Washington Mercy Hospital Case Essay Example | Topics and Well Written Essays - 1250 words

Washington Mercy Hospital Case - Essay Example Despite the fact that the best answer for this issue had just been distinguished, who will bear the expense of taking care of the issue is presently the fundamental issue within reach. Beforehand, the emergency clinic worked utilizing a six-year old PC framework, which gave general bookkeeping, tolerant bookkeeping and patient enlistment. Be that as it may, the disappointment of the emergency clinic staff with respect to the presentation of their old PC framework inspired the change to another IS. Tragically, no targets were set by the medical clinic to manage each progression the chiefs, the advisory groups, staff, and others would take. The top managerial staff appeared to be the one supervising the means toward another IS, from deciding the particulars required, picking the systems administration organization, and surveying the new IS’s execution, since it was the one that gave the subsidizing to those exercises. It was the one that named a Director of Information Systems to regulate the establishment and utilization of a patient data framework, and ordered the ranking directors to gather information among clinical staff with respect to the presentation of the old data framework and the attractive highlights of another framework. Be that as it may, beside delegating individuals and financing the undertaking, the board was withdrawn from the dynamic in regards to the venture. The DIS was the person who arranged the RFP to be appeared to expected bidders, supervised the choice of systems administration organization, and observed the establishment of the systems administration framework. He additionally appeared to have been the one to set the 3 sec. reaction time specified in the MOA. The premise of this was not given. No second during the planning of RFP to the marking of MOA was the structure of walking medical procedure office at any point referenced. He likewise didn't show in the MOA the need of the systems administration organization to give IS to offer space to development. All the more significantly, the genuine visits were just about a quarter more than the anticipated qualities he gave to

Gaspard Essay Research Paper Like There Ain free essay sample

Gaspard Essay, Research Paper Like There Ain T Nothing Wrong I envisioned that my life would stop at the guardianships of the blue bloods, yet non like this. For my entire life I thought on the off chance that I put stock in my fantasies I would achieve. As a child I had a fantasy of life rich and doing it enormous yet by the clasp I was seven I understood that I could non do it in this place where there is snake pit. I recollect my father semi-kidding when I was ten, Gaspard openings are that you will non go a lot, expressing me reality, you can t adjustment anything, yet recover no issue how terrible things get keep up your feeling of mind, you need to ready to grin through all the stinging and the equivocations. G-d put us on this spot for a ground ; we should do its best. As I think about that casual discussion now, I understand that he was looking for his best to fix me for the afflictions I would experience thusly throughout everyday life. We will compose a custom article test on Gaspard Essay Research Paper Like There Ain or on the other hand any comparative subject explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page As dull as things got once in a while, in my mind I at any point saw daylight and expectation. I contacted the sky when I met my to be hitched lady, Loanna A twelvemonth after we stole away we had a darling male kid, Little Gaspard, since Loanna and I recognized what kind of life lay before our youngster we put forth a valiant effort to raise him solid since the twenty-four hours he was conceived. I asked G-d to rescue him from the misfortunes we experienced, and The Lord must of addressed in light of the fact that the solitary way for my request to move out was to perish. At the point when Small Gaspard was four, Loanna kicked the bucket, I despite everything wear Ts know why she passed on, yet she simply did non wake up one forenoon. By then my contempt for the honorability raised in light of the fact that after I requested a final resting place and a grave marker I was brutally denied, and was given a whipping for my impoliteness. I was get bringing down to lose my head, implosion was constantly slithering up in my thoughts, however I attempted to stay sound for my kid. I continued expressing myself that life goes on, and in add-on I needed to do certain my kid to cognize that he could rely upon me. In spite of the fact that the blue bloods were populating off my wretchedness I attempted to do sure that my kid had a somewhat preferable guidance over I did by drawing in a mentor. To bear the cost of the mentor I had work in the Fieldss from morning to late dim without any than two yearss off every month. The mentor was all the more a male parent to my kid than I was so I needed to do an assurance on whether or non I ought to go on this way of life. After little thought I chose to get down working typical hours so I terminated the mentor. This was each of the one month before The Marquis killed Little Gaspard so I am everlastingly upbeat that I decreased my working day. After Little Gaspard was executed I in a flash concluded that I needed to get reprisal. So as The Marquis traveler vehicle was drawing off I gave my kid s inert natural structure to Madam DeFarge, made up for lost time to the traveler vehicle and held tight to the underside of the traveler vehicle. Not long before the Marquis house was arrived at I let travel of the traveler vehicle and in a split second ran into the backwoods. That dull I shed numerous cryings be aftering out my surge on The Marquis. I was skiping that if my kid s slayer was to perish Little Gaspard would have the option to find happiness in the hereafter. As I was trusting that nightfall will get I was get bringing down to hold a few vulnerabilities about executing The Marquis, subsequently I promised in blood on a tree that I was making a trip to go through with my program. After I killed the miscreant I was on the count for about a month, however I in the end surrendered in light of the fact that I did non want t o go through a mind-blowing rest disguise, I d rather bite the dust and rejoin my wedded lady and kid. After I was caught, I was beaten half to expire, tossed into a cell, and my executing was set for the accompanying twenty-four hours. I could non travel to kip that dim out of rage and burning disdain for the honorability. I am the main stone to the range, there will be progressively similar to me to due off and slaughter the darn butt heads. That long dim I had a chance to accept about my wedded lady s perish, she passed on of over fatigue, trying to pick up for an overabundance bit of staff of life for our angel kid. For my entire life I have dealt with a land that I did non have, lost both my wedded lady and my kid, my life has no aim, I will be glad to travel tomorrow.

