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N. Fowleri Diagnosis, Treatment and Prevention

N. Fowleri Diagnosis, Treatment and Prevention. Historical Aspect: Naegleria Fowleri (N. Fowleri ) is a free living, thermophilic protozoan that is a human specific pathogen that attacks the central nervous system. It can be found in contaminated freshwater sources. It enters through the nose and travels to the brain causing primary amoebic meningoencephalitis1. It was first observed in 1899 and later named after Dr. M. Fowler, who observed the first reported fatal cases of acute pyogenic meningitis in Australia in 19652. While these infections have been identified as early as the 19th century it is challenging to identify because it mimics many of the symptoms of bacterial meningitis[1]. Primary amoebic meningoencephalitis (PAM) is a necrotizing and hemorrhagic meningoencephalitis3. The symptoms begin 1-9 days after the onset of infection these symptoms include fever, nausea, headache and vomiting. The initial symptoms mimic those of bacterial meningitis, the later symptoms are unique to this disease. Later symptoms include neck stiffness, hallucinations, seizures, an inability to focus, lack of balance and eventually coma and death. The mortality rate for this disease is 95%. The disease progresses quickly and leads to death within 12 days of the initial infection1. While this infection has a high mortality rate, it is very rare. There have been 300 reported cases of PAM worldwide in the last 40 years4. It is important to note that this conditioned is often misdiagnosed so these numbers are estimates. In the United States there have been 138 cases in the last 50 years1. This infection was once a condition that plagued developing countries but the incidence is spreading all over the world. Researchers suspect that the increased temperatures due to global warming, increased use of public water sources due to scarcity and an overall increase in aquatic recreational activities are to blame3,18. While swimming and other aquatic recreational activities help proliferate this disease so do rituals. Aga Khan University in Pakistan noticed an increased number of deaths caused by PAM in young males that had no history of swimming, but were devout Muslims. Those who practice this faith pray five times a day and before every prayer, they perform ablution, ablution is the washing of the hands, face, ears, nose, mouth, arms and feet. While cleansing the nose, water is forced up the nose putting individuals performing this practice with inadequately purified water at a greater risk for PAM3. Religious festivals like the Kumbh Mela where Hindus gather and swim in the Ganges river put those who participate at risk of developing diseases like PAM caused by N. Fowleri 3. In addition to religious practices, therapeutic interventions like the Neti pot increase the risk of PAM. Nasal irrigation systems like the Neti pot work to relieve the symptoms of sinusitis and cold. It works by removing debris and mucus from the nasal passages. The recommendation is that the water should be boiled or mixed with a non-ionized sodium chloride. Basic structure: N. Fowleri are a part of the free living amoeba that cause infections in the central nervous system. Some of the other protists are Acanthamoeba spp and Balamuthia mandrillas. Naegleria fowleri have been classified by modern techniques which analyze morphology, biochemical pathway and molecular phylogeny2. The modern approach classifies N. Fowleri as a part of the super group Excavata, in the group Heterolobosea and a part of the family Vahlkampfiidae. Although the genome for N. Fowleri is not yet completed there are some studies producing information about its molecular and genetic characteristics. N. Fowleri ‘s genus includes more than 40 species, but N. Fowleri is the only one that is known to cause disease in humans. De Jonckheere created the most popular identification system for N. Fowleri . The identification system uses genetic markers like internal transcribed spacers (ITS1) and 5.8S rDNA 2. This identification system revealed at least 8 different genotypes. The genotypes are dispersed among different continents America (I,II,III), Europe (III,IV,V,VI,VIII), Oceania (V), and Asia (II,III). Of the eight genotypes only four have been found in humans, types 1-42. Naegleria are a part of the group heteroloboseans that have a three-phased lifecycle. They are first amoeba, then flagellate and lastly cyst formation5. N. Fowleri reproduces in the amoeba form via binary fission to produce the cyst and the flagellate forms. The entire cell cycle is 8 hours, N. Fowleri spends 28 minutes in M phase, 180 minutes in G1, 183 minutes in S phase, and 90 minutes in G22. In the amoeba form, the trophozoite ranges in size from 15-25 µm. Trophozoites also have cytoplasmic projections called food cups which allow phagocytosis of bacteria, yeast, erythrocytes and cellular waste. Trophozoites are the form of the amoeba that can feed and divide, they are also the form that enter the human host6.Trophozoites will transition into the flagellate stage after being exposed to a saline solution2. The flagellates cannot feed or divide, the transition also involves a change in shape from pleomorphic to pear shaped with a pair of flagella. The flagella have the typical 9 2 structure and are surrounded by a cytoplasmic membrane. The 9 2 