning process (Schein, 1985) whereby members are being better of the new culture through intentional training and workshops. This approach is used to change the underlying assumptions of members in an organisation and give new meaning to them.Case in point (Financial Times, 27 March 1991) Britis h Telecom organised a successful three-day course (Project Sovereign) to educate staff the new culture- the new BT will not allow customer calls to get lost.Case in point (Andrew Mayo, Director of Personnel, ICL International, 1989) ICL International conducted major educational programmes to educated members why we are doing what we are doing, to know why they have to shift their thinking.However, this approach faces a problem whether members will buy the message conveyed. Furthermore, the new messages conveyed may not be realistic in actual practise.Change agents may face the issue of how to film the better approach. Thus, we recommend using each approach in different stages of the CDC in a sequential/continuum way (although they are distinct and independent). For example, the Aggressive approach can be used in the unfreezing stage followed by the Conciliative (hearing from members suggestions) and Indoctrinative approach during the cognitive reconstructing stage. Lastly, the Cor rosive approach can be used for networking to sustain change.5. LEADERSHIPAlthough Stogdill suggests, There are almost as many definitions of leadership as there are persons who have attempted to define the concept (Stogdill 1974 pg259), we believe the most appropriate definition is- leadership is a process whereby an individual influences a group of individuals to achieve a common goal (Northouse 2004 pg 3). And process denotes that leadership and learning are indispensable to each other (John F. Kennedy).Moving on from the definition of leadership, one must also consider the different theories on understanding effective leadership in practise. The development of leadership theories can be understood in two categories and they are the mere and emerging approach in chronological order. We have characterised the two approaches in that the classical approach focuses on the hardware of leadership (which includes traits, functions, behaviours etc) while the emerging approach looks into the software of leadership (relationships, emotional/social intelligence, charisma etc).5.1 Classical approachcharacteristic theoryTrait theory is simply a response to the question of, what qualities distinguish an individual as a leader? It believes that effective and successful leadership styles are dependent on certain traits. Examples of leadership traits are self-efficacy, physical characteristics, conscientiousness and skills distinguish a leader from an ordinary man (Carlyle, 1841). These traits are argued to be inherited as leadership cannot be created or promoted and it cannot be taught or learned (Drucker, 1954 pg158).However, behavioral theory suggests that people can learn such(prenominal) traits through learning and observing others. According to the managerial grid theory (Blake Mouton, 1964), there are five different leadership styles resulting from two dimensions of behaviours (concern for people and concern for task) outlandish club style, impoverished manageme nt, middle of the road, team management and authority compliance.Although both theories agree that effective leaders must possess certain traits, they differ in that behavioural theory believes that such traits can be acquired. Thus, a learning attitude is important for effective leadership (Schein, 1992).Situational theoryUnlike trait and behavioural theories, Situational theory argues that successful leadership styles are dependent on the situational contexts (Hemphill, 1949). Therefore, it is crucial that leaders examine the situation prior to effecting any change.Case in point (Hogan, 2003) Enron, a real-life example of situational theory, was caught in a major scandal in 2001 for insider trading and conspiracy. Due to this situation, an immediate action was taken by dismissing many elder management and leaders.Contingency theoryContingency theory is an expansion of situational theory that suggests effective leadership styles are dependent on the situation and environmental vari ables such as the groups atmosphere, task structure and leaders power position (Fielder, 1967). The Vroom-Yetton contingency