Tetrodotoxin And The Threat Of Bioterrorism Biology Essay

Tetrodotoxin And The Threat Of Bioterrorism Biology Essay The threat of bioterrorism remains a reality worldwide, although of low probability, an attack would be a high-consequence event. Microbes are available to individuals with appropriate contacts and even many low-grade bacterial pathogens can severely affect health. Toxins provide bacteria with a system of defense that is often detrimental to humans and their versatility makes them potential tools of bioterrorism. It should be remembered that the aim of terrorism is not always to kill but rather to strike fear into peoples lives. Importantly, no state can ever be fully prepared for a response and it is probable that no state ever could be. It is for this reason that biological agents are so attractive as weapons. (British Journal of Biomedical Science, 2005) Deserving of a closer look as a potential weapon of bioterrorism and as a threat to public health and safety is tetrodotoxin. Tetrodotoxin (TTX) is a potent marine neurotoxin, named after the order of fish from which it is most commonly associated, the Tetrodoniformes (tetras four and odontos-tooth), or the tetraodon puffer fish. The tetraodon puffers are equipped with four large teeth which are nearly fused, forming a beak-like structure used for cracking mollusks and other invertebrates, as well as for scraping corals and general reef grazing. (Florida State University, January, 2002) According to the New York Times, first isolated from the puffer fish, tetrodotoxin is among the most potent toxins known. It is 100 times as toxic by weight as potassium cyanide two milligrams can kill an adult human and it is not destroyed by cooking. Tetrodotoxin is found in more than just marine creatures. It is present in high concentrations in the skin of certain newts in North American and Japan, and in several kinds of frogs in Central and South America and Banglaesh. (New York Times Science, December, 2009) The flesh of the puffer fish (i.e. fugu) is considered a delicacy in Japan. It is prepared by chefs specially trained and certified by the government to prepare the flesh free of the toxic liver, gonads and skin. Despite these precautions, many cases of tetrodotoxin poisoning are reported each year in patients ingesting fugu. (Medscape CDC Commentary Series, October, 2009) From 1974 through 1983 there 646 reported cases of fugu (puffer fish) poisoning in Japan, with 179 fatalities. Estimates as high as 200 cases per year with mortality approaching 50% have been reported. (Florida State University, January, 2002) Interestingly while tetrodotoxin is found in several different branches of the animal kingdom, the tetrodotoxin found in each of these creatures is identical unlike the venoms produced by snakes and scorpions which are made up of different kinds of toxins particular to that species. The evidence suggests that these animals do make the toxin themselves. (New York Times Science, December, 2009) The toxin itself appears to be made by relatively common marine bacteria, specifically Pseudoalteromonas haloplanktis tetraodonis, which associates with these animals. Validating this theory when puffer fish are raised in aquariums with filtered, bacteria-free water, they are non-toxic and the same results are achieved when Japanese newts or Panamanian frogs are raised on special diets they lose their toxicity. These experiments validate the theory that these toxic animals obtain the toxin from the food chain. Several species of tetrodotoxin-producing bacteria have been found in puffer fish, the blue-ringed octopus, and certain small and other animals. It appears that the animals become toxic by sequestering the bacterially produced toxin in their tissues. (New York Times Science, December, 2009) The exact origin of tetrodotoxin in the food chain remains unclear. The only common dominator seems to be that tetrodotoxin producing animals are closely related to an aquatic system and the bacteria that commonly inhabit the aquatic system. (MDPI Marine Drugs, May 2008) The toxic dose is not clear because puffer fish have different concentrations of tetrodotoxin. A dose of 1-2 mg of purified toxin can be lethal. Reported cases from the Centers for Disease Control and Prevention (CDC) have documented toxicity with ingestion as little as 1.4 ounces of puffer fish. (Medscape CDC Commentary Series, October, 2009) In contrast, the botulinum toxin (Clostridium botulinum) is reported to be the most toxic substance known. If evenly dispersed for inhalation, 1 gram of pure (botulinum) toxin is sufficient to kill 1 million people. (Ryan Glarum, 2008, p. 65) Tetrodotoxin is a neurotoxin. Neurotoxin is a toxin that acts specifically on nerve cells of the nervous system, typically by interacting with