Evaluate the Current State of the Economy Essay Example for Free

Evaluate the Current State of the Economy Essay Labor market conditions are important especially for the following categories, businesses, individuals, and governments. The nation’s labor market conditions are constantly monitored by statistical analysis, unemployment rate being the primary metric. In April of 2014, the unemployment rate fell from 6.7% percent to 6.3% percent (Bureau of Labor Statistics. May 2014), which was the lowest rate since September of 2008. Since January the unemployment rate had been somewhat flat, but in April 2014 it dropped. However in April, the labor force additionally dropped by 806,000 (Bureau of Labor Statistics, May 2014) meaning the current ratio drop from 6. 7% to 6.3% comparatively remains approximately the same as the constant trend. In other words, because of the decrease in workforce, the drop in unemployment may be partially a result of the decrease in workforce. The consistent level of unemployment makes shifts on AD and AS curve minor. When unemployment decreases, as it did in April, a correlation linking the drop in unemployment to an increased demand of goods and services can be made. This increased demand requires the productivity of companies to increase to meet the supply deficit, creating more jobs for individuals. With a greater demand for goods and services, there is a greater need for people to produce them, therefore a decrease in unemployment. Additionally, the decrease in unemployment means household income will improve, providing them with more disposable income. As noted above, because of the increase in demand (seen in the decline in the unemployment rate), a direct correlation can be made to an increase in supply, though delayed. The increase in supply increases the number of new employees as employers look to meet the demand for goods and services, shifting the AS  curve to the right as well. In most cases unemployment remains constant, but in US, the high unemployment rate (compared to the past) can have a negative effect on the economy. The steady unemployment rate can reduce the supply of labor in the economy, as unemployed people become discouraged and stop looking for jobs. This would shift the aggregate supply curve to the left. Also employers may use the threat of unemployment to cut wages, exploiting their workers. Expectations The great intangible factor directly affecting the economy currently is people’s expectations for future economic growth. These economic expectations influence the economy greatly. If businesses and households are more optimistic about the future of the economy, they are more likely to buy large items and make new investments, increasing the aggregate demand. The AD can change in a variety of ways. Peoples expectations causes them to spend less or be forced to cut spending, it causes the government to cut its spending, and it causes businesses to be more money conscious when choosing what their investment in goods will be from other companies. As a gauge, many people look at the gross domestic product (GDP), the broadest measure of economic activity, which grew at a 0.1% annual pace in the first quarter of 2014 (U.S. Bureau of Economic Analysis, April 2014). This is slow growth compared to recent annual rates of 2% to 3% (U.S. Bureau of Economic Analysis, April 2014). Many think the slowdown was caused by the long winter felt throughout the country. These slow growth rates shift both the AD and AS curves to the left, as consumers and business feel the affect or people’s â€Å"wait and see† attitude in economy. Assuming this is all weather based, the economy should bounce as household moral improves with the warmer spring and summer weather. Consumer expectations are also reflected in their spending. Consumer spending rose 0.3 percent last month after a downwardly revised gain of 0.2 percent in January (Mutikani, Lucia, March 2014), positive for now, but on a larger scale reports show the slowdown in real GDP growth is reflected in the downturn in exports. The exports of industrial supplies and materials as well as foods, feeds, and beverages  declined after increasing in the fourth quarter of 2013. (U.S. Bureau of Economic Analysis, April 2014). Additionally, imports have also declined by 0.4 percent in April, after increasing 1.8 percent in the first quarter of 2014 (Bureau of Labor Statistics. April 2014). The April drop was the first monthly decrease since the index fell 0.9 percent in November 2013 (Bureau of Labor Statistics. April 2014). Import prices also fell 0.3 percent over the past 12 months and have not recorded a year-over-year advance since the index increased 0.9 percent from July 2012 to July 2013 (Bureau of Labor Statistics. April 2014). There drops in the US economy are felt in the household sector through the implementation of monetary and physical policy which are used to combat economic declines which directly affect consumer’s expectation and spending habits. Consumer Income As mentioned above, consumers are still buying things. Consumer spending continues to be a bright spot, growing at a 3% annual pace. (Mutikani, Lucia, March 2014). This occurred even though prices of goods and services bought by U.S. residents rose 1.4 percent in the first quarter, after rising 1.5 percent in the fourth quarter of 2013. Both energy prices and food prices turned up. Excluding food and energy, prices increased 1.4 percent in the first quarter after rising 1.8 percent in the fourth quarter (U.S. Bureau of Economic Analysis, April 2014). This illustrates the shift in AD tow the right. Meaning consumers are willing to pay higher prices at current production rates. The increase in consumables indicates consumers have more disposable income to spend on goods and services, and they are not choosing to save. Personal income and personal saving statistic showing that personal income adjusted for inflation and taxes increased 1.9 percent in the first quarter, compared with 0.8 percent in the fourth quarter of 2013 (Mutikani, Lucia, March 2014). Incomes also rose 0.3 percent last month after rising by the same margin in January. Additionally, inflation has remained low. Combining  these factors, consumer spending, price increases, low inflation, increased personal income, will inevitably be forecasted by business as indicators to increase production. Increased production also increase supply, shifting AS to the right as business attempt to meet consumer demand. Interest Rates Interest rates in the United States are the lowest they have been in years. This indicates the policy and stance taken by the government for lending money. The government is trying to entice consumers to file for loans as well as encourage banks to lend and approve loans. With interest rates this low and consumer income increasing, one would expect consumers to increase their buying of more significant items. The aggregate demand curve shows, at various price levels, the quantity of goods and services produced domestically that consumers, businesses, and governments are willing to purchase. The increase in demand for low interest loans would shift the AD curve as a shift to the