Ethanol In This Experiment Biology Essay. The yield obtained through this experiment is 39 of the theoretical mass of ethyl-p amino benzoic acid. There are few events that could be improved in order to issue the amount of yield obtained. Firstly, the quality of reagent used is relatively small to acquire a good percentage of the product. In order for a greater percentage yield in this experiment, a great amount of reagent should be used. In order to obtain more white foam, the sulfuric acid should be added drop wise to a solution of p-amino benzoic acid and ethanol. Based on adding sulfuric acid slowly, a large amount of white precipitate can be formed. Besides, that the product is transferred into too many containers repeatedly. This causes a lost in product between the transfers. Therefore, fewer transfer of product should be done in this experiment to obtain higher percentage of yield. Moreover,. Even though it was only a small portion, it is still decrease the amount of purified yield obtained. Furthermore, more precautions should be taken while performing recrystallization such as adding as little methanol as possible. The yield can be improved by maximizing the formation of crystals. More crystals can be formed by scratching the bottom of the Erlenmeyer flask with a glass rod and adding a crystals seed into the solution. To add on, it should be given enough time for crystals to be found while the flask is placed in the ice water bath. Through this, more yields can be acquired. What is the advantage of using absolute ethanol rather than 95% ethanol in this experiment? If the 95% ethanol was used, the little amount of water present in the diluted ethanol can prevent the ester formation. This is because the presence of water that will lead the reaction to the left (Reverse reaction). When water involved in this reaction, from alkyl group, the acid presence in the reaction turn into ester. By using absolute ethanol, ester becomes acid due to the hydrogen from water. Therefore, absolute ethanol is chosen for this reaction which will lead the reaction to right (Forward reaction), rather than using any forms of diluted ethanol that could only negatively influence reaction for ester formation. Why is it important to add the sulfuric acid drop wise to the ethanolic solution of p-amino benzoic acid? Sulfuric acid is the most efficient catalyst for esterification. Water is a by-product of the esterification reaction and increasing the quantity of water would reverse reaction and decrease the yield of the reaction. when the reaction is performed in the presence of a concentrated sulfuric acid (hydrophilic), it will perform as a dehydration agent that will absorb the water molecules by produced from the reaction. So in the presence of a sulfuric acid catalyst, the reaction will be driven towards the right side, which is preferable to yield more ester. The reason for adding this concentrated sulfuric acid in drop wise is mainly to avoid the extreme reaction of the acid with the water. Because, if excessive water was produced from the ethanolic solution of p-aminobenzoic acid, the sudden addition of large quantity of concentrated sulfuric acid would lead to extreme reaction with this excessive water, and result to a large amount of heat(exothermic). This is not safe and it is harmful due to the use of concentrated sulphuric acid. In contrast, if acid was added drops wise, the reaction will be still happening in the solution though will be limited only to a smaller extent. Therefore such procedure is preferable to maintain better control. Another advantage of using drop wise adding acid would permit us to control the acidity of the final resultant. Because, if the acid content is increased in the final solution the subsequent neutralization process happens in the presence of an alkaline would lead to an extreme reaction. Therefore adding drop wise acid is essential to control the acidity of the solution, so the stability of the reaction can be maintained throughout the reaction. Draw the structure of the solid that is formed when the concentrated sulfuric acid is added to the solution of p-aminobenzoic. Why is it important that all of the solids dissolve during the reflux period for you to obtain a good yield of product? The solid precipitate after cooling down could be unreached benzoic acid. During the reaction, not all the solvents are participated in the reaction to produce Benzocaine. This could happen if the amount of the ethanol is too low. But most of chances this will be mainly due to the lack reaction between the available methanol. This can be avoided by stirring the mixture to swift the reaction. Thus, in order to get good yield of ester, all the precipitants of the mixture have to be dissolved in the first place. However, this is not possible in most of the occasions. Why is it important to neutralize the reaction mixture during the work-up? After refluxing, acid is added to the reaction mixture. During this reaction, the amino group of the reactant will be protonated and it become soluble in water. When the Na2CO3 is added to the mixture, the proton is separated and make the benzocaine insoluble in water. Thus the solution begins to precipitate when the reaction mixture is neutralized. Thus it is important neutralize the moisture in order to filter out the ester from the mixture, which otherwise will be in a dissolved state and will not be recoverable. Assuming it was necessary to add an additional portion of concentrated sulfuric acid, calculate about how much 10% aqueous sodium carbonate would be required to neutralize the reaction mixture. During the experiment, 28.6 mL of sodium carbonate need to neutralized the 18M sulfuric acid. Volume of sulfuric acid = 1.5 mL # of moles of sulfuric acid = 18 X 0.001 = 0.018 mol Mass of Na2CO3 = 10 g # of moles of Na2CO3 = 10 / 105.99 mol = 0.0943 mol Concentration of Na2CO3 = 0.0943/0.1 = 0.943M C1 x V1 = C2 x V2 18 M x 1.5 mL = 0.943 M x V2 V2 = 28.6 mL Therefore, volume of Na2CO3, V2 = 29 mL What is the gas that is evolved during the neutralization? In presence of sulfuric acid, p-amino benzoic acid reacts with ethanol to form ethyl p-aminobenzoate. The reaction medium contains sulfuric acid and it was neutralized with sodium bicarbonate. Thus the gas evolved during the reaction between the acid and base is carbon dioxide (CO2). Ethanol In This Experiment Biology Essay