model elaborates Fielders theory stating that personal characteristics and attributes of the leader are important contingent elements too (Vroom Yetton, 1973).Therefore, there is no right leadership style but only the best depending on the environment after carefully examining it. working(a) theoryFunctional theory dismisses the idea that effective leaders possess a common set of traits but propose that they possess the competence to handle a panoptic range of different situations (Gill, 2006). According to the Action Centred Leadership model (Adair, 1973), there are three areas a leader must consider1. Task- Accomplishing the teams goal.2. Team- The development and construct of teamwork.3. Individual- Empowering and helping individuals develop full potential.As all three aspects are interdependent, it is crucial for a leader to strike a balance among them in order for the group to succeed.Leadership stylesAn expansion of Lewins theory of three main leadership styles which are autocratic, participative and laissez-faire (Lewin, 1939) resulted in a continuum of seven leadership styles (Tannenbaum and Schmidt, 1958)Figure 1 (www.mindtools.com) describes the seven leadership styles by arranging them in a single continuum. This means that leaders are not restricted to choosing only one style (independent) but are able to select any point of degree within the continuum.5.2 Emerging approachTransformational/charismatic theoryTransformational theory suggests that effective leadership styles depend on the form of relationship between a leader and his members e.g. leaders and followers encourage one another to higher levels of morality and motif (Burns, 1978). This can be measured in the influence (trust, respect, inspiration and admiration) a leader has on his followers (Bass, 1985). The relationship between the leader and follower is extrem ely crucial and is likened to a magnetic force attracting people.Case in point Herb Kelleher, CEO of the Southwest Airlines, is an example of a transformational leader. Some call him the energizer bunny of the skies (Jones, 1994) and Americas funniest fly-boy (Beddington Loftus, 1998). His personality emanates a force that draws and influences others, producing warm and determined employees which ultimately define culture.5.3 Selecting the right theoryMost leaders face the question, How does one select the right theory or approach and apply it in a cultural change? Our first recommendation is that leaders can employ any one or more theories on a case by case basis. This means that if a leader needs to learn how to connect with his staff in order to motivate them for change, he can employ the trait/behavioural and/or transformational theory. Or the leader can employ the situational/contingency theory in the case of examining and understanding the current situation prior to effectin g change.Secondly, we recommend leaders to adopt all theories in a timbre by step manner sequentially flavor 1 (situational/contingency) Scan the environment to know what leadership needs are essential for change.Step 2 (trait) Select particular traits to meet particular demands for a successful change.Step 3 (styles) Select a style along the continuum model for conveying messages, leading members and motivating them for change.Step 4 (functional) Be clear on areas under each function that is needed to be considered when effecting changeStep 5 (transformational) Build and maintain relationships with members during the change for a successful outcome.To conclude, it is crucial to note that there are no right leadership styles or approaches, rather there are only the best ones depending on the situational context.5.6 Effecting a cultural changeWe now move on from selecting leadership styles to effect change to the actual steps in effecting change. We recommend the use of Lewins three steps model to effect change as a guiding principle1. Unfreezing To weaken resistance to change (Schein, 1992) and motivate members for change (Lewin, 1951) in three stages.(a) Disconfirming data This refers to any information that shows an organisation that it is not meeting its goals in order to stir up discomfort and disequilibrium (Schein, 1992 pg299). (b) Anxiety and/or guilt Disconfirming data must generate anxiety/guilt in order to leave members with no choice but to accept change.