flagella structure describes the cross- sectional arrangement of microtubules that make up the flagella. There are nine doublet outer tubules and two central singlet tubules7. The cyst form is resistant to most disinfection. The cyst formation is spherical, smooth, double walled and refractive. They measure about 20µm. The material of the cyst wall is synthesized and packaged by the rough endoplasmic reticulum2. Route of Transmission: N. Fowleri is a thermophilic amoeba, its optimal temperature ranges from 1150 to 1220 F. N. Fowleri can typically be found in warm freshwater like lakes and rivers, warm water from industrial parks, or inadequately chemically treated water, other warm water sources like water heaters and soil. In their natural environment N.Fowleri phagocytize cyanobacteria and eubacteria to regulate levels. Samples from the lakes of the southern United States reveal that N. Fowleri introphozoite formis present during the summer. During the winter months N. Fowleri in cyst form survive in freshwater sources, but no form of N. Fowleri can withstand freezing temperatures1 . Most cases of PAM are caused by swimming in warm freshwater, from drinking water, recreational activities, ritual abulation and sinus irrigation systems1. Infection occurs when water containing N. Fowleri gets into the nose. The amoeba enters the nose and travels along the olfactory nerve, through a bony plate in the skull called the cribriform plate3. Once it reaches the brain it causes meningoencephalitis, cerebral edema and results in herniation. The olfactory bulbs and orbitofrontal cortices become necrotic and hemorrhagic. The data on both humans and mice support the conclusion that death is ultimately caused by increased intracranial pressure and herniation3. Swimming in water containing N. Fowleri increases the risk for PAM but age and sex are also risk factors. From the 1962- 2015 there have been 138 reported cases of PAM in the United States, 114 of the cases have been children around the age of 12. Nearly 75% of the infections have affected males1. Certain behaviors are associated with an increased risk of infection, those infected individuals reported participating in water related activities like swimming, diving and head dunking1. Although N. Fowleri can be transmitted through water it cannot be transmitted through aerosols or droplets, or via person to person contact. N. Fowleri can be found in other organs of the body, such as the heart, lung, spleen and thyroid1. Pathogenesis: N. Fowleri enter the human host through the nose which provides access to the brain. Within eight hours of infection N. Fowleri is present in the mucus layer of the olfactory epithelium. Within 24 hours N. Fowleri are in the olfactory bulb and present in the cribriform plate. By 96 hours neutrophil polymorphs cause a severe inflammatory response in the olfactory bulb which leads to brain tissue damage3. Contact dependent mechanisms are N. Fowleri mediated pathogenic processes. The primary mechanism of pathogenesis in N. Fowleri is adhesion. Adhesion allows for movement and chemotaxis in the nasal mucosa and assists N. Fowleri with disease progression. Adhesins are expressed on the surface of N. Fowleri, the adhesins are integrin like proteins surrounded by adhesion like structures. Fibronectin binding protein, protein kinase C and NFa1 are important to interrupting the host mediated cytotoxicity3. In an experiment testing cytopathicity of N. Fowleri, a culture would bind to Fibronectin and in the presence protein kinase C the ability of the amoeba to adhere increased8. N. Fowleri also produces Reactive Oxygen Species (ROS) which damage the host cell. Following cell damage, N. Fowleri uses phagocytosis and amoebastomes to assist N. Fowleri in breaking down and consuming the cells through a sucker structure on its surface. These processes are mediated via actin and involve the polymerization of monomeric G-actin and filamentous F-actin. Studies have found that a membrane protein Mp2CL5 may also play a role in pathogenicity, without this protein N.Fowleri are nonpathogenic3 .This protein is suspected to aid in pathogenicity by navigating the environment, and movement toward food sources9. In addition to contact dependent mechanisms of pathogenicity, N.Fowleri also utilizes contact independent mechanisms. N-PFP is a cytolytic pore forming protein that depolarizes the cell membrane and decreases the integrity. Naegleriapores A and B are pore forming polypeptides that are very similar in structure and function. Both are antimicrobial and cytolytic polypeptides3. The enzymes phospholipase A, A 2 and C are present in patients with PAM. Phospholipases are responsible for the demyelination of white matter. Sphingomyelinase, neuroaminidase, elastase and proteolytic enzymes are responsible for demyelinating nerve tissue. N. Fowleri are hemolytic due to the heat shock protein 70 which is unaffected by salt concentrations, chelating agents, pH and temperature extremes3,10. This protein is present in the cytoplasm, pseudopodia and phagocytic food cups. There are many other factors associated with the pathogenicity of N. Fowleri and others that are suspected to have an effect on the pathogenicity. On the onset of infection the host’s innate immune system attempts to reduce the pathogen’s cytotoxicity. During the early infection the body releases mucin which surrounds the N.Fowleri