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one- to two-page (250 word) paperStep 1 Consider the scenario.University X is considering implementing a rule that requires all first-year students to purchase an Apple iPad to take classes and use newly purchased software in classrooms. The proposed rule is being met with support from some, but resistance from others.Step 2 Analyze the problem in the scenario using the steps in the critical thinking process:Consider multiple perspectives and recognize assumptions: Consider the issue from the following perspectives: a school administratoran instructor of a marketing classa studenta parentWhat might these people feel about the proposed rule, and why? What assumptions or biases do the groups have? What may be affecting their viewpoints?Evaluate the evidence and merits of each perspective: How would you seek to evaluate the evidence and merits of each perspective from the scenario above? What specific things would you do to assess the reliability of the evidence?Draw a conclusion: Looking at the viewpoints you discussed, if you were an outside consultant who was asked to make a decision about the proposed rule, what would you decide, and why?Step 3 Write a short paper.Write a short (250 word) paper describing the three steps of the critical thinking process you have just examined. Determine how each part of the critical thinking process relates to the others and to the overall concept of critical thinking.Step 4 Save and submit your assignment.When you have completed your assignment, save a copy for yourself in an easily accessible place and submit a copy to your instructor using the dropbox.Grading Requirements:Item:Points:1. Addressed three parts of the critical thinking process -Consider multiple perspectives-Evaluate the evidence of each perspective-Draw a conclusion45 points (15 points for each part)2. Wrote three (3) separate paragraphs30 points (10 points each)3. Spelling and Grammar – Please write complete sentences. Check your grammar and spelling.25 pointsAssignment total:100 points
Thalassemia is an inherited blood disorder characterized by defective production of hemoglobin and excessive destruction of red blood cells, which lead to anemia. It is a chronic disease that presents a range of serious clinical and psychological challenges. The effects of Thalassemia on physical health can lead to physical deformity, growth retardation, delayed puberty, and severe complications like heart failure, cardiac arrhythmia, liver and endocrine disorders, and other infections. These problems affect a Thalassemic child’s physical and psychological functioning, leading to emotional burden, hopelessness, and difficulty in social interactions. Thalassemia can be fatal if proper treatment is not provided to the child. The development of new treatments and clinical management, like regular blood transfusion during the past decades, has markedly improved the prognosis and survival rate of children with Thalassemia. Thalassemia is a chronic disease where a cure is not attainable, and treatment may be prolonged. Therefore, the parents should be reinforced continuously to care for their children with Thalassemia. The parents, in addition to their typical parenting roles, should assume the roles of care coordinator, medical expert, and system advocate when the children have special health care needs. The mothers play an important role in maintaining optimum physical and psychosocial health, and preventing complications in children with Thalassemia by adopting various measures appropriate to the condition of their children. Background of the Study According to Indian Academy of Pediatrics (IAP-2000), 15 million people have clinically apparent Thalassemia disorders world-wide. Every year approximately 100,000 children with Thalassemia major are born world over, of which 10,000 are born in India. According to Journal of Biomedica (2000), the major complications of Thalassemia are iron overload (76%), growth failure (65%), cardiac problems (17%), transfusion related infections (4.6%), and endocrine disorders (4.2%). According to Fuchsa C.J. and Tienboona P. (2007), for reducing complications and maintaining health, it is important to monitor iron levels in children receiving blood transfusion, and parents should pay close attention to iron intake of their children through diet. They also recommended that children under 10 years should keep iron intake to 10mg/day, and should increase the intake of calcium and vitamins. The parents should read food labels carefully, as well as avoid using cast iron cookware. According to Journal of Pakistan Medical Associations (2008), chronic disorders including Thalassemia Major have a great influence on the child’s performance, and family as a whole causing psychosocial imbalance. The extremely stressful consequence of Thalassemia causes a variety of physical, psychological, and social problems. In fact, the rate of psychiatric disorders such as depression and anxiety in children with Thalassemia is higher than children with other chronic diseases. A child with Thalassemia needs to be supervised continuously to ameliorate consequences of the disease so that he/she is able to lead an active and suitable life. With proper prevention and treatment, many diseases can be controlled before causing dangerous and irretrievable difficulties, and may result in longer life expectancy and improved quality of life. Yak, Siddikka, Sonugul (2010), stated that the self-esteem and behavior problems in children with Thalassemia depended not only on the child characteristics and associated conditions, but also the parental attitude towards the care of their children. Parents with better knowledge about the illness adhered more readily to treatment regimen. Health care professionals are uniquely positioned to assist the parents in meeting the challenges to promote optimum physical and psychosocial health in these children. Need for the Study Thalassemia is a potentially fatal disorder, if not adequately treated. It is a serious public health issue throughout the Mediterranean, the Middle East, the Indian subcontinent, south east Asia, and in several other countries (due to migration). In the last 30 years, introduction of regular blood transfusion therapy and effective iron chelating therapy with deferroxime have markedly improved the life expectancy of children with Thalassemia. However, these children faced various physical and psychosocial problems related to this chronic disease and its prolonged treatment regimen. The investigator, during clinical posting to the blood bank in the VHS, came across many Thalassemic children with complications like iron overload, oro-facial malformations, osteoporosis, stunted growth, recurrent injury and infection, and psychosocial problems like body image disturbances, hopelessness, powerlessness, poor social interaction etc. The investigator also found that the adolescents depended mainly on their parents for monetary and emotional support, because they were anxious about their future health and education. The investigator, while interacting with the mothers, found that all of the mothers had their own ways of dealing with the problems of their children. Some of these unique methods could be considered appropriate, where as some others could not be considered appropriate. When children have special health care needs, mothers play an important role in finding out their