right. Domestically, the Federal Reserve expected to remain in a wait-and-see mode, hoping to get a clearer picture of U.S.’s future economic strength (Kurtz, Annalyn, April 2014). Moreover, the Federal Reserve has been buying bonds to stimulate the U.S. economy on and off since 2008, but the central bank is now gradually bringing that program to an end. The withdrawal process is expected to reduce bond purchases to around $45 billion a month (Kurtz, Annalyn, April 2014), and this process potentially will shift the nations monetary policy to focus more on interest rates rather than adjustments to the monetary base. These changes to the interest rates will impact capital goods decisions made by consumers and by businesses. Lower interest rates will lower the costs of major products, such as houses, and will increase business capital project spending because of the reduction in long-term investment costs. Such changes will move the aggregate demand curve will down and to the right. But, in the event of an interest rate hike, the higher real interest rates  will make capital goods relatively more expensive and cause the aggregate demand curve to shift up and to the left. Recommendations America’s recent financial crisis and the anticipated future economic outlook can be traced back to 2007 when the U.S. housing bubble burst. The bank failures created a dominos affect, creating an economic meltdown in all sectors of the US economy. Despite government attempts to help the situation, the economy has slowed and has slipped in and out of recession. As a result, the current government policies have not been effective, creating hesitations in consumer spending. Since 2008, the actions taken by the Federal Reserve have put the U.S.’s economy in jeopardy. To stem the economic slide of the U.S. housing collapse, the Federal Reserve has printed off trillions of dollars and has increased government spending in the economy hoping the influx of cash will jump start economic activity. But is has had an inverse affect. This dilution of the monetary base has diluted the value of the U.S. dollar (USD) domestically and internationally and has caused concern of consumer spending in the loanable funds market. Consumer spending is a 69% of the US GDP (The World Bank, 2013). An increase in spending would stimulate additional demand for products. With an increase in demand, business would increase productivity resulting in an improved GDP and lower unemployment. Additionally, in 2014 one of the greatest uses of a consumer’s income is to pay health care costs. The Bureau of Economic Analysis noted that the increase in health care costs was driven primarily by the implementation of the Affordable Care Act. Removing the Affordable Health Care Act will improve consumer spending, as their disposable income percentage will increase. When the financial crisis began in 2008, the U.S. national debt stood approximately at $10 trillion. Based on the US Treasuries own figures, the national debt will reach be close to $20.0 trillion by the end of this decade (US Treasury Department – Treasury Direct, 2014), greater than our nation’s GDP. Reducing government  debt takes a long time, especially with the current international influences (China, Japan, EU). A fiscal policy to increased taxes and reduced government spending would be a place to start. Additionally, a reduction in monetary base will again, strengthen the USD internationally, helping facilitate and increase import/exports. Part 2: Evaluation of Recommendations Keynesian Perspective: Based upon the thorough analysis completed above, the Keynesian model is an appropriate mechanism for stimulating an economy that is growing but at a much slower rate than what is typical during a period of economic expansion. After a couple of years of substantive growth, the numbers for the first quarter of 2014 showed a GDP increase of just 0.1%. While the unemployment numbers continue to show a decline. While stubbornly remaining at 6.7% nationally through April, the most recent numbers show significant decline to 6.3%. The mortgage interest rates fell recently to 4.29% as the housing market has slowed down recently. While the Fed is beginning to slow down buying treasury bonds, it will continue to keep interest rates low until all signs point to GDP growth returning to a normal rate of 3.28% annually. Those numbers are indicative of annual GDP growth rates from 1948 to 2009. The first quarter of 2009 saw the economy shrink by nearly 5% following the market collapse and the bank bailouts just before President Obama took office. Subsequently, the bailout of GM and Chrysler in 2009 also impacted the economy as well, but was necessary to save the industry and jobs in Detroit and elsewhere for parts manufacturers and suppliers. The risk of course was the loss of more than a million jobs, but in the end the loss was $10.5 billion in taxpayer money not repaid by GM. Classical Macroeconomic theory assumes that market conditions will sort themselves out, but the confluence of catastrophic economic issues such as: the real estate market collapse, bank insolvency, the stock market collapse and the auto industry bailouts meant looking at long-term solutions would  not provide the confidence in the markets and consumers alike. Short-term or stop gap measures needed to stem the downward spiral to depression and economic contraction were and are required to right the economic ship. Keynesian economic theory is more prone to acceptance of government stimulus as it relied on government spending during economic downturns. They Keynesians believe that the economy is made up of consumer spending, business investment and government spending and because of this, Fed monetary policy adjustments should be made to promote banks to make loans, businesses to invest in growth and expansion and consumers to have more buying power due to lower interest rates. When consumer spending is decreasing, the Keynesian theory believes that the government spending can help with economic growth. The current course of action taken by the Fed and the President should be continued for the foreseeable future until economic conditions stabilize back to the norms over the last 60-plus years. Once GDP growth returns to expansionist highs and inflation begins to rise, there may be a need to take corrective action again to slow the economy down, but for now that is not an issue. Since economic growth is lacking, government intervention is needed to help regulate and jumpstart the economy. This will allow banks to lend more, businesses to invest more and households to spend more. It is crucial for these three entities to do as such since it will help the economy grow and progress. Classical Perspective: A portion of the AS curve that is almost vertical is associated with a real GDP rate that fully employs a nation’s resources. At a rate of output, the nation has reached the limitation of its short run capacity, so an attempt to increase employment or output beyond this rat would result only in a higher aver price level. The theory is built on the fact that in the long run, a nations move gradually and automatically moves toward full employment. This inexorable like