trophozoites to prevent cytotoxicity. In the later infection eosinophils and neutrophils surround the N. Fowleri cells to prevent cytotoxicity. Inflammation increases over time, although there are not many cells that penetrate the host epithelium. The inflammation and polymorph nuclear cells from the host response damage cerebral tissue2 . Diagnosis, Treatment, Prevention: Diagnosis of N. Fowleri is heavily dependent on laboratory techniques. The most effective way to diagnose N. Fowleri requires cerebrospinal fluid (csf) which is conducted while the patient is living and brain biopsy which is conducted post-mortem11. Different laboratory tests are utilized to analyze the specimen. When PAM is suspected, samples can be wet mounted and placed under a microscope to identify trophozoites12. Polymerase chain reaction is a method that can be used to amplify DNA, to identify the presence of N. Fowleri DNA in a sample11. Another laboratory technique involves antigens that were developed from mouse monoclonal antibodies (mAbs) against N. Fowleri . When indirect immunofluorescence assays are used mAbs react to N.Fowleri from specific geographic regions13. The infection due to PAM progresses quickly and as previously stated, mimics symptoms of bacterial meningitis. Even with the advances in laboratory diagnostics most cases are diagnosed post mortem making effective treatment elusive. One successful case study provides an example of effective diagnosis and treatment of this condition. On July 13, 2013, a 12 year-old girl presented to Arkansas Children’s Hospital vomiting, having trouble holding up her head and was unable to open her eyes. A few days prior to hospitalization the patient had been playing in a local water park. During her hospitalization she experienced hallucinations, and thirst. A spinal tap was performed which ruled out bacterial meningitis. The laboratory identified N. Fowleri trophozoites in the patient’s cerebrospinal fluid. After determining the infection was PAM caused by N. Fowleri, physicians initially treated the patient with antibiotics and antifungals like Amphotericin B, Rifampin, Fluconazole, Dexamethasone and Azithromycin .None of these treatments improved the condition of the patient. The hospital petitioned the Center for Disease Control (CDC) to allow the use of a new experimental drug available for the treatment of N.Fowleri14. The drug Miltesfosine was given 36 hours after the initial diagnosis, physicians also lowered the patient’s body temperature to 93.2 F0 to reduce cerebral edema and intracranial pressure. After 18 days in the ICU there was no N. Fowleri found in her system. The patient experienced a full but gradual recovery over the next fifty five days. After seven days the patient was able to write her name, in fourteen days she was able to speak in one and two syllable words. She also underwent both speech and physical therapy14. This patient is one of the three known survivors of PAM. While the virulence factors and the degree of recovery that surround the other two cases of survival are unknown. The prompt diagnosis, treatment with Miltesfosine within thirty six hours and maintaining a low body temperature for this patient played significant roles in effectively treating this infection14. Although the first case of N. Fowleri was over 50 years ago, the mortality rate for this disease continues to increase due to water scarcity which increases use of water from public sources. As previously stated this condition is either diagnosed post mortem or misdiagnosed. The development of a standard microbial treatment will aid in the reduction of high mortality rates14. In the three cases of survival the patients were all intially treated with amphotericin B, rifampcin, fluconazole, dexamethasone and phenytoin during the first week of infection15. In 1969 a patient survived PAM with the successful treatment of amphotericin B. The patient in 2013 was initially treated with amphotericin B and it was ineffective. Miltesfosine effectively treated this patient’s PAM14. Other drugs with the potential to treat PAM have been tested, and some have been proven effective while others have not. Clotrimazole a drug that has been used as an antifungal had potential to treat PAM but under further study was deemed ineffective16. In developing countries like Pakistan where water is in short supply and ablution is common practice the danger of becoming infected with N. Fowleri is greatly increased. Water sources in these countries include wells or water storage tanks which are often contaminated with N. Fowleri 17. In order to prevent infection the World Health Organization (WHO) encourages that water storage units and wells be regularly tested to ensure proper disinfection. Public health organizations have also encouraged the use of nose clips while swimming in lakes and other freshwater sources, and boiling water that is used for ablution17. Chlorine disinfection regimens prevent against most pathogens in drinking water systems however free living amoeba like N. Fowleri survive most disinfection. The cyst form of N. Fowleri is resistant to most disinfection and are associated with biofilm that can build up in drinking water systems. N. Fowleri have been isolated in drinking water systems in Australia, the United States and Pakistan, in both Australia and the United States they maintain chlorine levels of 0.5mg/L at all