Predictors Of Malaria Parasite Prevalence Health Essay Free Essays

Late progression in jungle fever control, for example, expanded handiness and inclusion of a few mediations, including bug spray treated bed cyberspaces ( ITNs ) , efficacious occasion heading with Artemisinin-based mix treatment, indoor residuary yield tidying of families, and discontinuous deterrent intercession IPT for pregnant grown-up females, is thought to hold decreased malady load. Targets have been set by the United Nations, the World Health Organization ( WHO ) and the Roll Back Malaria Partnership to build inclusion of control steps, chop down the figure of intestinal sickness occurrences and perishes by 75 % or more by 2015, and smother jungle fever in a few states ( 2,4 ) . With extended intestinal sickness control designs, a few states in Africa have archived large and supported lessenings in the heap of infection ( 2 ) . We will compose a custom exposition test on Indicators Of Malaria Parasite Prevalence Health Essay or then again any comparable subject just for you Request Now In parts that have accomplished low degrees of transmittal, more distant intestinal sickness control and riddance will require that interventions are non only joined into national control designs and acknowledged and utilized by people, yet that indicative and asymptomatic-contaminated people, especially under 5 children be distinguished and treated. Zambia is one of 11 states in sub-Saharan Africa that accomplished a more prominent than 50 % decline in the figure of jungle fever occasions somewhere in the range of 2000 and 2009 ( 2 ) . The predominance of parasitemia in kids more youthful than five mature ages old enough diminished by 53 % between the jungle fever list concentrates in 2006 and 2008, aside from Northern Province which is as yet demoing high intestinal sickness parasitaemia figures in less than 5s of ( 6 ) . Among kids who are hot, the extent with the jungle fever parasites in their blood may rise above 50 % ( 1 ) while family concentrates among apparently sound children have detailed parasitemia degrees of between 10-30 % ( 7 ) .This has reasoning for diagnosing and occurrence bearing, as undue trust on febrility and natural structure temperature lift rather than parasitaemia may disregard numerous examples of intestinal sickness which can do edgy wellbeing impacts for the child ( 9 ) .Apparently solid children in jungle fever endemic parts may harbor the parasite in their blood and these children may in any case persevere through the long haul sequalae of the infection, for example, subjective harm and trapeze artistry ( 8 ) ( 9 ) . In add-on to its utility as grounds base for intercession, discovering intestinal sickness parasitemia in less than 5s is other than a stage of jungle fever endemicity ( 10 ) . For these grounds it is of import to discover the level of parasitemia in any re gion. In Zambia, intestinal sickness parasitaemia in kids under five tumbled from 22 % in 2006 to 10 % in 2008, however so expanded again to 17 % in 2010. The pervasiveness of horrible iron deficiency ( Hb A ; lt ; 8g/dl ) in kids under five declined from 14 % ( 2006 ) to 4.3 % ( 2008 ) , however so up swinged again to 9.2 % ( 2010 ) . The record for this rise in jungle fever predominance and weakness is non clear ( Zambia National Malaria Indictor Survey 2010 ) . Moreover, Mpika domain in Northern Province has a noteworthy picture, indicated an extraordinary expansion from 12 % 2008 to 23.6 % 2010 in predominance of jungle fever parasitaemia in kids under five ( 5 ) The heap of intestinal sickness varies among various areas of the network. For case the frequence of febrility scenes and the predominance of parasitemia change among rustic and urban nations ( 8 ) .This has been identified with contrasts in network designs. Though in urban focuses, scenes of febrility are probably going to be accounted for to open health Centers for intercession, in provincial nations mediations are begun with customary redresss at spot and wellbeing focuses are just counseled when the conventional redresss come up short ( 9, 10 ) .Also poverty is an of import factor in jungle fever and the rustic hapless are bound to be naive of deterrent advances, less inclined to course provoke mediation and their children are bound to be not well sustained. In add-on, inciting locales for the mosquito vector are progressively bottomless in the provincial nations expanding the quality of transmittal ( 11 ) . The conceivable piece of KAP surveies to jungle fever research and control has non gotten a lot of going to in most Southern African states ( 12 ) . In Northern Province of Zambia, this is the principal study that will ship out to flexibly standard informations about intestinal sickness related comprehension, disposition and examples among essential wellbeing experts. Albeit numerous surveies in Tanzania and other African states have connected financial and conduct factors, network insight, mentalities and examples with jungle fever ( 13-19 ) , less surveies have had the option to set up such a nexus between these variables and intestinal sickness pandemics. A trepidation of perception, mentalities and examples among essential wellbeing experts and assignment of the central factors that impacts intestinal sickness mediation and defensive practices during scourges is henceforth of import in the plan and execution of fitting jungle fever pandemic control plans. In spite of good percept ion about jungle fever transmittal, imprints and side effects, mediation and control in some surveies, this review reason to reveal grounds of comprehension spreads about intestinal sickness by some essential wellbeing experts in provincial Mpika. A KAP study done in Tanzania, a few respondents detailed that jungle fever is transmitted through soaking up sullied/unboiled H2O, staying in the Sun and working in downpour. It is truly astounding that in this review