membrane proteins and especially ion channels. (Knowledgerush, n.d.) Tetrodotoxin binds to the sodium channel of the nerve preventing the passage of sodium ions through the cell membrane and therefore (passage) of the nerve impulse. (CBWinfo.com, 1999) Many of the venoms and other toxins that organisms use in defense against vertebrates are neurotoxins. A common effect is paralysis, which typically onsets extremely rapidly. (Knowledgerush) The first symptom of (tetrodotoxin) intoxication is a slight numbness of the lips and tongue, appearing between 20 minutes to three hours after eating poisonous puffer fish,. The next symptom is increasing paraesthesia in the face and extremities, which may be followed by sensations of lightness or floating. Headache, epigastric pain, nausea, diarrhea, and/or vomiting may occur. Occasionally, some reeling or difficulty in walking may occur. The second state of the intoxication is increasing paralysis. Many victims are unable to move; even sitting may be difficult. There is increasing respiratory distress. Speech is affected, and the victim usually exhibits dyspnea, cyanosis, and hypotension. Paralysis increases and convulsions, mental impairment, and cardiac arrhythmia may occur. The victim, although completely paralyzed, may be conscious and in some cases completely lucid until shortly before death. Death usually occurs with in 4 to 6 hours, with a known range of about 20 minutes to 8 hours. (U.S. Department of Health and Human Services; FDA U.S. Food Drug Administration, n.d.) No specific antidote has been tested in humans. No drug has been shown to reverse the effects of tetrodotoxin poisoning. Treatment is symptomatic. Specific drug efficacy has only been documented anecdotally. (Medscape CDC Commentary Series, October 2009) Animal studies using monoclonal antibodies against TTX have been done. Monoclonal antibodies were shown to e life saving in mice treated both before and after the ingestion of a lethal dose of TTX. Further studies are needed to document the efficacy in humans. In another study using guinea pigs intoxicated with tetrodotoxin, 4-aminopyridine (a potassium channel blocker) showed dramatic improvement in respiratory, cardiac, and CNS status occurred after administration of the drug. No human studies of this drug for use in tetrodotoxin poisoning are in progress. (Medscape CDC Commentary Series, October 2009) No specific laboratory test confirms tetrodotoxin ingestion exits; thus dietary history is key for diagnosis. Tetrodotoxin poisoning can be misdiagnosed as one of many differential diagnoses including: gastroenteritis, Guillain-Barre Syndrome, 1st, 2nd and 3rd degree heart blockage, hypocalcemia, Lambert-Eaton Myasthenic Syndrome, myasthenia gravis, octopus envenomations, and ciguatera, scombroid and shellfish toxicity. Since tetrodotoxin is produced from bacteria, there is a risk that the toxin could be manufactured on a significant scale by fermentation. (CBWinfo.com, 1999) Tetrodotoxin is a colorless crystalline solid that darkens when heated about 428 ° F or 220 ° C. (CDC National Institute for Occupational Safety and Health, n.d.) Relatively is little is known about tetrodotoxin as a possible toxin weapon although the Japanese did some work its weaponization in Unite 731 during World war II. It is included on the Australia Group lists by reason of its toxicity. It is not known to be made in large quantities that could be used in weapons and little or nothing is know about its inhalation toxicity. (CBWinfo.com, 1999) ( NOTE: The Australia Group (AG) is an informal forum of countries which, through the harmonization of export controls, seeks to ensure that exports do not contribute to the development of chemical or biological weapons. Coordination of national export control measures assists Australia Group participants to fulfill their obligations under the Chemical Weapons Convention and the Biological and Toxin Weapons Convention to the fullest extent possible.) (The Australia Group, n.d.) The National Institute for Occupational Safety and Health (NIOSH) offers insight into the various methods tetrodotoxin could be disseminated and the feasibility of each method. For example, dissemination through indoor air, outdoor air or water is extremely unlikely because the source of the toxin is living organisms and to manufacture tetrodotoxin in appreciable quantities is extremely difficult. And, since tetrodotoxin is unlikely to be disseminated in the air, it is also unlikely to be disseminated through agricultural products. Ingestion does seem the most likely source of dissemination. Exposure to tetrodotoxin usually occurs through eating improperly prepared fish or possibly through contamination of other food products. (CDC National Institute for Occupational Safety and