health needs, and in taking measures to manage their child’s chronic condition in the context of everyday life. Therefore, the investigator would like to assess the measures adopted by the mothers to maintain optimum health in their children with Thalassemia. Statement of the Problem A study to assess the measures adopted by the mothers to maintain optimum health in children with Thalassemia receiving care in a selected hospital in Chennai. Objectives of the Study To assess the measures adopted by the mothers to maintain optimum health in children with Thalassemia. To associate the measures adopted by the mothers of children with Thalassemia with selected demographic variables. Operational Definitions Assess: The process of gathering information through structured interview schedule, and analyzing the responses using statistical methods. Measures adopted: The actions and precautions taken by the mothers to promote optimum health in children with Thalassemia. Optimum health: The acceptable level of physical, social, psychological well-being of children with Thalassemia. Mothers of children with Thalassemia: It refers to any woman who has a child diagnosed with Thalassemia. Thalassemia: An inherited blood disorder, that results in reduced rate of synthesis of one of the globin chains which causes formation of abnormal hemoglobin molecules, which in turn results in anemia. Delimitations The study is limited to 60 mothers of children with Thalassemia. The study setting is limited to one setting. Study period is limited to 30 days. Assumptions Mothers of children with Thalassemia will adopt various measures to maintain optimum health of their children. The measures adopted by the mothers of children with Thalassemia will be influenced by the selected demographic variables. Projected Outcome The study will help to identify the various measures adopted by the mothers to maintain optimum health in their children with Thalassemia. The study will help us to analyze the adequacy of information provided by the health care workers, and the need for revising the content and teaching methods. The study will help the nurses to develop strategies to reinforce the mothers adopting appropriate measures to maintain optimum health, and to empower the mothers who are not adopting appropriate measures. Study will help the mothers to become aware of their unique role in the care of children with Thalassemia. Conceptual Framework Based on Kathryn E. Barnard’s Parent-Child Interaction Model Conceptual framework refers to concepts that offer structure or framework of propositions for conducting research. Polit and Hugler (1989) described conceptual framework as a “group of mental images or concepts that are related, but the relationships are not explicit”. The conceptual framework forms the basis of the researcher’s main view, and the common theme of research. It is a visual diagram, using which the researcher explains the specific area of interest. The conceptual framework adopted for this study is based on Kathryn E. Barnard’s parent-child interaction model. This model focuses on the child’s health, growth, and development, while viewing the parent and the child as an interactive system. Barnard stated that the parent-infant system was influenced by individual characteristics, but was modified to meet the needs of the system. She defined these modifications as adaptive behavior. This model focuses on care giver-parent characteristics, child characteristics, and the interaction between the parent, the child, and the environment. Concepts of Kathryn Bernard’s Parent-Child Interaction Model Child Characteristics Child’s clarity of cues The child sends cues to the parents in the form of physical, psychosocial, and spiritual distress. Parent should be skillful in identifying these cues, and should make appropriate modification of his or her own behavior. Child’s responsiveness to the care giver. The child will respond to the care giver both positively, and negatively. Parent-Care Giver Characteristics Parent sensitivity to child’s cues Parent must accurately read the cues given by the child, and should take measures to provide optimum health by modifying their behavior. Parent’s ability to alleviate the infant’s distress Parent must recognize the physical, psycho-social, and spiritual distress, and should take appropriate actions to alleviate the distress. Providing growth fostering situation Physical growth fostering Parent should encourage appropriate activities, diet, rest and sleep, preventive measures, treatment and follow-up etc. Social and emotional growth fostering. Parent should promote social interaction, play affectionately with the child etc. Cognitive growth fostering. The parent should provide stimulations which should be just above the child’s level of understanding. Environment Environment refers to the inanimate and animate resources like the physical environment, family support, financial resources, and social services and support groups available for the development of the child. Figure 1: Conceptual framework based on Kathryn Bernard’s parent-child interaction model CHAPTER 2 REVIEW OF LITERATURE A review of related literature is an essential aspect of scientific research. Review of literature refers to an extensive, exhaustive, and systematic examination of publications relevant to the research project. A review of literature was done in order to broaden the understanding and to develop an insight into the selected problem under study. This chapter is discussed under the following headings: General Information about Thalassemia Studies Related to Common Physical and psychosocial Problems in Children with Thalassemia Studies Related to Home Management of Thalassemia Studies Related to Care Giving Experience of Mothers of Children with Thalassemia General Information about Thalassemia The word Thalassemia is a Greek term derived from thalassa which means the sea (referring to the Mediterranean Sea), and emia which means related to blood. Thalassemia is a disorder characterized by defective production of hemoglobin and excessive destruction of red blood cells. Genetic mutation of the gene encoding for the Î±- and Î²- subunit of the hemoglobin leads to reduced or totally absent synthesis of hemoglobin, which results in abnormal development of red blood cells. This eventually leads to anemia, which is the characteristic symptom of Thalassemia. Î²-Thalassemia Major is the most severe form, which requires regular blood transfusions throughout the life of the afflicted person. According to the Indian Academy of Pediatrics (2009), Thalassemia occurs most frequently in people of Mediterranean, Middle-Eastern, African, Italian, Thai, Chinese, and Indian origin. Every year 10,000 children with Thalassemia are born in India, which constitute roughly 10% of the total number of children born with such a condition world-wide. Signs and Symptoms of Thalassemia