and others in intestinal sickness endemic expresses, a significant extent of respondents related jungle fever with guzzling sullied H2O or other wrong causes. A considerably higher per centum of respondents gave similar reactions in a review led in Uganda ( 20 ) and in another comparative study in Zimbabwe ( 18 ) . Comparable reactions were other than announced in country nations of West Africa ( 21-22 ) . Further, in accordance with two surveies in West Africa ( 20-22 ) , there was other than a disappointment by most respond ents in Muleba domain to connect frailty and icterus to jungle fever which in curve could take to inability to recognize intestinal sickness cases and consequently inability to look for fitting wellbeing consideration. As for steps to thwart jungle fever, there were perceptual encounters that ITNs are unsafe to the wellbeing of clients and all the more particularly to pregnant female guardians ( 22 ) . Proof of perception spreads on jungle fever has been accounted for by different surveies. Winch and his collaborators found that individuals in Bagamoyo domain in Tanzania neglected to tie in horrible jungle fever ( eruptions ) in kids, horrendous frailty and intestinal sickness in growth with intestinal sickness which in twist lead to individuals ‘s inability to concede the full burden and hence open health significance of the ailment in the nation ( 24 ) . The insight spreads uncovered in this study subsequently demonstrates that a few people may hold decided on unsound stride s of intestinal sickness control and security and along these lines added to the expanded figure of jungle fever examples saw during the plague. In choice, these discoveries demonstrate that so as to achieve the required degrees of acknowledgment of intestinal sickness control measures, more complement ought to be put on planing and execution of adequate wellbeing guidance interventions that will go to cognizance spreads on jungle fever among networks lastly among essential wellbeing experts of children under 5 mature ages old enough. The most effective method to refer to Predictors Of Malaria Parasite Prevalence Health Essay, Essay models

The Best Gig Jobs Site for Writers

If you’ve been hanging out with us for a while, you ‘re familiar with our favorite platforms for freelancers. Upwork, Fiverr and PeoplePerHour rank among the best sites for freelancers to find work. But if you’re looking for gig jobs, there are resources you can use as well. By gig job, we mean sites where you can apply to pick up an odd job here or there. These sites don’t usually result in long term work. But they’re a great way to make extra money. Fortunately for freelancers, there are a host of sites dedicated to this purpose. Freelancers actually create their own directories of sites where gig jobs can be found. Here are a few of the best gig job sites for writers. Freelance Writing Gigs Freelance Writing Gigs, or FWJ for short (we have no clue), is a great site to find the occasional gig jobs. The site posts regularly updated curations of job opportunities from around the web. Most are from Craigslist, and a majority of the gigs are remote. The site is updated almost daily, and is very simple to navigate. The jobs include positions for content writers, bloggers, editors and others. Need help with a freelancing project? The site also allows you to post a job for thirty bucks. Blogging Pro Blogging Pro is another curated site which directs writers to gig jobs. In addition to short term opportunities, you’ll also find links to full time editorial and other positions here. The variety of jobs on this site is huge. You can write scripts for video games, help to develop mobile apps or develop legal documents. The site also has a few resources for writers which you may find helpful. MediaBistro More into journalism or business to business writing? MediaBistro is a great place to start searching for a gig job. You can search by location or select the option to only include remote work. Jobs range from news reporting to content for business development, and they’re nationwide. Be sure to use caution when searching for jobs on this site, though. Many of the gigs posted require a specific geographic location. Morning Coffee Newsletter This is actually a nice little newsletter. We’re always hesitant to subscribe to anything because of the sheer amount of spam that generally results. But we gave this a shot, and are glad we did. The Morning Coffee Newsletter is a part of Freelance Writing. The site’s been around since pretty much the dawn of the internet, and the newsletter launched a year after that. The newsletter is delivered daily, and is another curated list. As of yet, we haven’t received any spam from the site, and the jobs are quality opportunities. There are plenty of gig jobs available; give Morning Coffee Newsletter a shot. You might find something you like! Freelance Writing We’re going to include this even though it’s technically the same site. Freelance Writing has its own job board, on which are posted both exclusive jobs and jobs from around the web. You can filter your job search by skill, location and source. The site points job seekers directly to the site where the job application can be found. Freelance Writing offers a few resources, as well. There are ebooks available for download, as well as lists of writing contests and a directory of freelancers. So if you’re looking to outsource your project, you can find a freelancer here. LinkedIn Let’s not underestimate the power of social media. Social media is a great place to find jobs, and LinkedIn is a good place to start. As you may know, LinkedIn users are able to post their resume on the site. They’re also able to network with other individuals. LinkedIn is going to take a bit more work than just the click to apply sites. You’ll likely need to sell yourself a bit, though there is a job board for those of us less inclined to self