Health, n.d.) According to NIOSH, there is no antidote for tetrodotoxin toxicity and initial treatment is primarily supportive. In 2007 two individuals developed symptoms consistent with tetrodotoxin poisoning after ingesting home-cooked puffer fish purchased in Chicago. Both the retailer and supplier claimed the product was monkfish. High levels of tetrodotoxin were detected in the remains of the ingested meal and fish retrieved from the contaminated shipment. This case of tetrodotoxin poisoning highlights the need for continued stringent regulation of puffer fish importation by the U.S. Food and Drug Administration, education of the public regarding the dangers of puffer fish consumption, and raising awareness among medical providers of the diagnosis and management of foodborne toxin ingestions and the need for reporting to public health agencies. (PubMed U.S. National Library of Medicine National Institute of Health, 2009) Currently tetrodotoxin is manufactured by several specialized biotech companies. CHEMTE Biotech Company, LTD located in Nanjing, Jiangsu, China specializes in the manufacture of tetrodotoxin. According to CHEMTE Biotechs website, after ten years research and development, we have achieved extensive isolation and purification of TTX based on the abundant resource in our area. We founded the TTX production base in the world with annual product (sic) is more than 1000g. (CHEMTE Biotech Company, Ltd., n.d.) Through the use of their technology process CHEMTE has raised production rate and product quality of TTX up to the worlds highest level. CHEMTE boasts that their customers in many countries find their purity is higher than their own pure products. Currently in the European market, TTX from CHEMTE is sold as the standard product. (CHEMTE Biotech Company, Ltd., n.d.) The China Kantte Bio-Chemical company located in Shanghai, China produces tetrodotoxin extracted from puffer fish in large scale, and purified close to 100% by high-performance liquid chromatograph (HPLC) and capillary electrophoresis. (China Kantte Bio-Chemical, n.d.) While it is possible to procure TTX for research as a potential pain therapeutic and medicine for opium withdrawal symptoms, its purchase is limited to researchers and scientistsà ¢Ã¢â€š ¬Ã‚ ¦.just ask Edward F. Bachner IV of Lake Hills, Illinois. On August 26, 2008 a federal grand jury in Rockford, Illinois returned a ten-count indictment charging him with unlawfully acquiring and possessing tetrodotoxin, on five separate occasions between November 7, 2006 and June 30, 2008. Five of the counts allege that on five separate occasions, Bachner acquired tetrodotoxin in order to use it as a weapon. Bachner possessed tetrodotoxin in a quantity that was not reasonable justified by a prophylactic, protective, bona fide research, or other peaceful purpose. If convicted of acquiring TTX to use as a weapon, Bachner could be sentenced to a maximum penalty of life imprisonment. (U.S. Department of Justice, 2008) As a fun aside, during my research I came across an interesting article about the use of tetrodotoxin and folklore surrounding creation of zombies. In eight samples of zombie powder collected from four regions of Haiti all appeared to have four ingredients in common: 1) one or more species of puffer fish which contained tetrodotoxin, 2) a toxic marine frog, 3) a hyla tree frog which secretes an irritating substance, and 4) human remains. (Strayer University, n.d.) According to some theories a person poisoned with Haitian zombie powder regains consciousness either while in the coffin or shortly after being removed from it and therefore, think they have died and are now a zombie. (How Stuff Works, n.d.) When analyzing an agent as a potential biological agent for use as a weapon of bioterrorism one must examine certain attributes as they apply to that specific agent. Some of these attributes include ease of dissemination, route of entry, morbidity, mortality, infectivity, potential for contagion, potential for panic and social disturbance, and the impact on public health and public health preparedness. The most efficient route of entry for tetrodotoxin would be ingestion either through consumption of the toxin itself or the consumption of other food products tainted with tetrodotoxin. Because ingestion is the favored route of entry, tetrodotoxin does not lend itself for use as a weapon that is easily disseminated or for use as a bioterrorism weapon. Tetrodotoxin does have some potential use as a target specific biological weapon. Bioterrorists could use tetrodotoxin for targeted victims, such as political figures, world leaders or small contingents of military forces. Even for use on targeted specific victims tetrodotoxin is not be easily disseminated. Tetrodotoxin poisoning would require the introduction