movement toward full employment is the  result of supply and demand forces that cause prices (wages, interest rates, and exchange rates) to adjust so that markets clear. And after enough time, the market will settle the supply and demand in all markets, and thereby eliminate any imbalances, such as employment. Since many classical economists do not believe that government spending gives power to the public sector and decreasing the private sector, they do not fully agree with too much government spending as it ex ploits a lot of economic resources. Example: â€Å"Suppose a nation had excessive unemployment. Classical economist would agree that a major cause of the unemployment was an average real wage rate that was above equilibrium. At this wage rate the amount of labor supplied exceeds the amount demanded, resulting in unemployment. The excessive supply of labor would put downward pressure on real wages. Falling real wages would then have two reinforcing affects that acted simultaneously to bring the labor market back into equilibrium. First, lower real wages would increase the incentive for businesses to hire workers; second, they would reduce the number of individuals in the workforce. For instance, instead of looking for work, some individuals might stay in school or remain homemakers. If real wages fell the amount of labor supplied would equal the amount demanded and unemployment would be solved.† (Marthinsen, John E. (2007)) The classical perspective emphasizes on the belief that government spending is detrimental to the economy and that the market itself is self-sufficient and can automatically adjust to increases and decrease of employment, consumer spending, business investment and so on. The current government policies have not been effective and when looking at it from this classical perspective, it might be necessary for the government to step back and let the mark equilibrate itself. References: Bureau of Labor Statistics. (April 2014), U.S. Import and Export Price Indexes Retrieved from http://www.bls.gov/news.release/ximpim.nr0.htm Bureau of Labor Statistics. (May 2014), Labor Force Statistics from the Current Population Survey Retrieved from http://data.bls.gov/timeseries/LNS14000000 Conerly, Bill (2014) Economic Forecast 2014-2015: Looking Better With Help From Oil And Gas Retrieved from http://www.forbes.com/sites/billconerly/2014/01/22/economic-forecast-2014-2015-looking-better-with-help-from-oil-and-gas/ Congressional Budget Office, (February 2014). The Budget and Economic Outlook: 2014 to 2024 Retrieved from http://www.cbo.gov/publication/45010 Kurtz, Annalyn, (April 2014). U.S. Economy Slows to Stall-Speed Retrieved from http://money.cnn.com/2014/04/30/investing/gdp-economy Marthinsen, John E. (2007) Managing in a Global Economy: Demystifying International Macroeconomics. Mason, OH: Thomas Southwestern Mutikani, Lucia (March 2014). U.S. consumers lift spending, but sentiment slips. Retrieved from http://www.reuters.com/article/2014/03/28/us-usa-economy-idUSBREA2R0UB20140328 The World Bank. (2013). Household final consumption expenditure, etc. (% of GDP) Retrieved from http://data.worldbank.org/indicator/NE.CON.PETC.ZS U.S. Bureau of Economic Analysis, (April 2014). National Income and Product Accounts Gross Domestic Product: First Quarter 2014 (advance estimate). Retrieved from https://www.bea.gov/newsreleases/national/gdp/gdpnewsrelease.htm US Treasury Department – Treasury Direct, (2014). Historical Debt Outstanding Annual 2000 – 2012 Retrieved from http://www.treasurydirect.gov/govt/reports/pd/histdebt/histdebt_histo5.htm

Effects of Paraneoplastic LEMS on Neuromuscular Junction

Effects of Paraneoplastic LEMS on Neuromuscular Junction Qing Zhi Tan Effects of Paraneoplastic  Lambert-Eaton Myasthenic Syndrome on the Neuromuscular Junction IntroductionThe Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disease. It is characterised by muscle weakness of the proximal lowerlimbs as a result of auto-antibodies produced against the voltage-gated calcium channels (VGCC) found on the presynaptic membrane of the neuromuscular junction(1). Most of the time, LEMS is classified as a paraneoplastic syndrome as it is often associated with cancer (small cell lung cancer in particular) (2, 3). One of the earliest descriptions of this disease was reported by Anderson and his colleagues in the year 1953, describing a 47-year-old patient with bronchial carcinoma presenting with progressive muscle weakness(4). Upon examining this patient, Anderson wrote: His (the patients) muscle power was generally weaker than his muscle bulk would suggest, especially the muscles of the shoulder girdle, hip girdle, trunk, and anterior compartments of the legs.(4) Since then, much research has been done to find out more about this disease. It is now known that the auto-antibodies are primarily directed against the P/Q-type VGCCs at the neuromuscular junction (1-3, 5, 6). This report will discuss the effects of LEMS on the neuromuscular junction. Voltage-Gated Calcium ChannelsIt would be useful to first understand the structure of the voltage-gated calcium channels (VGCC). In general, VGCCs are made up of 5 subunits (ÃŽÂ ±1, ÃŽÂ ±2, ÃŽÂ ², ÃŽÂ ´, ÃŽÂ ³) and can be divided, according to the electrophysiological and pharmacological properties of their ÃŽÂ ±1 subunit, into 5 different subtypes (L, N, P/Q, R and T-type)(2, 7). The structure of a typical VGCC is shown in Figure 1 below. As mentioned before, the LEMS auto-antibodies are mainly directed against the P/Q-type VGCCs (1-3, 5, 6). The ÃŽÂ ±1 subunit of the P/Q-type VGCCs is known as ÃŽÂ ±1A(8). This ÃŽÂ ±1A subunit forms the channel which allows the movement of Ca2+ ions into the synaptic knob(8), and can be further broken down into 4 identical domains (I, II, III, IV), each possessing 6 transmembrane segments (S1-S6)(2, 8) (see Figure 2). What Happens at The Neuromuscular Junction?Now that we have understood the basic structure of the VGCCs, let us move on to its role and how it is affected by the pathogenesis of LEMS. The neuromuscular junction is made up of the pre-synaptic membrane, the synaptic cleft and the post-synaptic membrane (5, 9, 10). P/Q-type VGCCs present on the surface of the pre-synaptic membrane play a vital role in allowing synaptic transmissions to cross the neuromuscular junction (7, 9). In studies conducted by multiple different researchers, anti-P/Q-type VGCC auto-antibodies were found in more than 85% of LEMS patients (3, 6, 11). Japanese researchers Masaharu Takamori and his colleagues even went a step further to determine the specific immunodominant sites within the P/Q-type VGCC in which the auto-antibodies would bind. In their study, they found that majority of their test subjects had auto-antibodies directed against domains II and IV of the ÃŽÂ ±1A subunit in the P/Q-type VGCC(12)(highlighted in red in Figure 2). Depolarisation of the pre-synaptic membrane occurs when stimulated by an action potential initiated by a nerve impulse(13). This membrane depolarisation causes the VGCCs to open, allowing the local influx of calcium ions (Ca2+)into the synaptic knob(13). The increase in Ca2+ concentration will stimulate the exocytosis of vesicles containing the neurotransmitter Acetylcholine (ACh) into the synaptic cleft(13). ACh then goes on to bind to the nicotinic acetylcholine receptors found on the motor end plate which will trigger an action potential and subsequently causing muscle contraction.