times in the drinking water18.To test the amount of chlorine needed to eliminate N. Fowleri, researchers conducted an experiment using two separate sites, a pre re-chlorination site and a post re-chlorination site, both sites were monitored before and after re-chlorination for a year. The results were that after chlorination of greater than 1mg/L at each site, in the post re-chlorination site the amoeba were gone within 60 days. The pre re-chlorination site would have seasonal flares of N.Fowleri but the chlorine levels eliminated the protozoan and prevented further spread. Overall chlorine levels above 1mg/L result in the elimination of N.Fowleri in drinking water systems18. Summary of current areas of research notes: N. Fowleri is a rare pathogen that was discovered over fifty years ago. Since its discovery still not much is known about this pathogen. Future research into this pathogen will focus on patient complaint diagnosis and treatment, expanding the drugs that are used, biomarkers, and drug targets. In order to determine whether the patient has contracted PAM due to N.Fowleri the patients csf is tested and if the test is negative for bacterial cultures and the patient has a history of swimming or other aquatic activities, then the patient tests positive for N.Fowleri. Extracting csf can increase the pressure in the patient’s brain and lead to herniation of the brain. Because N. Fowleri travels to the brain via the nasal passage, the proposed route of diagnosis is collecting a nasal sample. Research confirms that N.Fowleri can be collected in both csf and nasal cultures3. Drugs administered through the nasal cavity, through the transcribial route would be delivered across the cribifrom plate to the inferior portion of the frontal lobe. This is the site where N. Fowleri attacks and spreads to the central nervous system. Drugs like amphotericin B do not decrease the minimum inhibitory concentration (mic) when administered intravenously. By potentially administering the drug transcribialy, the drug passes the blood barrier which would “allow the drug to be more potent, trail the route of N.Fowleri, attack the site of infection, allow the lethal dose of drug to achieve the mic without venous drainage, and lastly to avoid symptoms of intravenous drug administration” 15. There are clinically approved drugs that have promising amoebicidal effects. These drugs interrupt the mechanisms and processes of the amoeba. Digoxin and proyclidine both exhibit amoebicidal properties. Digoxin treats atrial fibrillation and heart rhythm disorder by helping the heart beat stronger and with more rhythm19. Proyclidine is used to treat Parkinson’s and other diseases that cause involuntary muscle movement20. In order for further testing of the amoebicidal effects of these drugs to continue to be studied more drugs that have the potential to be amoebicidal must be identified and screened for tests to go from in vitro testing to in vivo testing. There has not been a lot of emphasis on finding drugs that treat N. Fowleri because the condition is rare and affects populations in the developing world. Biomarkers for PAM have been challenging to identify because little is known about N. Fowleri’s pathophysiology. Mass spectrometry, NMR and other tools of analysis are being utilized to identify biomarkers. Researchers are also making biochemical profiles of individuals in populations that contracted the disease against those who did not. These profiles will include information on the individual’s age, gender, ethnicity and factors that predispose them to this condition3. This condition is rare and because of its rarity has been studied infrequently. With limited time and resources N.Fowleri is funded and studied less frequently than conditions that affect larger populations like Malaria or the Zika virus. The range of drugs used to treat patients with PAM is severely limited, researchers are developing drugs that would inhibit different processes of N.Fowleri. The drug pathways are “hydrolytic enzymes that invade the host cells, glycocytic enzymes that are expressed differently by the pathogen, thiol based redox metabolism pathway, oxidative stress pathway, trypanothione pathways, and encystation and excystation pathways”3. Bibliography 1. Naegleria fowleri- primary amebic meningoencephalitis (PAM) amebic encephalitis. Centers for Disease Control and Prevention Web site. =. Updated December 2015. Accessed January, 2017. 2. Martinez-Castillo M, Cardenas-Zuniga R, Coronado-Velazquez D, Debnath A, Serrano-Luna J, Shibayama M. Naegleria fowleri after 50 years: Is it a neglected pathogen? J Med Microbiol. 2016. doi: 10.1099/jmm.0.000303 [doi]. 3. Siddiqui R, Ali IKM, Cope JR, Khan NA. Biology and pathogenesis of naegleria fowleri. Acta Trop. 2016;164:375-394. doi: 4. Coupat-Goutaland B, Régoudis E, Besseyrias M, et al. Population Structure in Naegleria fowleri as Revealed by Microsatellite Markers. Chiang T-Y, ed. PLoS ONE. 2016;11(4):e0152434. doi:10.1371/journal.pone.0152434. 5. – The genome of naegleria gruberi illuminates early eukaryotic versatility. – Cell. (- 5):- 631. doi: – 10.1016/j.cell.2010.01.032. 6. Marciano-Cabral F, Cabral GA. The immune response to naegleria fowleri amebae and pathogenesis of infection. FEMS ImmunologyN. Fowleri Diagnosis, Treatment and Prevention
University of Phoenix Applied Research Article Analysis and Accessibility Essay.