An infant with Thalassemia major appears normal at birth. As the child grows he/she exhibits paleness, fussiness, irritability etc. At second year of life: fatigue weakness, shortness of breath during mild activities Later stage: slanted eyes prominent facial bones malocclusion of the teeth stunted growth distended abdomen Major Complications of Thalassemia Iron overload due to regular blood transfusions: infections bone deformities spleenomegaly osteoporosis metabolic and endocrine disorders Hepatitis-B and HIV infections congestive cardiac failure neurological complications Psychosocial Problems Social isolation: Powerlessness Hopelessness Body image disturbances Financial burden of the family Treatment of Thalassemia Medical Management Regular blood transfusions: Calcium and folic acid supplementation Prophylaxis antibiotic therapy Iron chelation therapy Surgical treatment: spleenectomy bone marrow or stem cell transplantation Current Trends in Management According to Journal of Hematology (2011), novel modes of therapy have been developed for Thalassemia based on the pathophysiology and molecular pathology of the disease. Currently used treatment modalities are antioxidants, various inducers of fetal hemoglobin (hydroxyurea, erythropoietin, butyrates, hemin), and bone marrow transplantation in its various forms. Many therapeutic methods, such as intrauterine bone marrow transplantation, pre-implantation diagnosis with HLA matching, and gene therapy are currently under research. Future clinical studies will determine the place of newer agents and modalities in improving the quality of life, as well as the life expectancy of Thalassemic children. It is evident from the discussion so far that Thalassemia is a dreadful disease, which can cause serious complications in almost all the systems in the body. Thalassemia is a disease which needs treatment on a regular basis, and most of the novel methods will increase the life expectancy of the child. It is important to orient the parents towards new treatment modalities available, and reinforce them regarding the need for regular treatment. Therefore, the investigator identified a need to conduct a study on mothers with Thalassemic children. Studies Related to Common Physical and psychosocial Problems in Children with Thalassemia Gharaibeh H.F. and Gharaibeh M.K.(2011) conducted a study in Jordan to identify the health related quality of life of children with Thalassemia, and they highlighted the negative impact of Thalassemia on the quality of life of these children, especially in terms of physical well-being and school achievement. They also stated that parents, health care providers, counsellors, and school teachers had a very important role in helping these children to overcome their problems and enhancing their quality of life. The investigator, as a health care provider, felt the need to identify the common physical problems in children with Thalassemia, and assess how parents are helping them to overcome these problems. Therefore, while preparing the questionnaire, the investigator focused more on the measures adopted by the mothers to maintain optimum physical health in their children with Thalassemia. Rivella S. (2007) stated that, iron overload remained the biggest threat to the health of patients with Thalassemia. The iron overloading in Thalassemia depended on the volume of blood transfused, and the amount accumulated from gut absorption. In fact, this excess of iron is the cause of many serious complications, and can even prove fatal. The organs most severely affected are the liver, the heart, and the endocrine gland. In another study, Ali T. and Khaled M. (2002) conducted a study in the United States of America to assess the practices in Thalassemia management aimed at lowering complication rates among children with Thalassemia Major. They found that the most common disease related complications were osteoporosis and extra medullary hematopoeisis. Another study by Fung E.B. et al (2002) found that the frequency and type of bone disease was affected by the underlying type of Thalassemia and its treatment. Major problems included rickets, scoliosis, spinal deformities, nerve compression, fractures and severe osteoporosis. Multifactorial etiological factors were also detected, such as hormonal deficiency, bone marrow expansion, and desferal toxicity. They stated that nutritional deficiency of calcium might add to the risk. The data from the above studies indicate that the major complication of child with Thalassemia is iron overload due to frequent blood transfusions, and increased absorption of iron from the gut. Another complication is bone deformity. Though these complications can be reduced by dietary modifications, the children carry a high risk of bone fracture. The data helped the investigator to focus on dietary modifications and protection from injury, while preparing tool. Shaligram D. et al (2001) conducted a study to assess the psychological problems and quality of life in children with Thalassemia, attending day care services for blood transfusion in India. They concluded that 44% of the children had psychological problems, and 74% had a poor quality of life. Anxiety related symptoms (67%), emotional problems -particularly depression (62%), and conduct problems (49%) were the main findings. From these findings it is evident that children with Thalassemia suffered from many psychological problems. In addition to the children, the siblings, parents, and other family members were also affected. Therefore, the investigator focused on the psychological aspects of child health like social interaction, recreation, coping with psychological problems etc. Khurana A. et al (2001) conducted a study to assess the psychosocial life aspects of Indian adolescents suffering from transfusion dependent Î²-Thalassemia Major. The study found that the adverse impact of Thalassemia was perceived mainly in the domains of education (70%), and sports (72%). Most Thalassemics were not satisfied with their body image, and almost all the study subjects felt that the disease did not affect their family or social relationships. The adolescents were anxious about their future health and education. Majority (80%) of the subjects did not discuss their disease and its related problems with their friends. They mainly depended on their parents for monetary and emotional support. The above findings reveal that adolescents with Thalassemia faced problems related to education, occupation, body image etc. Therefore, the investigator formulated separate questions to assess these problems. Spyridoula L. and Stavroula B. (2000) stated that Î²-Thalassemia is a chronic disease causing serious symptoms to the patients, and considerable burden to their families. Their study revealed that siblings of Thalassemic patients were found to have significantly more psychiatric disorders and impaired psychosocial