promote. Be sure you’ve got a complete profile, and keep your content relevant to the job you want. Facebook Another social media site that we’re sure you’ve heard of, Facebook can be a great resource if you’re looking for a writing gig. But you’ve got to know where to look. It’s going to help if your circle of friends is professional. We don’t mean that they’ve all got to wear suits to work in the morning, but it’s best if your profile and your wall are clean, professional and free of questionable content. If you’re looking for a gig job, use Facebook to network as such. Tell your friends (via public post) that you’re available for work, and include a brief summary of what you can do. Invite your friends to share your post, and be sure to appropriately respond to questions posted as replies. Textbroker We’ve covered Textbroker on Freelance With Us in the past, but it’s worth a mention here. Working on Textbroker is going to take a bit of preparation. You’ll need to submit a writing sample to the site admin. At that point, your sample will be rated on a scale ranging from one to five stars. Once you receive your star rating, gigs are up for grabs. They’ll pay from $.04 to $.10 per word, but we’d like to issue a caveat. It’s time consuming to choose an assignment due to the layout of the site. Looking at the job posts will make your eyes cross. Most of the topics will make your eyes cross, too. But all in all, we’d recommend Textbroker for a quick fix when you’re on vacation or just want something to work on while you’re watching television after supper. Online Writing Communities This list wouldn’t be complete without mentioning the resources available within online writing communities. These can be social media sites, or they can be forums like ours. The benefit to these sites is they’re topical. Writers can collaborate on current projects, announce job openings or just chat about the stresses of freelancing. There’s little of the drama associated with some social media, and it’s a great venue for writers to help each other out. As writers learn of new gig job opportunities, they’ll be inclined to let their forum buddies know. Finding full time and lucrative freelancing work is great, but little gig jobs also have their role in a freelancer’s career. There are plenty of other sites available for freelancers to find gigs. These, though, are a great place to start.

The Effect Of Imperialism And Nationalism - 1092 Words

The effects of imperialism and nationalism brought the world into an unenviable position during the early 1900 s. Colonies began to revolt against their rulers and left civilian unrest behind. The people began to question and change different structures of governments. Wars began to brew amongst nations and revolutions sparked. These events, however, remain far from inconsequential to modern day societies. Certain aspects, specifically, Gandhi s non-violent resistance, Karl Marx s The Communist Manifesto, and Pablo Picasso s Guernica, continue to hold significance in modern day politics and communities. In India, during the 20th century, Gandhi s successfully fought for his colony s independence. The English colonized the country,†¦show more content†¦Furthermore, other groups have decidedly declared their opposition to this recent presidential election in the forms of the International Women s March and the boycott against Uber. Regardless of the time period, Gandhi s metho ds help ensure that the common man has a voice in society. Moreover, Karl Marx expands on similar ideas that concern the common man in his comprehensive pamphlet, The Communist Manifesto. In this document, he articulates the two main economic classes consist of: the bourgeoisie and the proletariat. He claims that the bourgeoisie dominate the ruling class, while the proletariats are exploited physically and emotionally. Another major concept Marx introduces is economic determinism, the theory that the specific economic system that a country has instated affects the values that exist in it. However, he claims that the bourgeoisie, who are in the optimal place in society, will refuse to abandon their economic standings unless there is a violent revolt from the proletariats. Afterwards, a society with no economic classes would be created where the government would manage everything, termed as communism. Overall, Marx believed that capitalism presented an unnecessary amount of difficulti es and that communism was the solution to them. These concepts that Marx promotes, increase in prevalence amongst the various, current government systems. In regards to capitalism, Marx gives the warning of merely havingShow MoreRelatedNationalism And Imperialism841 Words   |  4 PagesNationalism and Imperialism are two important yet distinct ideologies that have shaped the geopolitical world. Both have led to the annexation of lands and the formation of national borders. Nationalism and Imperialism can be viewed as two ends of a spectrum of patriotism, with nationalism on the weak end and imperialism on the strong end. In terms of global significance, imperialism, as a force of domination, subjugation, and exploitation, is more important than nationalism. Nationalism can beRead MoreThe War Of The Great Depression1019 Words   |  5 Pagesended in 1918. The effects of the war had a tremendous affect on the nations. The most significant causes of WWI were: Nationalism, Imperialism, and Militarism. Nationalism is, in the simplest of words, pride in your nation. Although, it goes deeper than simply being proud of who you are and where you are. Nationalism also means having a belief that your nation comes before anything, and most importantly you are strongly opposed to being dominated by another nation. Nationalism is one of the mostRead MoreNegative Impacts Of Nationalism1408 Words   |  6 Pagestogether to go to war against Communism. Nationalism was invented in Europe by intellectuals who were inspired by