(10, 13) In patients with LEMS, the LEMS auto-antibodies would bind to the VGCC present on the pre-synaptic membrane of the neuromuscular junction(5). This causes the VGCC to lose its ability to function as an ion channel, thus inhibiting the influx of Ca2+ into the synaptic knob during membrane depolarisation(5). Since the exocytosis of synaptic vesicles are dependent on Ca2+ (14), it is believed that a decrease in Ca2+ influx would result in a reduction in synaptic vesicle exocytosis(5, 13, 15). A recent study conducted in 2015 confirmed the phenomenon in which the LEMS IgG directly causes a reduction in the exocytosis of synaptic vesicles (16). They did this by using fluorescence imaging techniques to observe the exocytosis of synaptic vesicles in rat neurons incubated with LEMS IgG (16). Pooled IgG from healthy individuals were used in comparison and as a control (16). Hence, it is evident that the muscle weakness seen in LEMS patients is a direct consequence of reduced exocytosis of ACh-containing synaptic vesicles. In summary, the Lambert-Eaton myasthenic syndrome is an autoimmune disease that causes muscle weakness in patients. The reduction in muscle power is due to insufficient ACh release at the neuromuscular junction. In 85% of these patients, this is caused by auto-antibodies inactivating the P/Q-type VGCCs on the presynaptic membrane. Going Beyond VGCCs So, what happens in the remaining 10-15% of LEMS patients that do not have anti-P/Q-type VGCC antibodies? Many scientists have asked the same question and investigations have been carried out to find alternative mechanisms in the pathogenesis of LEMS in seronegative patients. (The term seronegative is used to describe patients with undetectable anti-P/Q-type antibodies.) In the absence of anti-P/Q-type VGCC antibodies, it is almost impossible that LEMS would have the same pathogenesis in seronegative patients. Yet, it is found that there are no significant differences in the electrophysiological and clinical characteristics between the seronegative and seropositive patients(17, 18). One possible explanation for this phenomenon is that there might be auto-antibodies directed against a different molecule involved in the synaptic transmission; hence causing seronegative patients to have the same clinical and electrophysical features albeit having no anti-P/Q-type VGCC antibodies. To date, many auto-antibodies with different target molecules have been found in LEMS patients. One of the earliest to be discovered is an auto-antibody to synaptotagmin, which is a protein involved in synaptic vesicle exocytosis (2, 5, 13, 15, 19). Furthermore, antibodies to the M1-type presynaptic muscarinic ACh receptor (M1-mAChR) have also been discovered(20). The M1-mAChR is a G-protein coupled receptor that regulates ACh release at the neuromuscular junction(5, 20). We will not be going into the specifics of these antibodies in this report as the mechanisms involved are largely complicated. ConclusionEven though LEMS is a rare autoimmune disease, the prevalence of LEMS as a paraneoplastic syndrome in patients with small cell lung cancer (SCLC) is extremely high. More than half of LEMS patients have SCLC and more often than not, the diagnosis of LEMS precedes the diagnosis of SCLC(21). Therefore, LEMS could potentially play a crucial role in allowing certain cancers to be detected at an earlier stage. Hence, understanding the pathophysiology of this disease would not only prove useful in discovering better treatments for LEMS patients but also aid the early detection of cancer. References: 1.Weiss N, Koschak A. Pathologies of Calcium Channels. Weiss N, Koschak A, editors: Berlin, Heidelberg : Springer Berlin Heidelberg : Imprint: Springer; 2014. 2.Takamori M. An autoimmune channelopathy associated with cancer: Lambert-Eaton myasthenic syndrome. Intern Med. 1999;38(2):86-96. 3.Lennon VA, Kryzer TJ, Griesmann GE, OSuilleabhain PE, Windebank AJ, Woppmann A, et al. Calcium-Channel Antibodies in the Lambert-Eaton Syndrome and Other Paraneoplastic Syndromes. New England Journal of Medicine. 1995;332(22):1467-75. 4.Anderson HJ, Churchill-Davidson HC, Richardson AT. BRONCHIAL NEOPLASM WITH MYASTHENIA. The Lancet. 1953;262(6799):1291-3. 5.Hulsbrink R, Hashemolhosseini S. Lambert-Eaton myasthenic syndrome diagnosis, pathogenesis and therapy. Clin Neurophysiol. 2014;125(12):2328-36. 6.Motomura M, Lang B, Johnston I, Palace J, Vincent A, Newsom-Davis J. Incidence of serum anti-P/Q-type and anti-N-type calcium channel autoantibodies in the Lambert-Eaton myasthenic syndrome. Journal of the Neurological Sciences. 1997;147(1):35-42. 7.Catterall WA. Voltage-gated calcium channels. Cold Spring Harbor perspectives in biology. 2011;3(8):a003947. 8.Structure and Regulation of Voltage-Gated Ca2+ Channels. Annual Review of Cell and Developmental Biology. 2000;16(1):521-55. 9.Hughes BW, Kusner LL, Kaminski HJ. Molecular architecture of the neuromuscular junction. Muscle Nerve. 2006;33(4):445-61. 10.Martini F, Nath JL, Bartholomew EF. Fundamentals of anatomy physiology. San Francisco: Benjamin Cummings; 2012. 11.Motomura M, Johnston I, Lang B, Vincent A, Newsom-Davis J. An improved diagnostic assay for Lambert-Eaton myasthenic syndrome. Journal of Neurology, Neurosurgery Psychiatry. 1995;58(1):85-7. 12.Takamori M, Iwasa K, Komai K. Antigenic Sites of the Voltage-gated Calcium Channel in Lambert-Eaton Myasthenic Syndromea. Annals of the New York Academy of Sciences. 1998;841(1):625-35. 13.Lang B, Newsom-Davis J. Immunopathology of the Lambert-Eaton myasthenic syndrome. Springer seminars in immunopathology. 1995;17(1):3-15. 14.Mechanisms of Synaptic Vesicle Exocytosis. Annual Review of Cell and Developmental Biology. 2000;16(1):19-49. 15.Takamori M. Lambert-Eaton myasthenic syndrome as an autoimmune calcium channelopathy. Biochem Biophys Res Commun. 2004;322(4):1347-51. 16.Spillane J, Ermolyuk Y, Cano-Jaimez M, Lang B, Vincent A, Volynski KE, et al. Lambert-Eaton syndrome IgG inhibits transmitter release via P/Q Ca2+ channels. Neurology. 2015;84(6):575-9. 17.Oh SJ, Hatanaka Y, Claussen GC, Sher E. Electrophysiological differences in seropositive and seronegative Lambert-Eaton myasthenic syndrome. Muscle Nerve. 2007;35(2):178-83. 18.Nakao YK, Motomura M, Fukudome T, Fukuda T, Shiraishi H, Yoshimura T, et al. Seronegative Lambert-Eaton myasthenic syndrome: study of 110 Japanese patients. Neurology. 2002;59(11):1773. 19.Takamori M, Hamada T, Komai K, Takahashi M, Yoshida A. Synaptotagmin can cause an immune-mediated model of Lambert-Eaton myasthenic syndrome in rats. Annals of neurology. 1994;35(1):74-80. 20.Takamori M. Lambert-Eaton myasthenic syndrome: Search for alternative autoimmune targets and possible compensatory mechanisms based on presynaptic calcium homeostasis. Journal of Neuroimmunology. 2008;201-202:145-52. 21.Titulaer MJ, Verschuuren JJGM. Lambert-Eaton Myasthenic Syndrome. Annals of the New York Academy of Sciences. 2008;1132(1):129-34.