functioning. Dragonas T. J. et al (1996) conducted an exploratory study to assess the psychosocial problems and adjustment of children with Thalassemia and their families. They compared the psychosocial problems, and family adjustment to the effect of illness Father’s low education level and the presence of major medical complications were predictors of poor family adjustment. The data from the above sources helped the investigator to identify various psycho social problems faced by the children with thalassemia and this helped the investigator to focus more on these areas while preparing tool for the study. Literature Related to Home Management of Thalassemia Emine E. et al (2012) conducted a descriptive study in Turkey to determine the types of complementary, and alternative medicine used among children with Thalassemia, and concluded that 82.5% of the parents used one or more of the complementary and alternative medicine, 61.8% used prayer/spiritual practice, 47.4% used nutritional supplements, and 35.1% used animal materials. They also stated that in order to sustain medical treatment and better prognosis of Thalassemia, it was important for nurses to consult with their patients and parents regarding the use and potential risks of some of the complementary and alternative medicine. Gulli L.F. et al. (2005) stated that monitoring iron levels in the body is essential. Individuals receiving blood transfusions should keep total body iron levels at 3-7mg of iron per gram of body weight. In addition, these individuals should pay close attention to the iron intake through their diet. It is recommended that children under the age of 10 keep dietary iron intake to 10 mg/day or less. Individuals aged 11 or older should keep dietary iron intake at 18 mg/day or less. Children should avoid using foods high in iron, including beef, beans, liver, pork, peanut butter, infant cereal, cream of wheat, prunes, spinach, raisins, and leafy green vegetables. Individuals should read the food labels carefully, and avoid using cast iron cookware that can infuse more iron into the food during cooking. Individuals with Î²-Thalassemia major are at risk for developing osteoporosis. Increased dietary intake of calcium and vitamin D can help increase the storage of calcium in the bones, thus making the bones stronger, and decreasing the risk of osteoporosis. Alarcon P.A. et al. (2002) conducted another research study on the effect of tea as an inhibitor of non-heme iron absorption. Iron absorption increased as the hemoglobin concentration decreased, although iron absorption was much higher at any given hemoglobin level in subjects with Thalassemia. They concluded that, tea produced a 41%-95% inhibition of iron absorption. Since patients with Thalassemia intermedia may absorb a large percentage of dietary iron, inhibitors of iron absorption, such as tea, may be useful in their management. The study results mentioned above highlighted the importance of restricting dietary intake of iron, and the need to increase the intake of calcium and vitamins. These data helped the investigator to prepare questions related to dietary practices adopted by the mothers to maintain optimum health in their children. Studies Related to Care-Giving Experience of Mothers of Children with Thalassemia Ali S. and Sabih F (2012) conducted a comparative study among parents of children with Thalassemia, and those of normal children to assess the care-giver experience in Pakistan. They revealed that parents of Thalassemic patients experienced higher degrees of distress when compared with parents of normal children. The frequency of psychological distress leading to parental stress was higher due to the multiple problems the parents had to face while going through the rigorous and painful treatment procedures of Thalassemia. The parents had to face many concerns like the psychosocial adjustment of the child, financial problems, provision of treatment, traveling, and other social problems. Pruthi G.K. and Singh T.B. (2010) conducted a comparative study among care-givers of children with Thalassemia, and cerebral palsy in India. The results of this study indicated that psychosocial burden was high, and overall perception of quality of life was very poor and dissatisfactory among the care-givers of children with Thalassemia. In another study, Aydinok Y. et al (2005) stated that the increased risk of psychosocial and behavioral problems in Thalassemics, and their parents indicated the importance of a lifelong psychosocial support for the prevention of mental health issues. The patients, and their parents who were more conscious of the illness, were more worried but more compliant with the therapy and needed stronger psychiatric support. The data on the experience of the care-givers helped the investigator to formulate a conceptual framework based on Kathryn Bernad’s child-parent interaction model. This model proposes that a sound body, and mind of the parent will help them to identify the needs and problems of their child as early as possible. Psychological distress of parents can interrupt the interaction with the child. The environmental component in this model explained the financial, social support groups that affected the child’s health. Suksiri P. and Arunee J. (2000) conducted a study to assess the life experiences of Thai families with Thalassemic children, and found that most mothers did not know about Thalassemia or its complications. They also found that mothers had strong concerns about the present status, and the future of their children. The major concern was the need for their children to be strong and healthy. The treatment of Thalassemia was very strenuous, and caused suffering for both parents and children throughout the child’s life. It is clear that as health care providers, we have to reinforce the parents for regular treatment. This information helped the investigator prepare questions related to measures adopted to maintain regular treatment and follow up. Tiantis J. et al (1982) conducted a study to assess the family reactions, and their management in a parents’ group with Î²-Thalassemia. They found that the parents displayed various emotions (guilt, death anxiety, denial of feelings etc.), and their behavior towards the child was inappropriate (overprotective, conspiracy of silence). This could affect child’s psychosocial development, and lead to tensions within the family. The data from the above studies indicate that the parents of children with Thalassemia experienced psychological problems which were similar to, or more than that of their children. The mental status of the parents could affect the children in many ways. Therefore, the investigator felt the need to explore further on these aspects.
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Introduction to Research Methods: Build a Qualitative Proposal
Introduction to Research Methods: Build a Qualitative Proposal.