(c) psychological safety Change is stressful (Korunka, 2003) as it removes members from their comfort zone (Jarrett, 2003) causing fears of uncertainty and discouragement. Providing a psychological safety net for members through adequate assurances (long term especially) relevant information and gratitude to members (Weick Quinn, 1999)2. Cognitive restructuring Redefine organisational traditional values, basic assumptions and processes etc through workshops and courses.3. Refreezing Constantly rei nforce changes through artefacts reflections, certain behaviours and processes.Case in point (http//www.youtube.com/ user/tansueechieh) Incomes CEO gave disconfirming data in his speech entitled, cultural revolution, awakening staff of their lethargy. Cognitive restructuring was accomplished through workshops and new companys statement. Furthermore, Income underwent a rebranding reflected in advertisements, new logo and new colours. These help to reinforce the changes and new culture of Income.Sustaining a new culture, be it a discontinuity or continuity change, is tedious and difficult. The role of rites theory, by Trice and Beyer (1990), suggests cultures can be reinforced by repeating a certain set of rituals. The six rites are the rites of passage (induction), enhancement (rewards), degradation (to publicly identify failures ATT case), conflict reduction (acknowledge and resolve differing opinions), integration (foster cohesion) and renewal (maintenance).4. CONCLUSIONWe have beg an with the end in mind which is that change agents will have a deeper understanding of two major change management issues, which are culture and leadership, when managing a cultural change. This assignment has discussed issues pertaining to culture such as resistance, different perspectives and the iceberg concept. Issues pertaining to leadership such as the different theories and the guidelines on how to effect a cultural change have been described in detail as well. some(prenominal) change management issues are supported with case studies and recommendations to assist change agents make better decisions.(4,187 words in total)

The Kawasaki disease

The Kawasaki ailmentKawasaki unhealthiness is an intense systemic paediatric vasculitis sickness that is seen commonly in childhood. Kawasaki malady is one of the most common heart diseases. It is the inflammatory disorder but the aetiology of Kawasasaki disease is unknown. It first appe bed in 1967 by report of Tomisaku Kawasaki who was a japanese paediatrician. He also called Kawasaki disease as mucocutaneous lymph node syndrome. There is no diagnostic test therefore, doctors atomic number 18 development the clinical criteria that were proposed by Dr. Kawasaki 45 years ago to diagnose the Kawasaki disease. There atomic number 18 many different diagnosis of Kawasaki disease such as viral infections, genic sensitiveness or environmental computes. Many research proposed that Kawasaki disease is an infectious disease that whitethorn be ca utilize by Epstein-Barr virus, measles, adenovirus, enterovirus. However, there is no confirmed evidence. Usually, KD rouse establish m ore in Japanese society but it keep spread to western countries and the incidence of KD in western countries ar increase dramatically. There are typical symptoms that fanny be seen in KD such as rash, edema, and mucosal membrane changes. But there are more symptoms that are take upd which are not typically be from every KD patients. Therefore, it is hard to diagnosis patients if they rent KD or not. The interference of KD is different depends on if patients are send off or fractional KD and also, the susceptibility of IVIG pass on make treatment different along patients. The etiology is not certain but there are several researches shown that KD is caused by infectious agents, genetic factors, or resistive system disorder.Current knowledge on the subjectThere are several symptoms that washbasin be found in patients with Kawasaki disease. When patients energise more than 5 days of fever for more than 38C and withstand more than 4 symptoms such as bilateral nonexudative con junctival injection, polymorphous exanthem, nonvesicular rash, hemangioma simplex tongue, edema of hands and feet, bilateral non-suppurative cervical lymphadenopathy, and mucosal membrane changes, patients will diagnosis as KD. Kawasaki disease notify be divided into complete Kawasaki disease and half(prenominal) or