Madeleine Leininger Theory Of Culture Care Nursing Essay

Madeleine Leininger Theory Of Culture Care Nursing Essay Madeleine Leninger was born on July 23 1925 in Sutton, Nebraska.  She is a Fellow of the Royal College of Nursing in Australia, and a Fellow of the American Academy of Nursing.  Her theory of Culture Care is now a nursing discipline. In this modern health care system, nurses should consider culture as an important aspect to provide holistic care. Rationale for selecting Leiningers theory We selected Madeleine Leiningers Theory of Culture Care: Diversity and Universality for our clinical practice with many reasons. We observe diversity among our patient population on a daily basis. Patients come from different cultures with different values and beliefs. One practice that is accepted in one society or culture may not be accepted in another culture. Patients have the right to get the care based on their cultural values and beliefs. For this reason, it is one of the major responsibilities of nurses to provide culturally competent holistic care to improve patient outcome. For this reason it is of utmost importance to promote cultural competence among all nurses. Leininger (2006a: 16) refers to culturally congruent care as knowledge, acts, and decisions used in sensitive and knowledgeable ways to appropriately and meaningfully fit the cultural values, beliefs, and life ways of clients for their health and well-being, or to prevent illness, disabilities, or death. Biography of Madeleine Leininger Madeleine Leininger is well known to as a nursing theorist who developed transcultural nursing model. She was born in Sutton, Nebraska in July 23, 1925. She received her nursing diploma from St. Anthonys School of Nursing in Denver, and in 1950, she received her bachelor of Nursing from St. Scholastica College. She completed her Master of Science in mental health nursing from Catholic University of America in 1954. She attended University of Washington in 1965 and studied cultural and social anthropology in which she was awarded a Ph.D. In her earlier years in the nursing profession, she realized care as one of the important function in nursing. Transcultural nursing was an idea that was formulated by Leininger when she realized that the behaviors of the children in the guidance home were recurrent patterns from their cultural background. Transculture theory was developed to provide nursing care in a holistic and comprehensive approach. Her theory gives nurses avenues on how to provide care in harmonious way through applying the patients cultural beliefs, values and practices. Classification of the Theory McEwen Wills (2011) places Leiningers Theory in the high middle range theory classification based on the level of abstraction or degree of specificity. Leininger states that it is not a grand theory because it has particular dimensions to assess for a total picture. It is a holistic and comprehensive approach, which has led to broader nursing practice applications than is traditionally expected with a middle-range, reductionist approach . Assumptions of Theory of Culture Care The central focus of the theory is care. Caring is important for health, well-being, healing, growth, survival, and for facing illness or death. Culture care is a wholistic approach to serve human beings in health, illness and dying. There is no cure without giving and receiving care. Concepts of culture care have different and similar aspects in different parts of the world. Each human culture varies in folk remedies, professional knowledge and practice. Knowledge regarding this variation is important for the nurses to know to provide quality care. Worldview, language, religious, spiritual, social, political, educational, economic, technological, ethno historical, and environmental factors affect culture care values, beliefs and practices. Healthy applications of culturally based care promote the wellbeing of the patient. Thorough knowledge of the culture is necessary to provide competent care to the clients. Clients who experience nursing care without incorporating the cultural iss ues experience stress, cultural conflict, noncompliance, and ethical moral concerns. Major concepts of the theory Understanding of major concepts of theory is important to understand the whole theory. Care is to assist others with real or anticipated needs in an effort to improve a human condition of concern or to face death. Caring is an action or activity directed towards providing care. Culture refers to learned, shared, and transmitted values, beliefs, norms, and life ways of a specific individual or group that guide their thinking, decisions, actions, and patterned ways of living. Cultural care refers to multiple aspects of culture that influence and enable a person or group to improve their human condition or to deal with illness or death. Cultural care diversity refers to the differences in meanings, values, or acceptable modes of care within or between different groups of people. Cultural care universality refers to common care or similar meanings that are evident among many cultures. Person  refers to an individual human caring and cultural being as well as a family, group, a social i nstitution, or a culture. Nursing is a learned profession with a disciplined focused on care phenomena. Worldview refers to the way people tend to look at the world or universe in creating a personal view of what life is about. Cultural and social structure dimensions include factors related to religion, social structure, political/legal concerns, economics, educational patterns, and the use of technologies, cultural values, and ethno history that influence cultural responses of human beings within a cultural context. Health refers to a state of well-being that is culturally defined and valued by a designated culture. Cultural care preservation or maintenance refers to nursing care activities that help people of particular cultures to retain and use core cultural care values related to healthcare concerns or conditions. Cultural care accommodation or negotiation refers to creative nursing actions that help people of a particular culture adapt to or negotiate with others in the healt hcare community in an effort to attain the shared goal of an optimal health outcome for client(s) of a designated culture (Summarized from Leininger, 2001, pp. 46-47). Major Propositions of the Theory Leininger (1991) proposes that there are three modes for guiding nurses judgments, decisions, or actions in order to provide appropriate, beneficial, and meaningful care. They are cultural preservation or maintenance, cultural care accommodation or negotiation, and cultural care repatterning or restructuring. Cultural preservation or maintenance retain or preserve relevant care values so that clients can maintain their well-being, recover from illness, or face handicaps and/or death. Cultural care accommodation or negotiation adapt or negotiate with the others for a beneficial or satisfying health outcome. Cultural care repatterning or restructuring records, change, or greatly modify clients life ways for a new, different and beneficial health care pattern (Leininger, 2002). The modes have greatly influenced the nurses ability to provide culturally congruent nursing care, as well as fostering culturally-competent nurses. These three modes of action can lead to the deliverance of nurs ing care that best fits with the clients culture and thus reduce cultural stress and chance for conflict between the client and the caregiver. Examples from the literature of how the theory been used According to the article the expression of pain and its management has social and cultural facts that affect the biological state of the person, therefore many societies and cultures have their own ways and perception to pain and how they treat it. In this article the nurses who were giving care to the patient used the international treatment guideline which is a stepwise approach to the treatment of chronic non-cancer pain, involving not only over-the counter anti-inflammatory drug, but also lower dose opioids (Lu Javier, 2006). The nursing decisions that were used in this article are cultural care accommodation and negations in which the nurses incorporated the holistic approach of using hilot. Hilot is a form of traditional Filipino healing massage; the patients were allowed to use natural topical ointment which is commonly found in their culture for relief of pain. This process allowed the patients to be comfortable with the care that they received due to incorporating cultural believes with western medications. This also allowed the patient to have knowledge that is related to the treatment of pain, cultural values and heritage especially in the older population who view pain medication such as opioids and administration of it as addictive and would rather suffer through it than to use it. The rational for this is because of the beliefs in the Filipino culture by both prescribing doctors, nurses who administer the medications and the patient that there will be high incidents of the patient becoming addicted opiods