AAssignment ContentThis assignment has two parts:Part 1: Article AnalysisKnowing the difference between applied and basic research is necessary for developing an effective research study. The difference between basic research and applied lies in their respective aims.Basic research refers to research aimed at acquiring new, fundamental knowledge and theoretical understanding about basic human and other natural processes without any particular application in view.Applied research also is conducted as an original investigation to acquire new knowledge, but it is primarily directed toward practical objectives with the aim of providing relatively immediate solutions.Locate an applied research article on a topic in your program of study from the University Library. To familiarize yourself with the different applied designs, review the Qualitative and Quantitative research designs in the Dissertation Guide located in CDS Central.Some key words to use while searching for an article in the library might include: Action Research, Program Evaluation, etc.Write a 350- to 525-word analysis about what makes the study discussed in the article applied versus basic research. Include in your analysis:- How the study in the article addresses a real-world, practical problem- How the results of the study could impact people’s lives, work, health, and/or general well-beingProvide a properly APA formatted citations and references with links to the articles.Part 2: AccessibilityReminder: Additionally, an important aspect of choosing a topic is access or the ability to conduct your study. For example, you may want to know how leaders in XYZ company use social media to increase sales, but leaders in XYZ company are unwilling to talk to you. If you are not able to gain accessibility to the leaders, then you will not be able to gather the data you need for your study.When selecting a topic for your study, consider whether conducting the study would involve talking to protected classes of people or vulnerable populations. Federal regulations require protecting the welfare of vulnerable subjects who may not be of age, have the authority or ability to speak for themselves, or are vulnerable in any other way. Protected classes include the following:· children or minors under age 18· prisoners· pregnant women· people with cognitive impairments or mental disabilities· people who are educationally or economically disadvantagedIf you are considering conducting research with any of the protected classes of human subjects, consider options for conducting your study in a different way. For example, instead of talking to minor children, talk to their parents. There are many creative options!Write a 250- to 500-word response to the following questions related to access and permission:· What permissions will you need to access the people, organizations, and/or data to conduct your research?· Who might you need to consult to gain permission to conduct your study?· What potential issues might you encounter?· How might you address these potential issues?Include both parts in one document.Use the attached APA formatted student paper template to ensure proper APA formatting.Include APA-formatted in-text citations, a title page, and a reference page. Submit your assignment.
University of Phoenix Applied Research Article Analysis and Accessibility Essay