of the toxin directly into a food or liquid source ingested by the target. Ingestion as a route of entry makes tetrodotoxin not easily disseminated. Morbidity rates are 100% for tetrodotoxin poisoning; rarely will ingestion of tetrodotoxin contaminated food leave the victim unscathed as evidenced by the number of fugu poisoning cases recorded in Japan each year. Tetrodotoxin with its high morbidity rate could be considered as a weapon for bioterrorism. Infectivity rates for tetrodotoxin are 100%. Another fact influencing the high morbidity rate of tetrodotoxin poisoning is the possibility it can easily be mistaken for one of many differential diagnoses. Patients presenting with tetrodotoxin poisoning could easily be misdiagnosed especially if a valid dietary history is unavailable or overlooked. Mortality rates for tetrodotoxin are difficult to establish; anecdotal reports suggest 50-60% mortality, even with good supportive care. One report suggests that prognosis is good if the patient survives the first 24 hours. (Medscape CDC Commentary Series, October 2009) The same cannot be said for biological agents like plague. In the pneumonic form plague is almost 100% fatal without immediate medical attention. (Ryan Glarum, 2008) A biological weapon with only a possible 50-60% mortality rate would probably not be perceived as an effective weapon of bioterrorism. Unlike some other biological agents that lend themselves to inhalation or person-to-person transmission, tetrodotoxin poisoning is transmitted only through ingestion of the toxin. It does not have the potential as a weapon of bioterrorism because transmission is limited to persons ingesting the toxin. Tetrodotoxin poisoning offers no potential threat for contagion in terms of an epidemic or pandemic. The bacteria are contained within the host organism. Tetrodotoxin poisoning could certainly create panic and social disturbance, especially if the targeted victims were persons of political or military importance. There could also be public panic caused by the concern as to the nature, origin and location of the toxin. To be considered as a potential weapon of bioterrorism the biological agent would need to: 1) be easily disseminated or transmitted, 2) cause high mortality, 3) severely affect the public health, 4) cause public panic and social disruption, and 5) require special action for public health preparedness. Overall, while tetrodotoxin is a lethal neurotoxin with: 1) a high level of morbidity, 2) moderate level of mortality, 3) a difficult dissemination method, 4) ingestion as the route of entry, 5) no transmission qualities, 6) no likelihood of contagion and 7) unlikely to cause panic or social disruption, in my opinion it would not be useful as a biological weapon of mass destruction. In my opinion tetrodotoxin has some modest potential as a limited bioterrorism agent in special circumstances. Tetrodotoxin does not meet all the necessary criteria to be considered as a biological agent capable of causing severe damage to the health and safety of the public.

Comparison Of Apollo From The Portonaccio Temple And Aule Metele :: essays research papers

Comparison of Apollo from the Portonaccio Temple and Aule Metele   Ã‚  Ã‚  Ã‚  Ã‚  Though the figures are not far from each other is height comparison, they seem to contain a distinct amount of difference in other aspects. First of all, they were made from different materials. While the Apollo statue is terracotta, the Aule Metele is of bronze. Generally speaking, the Apollo statue appears in a very symbolical manner in that his features are not well defined in detail while the Aule Metele displays a type of inspiring complexity with detail.   Ã‚  Ã‚  Ã‚  Ã‚  The Apollo statue consists of a garment that is shown in a pattern like manner. The robe does not display realism but symbolism due to its lack of variation in the folds. The Aule Metele however, shows a great deal of realism in the drooping folds and twisted shoulder strap. It looks as though the material is in fact freely moving and could be manipulated. The muscle structure of the Apollo statue also displays a great deal of generalization. The limbs are robust and irregularly plump in areas as can be seen in the calf area of the right leg. The Aule Metele displays a great deal of understanding of muscle as well as bone structure in the limbs as can be seen in the edges created in the extended right arm of the figure.   Ã‚  Ã‚  Ã‚  Ã‚  In terms of head and neck features, the figures seem to be most distant. While the Apollo statue has a large smile on his face, the Metele has an expression of stern seriousness. The Apollo statue has no more facial detail than cheekbones roughly instilled. The Metele shows complete understanding of the human muscle and bone structure in the face.