Taking what you have learned from the readings and the feedback given on your past assignments, present a mini proposal that includes the following:Statement of problem. Provide a clear justification with evidence on why this study is relevant to your field and worthy of doctoral-level study. Support your efforts using scholarly information published within the past 5 years to ensure relevancy. Remember the problem statement should reflect your degree type (applied or research).Purpose statement (how your study will address the problem using qualitative methodology). This statement should flow from the problem statement.Research questions (make sure there is alignment with the problem and purpose).Find 2 to 3 articles related to your topic of interest and provide an overview of the research methodology and design where you specifically discuss the elements below from each article and discuss how each applies (or does not apply to your current study):A specific qualitative design,The population and sample,Steps for data collection and protection of human subjects,Steps for the analysis of the data, andIssues of trustworthiness within a qualitative framework.Based on your analysis above, what seems most applicable to your hypothetical study and why? Be sure to discuss the qualitative design, population and sample, data collection, analysis, and trustworthiness.Discussion of the inherent strengths and challenges of your hypothetical study to include any ethical considerations that might need to be addressed in the study.Make sure to support all assertions and research choices, using the course resources as well as additional scholarly literature you have found.Make sure to justify your steps and choices, using the course resources to help support your points.Length: 5-7 pages, not including title and reference pagesGrading RubricCriteriaContent (300 points)Points1Proposal includes problem statement, justification, and relevant supporting research752Purpose statement and research questions align with the problem statement753Provides an overview of research methodology and design from 2 – 3 articles 754Analyzes the qualitative design, population and sample, data collection, analysis, and trustworthiness of your study as well as the ethical considerations, strengths and weaknesses75Organization (100 points)5Organized and presented in a clear manner. Included a minimum of five scholarly references, with appropriate APA formatting applied to citations and paraphrasing.100Total400Your paper should demonstrate thoughtful consideration of the ideas and concepts presented in the course by providing new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards. Be sure to adhere to Northcentral University’s Academic Integrity Policy.
Introduction to Research Methods: Build a Qualitative Proposal
Re-writing only; dont change the meaning
essay order Re-writing only; dont change the meaning.
Combination therapy for early melanoma patients against immune suppression pathway Abstract Cancer is currently the leading cause of death in worldwide, Surgery, platinum-based chemotherapy, molecular targeted agents and radiotherapy are the traditional treatment used. However, the prognosis of early melanoma patients, especially those in clinical stage II and III is not as effective as patients in stage I. Therefore, new sorts of treatments are needed to be exploited for these patients. Immunotherapy is a promising strategy for the treatment of various types of cancer. Programmed death 1 (PD-1) and its ligand PD-L1 play a key role in tumor immune escape and the formation of tumor microenvironment, closely related with tumor generation and development. Blockading the PD-1/PD-L1 pathway could reverse the tumor microenvironment and enhance the endogenous antitumor immune responses. Utilizing the PD-1 and/or PD-L1 inhibitors has shown benefits in clinical trials. An antibody that targets programmed death-1 (PD-1) pathway has been shown to be active towards various types of cancer, including melanoma, resulting in a breakthrough therapy designation granted by FDA. These events pronounce the importance of targeting the PD-1 pathway in the treatment of melanoma cancer Nevertheless, monoclonal antibody targeting PD-1 therapy inherently carries a number of disadvantages such as their immunogenicity (following repeated administration) and high production costs which may limit their use and broad availability to patients. For example, recently FDA approved anti pd-1 antibody keytruda is only available for patients with metastatic cancer, for it would largely increase patient survival rate and increase tumor regression while it will also trigger severe autoimmune responses. And since PD-L1 expression correlates greatly with PD-1 expression in patient profiles, administration of treatment only targeting PD-1 leaves some patients unresponsive to immunotherapy as well. Therefore, in this study, we propose developing a combination therapy targeting PD-1/PD-L1 pathway for early stage melanoma patients with limited side effects. The development of this project can be organized into two parts. First, we propose a new design for immune checkpoint PD-1/PDL-1 inhibitor by formulating a nanoparticle that could inhibit the immune suppression. After designing this particle, pharmacodynamics study and in vitro, in vivo functional study will be performed. Secondly, a combinational therapy with anti-PD-1 should be tested in animal model for both its synergistic effect and treatment efficacy. Collectively, developing a combination therapy by Introducing nanomaterial to traditional cancer immunity treatment would help to solve unwanted side effect raised by antibody blockade action, while broadening and benefiting more patients with sufficient treatment efficacy. Experimental Plans Relevant background Cancer as a chronic, polygene and often inflammation-provoking disease, the mechanism of its emergence and progression is very complicated. There are many factors which impacted the development of the disease, such as: environmental factors, living habits, genetic mutations, dysfunction of the immune system and so on. At present, increasing evidence has revealed that the development and progression of tumor are accompanied by the formation of special tumor immune microenvironment. Tumor cells can escape the immune surveillance and disrupt immune checkpoint of host in several methods, therefore, to avoid the elimination from the host immune system Drugs targeting PD-1/PD-L1 pathway has been formulated and FDA approved for marketing. For example, pembrolizumab (Keytruda, Merck & Co., Inc., Kenilworth, NJ, USA) is a potent, humanized IgG4 monoclonal antibody against programmed death 1 (PD-1) receptor that directly blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2. Pembrolizumab has demonstrated robust, durable antitumor activity. However, because of the unmanageable and severe autoimmune side effect of using this medication in patients, it is only approved for advanced or even metastatic melanoma patients. However, it has been reported in literature that, PD-L1 expression level is independent of disease stage, but also