when used in treating chronic pain. Action plan The theory of Madeleine Leiningers will be integrated into practice in the work place by first reviewing the care and cultural values that fits the patient. This will be done by the way the nurse approach, work with and assist or help the patient. The integration will be approach through culturally congruent care or care that fits the culture, because care is enabling process by which the nurse will facilitate assist, guide and help the patient to link what the nurse is trying to help them in the treatment of their disease. This approach will help the nurse mange the diseases from a unique cultural perceptive of the patient. The nurse will monitor home remedies that are unique to the patient during admission and determine if any of them are contraindicated with the medications which the patient was taking. Also integrating religious rituals into the care plan can help make a significant impact on the success of the patients treatment; it will impact on the perception of the patients health, disease process and treatment. With the patients permission, involving close family member can give the patient emotional support. Including respect of cultural values may allow the patient to express themselves to the nurse because they may view this as a sign of respect. When a nurse is having difficulty to get the patient to buy into to a particular treatment, negotiating will help them adapt without compromising the patients values. When the nurse develops the basic understanding of health behavior of a culture, this helps to have a positive impact on the nurse-patient relationship. Concrete examples of how theory would be integrated During assessment, the plan of care for the patient will be established. This will give the nurse clear concise pertinent information about the patient. Cultural needs such as language barrier, dietary restrict, and beliefs will be assessed. Also rituals that may affect the patients care such as dietary restrict will be considered. An example is if the patient is Jewish, or Seventh day Adventist food product or meat made from pork should be omitted from their dietary tray. Meal planning is important because diet plays such an import healing process in the patients illness. Language barrier is another cultural issue that may arise during the patients stay in the hospital. Using the right interpreter such as someone who is certified and competent in the patients language is beneficial to prevent the wrong information being given to the patient. All these will be beneficial, helpful, assistive, and therapeutic in the board sense to maintain an open communication between the nurse and th e patient. Conclusion In todays healthcare field, it is required for nurses to be sensitive to their patients cultural backgrounds when creating a nursing plan. This is especially important since so many peoples culture is so integral in whom they are as individuals, and it is that culture that can greatly affect their health, as well as their reactions to treatments and care. The practice of nursing today demands that the nurse identify and meet the cultural needs of diverse groups understand the social and cultural reality of the client, family, and community, develop expertise to implement culturally acceptable strategies to provide nursing care, and identify and use resources acceptable to the client (Boyle, 1987). When Leiningers Transcultural Nursing theory guides nursing practice, nurses can look at how a patients cultural background is involved in his or her health, and use that knowledge to create a nursing plan that will help the patient get healthy quickly while still being sensitive to his or her cultural background. Nursing is in a new phase of health emphasis where there is an increased display of cultural identity, accompanied by increased demands for culture specific care and general health services.   Unquestionably, it is the theory of today and tomorrow and one which will grow in use in the future in our growing and increasingly multicultural world. The research and theory provide a new pathway to advance the profession of nursing and the body of transcultural knowledge for application in nursing practice, education, research, and clinical consultation worldwide.

One of the Few, One of the Proud Essay -- United States Marine Corps S

One of the Few, One of the Proud To some it may seem â€Å"easy† to become a soldier in the United States Marine Corps. A recruit goes to boot camp, passes, and goes on to save the world and defend the nation, but in fact it is much harder. Boot camp in itself is a test for the body to see its weaknesses and turn them to strengths and to see how long the brain can be mentally alert and ready and when tired can still give a hundred percent. Within boot camp there is the ultimate test that proves whether a recruit is just another person or if they have what it takes to be a Marine. This test is called the Crucible; it is not just the title of a book. Boot camp begins in the recruit’s home state when they sign the papers and a contract to allow the recruit to be shipped to Parris Island, South Carolina. It is eighty-nine days of depending on one’s self and trusting people that would normally be considered strangers. These are teammates and allies. Everyday is spent with them and they will help you succeed or suffer in those eighty-nine days. A recruit accomplishes a goal with his fellow recruits or fails with them. It is never a one-person effort. This is important in the end. During boot camp, each personal receives eight hours of sleep for a sixteen-hour workday. In this time, civilians learn what it takes to become a Marine and know what is expected of them. There is constant movement and training so that there is no free time to sleep or get distracted from the goals (Seymour). Every task and mission asked of a person during boot camp has a purpose. The purpose is to prepare the future soldier for any kind of situation that may take place in the field during a real mission. T... ... USMC - MCRDSD/WRR - Description of Recruit Training. United States Marine Corps. 19 Nov. 2003 <http://www.mcrdsd.usmc.mil/RTR/trainingDS.htm>. Woulfe, James B. Into the Crucible: Making Marines for the 21st Century. New York: Ballantine Books, Inc, 2000. Mission Complete: "The battle of Iwo Island has been won. The United States Marines by their individual and collective courage have conquered a base which is as necessary to us in our continuing forward movement toward final victory as it was vital to the enemy in staving off ultimate defeat. By their victory, the 3d, 4th and 5th Marine Divisions and other units of the 5th Amphibious Corps have made an accounting to their country which only history will be able to value fully. Among the Americans who served on Iwo Island, UNCOMMON VALOR WAS A COMMON VIRTUE." -Admiral Chester W. Nimitz

virtues :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  The Ten Commandments, Seven Deadly Sins, Seven Virtues, and the Attitudes are the sets of laws that people base their lives around in becoming good Christians. Each set of the laws affect a Christian individual, more than any other because of the laws are rooted to the bible and Christian beliefs. So, a Christian individuals knowingly or unknowingly bases what they do in life around these sets of law. The Ten Commandments and seven deadly sins tell an individual on what they are not supposed to do. The Seven Virtues and the attitudes tell an individual on what they must do and how they can combat the deadly sins. However, even though some of the laws are outdated they still play a role in how we act. Each set of laws has its own distinct characteristic, for example some tell people what not to do in their lives and some tell people what to do in their lives and how to live their lives. The Seven Virtues are separated into two different types of virtues. They are Theological and Cardinal Virtues, and they can be defined as the heart of our moral life. Virtues are healthy, good habits that help us to do well and empower us to become what God wants us to be. These personal qualities emphasize that who we are affects what we do. There are two types of virtues, Theological and Cardinal virtues. Theological Virtues: The theological virtues can be defined as gifts from God that empower us to be good so that we may do good. The three theological virtues are love, hope and faith. These are the three virtues that will combat the three of the deadly sins pride, envy and wrath. Also the reaming four out of the seven deadly sins being lust, greed, sloth and gluttony are combated by four Cardinal Virtues justice, prudence, temperance, and fortitude. While one set of laws tells a person what things to avoid in their lives to live a good Christian life, the other sets tells us how a person may combat these desire and what they can do to live a good Christian life. These sets of laws even effect individual who are not of Christian background. Over time these laws have been translated and absorbed into many other religions and affect many others in a different way.