UMGC Blended Learning in the School System Discussion.

Evidence-Based PracticeOne of the design concepts attributed to successful EdD programs is the scholarly practitioner, which The Carnegie Project on the Education Doctorate (CPED) defines as practitioners who “blend practical wisdom with professional skills and knowledge to name, frame, and solve problems of practice. They use practical research and applied theories as tools for change because they understand the importance of equity and social justice. They disseminate their work in multiple ways, and they have an obligation to resolve problems of practice by collaborating with key stakeholders, including the university, the educational institution, the community, and individuals” (n.d., Design-Concepts Upon Which to Build Programs section).As you move toward the final weeks of our course, a high priority for all who lead learning is the application of systems thinking as you identify a problem of practice relevant to your organization.As noted by Dirkx (2006):The demand for evidence-based research (EBR) in education has evoked considerable debate regarding the nature of knowledge practitioners hold, how they come to know, and the sociopolitical contexts in which that knowledge is generated. Proponents of EBR such as Michael Feuer stress the need for research that validly identifies solutions to important problems of educational practice. Critics such as Elizabeth St. Pierre decry such approaches to research on practice as epistemologically inappropriate and oblivious to their political and moral implications. Both positions illuminate important dimensions of improving practice, but what works seems to get lost in the rhetoric. In this article, the author suggests that we in adult education take seriously the question of what works in practice by developing a knowledge base grounded in research methods and strategies that give voice to the particularities of practice contexts, what he refers to as the “insider perspective.” (p. 273)As you proceed through your EdD program, you’ll be required to identify a problem of practice, not simply an isolated problem in your organization, but instead a problem of practice that is clearly supported in the professional literature. Note that such problems were most likely identified as you developed the Literature Review assignment—all work of doctoral scholars must be firmly corroborated in the literature and research relevant to your organization’s problems of practice.As you work to identify a problem of practice in your organization, please note the imperative to apply systems thinking. As noted by Senge, Cambron-McCabe, Lucas, Smith, Dutton, and Kleiner (2012):Systems thinking is the ability to understand (and sometimes to predict) interactions and relationship in complex, dynamic systems—the kinds of systems we are surrounded by and embedded in. Some of the systems already under study in classrooms (population growth; land use, climate, and agricultural production; the causes of revolution; and traffic patterns) readily lend themselves to the use of systems thinking and its tools.The ability to think systemically is neither new nor mysterious. One teacher, after an introductory course, gave voice to many people’s reactions when she exclaimed: ‘This is just common sense!’ In many ways that is true. Systems thinking enables you to see the big picture, the minute details that make it up, and the way parts interact over time, making explicit the patterns of behavior that people see all the time but that are rarely explained.The tools of system dynamics—behavior-over-time graphs, stock-and-flow diagrams, causal loops, computer models, simulations, and archetypes—are all ways to help us more effectively understand those patterns and the systemic dynamics that drive them.ReferencesDirkx, J. M. (2006). Studying the complicated matter of what works: Evidence-based research and the problem of practice. Adult Education Quarterly, 56(4), 273–290.The Carnegie Project on the Education Doctorate. (n.d.). The CPED framework ©. Retrieved from, P., Cambron-McCabe, N., Lucas, T., Smith, B., Dutton, J., & Kleiner, A. (2012). Schools that learn: A fifth discipline fieldbook for educators, parents, and everyone who cares about education. New York, NY: Crown Publishing.Researching Problems of PracticeThe following article helps place the problem of practice into an evidence-based context:Dirkx, J. M. (2006). Studying the complicated matter of what works: Evidence-based research and the problem of practice. Adult Education Quarterly, 56(4), 273–290.Systems ThinkingWhile the following resource focuses on schools, the principles presented apply to all leaders responsible for leading professional development, training, and professional learning:Senge, P., Cambron-McCabe, N., Lucas, T., Smith, B., Dutton, J., & Kleiner, A. (2012). Schools that learn: A fifth discipline fieldbook for educators, parents, and everyone who cares about education. New York, NY: Crown Publishing.Part VII, “Systems Thinking in the Classroom,” pages 269–318.Critical ThinkingRead the following standards presented by Paul and Elder. This website provides a concise overview of each of the standards you should incorporate into your discussion responses this week.Paul, R., & Elder, L. (2010). Universal intellectual standards. Retrieved from…
UMGC Blended Learning in the School System Discussion