atypical Kawasaki disease depending on the number of symptom that are present in the patient. When patients have more than four symptoms or have developed coronary thrombosis thrombosis artery abnormality, patients will be diagnosed as complete Kawasaki disease. In contrast, patients who have less than four of the diagnostic criteria and still develop coronary artery abnormality is diagnosed as atypical or incomplete KD. Because of the cause of Kawasaki disease is unknown, diagnosis of Kawasaki disease in infants are very challenging. Kawasaki disease can be divided into three contours. First, from one week to two weeks from onset is called incisive phase. Typical symptoms are highly feverish, irritable and the fever approaches more than 39 Celsius. Oral changes continues and also rash can be found in perineal area. Secondly, from two to eight weeks from onset is called subacute phase. In this phase, fever rifle to decrease slowly and the perineal area, soles, and periungual areas start to peel off. Lastly, from months to years from onset, it is called convalescent phase. In this phase, laboratory value gets normal but there may be severe consequences. For example, patients who had aneurysms may continuously have, for rest of their life, persistent cardiac dysfunction, or myocardial infarction.Coronary artery aneurysm can be highly found in incomplete Kawasaki disease patients. It is defined as coronary dilatation that the diameter of coronary vessel gets enlarged 1.5 folds. It can be diagnosed by angiographically and it is uniform to patients with coronary artery disease. The end-diastolic pressure, end-diastolic volume, and ejection fr action directs are not normal and the left ventricular contraction is not normal. The coronary artery aneurysms are by and large caused by atherosclerosis.There are several associated symptoms that can be seen in Kawasaki patients. Diarrhea and abdominal pain and patients may develop arthritis. Also, myocardial dysfunction can be found in early phase of Kawasaki disease such as pancarditis which is the inflammation of all three layers of heart. Another symptom is periarteritis nodosa which is disease in connective tissue that is blocked by nodules in arteries thereby ca employ blood to not circulate properly. When Kawasaki disease shows periarteritis nodosa, other symptoms cannot be found.Kawasaki disease can be diagnosis by physical exam but also it can be diagnose by laboratory exam and imaging technique. First, complete blood count test should be performed to look at the meter of white blood cell in blood. Complete blood count is the counting of white blood cells, red blood ce lls, and platelet. The number of white blood cell increased to more than 15,000. Also, the erythrocyte sedimentation rate and C-reactive protein increase. After 2 weeks from onset of disease, the platelets train dramatically increases up to 1 to 2*106. There are other abnormalities such as sterile pyuria, increases of hepatic transaminases, hypoalbuminemia. In patients who have KD will have higher level of transaminase than normal person. Also, they will have higher level of ALAT and GGT than other patients who have other febrile diseases. When ALAT level increases, it will lead to coronary artery disease. Research proposed that almost 50% of incomplete KD patients had pyuria in bladder urine. Pyuria can cause different diseases depends on where it is. When pyuria is in bladder, it can cause tubulointerstitial nephritis but when it is in voided urine, it will cause urethral inflammation. Another symptom to diagnosis incomplete KD is to look at acute anterior uveitis after the onset . Patients who have anterior uveitis do not have pain, photophobia, nor visual impairment. By using ophthalmological evaluation, it can detect if patients have different disease which have similar symptoms with anterior uveitis. One of the research in 2006 showed that there were 40% of KD patients had hyponatromia. It is caused by incorrect hormone secretion by cerebral vasculitis, dehydration, or tubular dysfuction. It is hard to diagnosis KD since there is no diagnosis test. To treat incomplete KD, the principle clinical criteria should be renewed in order not to miss out somewhat patients who did not have principle symptoms. By missing out patients will develop severe other diseases and will not be able to refund proper