Down Syndrome Essay -- Biology Biological Medical Essays

Down Syndrome They used to be called "Mongoloids," an ethnic insult coined by John Langdon Down, an English physician during the nineteenth century. But now they are known as people, individuals with a condition known as Down syndrome. (3). It wasn't until the 1960s that Jerome Lejeune and Patricia Jacobs discovered the cause of Down syndrome (also called trisomy 21). But with technological advancements within the scientific community, more and more information has been gathered about the condition that affects about one in every one thousand children born around the world. (4). Research shows that Down syndrome is a genetic condition caused by certain chromosomal abnormalities. Chromosomes within cells are composed of proteins and genetic information in the form of DNA. Human cells normally contain 23 pairs of chromosomes to make a total of 46 chromosomes in each cell. When sex cells (eggs and sperm) divide through the process of meiosis, one cell splits into two parts so that each of the resulting cells only has 23 chromosomes, rather than 46. But many errors can occur during cell division. During meiosis, the chromosomes are supposed to split and go to different areas of the cell. This step in the process of meiosis is called disjunction. But sometimes during cell division, a chromosome will not detach and it will stay with its pair chromosome. This results in one of the new cells having 24 chromosomes and the other having only 22 chromosomes. An error such as this is called nondisjunction. If a cell with this error mates with a normal cell, the fert ilized egg will end up with an uneven number of chromosomes. (3). In the instance of Down syndrome, 95 percent of all cases are caused by nondisjunction, and 90 p... ... some cells, researchers get closer and closer each year to discovering the mystery of trisomy 21. With every new development, and with increased education and research, the quality of life improves for the people who, not long ago, were exiled from society for being "different" from other people. Internet Sources: 1)"Prenatal Screening for Down Syndrome", http://www.ds-health.com/prenatal.htm 2)"Comprehensive Speech and Language Treatment for Infants, Toddlers, and Children with Down Syndrome", http://www.ds-health.com/speech.htm 3)"Trisomy 21: The Story of Down Syndrome", http://www.ds-health.com/trisomy.htm 4)Down Syndrome: Background Information", http://www.nas.com/downsyn/faq1.html 5)About Down Syndrome", http://www.ndss.org/aboutds/aboutds.html#PPgenetic 6)About Down Syndrome http://www.ndss.org/aboutds/aboutds.html#PPmedical

Inflation and Unemployment

Macroeconomics help Name: Institution: Inflation is the rise in general prices of goods and services over a specific period of time. Unemployment is a state where people are able and willing to work at the ongoing market prices of labor but they are unable to secure a Job. According to the Phillips curve, there is a consistent relationship between inflation and unemployment (Nevi, J. W. 1981, peg 3). When the rate of unemployment is low, the level of inflation is high and when the level of employment is high, inflation level is low.Since majority of the Americans regard inflation to be a bigger threat than unemployment, they will ether stay unemployed but to let the value of a dollar stabilize. Therefore they will rather be employed during stable prices than rising prices. The Americans favor unemployment to inflation. When 10% of the workers are laid off, it will imply that unemployment will increase and an Increase in unemployment Implies a decrease In inflation. If the wages are r educed by 5%, it will mean that even more worker can be employed due to the reduction of labor cost.This will lead to an Increase In employment thus the level of unemployment will go down. A decrease In unemployment leads to an increase In level of inflation. Therefore they will rather go for 10% of workers being laid off than a 5% cut In their wages. They will vote for 10% workers being laid off. Their knowledge of who will be laid off won't affect their decision in voting because they are all against Inflation. They will rather not work than work for a wage with low purchasing power. Therefore they are after their purchasing power than Just a Job.Fiscal policy Is an attempt to manipulate government expenditure and taxation so as to affect aggregate demand and aggregate supply to achieve full employment and price stability. Monetary policy Is a policy that affects money growth (Landing, F. K. 2009, peg 34). Therefore when the government uses monetary policy, the money supply will I ncrease. The government will cut taxes to treat the deficit. When the Fed will prevent growth In reserves, It Implies that the borrowing will be constant thus no preventions on borrowing from commercial banks.This will result to an Increase In money supply as the government too Is borrowing. According to the ELM curve, when the two polices are used, at the point where the Interest rate Is low, monetary policy has no power. When fiscal policy Is used, Increase In supply of money has no effect on the Interest rate. Therefore when the IS-ELM equilibrium Is low, fiscal policy Is the suitable policy to use. When the Fed Increase the supply of alienable funds through and expansion of commercial banks, the supply of money will Increase at the same ongoing Interest rate.The Fed will not succeed to prevent the Interest rates from rising. Interest rate Is assumed to be flexible according to the classical economists. This Implies that the Interest rate will rise In order to attain the previous equilibrium. Therefore a lower Interest rate trap as advocated by the Keynesian economist is where inflation will be set. When he economic resources are idle, the output is always low. The reason the government will borrow will be to stimulate the economy. Inflation and Unemployment INTRODUCTIONInflation seems to be a chronic problem in many parts of the world today and unemployment, a phenomenon, true for Pakistan, and valid for United States and other western economies. Even the fastest growing Chinese economy is not totally immune to it. Thus this research project deals with the analysis of unemployment and inflation in Pakistan. The purpose of this research is to analyze the relationship that exists between these two macroeconomic variables, which affect every nation as well as an individual.The Phillips curve shows a historical inverse relation between the rate of unemployment and the rate of inflation in an economy. It is the trade-off between inflation and unemployment (Mankiw, 2002). The lower the unemployment