Fisher College Role of IT Infrastructure in Evidence Based Management Discussion.

In review of Marr’s four-step process (p. 145) for contextualizing information, discuss your selected topic associated with decision-making in any of the following areas: decision making models, behaviors in decision making, the relationship between data and decisions, using technology in decision making, cognitive biases, ethical decision making, strategies for decision making, or traditional vs. evidence-based decision making. How are you leveraging Marr’s four-step process for designing an impactful presentation?Cite in all posts, preferred method is APA. In addition, please note terms utilized in the Textbooks, please include 2- 3 terms in your weekly posts
Fisher College Role of IT Infrastructure in Evidence Based Management Discussion

A T Still University Nicomachean Ethics Reflection Question

A T Still University Nicomachean Ethics Reflection Question.

In Nicomachean Ethics, Book VII, Aristotle discusses “incontinence,” or weakness of will. In the case of weakness of will, a person knows which action is in accord with virtue, but allows appetites to overpower reason and chooses to act against reason and virtue. Aristotle argues that the possibility of weakness of will shows that virtue is more than simply knowledge (as Socrates thought), for a person can have knowledge of what is right yet fail to do it.According to Aristotle, what gives rise to weakness of will, and how can a person with weakness of will be improved?AT LEAST 300 WORDS
A T Still University Nicomachean Ethics Reflection Question