treatments.KD also can be found out by using imaging technique. At acute phase, bureau x-ray or echocardiography (ECG) are used to look at heart problem. Patients may develop coronary artery abnormalities in acute phase and this can be showed by ECG. When patie nts are very severe, heart specialists sometimes use single photon emission computed tomography to look into bloodstream of patients. SPECT will provide an kitchen stove in 3D by using gamma rays.EpidemiologyKawasaki disease is new disease that is predominantly found among Asian children1,2,3. It was first found in Japan by Dr.Kawasaki in 1961. In early 1970s, Pathologist Eunice Larson and Benjamin Landing at Los Angeles recognized it as a new disease. Still today, there is no evidence of how Kawasaki disease emerged but some researchers proposed that Kawasaki disease emerged from Japan and spread to Western countries through Hawaii after World War II. Kawasaki disease was across the country epidemics but now it is more likely a regional outbreak. The mean annual incidence rate is different in variety of countries and districts3. There are 90 to 112 per 100,000 in Japan, 8.0 to 47.7 per 100000 in US, and 3.6 to 3.7 per 100000 in the United Kingdom and Australia for children who ar e less than 5 years old. Research in mainland China indicates that the incidence rate is 18.2 to 18.6 per 1000003. The statistics shows that Japan predominantly has highest incidence rate among Asian. Kawasaki disease can be found commonly in males than females and the reoccurrence rate is less than 1%3. The incidence of Kawasaki disease has been increasing annually. In 2000, the incidence rate was 73.7 per 100000 but in 2002, the number of occurrence increased to 95.5 per 1000003.There are relationships surrounded by season and occurrence of Kawasaki disease3. But there are variations among different countries. From Japanese reports, there were more patients in winter but in American selective information shows that patients will develop KD more in the spring and winter. For female the occurrence appeared to be high in March, and highest in July. For boys, the highest occurrence rate was in whitethorn and the lowest occurrence rate was in February. As the research indicated, the s eason and climates have relationship with the susceptibility to Kawasaki disease3.GeneticsPatients with Kawasaki disease may develop coronary artery abnormalities (CAAs) if patients are not treated early. Usually patients are treated with high amounts of endovenous gamma-globulin (IVGG) as well as aspirin which are used to reduce the possibility of developing CAAs2. However, 10-20% of Kawasaki patients do not response to induced intravenous gamma-globulin. Coronary artery abnormality will develop more a great deal to patients who are not responding well to IVGG than patients who respond well to IVGG. Recent research reported that matrix metalloproteinase-9 (MMP-9) is involved in formation of CAA in acute phase of Kawasaki disease patients2. From research, the level of MMP-9 in serum who have Kawasaki disease have much(prenominal) higher than serum from children who does not have KD and patients who have other kinds of febrile diseases2. Using MMP-9 inhibitors might prevent the for mation of CAA. However, MMP-9 inhibitors are not used clinically. MMP-9 is endopeptidase that depends on zinc that has zinc at the active site. MMP-9 have major agency in tissue remodelling of extracellular membrane (ECM) 2. It can be seen in cardiac remodelling after myocardial infarction, plaque destabilization of atherosclerotic lesion. The mechanism of angiotensin-converting enzyme (ACE) inhibitors is involve with the bind zinc to the active site and stabilize by hydrogen bonds and hydrophobic interactions in the active site. The ACE inhibitor can inhibit the activity of MMP-9 and MMP-2, which have major graphic symbol in neointimal formation and angiogenesis. The effect of the ACE inhibitor on MMP-9 can be measure by using captopril to the enzyme2.Involvement of the immune systemFrom the studies by Satoshi Sato, Kawasaki disease is commonly found from patients who are younger than 5 years old1. The average age of occurrence of this disease is 2 years. Kawasaki disease does no t occur frequently from children who is less than 6 months and can hardly find patients who are less than 3 months1. Kawasaki disease usually does not occur