Napoleons conquest. This ideology to changed people’s perspective about what their country meant to them. Unified States such as Italy, Germany were created during a great migration that formed unified states. Instead of the smaller societies people once lived in became a nation of individuals in certain countries that they could call their own. Nationalism has also helped in the improvementRead MoreThe Three Principles Of The People968 Words   |  4 Pagesbeliev es that the countries [or nations] that will establish the foundation for world government and global culture will be those that use imperialism to maintain their position as the ultimate powers of the world. However, before these nations attempt to govern countries, they must rule over their own. He states, â€Å"The nations which are employing imperialism to conquer others and which are trying to maintain their own favored positions as sovereign lords of the whole world are advocating cosmopolitanismRead MoreThe Great War Of Archduke Franz Ferdinand1558 Words   |  7 Pagesof the Great War centralised on the assassination of Archduke Franz Ferdinand; a Royal Prince of Hungary and of Bohemia, imperialism; generating pressures on the European continent, increasing conflict throughout the Balkans region, and also expanded the conflict that was dedicated to the Europeans to now be transferred to the rest of the world. Lastly nationalism. Nationalism was a major factor in bringing t he Great War to action, causing war due to the economic and territorial competition, andRead MoreEssay about The Pros and Cons of Imperialism540 Words   |  3 Pagespolitical or cultural life is called as imperialism. Imperialism is often separated into two sects. The first one is old imperialism, which was the period from the 1500s to the 1800s, where European nation started to colonize many areas such as the Americas, and parts of Southeast Asia. On the other hand, the new imperialism was the period between the years â€Å"1870-1914†, where Europe became more focused on expanding their land into Asia and Africa. Imperialism had many pros and cons. In addition, itRead More British Imperialism in India and China Essay736 Words   |  3 PagesBritish Imperialism in India and China Imperialism is the domination of a weaker country by a stronger country. For instance Britain dominated India and China in the mid 1880s to the beginning of the 20th century. Imperialism has had both a positive and negative effects on the countries involved. Britain was imperialistic for many reasons, it could dominate because it had the technology and power to do so. They also needed land to acquire raw materials for growing markets.   Ã‚  Ã‚  Ã‚  Ã‚  One countryRead MoreEssay What Extent Is Germany to Blame for Ww11735 Words   |  7 Pagesyears? Some may suggest that it is more productive to look at the events leading up to the war to determine who was at fault. The blame attached to World War One (WWI) is not exclusively German, but may lie with the concepts of militarism, imperialism, nationalism, and alliances. Militarism played an immense part in the start of WWI and without it, there was a chance WWI would have never have lasted as long as it did. Militarism is when an entire country is in love with the idea of war. SoldiersRead MoreNationalism And Perspectives Of People About Nation Can Bring Revolution1544 Words   |  7 Pages1. Ever wondered how nationalism and perspectives of people about nation can bring revolution in the society?, First of all nationalism can be taken as both positive and negative ways. For instance, being faithful to your country is acceptable but when you cross your limit in order to degrade another race, culture or to show that you are the dominant one, that’s when it becomes negative and delivers a wrong message among other people. Phases of nationalism kept on changing as the time passed in EuropeRead MoreCauses Of Imperialism843 Words   |  4 Pagesoutbreak, such as previous historical tension and nationalism. Supporting evidence shows that imperialism was the main and most significant factor of the outbreak of World War 1. Imperialism is defined as the domination of one country’s political, economic or cultural life by another. European countries had been establishing colonies and building empires since the late 1400’s. The period of 1850 to 1914 is often referred to as the â€Å"Age of Imperialism†, since a lot of powers used their military, technological

Availability of Medical Foods and Dietary †Free Samples to Students

Question: Discuss about the Availability of Medical Foods and Dietary. Answer: Introduction: During early 1900s, Sir Archibald Garrod realised that the genetic disease in human results from certain enzymatic deficiency. The enzymatic deficiency results from the recessive traits which are inherited in a Mendelian manner. Such inherited human diseases are known as Inborn Error of Metabolism, the term coined by Sir Archibald Garrod. One of the first diseases that were studied under the banner of Inborn Errors of Metabolism is Alkaptonuria or Phenylketonuria (PKU) (Voet and Voet, 2012). Phenylketonuria is one of most studies disease under the domain of Inborn Errors of Metabolism. It is disease which occurs as a result of deficiency of an enzyme known as homogenetisate dioxygenase. Homogentisate dioxygenase is an important enzyme involved in the pathway of phenylalanine catabolism. Deficiency of the enzyme Homogentisate dioxygenase prevents the breakdown of homogenetic acid, an intermediate of the phenyl alanine catabolism pathway, to dissociate into Maleylacetoacetate. This un dissociated homogenetic acid or homogentisate gets excreted through urine. Urine with high concentration of homogenetic acid exhibit black colouration and hence the disease is also known as alkaptonuria (black) or phenylketonuria (since resulting out of faulty phenyl alanine catabolism) (Voet and Voet, 2012). Classic PKU results from the deficiency of