Physics homework help

online dissertation writing Physics homework help. This is a paper that requires the student to choose one jazz artist or group to display diversity or race. The paper also provides additional Rubric guidelines to use in the writing of the assignment paper. Below is the description to read:,Choose one jazz artist or group to display diversity or race,Choose one of the following jazz artists/groups from the list below to research the way(s) in which race and/or diversity played a role in their interactions with American society in the earlier part of the 20th century (1900’s -1960’s.) This could include employment issues – performance opportunities, equal treatment, touring issues – hotels, travel options, etc.). Criminal justice issues (cabaret cards, arrests, drug use-targeting of musicians and neighborhoods, etc.) and other societal issues of the day. Learn how they responded (or were forced to respond) to these issues and how they involved themselves in issues of civil rights and race and diversity discrimination. Discuss how they used their music or status in the entertainment industry to address these issues.,Write a short (approximately 1000-1500 word paper) and submit. (Word count is NOT the most important component of a research paper.) Both versions will use the TurnItIn application. A well-edited, concise, clear and effective presentation is an important component of this assignment.,GRADING RUBRIC,Basic standards for grammar, sentence structure, citations (if used), and other considerations for a Research Paper style assignment need to be observed.,In order to achieve the highest grade you need to include the following topics in your presentation:, Firstly, a short description of the Artist or group and what issue(s) of discrimination based on race and/or diversity you are writing about., Secondly, how race and/or diversity affected their interaction with society during their historical period in America, Thirdly, what sort of responses (if any) the artist/group made to react to the racially/diversity-divided society found in America as jazz music grew along with the country., Fourthly, how the artist/group used their music or status in the entertainment industry to address these issues,List of Jazz Artists/Groups who were affected by issues of Diversity and/or Race and some of the issues they dealt with. The list of issues are JUST suggestions of a place to start your research. You need to also find much more material on the artist you choose.,Louis Armstrong– early 20th century stardom for a Black musician,Fletcher Henderson – Black swing bands vs. White Swing Bands – opportunities, acceptance, Black composers/arrangers and White Swing Bands,Benny Goodman– segregation, Black and White musicians playing together,Billie Holiday – female jazz performer,, “Strange Fruit”, cabaret card, drug issues,John Coltrane – “Alabama”, how he used his music to comment on Society,Cannonball and Nat Adderley Sextet –raised awareness through their music – “Work Song”, and other songs which were an inspiration by African American history and also traditions. Active in Civil Rights movement in the 1960’s,Attachments,Click Here To Download,Physics homework help

What impact does Facial Recognition Technology has on citizens and how does it impact globally?

What impact does Facial Recognition Technology has on citizens and how does it impact globally?. Can you help me understand this English question?

Explain the both side of the question: god and bad side, more of the bad side
Global Impact and Stakes

Why does this pose a threat on multiple different levels?
Who is using this?
what is it going to affect and what is not going to be affected/ scale/size/ what is not done
Any statics to help prove the point

NO Plagiarism!!!
Any sources can be used but with citations. MLA Style; And only reaible sources.
One necessary source to use is provided; (maybe just 1 or 2 citation, not necessary to use for the whole paper.)
Length of the paper:1 to 1.5. the citation don’t count in the length
What impact does Facial Recognition Technology has on citizens and how does it impact globally?

RU Applied Ethics Business Disciplines Ch 9 Marketing & Advertising Questions

RU Applied Ethics Business Disciplines Ch 9 Marketing & Advertising Questions.

WEEK SIX: Applied Ethics: Business Disciplines (continued)Chapter 9: Marketing and Advertising, Review Case 9.1, 9.3, 9.4Assignment – Be prepared to answer these questions:What do you think of Clapp’s assessment of American consumer culture? Do you think he is correct, or has he overstated the case? Do you think it is necessary as a Christian to resist the consumer culture? Should Christians favor asceticism (being happy with nothing)? According to Kilbourne, how are our emotions used in advertising? And what is advertising’s biggest problem? What percentage of an ad’s message is received by our conscious mind? What happens to the rest of that message? How does Hagenbuch respond to Kilbourne’s observations? What paradox does Hagenbuch invoke in describing the title and subject of his paper, “Marketing as a Christian Vocation?” If we agree with Hagenbuch that Christians, no matter their vocation, are called to be agents of reconciliation, then how does this apply to the field of marketing (or to your own field)? Who are the stakeholders and what is their role in encouraging reconciliation in this discipline; and in all disciplines presented in higher education?
RU Applied Ethics Business Disciplines Ch 9 Marketing & Advertising Questions

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