in an economy, the higher the rate of change in wages paid to labor in that economy.LITERATURE REVIEWThe relationship between unemployment and inflation the two macroeconomic variables is usually summarized by the Phillips curve. Different studies have been conducted related to these variables in order to see whether any relationship between these two macroeconomic variables exists or not. While analyzing the trade-off between inflation and unemployment in Asia, (Dua 1996), takes inflation as the function of expected inflation, unemployment gap/ output gap, exchange rate, import inflation and oil price inflation. In India and Philippines the tradeoff between inflation and unemployment does not exist, whereas, in Japan, Korea, Singapore, and Hong Kong it does. (Rafael, MacCulloch, & Oswald 2000), on the other hand, suggest that welfare  and life satisfaction level is a function of inflation and unemployment and people are happier when rates of both are low.However unemployment in comparison with inflation depresses people more than inflation. Thus while controlling country fixed-effects, year effects, and time trends, it is estimated that people will trade 1% increase in unemployment for 1.7% increase in inflation. A strong positive relation between unemployment rate and inflation rate lagged one or two years is also shown, which is inconsistent with both Philips curve and NAIRU. In other words the trade-off between inflation and unemployment rate does not exist, except in the same year, and in the long run unemployment is a positive function with inflation (Niskanen 2002). Namibia, using the time series data from 1991-2005, exhibits the presence of stagflation in its economy.In other words he found increase in both inflation and unemployment at the same time, which contradicts the traditional short-run Philips curve (Ogbokor 2005). (Furuoka 2007) using the data of Malaysia from 1975-2004 shows and existence of co-integrated as well as casual relationship between inflation and unemployment. That is the study provides an empirical evidence to support the Philips curve.Likewise, Philips curve also exists in Japan, with negative coefficients of linear link between inflation and unemployment. Also there is a generalized linear and lagged relationship between labor force, unemployment and inflation in Japan, which is confirmed by the fact that the driving force behind unemployment and inflation is the change rate of labor force level (Kitov 2007). In this paper, a Philips curve with linear link will be calculated for Pakistan to see if the negative relationship between the variables exists or not.Problem Statement: What is the likely relationship between inflation and unemployment in Pakistan? Hypothesis: If unemployment increases, then inflation decreases.Data Source: Secondary data for the purpose of this research has been obtained from the year 2000-2011. The data on unemployment rate (percentage of total labor force) and inflation rate (general not adjusted for food and energy) for Pakistan, has been taken from the Economic Survey of Pakistan.ObjectiveThe objective of this research is to determine the relationship between inflation and unemployment for the economy of Pakistan. Phi lips curve is based on the equation where unemployment is the function of inflation.METHODOLOGYHere, a regression is run for inflation rate and unemployment rate for Pakistan. The functional form of the model which is as follows: Y = ÃŽ ²ÃŽ ¿ + ÃŽ ²1X1 + ЄSubstituting the above inflation function in the equation INFt = ÃŽ ²ÃŽ ¿ + ÃŽ ²1Ut + Єt Where U is the unemployment rate and INF is inflation rate for a given time â€Å"t†. The Equation obtained after running the OLS model is: INFt = 30.96981 – 3.306067 UtDependent Variable: INFMethod: Least SquaresDate: 08/01/13 Time: 21:49Sample: 1 12Included observations: 12Variable Coefficient Std. Error t-Statistic Prob.C 30.96981 6.078158 5.095263 0.0005 U -3.306067 0.882942 -3.744377 0.0038R-squared 0.583686 Mean dependent var 8.549167 Adjusted R-squared 0.542055 S.D. dependent var 5.344512 S.E. of regression 3.616718 Akaike info criterion 5.560023 Sum squared resid 130.8065 Schwarz criterion 5.640841 Log likelihood - 31.36014 Hannan-Quinn criter. 5.530101 F-statistic 14.02036 Durbin-Watson stat 2.038825 Prob(F-statistic) 0.003819While interpreting the regression line, the negative sign with the coefficient of unemployment shows that in Pakistan Inflation and unemployment are inversely related at â€Å"t† period. One percent increase in unemployment in one year will bring a decrease in inflation of 3.306067 percent. Unemployment in this simple regression model is statistically significant as the probability of t-stats is less than 0.05 and so we reject H0. The intercepted value 30.96981 of B0 shows the inflation rate when unemployment is zero. The R2 for this model, which lies between 0 and 1, comes out to be 0.583686 which shows that 58.36 percent of the variation in inflation is explained by unemployment.The adjusted R2 statistics comes out to be 0.542055. The Durbin-Watson d statistics test, which is done for autocorrelation, is 2.038825 for Pakistan, showing that there is no auto or se rial correlation. As this is simple regression model multicollinearity is not present. As the probability of F-stat is less than 0.05 we will reject H0 which means that the model is overall statistically significant. The Scatter Plot for Inflation and Unemployment somehow depicts the same relationship as above.CONCLUSION & RECOMMENDATIONThis study is conducted in order to make an analysis of inflation and unemployment in Pakistan from year 2000-2010. It has employed a simple regression analysis technique. The main conclusion derived from this study is that the tradeoff between these two variables, the Philips Curve, is observed in Pakistan. When unemployment is high, the cost of goods will increase during an inflationary period, but firms will be able to hire cheap labor, as labor will be in surplus.Wages will not rise while unemployment remains high. Workers will have to borrow money or reduce the amount of goods they purchase. If workers cannot get loans, firms will have to lower prices to continue to sell products, thus reducing inflation. This study makes the following recommendation in the light of its analysis. Easy fiscal policy can be used to decrease unemployment at the expense of inflation, as mild inflation is desirable in every economy. However in Pakistan the inflation rate is much higher than the unemployment rate. Thus Pakistan has to focus more on policies which lead to reduction in inflation but the  Government should also control unemployment at the same time.