phenylalanine hydroxylase (PAH). PAH is the first enzyme involved in the phenylalanine break down and it converts Phenylalanine into Tyrosine. Victims suffering from classic PKU have lighter skin and hair colour in comparison to their siblings. This is due to the fact that tyrosine hydroxylation, the first reaction involved in the pathway of black pigment skin formation (melanine) is inhibited by the elevated levels of phenylalanine (Voet and Voet, 2012). Serial Number Name of the Enzymes 1 Phenylalanine hydroxylase 2 Aminotransferase 3 Para hydroxy phenylpyruvate dioxygenase 4 Homogentisate dioxygenase 5 Maleylacetoacetate isomerase 6 Fumaryl acetoacetate Table: List of Enzymes Involved in Phenylalanine Degradation Source: Created by author Clinical Findings on Phenylketonuria Source Key Findings Brief Explanation (Voet and Voet, 2012) Black coloration of urine along with arthiritis The persons who are suffering from Alkaptoniria are known as Alkaptonurics. They suffer no ill effects. However, they encounter severe arthritis during the later stages of their life. Moreover, their urine darkening increases at an alarming rate because of the rapid oxidation of homogenetic acid excreted in urine under the contact of atmospheric oxygen. (Voet and Voet, 2012) Mental Retardation and Excess of Phenylalanine in blood Severe mental retardation occurs during few months after birth if the disease is not detected and treated immediately. PKU is an inability to hydroxylate phenylalanine. The patients who are suffering from PKU have increased levelof blood phenylalanine or a condition known as hyperphenylalaninemia. The excess of phenylalanine is transaminated to phenylpyruvate. This high concentration of phenylalanine in blood leads to brain dysfunction Prick, Hop and Duvekot, 2012 Phenylketonuria in pregnant mothers Untreated hyperphenylalaninemia or phenylketonuria during pregnancy may result in the generation of nonphenylketonuric offspring. However, neonatal sequelae, suffers from microcephaly (protruding of the forehead), intellectual disability and congenital heart disease (CHD). Microcephaly or facial dysmorphism is evident during the first trimester of pregnancy of women with high blood concentration of phenylalanine. A proper dietary supplement to control phenylalanine concentrations can prevent this unwanted outcome among the new born. Starting treatment before conception is one of the most recommended way to fight back against this sequelae condition. Ghaziuddin and Al-Owain, 2013 Phenylketonuria results in mental dysfunction Phenylketonuria results in mental dysfunction like autism. Autism is a special spectrum of mental disorder that is characterized by high rate of social communicative deficits with restricted interests. It is rare disease occurring in about only 1% of the total population.Apart from phenylketonuria, glucose-6posphate deficiency has also been found responsible for this disease. Glucose 6-phosphate deficiency is another disease that falls under the category of inborn errors of metabolism. de Groot et al., 2013 Phenylketonuria causes cognitive brain impairment Elevated blood concentration of phenylalanine (Phe) in phenylketonuria (PKU), are thought to impair the entire transportation pathway of large neutral amino acids (LNAAs) from blood stream to the neurons of the brain. This impairment is thought to underlie the complex cognitive deficits which are common in PKU. PKU also causes reduced cerebral protein synthesis thus leading to further mental impairment. Therapy and Treatment of this Disorder Infant screening technique due to the detection of high levels phenyl alanine in blood have led to the elucidation of the deficiency of the enzyme 5,6,7,8tetrahydrobiopetrin (BH4) and PAH co-factor. In such cases, patient are externally supplied with L-3,4-dihydroxyphenyalanine (L-DOPA) and 5-hydroxytryptophan. These are the metabolic precursor of the neurotransmitters like norepinephrine and serotonin. Since tryptophan hydroxylase and tyrosine hydroxylase, the PAH homologs that produce these psychological amines require BH4 as an important cofactor. But adding BH4 alone is not enough as BH4 is largely unstable and fail to cross the blood vein barrier, restricting the chances of effective treatment (Voet and Voet, 2012; Leuretet al., 2012). In most of the cases, where the patients suffers from PKU due to the deficiency of PAH enzyme, all the tyrosine breakdown enzymes are found within the normal limits. In such cases, the treatment involves, low phenyl alanine diet along with period monitoring of phenyl alanine in blood while ensuring that it remains within the normal level during first 5 to 10 years of life. The adverse effect of hyper phenylalanineinemia tends to disappear after that age. Protein like meat, fish, eggs and dairy products are excluded from the diet plan of PKU patients. The standard diet of PKU patient is rich in low protein natural food like fruits, vegetables and cereals. This type of special dietary regime provides low polysaturated fatty acids and cholesterols. Vitamins like folates, A, C, D, E and B2, B6, B12 along with carnitine taurine, iron, zinc, selenium, calcium, are deficient in the paediatric population suffering from PKU due to the low protein content in their diet. Thus, patients with PKU require long-term dietary counselling and daily external supplement of micronutrients (Giovannini at al., 2012; Campet al., 2012). Mental retardation of facaial malformation of the offsprings arising out of the phenylketonuric mother can be effectively prevented via maintaining the blood concentration of phenylalanine. The estimate range of phenylalanine must stay in between 120 to 300 micro mole per litre. Such restricted phenyl alanine range can only be obtained via providing the mother with phenylalanine restricted diet (Teissier et al., 2012). Problems with Curing of the Disease Providing dietary supplements and giving external supply of