correlates greatly with the prognosis and survival of early to mid-stage patients. Therefore, developing a combination therapy for these melanoma patients targeting immune suppression pathway i.e. PD-1/PD-L1 axis is necessary Spherical nucleic acids (SNAs) are structures with densely packed oligonucleotides with highly oriented functionality. Compared to their free composite oligonucleotides and nanoparticles they derived of, SNA structure confers efficient and rapid cellular uptake with great ability to modulate gene expression. Moreover, previous studies have demonstrated it also have advantages in stimulating both innate (toll-like receptor-9(TLR-9)) and adaptive immunity for cancer treatment. However, given the heterogeneity of in situ cancer population and various evading mechanisms, SNAs could be used as a platform to remove the hurdle of inhibitory signal and modulating immune response against tumor. Significance Developing a combination therapy by Introducing nanomaterial to traditional cancer immunity treatment would help to solve unwanted side effect raised by antibody blockade action, while broadening and benefiting more patients with sufficient treatment efficacy. Innovation Our immune system have a number of immune mechanism which in theory can attack/destroy tumor cells with those neo antigen, which induce a immune response. One of the major player is the cytotoxic t cells. with the help of several different kinds of immune cells, they could be trained to attack and destroy tumor cells. so if everything is working appropriately, this immune response could be quite potent. During cancer immunity cycle, t cell has to be activated and trained to be able to target tumor cells, however, tumor cells develop evading mechanism to escape from cytotoxic t cell attacking. PD-1/PD-L1 is one of the inhibitory signal tumor microenvironment use to tur down immune response. Therefore, to boost immune therapy efficiency, it is necessary to suppress inhibitory pathway. With the recently FDA approved anti pd-1 antibody keytruda for metastatic melanoma, it would largely increase patient survival rate and increase tumor regression, suggesting targeting this pathway is promising even in clinical application. However, since it’s targeting pd1 on the t cell, it has its own limitation that antoimmune side effect is inevitably. And the reason for there is no available anti pdl1 antibody, it’s because limited delivery efficency to target tumor environment. Therefore, in this project we want to benefit from SNA superior structure advantage of highly uptake in tumor environment, and knockdown/interfere pdl1 expression/function to remove the escaping mechanism, and boost t cell killing to remove tumor burden The concept of T-cell co-stimulation has evolved over time. The two-signal model for T-cell activation was proposed by Kevin Lafferty and co-workers as a model for the activation of naive T-cells. According to this model, T-cells require two signals to become fully activated. (Lafferty and Cunningham, 1975) The first signal, which gives specificity to the immune response, is provided by the interaction of the antigenic peptide−MHC complex with the T-cell receptor (TCR). The second, antigen-independent co-stimulatory signal, is delivered to T-cells by antigen-presenting cells (APCs) to promote T-cell clonal expansion, cytokine secretion, and effector function. (Keir et al., 2008) Current immunotherapies have been developed based on this model to boost or train immune CD8 T-cells to kill tumors.(Radovic-Moreno et al., 2015)[Ed1] However, tumor cells have progressively developed ways to evade the immune system. One way is through inhibitory second signal pathways like CTLA4 and PD1 interactions. Both clinical and research studies have proved that blocking these pathways could lead to enhanced tumor killing effects. (Blank et al., 2004) However, given the high cellular toxicity of present transfection reagents and the low stability of antibody-based treatment, a more stable and less toxic therapeutic approach is needed. Previous work from our lab have demonstrated the advantages of using the spherical nucleic acid (SNA) platform as a new strategy in cancer treatment, including for diseases such as glioblastoma multiforme (GBM), retinoblastoma, and prostate cancer.(Jensen et al., 2013; Narayan et al., 2015) Promising data have also confirmed the potential of SNAs in stimulating the immune system as potent cancer vaccines. (paper in progress[Ed2] ). Therefore, developing a new SNA targeting PDL1 as a combinational agent with the current antibody treatment could be an obvious promising step[Ed3] . Evaluate combination treatment of nanoparticle and anti-PD-1 antibody in melanoma mouse model i) First and most importantly, given the mechanism of action of anti-PD-1, several studies have tried to determine whether the efficacy of these Abs correlated with PD-L1 ligand expression in the tumor. The first studies provided evidence that there was indeed a strong link between PD-L1 expression by tumor cells and the response to anti-PD-1 Ab. Topalian et al. showed that all the responses to nivolumab were observed in patients whose tumors expressed PD-L1. Likewise, in the KEYNOTE-001 trial, responses to pembrolizumab correlated with PD-L1 expression by tumor cells. A trial assessing the effect of an anti-PD-L1 (MPDL3280A) on different types of cancer found a correlation between the level of PD-L1 present in the intratumoral immune infiltrate (but not by the tumor cells themselves) and clinical response. However, other studies did not confirm this correlation. In a meta-analysis including 1475 patients treated with nivolumab, pembrolizumab or MPDL3280A, response rates were significantly higher in PD-L1-positive tumors (34% versus 19.9%). Pembrolizumab (Keytruda, Merck & Co., Inc., Kenilworth, NJ, USA) is a potent, humanized IgG4 monoclonal antibody against programmed death 1 (PD-1) receptor that directly blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2. Pembrolizumab has demonstrated robust, durable antitumor activity and a manageable safety profile against several advanced malignancies. Early clinical studies of pembrolizumab employed a body-weight–based dosing strategy of 2 mg/kg every 3 weeks (Q3W) to 10 mg/kg every 2 weeks (Q2W), but in more recent trials a fixed-dose regimen (fixed with respect to body weight) has been introduced. Given the mechanism of action of pembrolizumab, binding to PD-1 receptors on T cells, independent on direct engagement of the molecule with tumor cells, substantial differences in exposure–response and dose–response are not expected across different tumor types. Indeed, it has been found that the pharmacokinetics (PK) of pembrolizumab are similar across oncology indications. On this basis, selection of a fixed-dose regimen focused on establishing a dose that would provide comparable (central tendency and distribution) exposures as the 2 mg/kg Q3W regimen approved in the United States for melanoma and NSCLC. The fixed dose selected also aimed to maintain exposures within the existing clinical experience range that has been established for melanoma and NSCLC