for expectants who have immunity to common infectious disease. This result explains that children are more susceptible to Kawasaki disease because they might not produced antibodies to common infectious viruses, and bacteria1. Mannose bind lectin (MBL) is an classic component of the innate immunity and is a reactant for hepatic origin which can bind to multiple lectin domains1. MBL has very important role in complement activating and opsonization. Complement activation refers to as the biochemical activity that helps to get rid of pathogen from animal and opsonization have similar activity to complement activation that plays role of pathogens to get rid of the organism by ingestion and destruction by phagocyte1. It is usually found in bacterial cells, fungus cells, and viruses. It has repeating pattern of mannose and N-acetyl glucosamine sugar. There are three single polymorphisms in chromosome 10 for MBL gene at codon 52 (CGT to TCT), codon 54 (GGC to GAC), and codon 57 (GGA to GAA). This mutation will lead to reduction of the level of MBL soaking up but polymorphism of the promoter region of MBL will lead to increase the level of MBL compactness in the serum1. When the base changes from glycine to aspartic acid in codon 54, it will distract the interaction between MBL and MBL-associated serine protease. The interaction between MBL and MBL-associated serine protease defend against infection when patients are young. But when patients become older, the interaction of these two molecules will not have impact on the innate immunity1. Because, the patients will develop the mature lymphocytes and immunoglobulins and they will engulf the invaded pathogen. Therefore, this research proposes the susceptibility of the Kawasaki disease will be influenced by the MBL polymorphism1.Children who have Kawasaki disease develop endothelial dysfuntion in early phase after onset of disease and this will caused by the yield of nitric oxide (NO)5. As described earlier, the primary innate immune system is very important feature for Kawasaki disease. Tumour necrosis factor alpha, IL-1, 6, 8, monocyte, chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF) will be activated to produce cytokine storm5. After cytokines are produced, it will release iNOS (inducible nitric oxide synthase) in neutrophils, endothelial cells, and smooth muscle cells. Nitric oxide is produced by two enzymes which are endothelial NOS and iNOS5. Recent research found out that patients who developed Kawasaki disease have higher level of iNOS concentration in neutrophils in acute phase. Also, children have high level of nitric oxide metabolites such as NOx, NO3-, and NO2-. After production of Nitric Oxide, it will react with Reactive Oxygen Species (ROS) to give more biochemical reactions. This will be meas ured by new device called fluorescent indicators5. There are new devices used to measure the concentration of NO and ROS. First, Hydroxyphenyl fluorescence (HPF) was used to measure the concentration of ROS. Another device is called Diaminofluorescin-Flu Diacetate (DAF-FM DA) which is used to measure the concentration of intracellular Nitric Oxide5.There are significant evidences that the production of ROS and NO by neutrophils were much higher in Kawasaki disease patients in compare to people who have non-KD febrile children or non-febrile children5. By treating with IVIG, NO level will decrease. But, the production of NO can be beneficial or harmful. Usually, NO is cytotoxic but sometimes, it can protect cells from toxic materials. NO may react with hydroxyl radicals to produce much higher toxicity. To control the influence of NO, the duration, the amount of NO synthesis should be controlled. Therefore, in acute phase of Kawasaki disease, NO and ROS is highly produced and will cau se damage to endothelial cells5.Treatment and future researchWhen patients are diagnosis as complete or incomplete KD, treatment should be induced right away. Because when patients have more than 10 days of fever will develop CAA. Major treatment that doctors use to treat KD is intravenous immunoglobulin (IVIG). Intravenous immuglobulin induced into bloodstream which contains immunoglobulin antibody G that is brought from other control blood donors. IVIG is still a major recommended treatment but some patients do not response to this treatment. The effects of IVIG last for 2 weeks up