enzyme is the only way out in the pathway of treating inborn errors of metabolism like PKU. Since the problem lies in the genetic level (recessive faulty gene) complete cure of the disease via a directed therapeutic approach is not possible. The genetic back of the metabolic pathway remains the same. The only way out is to reduce the high concentration of phenylalanine in blood in order to fight back against mental retardation and other associated problems producing debilitating outcomes during childhood. Moreover, at time PKU is not directly expressed in the offspring but they show certain kind of mental retardation which is common with the parents who have a recessive gene for PKU. In that case, if the proper treatment of the expecting mother with low phenylalanine diet is the only way out to restrict the possible chances of disease manifestation in an indirect way (Hennermann et al., 2012). Metabolic pathways can be defined as a series of enzymatic reactions occurs in a sequence based manner to produce specific end products. The intermediates or the reactants which are produced in the middle of the enzymatic reaction are known as metabolites. Since the body of any organism like humans is an interconnected array of several metabolites such that it is body of human or rather say mammals has been biochemically designed with several metabolic pathways. Metabolism can further be sub divided into two separate pathways namely Catabolism and anabolism (Voet and Voet, 2012). Catabolism: Catabolism is known as the degradation pathway. In this pathway, the nutrients are broken down into is smaller constituents via exergonic process (evolution of energy) in order to salvage the components and to generate free energy (mostly ATP or Adenosine Triphosphate) (Voet and Voet, 2012). Anabolism: Anabolism on the other hand is defined as bio synthesis pathway. In this pathway, the biomolecules unite to give rise to the final completed product (Voet and Voet, 2012). The free energy which is released via the process of catabolism is utilised in the anabolism. The energy is conserved via the synthesis of ATP from ADP (Adenosine Diphosphate) and Phoshate molecule. At times energy synthesis also occurs via the synthesis of the coenzyme NADP+ (Nucleoside Adenosine DiPhosphate) or NADPH. Thus ATP and NADPH are the two major energy source available to aid the anabolic pathways (Voet and Voet, 2012). Metabolic pathways are characterized to be exergonic in nature (reserviour of large negative free energy) and irreversible. The irreversibility of the process means, each pathway once started must proceed up to its completion since free negative energy is spontaneous. Moreover, it the two metabolites are interconvertible, the pathways from the first step tp the second step must differ from the pathway from the second step to the back (towards the first step). This is due to the fact that metabolite 1 when converted into metabolite 2, it undergoes via exergonic process. But the conversion into metabolite 2 back to metabolite 1 requires that very supply of the free energy in order to carry the reaction against the hill. Every metabolic pathway has a first committed step, if the pathway pass through that committed step then it is bound to reach up to its end product. This is due to the fact that, although most metabolic pathways are reversible, the majority of their component reactions functions close to equilibrium. All metabolic pathways are regulated and in eukaryotes, each metabolic pathway occurs in specific cellular location (Voet and Voet, 2012). Organelle Function Mitochondria Amino Acid breakdown, electron transport chain, fatty acid oxidation, citric acid cycle Cytosol Glycolysis, pentose phosphate pathway, fatty acid biosynthesis Nucleus DNA replication, transcription, RNA processing Table: Cellular Location of Specific Metabolic Pathway Source: Created by author Metabolic Breakdown of Amino Acids The degradation of amino acids converts them into citric acid cycle intermediates or any other precursor products. While inside the citric acid cycle they are metabolised into carbon dioxide (CO2) and water (H2O) or is used in the process of gluconeogeneisis. The oxidative break down of the amino acids via the catabolic pathway amounts to about 10 to 15 percentage of the total metabolic energy generated by the animals (Voet and Voet, 2012). Glucogeneic amino acids whose carbon skeletons are degraded into pyruvate, alpha ketoglutarate, succinyl coA or oxaloacetate are therefore salvaged into glucose precursors. Ketogenic amino acids on the other hand, whose carbon skeletons are broken down into acetyl CoA or acetoacetate are converted into ketone bodies or fatty acids. For example, alanine, the simplest form of amino acids is glucongenic in nature. It is transaminated into pyruvate and can be further be converted into glucose via the process of gluconeogenesis. Leucine is a ketogenic amino acid. The carbon skeleton of leucine is converted into acetyl coA and acetoacetate. Since animals do not have any specific metabolic pathway to convert acetyl coA or acetoacetate into gluconeogenic precursor, no synthesis of carbohydrate is feasible from the breakdown of these two amino acids (lysine and luceine) and hence the are known as true ketogenic amino acids. Isoleucine, phenylalanine, threonine, tryptofan and tyrosine are both glucogenic and ketogenic. For example, isoleucine is simultaneously broken down via the process of catabolism into succinyl coA and acetyl coA and hence can be regarded as a precursor of both carbohydrate and ketone bodies (Voet and Voet, 2012). References Camp, K.M., Lloyd-Puryear, M.A. and Huntington, K.L., 2012. Nutritional treatment for inborn errors of metabolism: indications, regulations, and availability of medical foods and dietary supplements using phenylketonuria as an example.Molecular genetics and metabolism,107(1), pp.3-9. Available at