and which has been associated with a lack of clinically important differences in efficacy or safety the central tendency (mean, median) at 200 mg Q3W is modestly increased (~35%) relative to 2 mg/kg Q3W for all PK measures (AUCss, 0-6weeks, Cmax, ss and Ctrough, ss), while these values are ~25% of those obtained at 10 mg/kg Q3W. Intersubject variation (% CV) is similar for all regimens and the 10–90% percentiles are largely overlapping for 2 mg/kg and 200 mg Q3W. A minimum effective administration of anti-PD-1 antibody should be tested in mouse model we developed. The administration route, dose amount and dose schedule should be tested in vivo. Regarding to the in vivo biomarkers they tested for anti-PD1 mAb, A multitude of biomarkers has been studied, predominantly involving indices from the patient’s tumor (tumor cells or cells from the microenvironment) or blood (circulating cells or serum).Treatment with anti-PD-1 Ab was associated with increased circulating IFN-γ, IL-18 and ITAC (an IFN-γ inducible chemokine which is chemotactic for activated T cells) and decreased IL-6. However, no correlation was found with clinical efficacy. The presence of lymphocytes within the tumor is another favorable prognostic factor in numerous cancers treating with checkpoint inhibitor antibody. In patients with metastatic melanoma, an increase in lymphocyte infiltrate in the tumor between baseline and at 3 weeks after treatment initiation correlated with clinical response. Moreover, in melanoma patients, response rate was better in patients with high numbers of peri- and intratumoral CD8 T cells in their pretreatment samples. Analysis of biopsies after treatment showed a correlation between a high ratio of intratumoral CD8/regulatory T cells and tumor necrosis. Moreover, in patients with metastatic melanoma, Tumeh et al. found that clinical response to anti-PD1 therapy (pembrolizumab) correlated with (i) a more clonal (i.e. more restricted, less diverse) TCR repertoire in pretreatment tumor samples and (ii) an increased clonal expansion of T cells in the tumor after anti-PD1 therapy. ii) Synergistic effect of administrating both nanoparticle and antibody should be tested in vivo. A overall PD-L1 expression level, circulating cytokine, and tumor microenvironment remodeling should be 3 factors to be valued following combination treatment. A tumor regression curve and mouse survival rate should also be performed [Ed1]Not sure if I would reference this here. As written, it makes it sound like there are disadvantages to our work. I don’t think you should describe it in that way. [Ed2]` [Ed3]Add a sentence or two about fundamental scientific issues you will explore.
Re-writing only; dont change the meaning
Discussion. Need help with my Psychology question – I’m studying for my class.
Address the topics below ( View the scenario). Your original response should reflect the fact that you have completed the assigned Readings for the week (see the reading below). Remember, this is your chance to illustrate not only your understanding, but also your mastery of the materials for the unit. Use your words wisely so the posting has substance and includes examples and explanations. Limit the use of direct quotes, and do your best to critically synthesize and evaluate the literature in your own words wherever possible. Make sure to include in-text citations and a reference list as appropriate.
Several different data-gathering methods (e.g., questionnaires, interviews, focus groups, etc.) for employee satisfaction research can be selected when conducting research in organizations. View the following scenario. Describe your target population and the metric you are trying to improve. Select an appropriate data-gathering methodology. Provide a clear rationale as to why you believe this method would be the most appropriate. In addition, briefly describe how your method of data-gathering design is reliable and valid for your study.
This week, you will spend some time looking at some of the controversies related to I/O psychological theory in studying workplace motivation. Your two Readings will: (1) summarize the research controversies faced by I/O psychologists in the latter part of the 20th Century, and (2) look at employee engagement as an approach to improve workplace satisfaction and performance.
Latham (2011), Chapter 5, “20th Century Controversies”
In this chapter, you will look at four controversies related to workplace motivation and attitudes: (1) financial incentives as a motivator, (2) intrinsic versus extrinsic motivation, (3) the relationship of workplace satisfaction to job performance, and (4) participatory leadership in creating work teams as a motivational approach.
Macey, Schneider, Barbera, & Young (2009), Chapter 2: “The “Feel and Look” of Employee Engagement”
In this chapter, you will read the pros and cons of employee engagement and strategies for employee engagement
Biochemistry Unit 2 Assignment
Biochemistry Unit 2 Assignment. I’m trying to learn for my Medicine class and I’m stuck. Can you help?
For your Assignment you will be preparing a case study. A case study reflects a detailed analysis of a particular situation or person over a period of time. You will use your textbook and additional internet research along with a little creativity to create a detailed investigation into an assigned disease state. Remember that a good case study is not a simple description, but more of an experience for the reader to be able to walk through the processes that occur, and come to a specific conclusion.
Case Study – Alzheimer’s Disease
For your Assignment you will be creating a case study based on an individual who has been diagnosed with Alzheimer’s Disease. One of the principle features of Alzheimer’s Disease is the formation of fibrous protein aggregates in the form of amyloid plaques. You will be concentrating your case study on the mechanisms behind the disposition of these plaques, associated neuronal death, and how this knowledge could lead to potential treatments and diagnostic opportunities.
Your case study needs to include:
A description of the problem or case question you want the reader to solve.
An introduction to the patient or case.
An explanation of the defects associated with this disease. Please concentrate your communications on the biochemical related events in the brain. You should provide bulleted highlights in the slide and then a detailed explanation in the notes section of the slide or a separate document.
A review of diagnostic and preventative measures.
Basic Writing Expectations:
This Assignment can be submitted using the provided Microsoft PowerPoint template, or you may use Microsoft Word to present the necessary information.
The explanation of the biochemical processes involved needs to be in essay format. You may provide this information in the notes section of the slide presentation or a separate Word document.
Free of grammatical and spelling errors
No evidence of plagiarism
You should provide the requested information with references. References should be complied into a list in APA style. Refer to the APA Quick Reference Guide.
Biochemistry Unit 2 Assignment