to 3 months. The typical amount of IVIG is a dose of 1000mg per kg of patients bodyweight. High amount of IVIG with aspirin will reduce the rate of coronary artery abnormalities (CAA) which includes coronary artery dilatation or aneurysms from 20% to 3 to 5%. Also, depends of patients, IVIG can also used with acetylsalicylic acid to treat KD.There is one example about the incorrect treatment will cause severe disease. When IVIG was induced, patients could not heal coronary artery lesion. When patients induced with corticosteroid, they developed more coronary artery lesion3.There are two therapies which are antiinflammatory and antithrombotic therapy which are to treat Kawasaki disease instead of using IVIG. In antiinflammatory therapy, methylprenisolone, prednisone, prednisolone, and infliximab are used to treat Kawasaki disease. For antithrombotic therapy, Aspirin, heparin, warfarin, exoxaparin, tissue plasminogen activator, clopidogrel, and abciximab are used. Recently, infliximab proved by US Food and Drug presidential term to cure not only Crohn disease but also used to treat Kawasaki disease patients. It was not used at all in 2001 but today, the administration of infliximab usage increased up to 2.3% of total number of therapies used. It became favourable because of two reasons. First, it only administer to patients only one time. Secondly, by not using infliximab more tha n once, it reduce the tortuousness as seen in other therapies which are used more than once. Infliximab is an antibody to tumour necrosis factor alpha, and cytokine in inflammatory response. It binds to tumour necrosis factor alpha and blocks the T-cell receptors to block the biochemical cascade. It will decrease the coronary artery abnormalities in patients who developed Kawasaki disease in early acute phase.To treat KD much better way, there should be more research. First, there should be more laboratory and echocardiographic data. Second, more development of clinical criteria and symptoms should be proposed. Even today, there is no perfect evidence that can explain the cause of KD therefore, there should be more research on genetic factors by looking at KD patients family. Lastly, after treatment of KD in childhood, complication may be developed after several decades and there is not much information about complication. Therefore, by monitoring and keep in touch with KD patients are good way to find out more about complication after initial treatment.ReferencesSato, S., H. Kawashima, Y. Kashiwagi, T. Fujioka, K Takekuma, and A. Hoshika. 2009. Association of mannose-binding lectin gene polymorphisms with Kawasaki disease in the Japanese. I. Jour. R. Dis. 12307-310.Inoue, N., S. Takai, D. Jin, K. Okumura, N. Okamura, M. Kajiura, S. Yoshikawa, N. Kawamura, H. Tamai, M. Miyazaki. 2010. Effect of angiotensin-converting enzyme inhibitor on matrix metalloproteinase-9 activity in patients with Kawasaki disease. Clinica Chimica Acta. 411267-269.Huang, G.Y., Ma, X.J., Huang, M., Chen, S.B., Huang, M.R., Gui, Y.H., Ning, S.B., Zhang, T.H., Du, Z.D., Yanagawa H., and Kawasaki T. 2006. Epidemiologic Pictures of Kawasaki disease in Shanghai from 1998 through 2002. Journal of Epidemiology. 16No. 1.Yeo, Y.K., Kim, T.Y., Ha, K.S., Jang, G.Y., Lee, J.H., Lee, K.C., Son, C.S., and Lee, J.W. 2009. Incomplete Kawasaki disease in patients younger than 1 year of age a affirmabl e inherent risk factor. Eur J Pediatr. 168157-162.Yoshimura, K., Tatsumi, K., Iharada, A., Tsuji, S., Tateiwa, A., Teraguchi, T., Ogino, H., Kaneko, K. 2009. Increased nitric oxide production by neutrophils in early stage of Kawasaki disease. Eur J Pediatr. 1681037-1041Perrin, L., Letierce, A., Guitton, C., Tran, T.A., Lambert, V., Kone-Paut, I. 2009. Comparative study of complete versus incomplete Kawasaki disease in 59 pediatric patients. Joint Bone Spine. 76481-485.Son, M.B.F., Gauvreau, K., Ma, L., Baker, A.L., Sundel, R.P., Fulton, D.R., Newburger, J.W. 2009. Treatment of Kawasaki Disease Anlaysis of 27 US Pediatric Hospitals From 2001 to 2006. Pediatrics. 1241-8.Ugi, J., Lepper, P.M., Witschi, M., Maier, V., Geiser, T., Ott, S.R. Nonresolving pneumonia and rash in an adult pulmonary involvements in Kwasakis disease. EUROPEAN RESPIRATORY JOURNAL. 35452-454.Climaz, R., Sundel R. 2009. Atypical and incomplete Kawasaki disease. Best Practice Research Clinical Rheumatology. 23 (5) 689-697.