https://www.sciencedirect.com/science/article/pii/S1096719212002612. [Accessed 30 Sept. 2017] de Groot, M.J., Hoeksma, M., Reijngoud, D.J., de Valk, H.W., Paans, A.M., Sauer, P.J. and van Spronsen, F.J., 2013. Phenylketonuria: reduced tyrosine brain influx relates to reduced cerebral protein synthesis.Orphanet journal of rare diseases,8(1), p.133. https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-8-133[Accessed 30 Sept. 2017] Ghaziuddin, M. and Al-Owain, M., 2013. Autism spectrum disorders and inborn errors of metabolism: an update.Pediatric neurology,49(4), pp.232-236. https://www.sciencedirect.com/science/article/pii/S0887899413003433 [Accessed 30 Sept. 2017] Giovannini, M., Verduci, E., Salvatici, E., Paci, S. and Riva, E., 2012. Phenylketonuria: nutritional advances and challenges.Nutrition metabolism,9(1), p.7. Available at https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-9-7. [Accessed 30 Sept. 2017] Hennermann, J.B., Roloff, S., Gebauer, C., Vetter, B., von Arnim-Baas, A. and Mnch, E., 2012. Long-term treatment with tetrahydrobiopterin in phenylketonuria: treatment strategies and prediction of long-term responders.Molecular Genetics and Metabolism,107(3), pp.294-301. https://www.sciencedirect.com/science/article/pii/S1096719212003629 [Accessed 30 Sept. 2017] Leuret, O., Barth, M., Kuster, A., Eyer, D., De Parscau, L., Odent, S., Gilbert-Dussardier, B., Feillet, F. and Labarthe, F., 2012. Efficacy and safety of BH4 before the age of 4 years in patients with mild phenylketonuria.Journal of inherited metabolic disease,35(6), pp.975-981. https://link.springer.com/article/10.1007/s10545-012-9464-3[Accessed 30 Sept. 2017] Nelson, D.L., 2013. i Cox, MM" Lehninger Principles of Biochemistry"(2013). Prick, B.W., Hop, W.C. and Duvekot, J.J., 2012. Maternal phenylketonuria and hyperphenylalaninemia in pregnancy: pregnancy complications and neonatal sequelae in untreated and treated pregnancies.The American journal of clinical nutrition,95(2), pp.374-382. Available at https://ajcn.nutrition.org/content/95/2/374.short. [Accessed 30 Sept. 2017] Teissier, R., Nowak, E., Assoun, M., Mention, K., Cano, A., Fouilhoux, A., Feillet, F., Ogier, H., Oger, E., De Parscau, L. and AFDPHE (Association Franaise pour le Dpistage et la Prvention des Handicaps de lEnfant, 2012. Maternal phenylketonuria: low phenylalaninemia might increase the risk of intra uterine growth retardation.Journal of inherited metabolic disease,35(6), pp.993-999. Available at https://www.sciencedirect.com/science/article/pii/S0887899413003433. [Accessed 30 Sept. 2017] Voet JG, Voet D. Donald E. Nicholson, 19162012. Biochemistry and Molecular Biology Education. 2012 Jul 1;40(4)

What to Look For in Academic Interests Research Papers

What to Look For in Academic Interests Research PapersAcademic interests are one of the many things that help us in succeeding in school. And when it comes to essay samples, we should make sure that we get a right one for ourselves so that we can use it effectively in our essay writing and in various kinds of writing assignments. There are lots of them available out there on the Internet but the choice of getting a right one is always a tough task. If you want to use the best for yourself, you should know about academic interests and how to go about choosing one for yourself.One of the best ways to find what you need is to look for interest research papers. These will give you good ideas on what to write about. It is easy to find these kind of papers because you can find them all over the Internet. You can visit the websites of the schools you are interested in or the journals related to your academic interests. The best thing is that you can download academic interests essay samples from these sites.Academic interests can vary with each student. Some people might be interested in using topics about their family, while others might like to talk about their particular career field. However, the academic interest they will be discussing in the essays that they will write is what they find interesting in their field.Academic interests can also be found in different subjects such as psychology, math, geography, chemistry and many others. When you are interested in writing an essay about your interests, you will find it easier to write and more successful when it comes to the achievement of your objective. These are all examples of the benefits that you can get from these interest research papers. This is why they are an ideal choice for your essay writing needs.However, the best place to look for these academic interests research papers is the ones that offer online version of the papers. This way, you can get a copy of the paper instantly and it will be there read y for you to download. In this way, you can make use of the papers even if you do not have access to any kind of computer or the Internet. The good thing about this is that you can get the paper at your own pace and at your own convenience.For those who would like to choose the best among the academic interests research papers, they should consider the length of the paper. The length of the paper should be the important factor, because it will determine how much time you will have to complete the project. So, make sure that you choose one that is long enough for you to complete it in the allotted time frame.Before you start looking for academic interests research papers, you should have a clear idea about what you are going to discuss. This way, you will be able to determine what kind of topic to include in your paper. You should also know about the topics that are commonly used by the majority of the people. This will help you determine which of the papers to choose for your assign ment.In summary, academic interests essay samples are important in terms of helping you with your academic interests. Make sure that you get one that will suit your needs so that you can be assured of the completion of your assigned tasks in a timely manner.