Goodrich-Rabobank Interest Rate Swap Essay -- Economics Economy Essays

Goodrich-Rabobank Interest Rate Swap1. How large should the discount (X) be to make this an attractive deal for Rabobank?2. How large must the annual fee (F) be to make this an attractive deal for Morgan Guaranty?3. How small must the combination of F and X be to make this an attractive deal for B.F. Goodrich?4. Is this an attractive deal for the savings banks?5. Is this a deal where everyone wins? If not, who loses?IntroductionPlayers Morgan Bank, Rabobank, and B.F. Goodrich, Salomon Brothers,Thrift Institutions and Saving BanksGoodrichIn early 1983, Goodrich needed $50 million to fund its ongoingfinancial needs. However, Goodrich was reluctant to borrow ( get around termdebt) from its committed bank lines because of the following reasons1. It would lose positive about of its remaining short term capital availability under its bank lines.2. It would compromise its future flexibility by borrowing in the short term.Instead, it wanted to borrow for an 8 year range (or longe r) at afixed rate.However, since the general level of beguile rates were pretty high,and Goodrich?s conviction ratings had dropped from BBB to BBB-. Goodrichbelieved that it would have to pay 13% affair for a 30 yearcorporate debenture.Salomon Brothers had advised Goodrich that they could borrow in the USpublic debt market with a floating rate debt issue tied to the LIBOR,and then swap payments with Euro market bank that had raised funds inthe fixed-rate Eurobond market.Note The reason that Salomon were confident that this could be doneis described as follows1. There was a recent deregulation of deposit markets had allowed deposit institutions to offer n... ...% - (x1+11.2%) = 1.3%-x1.7. From (2), and (5) Rabobank saves the following amount in semiannual interest payments LIBOR ? 1/8% - (LIBOR ?x2) = x2 ? 1/8%.8. For this deal to occur, Rabobank, Morgan, and Goodrich must profit hence the following also must be truea. (x1-x2)= F where 37.5 F 8 (footnote 2 on page 362).b. 130 ? x1 0 i.e. 130 x1c. X2 ? 12.5 0 i.e. x2 12.5Assuming that x2 = 20 basis, and x1 = 100 basis. We can conclude thefollowingGoodrich pays a fixed interest of 11.2% + 1% = 12.2% a savings of 20basis points (after transaction costs).Rabobank saves a total of 2% - 1.8% = 20 basis points.And Morgan collects 2% - 1.25% = 75 basis points in fee, in additionto the $125,000 one time fee.Note The total savings that this deal provides as a result of theswap is 5 + 20 + 75 = 100 basis points.

Andrew Marvells To His Coy Mis :: essays research papers

The Non-Discriminatory Nature of Timein Andrew Marvell&8217s&8220To His overmodest MistressTime passes. Its journey is oblivious to power, weakness, beauty, or mercy. The constitution of time itself lies in its unrelenting feeler through life, until we are removed from it&8217s favor and then wither and die. The purpose of most carpe diem poetry is to draw a character&8217s circumspection (usually the female) to the pressing nature of time&8217s progress, as well as illustrating the bountiful rewards of seizing the moment and giving into the momentary passions of life. Andrew Marvell&8217s poem &8220To His Coy Mistress is a classic example of carpe diem poetry, exemplifying the foreboding nature of time. It&8217s distinction from similar works, however, lies in its inherent ability to express the ominous nature of time&8217s advancement in terms of both the male and female&8217s perspectives. Rather than lament about missed opportunities, &8220To His Coy Mistress really serves t o force one to consider how we compartmentalize time into stages of life, and thence commit ourselves to its mercy without allowing ourselves to relish its immediate rewards. Marvell&8217s sense of time affects both his characters in unique ways, and therefore unites their plight as a human cause rather than a gender based issue. Andrew Marvell expresses this point by structuring his poem into ternary components that propose the issues of time&8217s existence, its limited availability, and finally a solution of sorts.The first section of &8220To His Coy Mistress serves the task of identifying that time is a limited commodity, and thus can not be wasted. Immediately the speaker states openly that &8220Had we but world enough, and time, This backwardness, lady, were no crime (1-2). The implication here, if taken at face value, suggests that the mistress&8217 coyness is a crime only because of the lack of time available. The speaker continues with &8220We would sit down, and think w hich way To walk, and pass our long love&8217s day (3-4). The tone of such a verse is overtly suspicious, automatically suggestive of the insidious nature of a man hungry to feed his lust. However, another possibility lies in the read message Marvell puts forth in his verse. The spoken comments themselves suggest that &8220We would sit down, and think&8230 and &8220pass our long love&8217s day (3,4). The impression given is one of sound out merriment in love. The speaker associates the passion of his coy mistress with his own, creating a sense of understanding and common ground.