Song of Bernadette

The Song of Bernadette Franz Werfel’s, The Song of Bernadette tells the story of Saint Bernadette Soubirous. The movie Was directed by the American screenwriter, George Seaton and released in 1943, only two years after the book was published. In 1943, The Song of Bernadette was awarded four Ocsars for: Best Actress in a Leading Role, Best Art Direction-Interior Decoration, Best Cinematography, and Best Music. I believe that George Seaton’s goal for the film was not only to give the novel visual content, but to also spread the word of Saint Bernadette, Lourdes, and to give his opinion on atheism.At the beginning of the film, Seaton quotes, â€Å"For those who believe in God, no explanation is necessary. For those who do not believe in God, no explanation is possible. † I believe this quote plays a big role in The Song of Bernadette, being that most of the people that do not believe that Bernadette sees the Virgin Mary portray atheist and atheism. The Song of Berna dette was filmed in black and white. The shadowing in the movie was very good. It helped you visualize the film better and adds detail to the movie being that it is in black and white.The lighting also helps portray that the woman Bernadette sees is, in fact, something extraordinary. Whenever she appears in the film, she is always bright. I think the actors that played in The Song of Bernadette played their rolls very well. Jennifer Jones was a great in the film as the main character, Bernadette. Gladys Cooper did an amazing job as Sister Marie. Charles Bickford also did a great job for the part of Father Peyramale. Like I said, everyone did a great job, but those three character just stand out for me. In The Song of Bernadette, there are many of God moments, particularly being that the film is religious.I believe one of the first God moments is when Bernadette sees the lady for the first time. After she sees her, Bernadette just walks right through the river that was freezing cold just moments ago. Another God moment is when Father Peyramale tells Bernadette to ask the lady to make the roses bloom early. When she does, she is asked to wash from the water by the lady, but not from the river. Bernadette decides to go in the cave and dig in the from the ground and begins washing(dirtying) her face with dirt from the hole she had dug up.Nothing happens to the roses after that moment, so some people lose believe in Bernadette and leave but Water begins flowing from the hole she dug and when drank or bathed in the water it preformed miracles. The last God moment is when Sister Marie Therese Vauzous calls out Bernadette for not suffering, and that God should have chosen her because she has suffered. Little did she know Bernadette was indeed suffering from Tuberculosis of the bone, which causes intense pain, and had never complained about it.At the end of the movie conversion and change is made by Prosecutor Vital Dutour when we find out he has cancer to the throat. Dutour goes to the well and asks Bernadette to pray for him, when throughout the whole movie he does not believe Bernadette and even portrays the atheism in movie. In the movie there are many of crosses that are religious symbols. I believe that the church appeared to be well. The characters that exemplifies Christ are Bernadette, the sisters, the Priests, and the Virgin Mary. I do not believe that religion was misused at all in The Song of Bernadette.I did enjoy the film. I can honestly say, I’m not that in to religious films, but I really did like this one. Something about it kept my attention, and in my case it is pretty hard for me to keep interest in movies because I’m not a big fan of watching movies, but The Song of Bernadette definitely kept me interested throughout the whole movie. I think that The Song of Bernadette can relate to anyone that has ever doubted something or not believed something. I would most certainly watch this again if it would ever come on television and I happen to be watching.

Marketing Strategies Of Bharti Airtel Essay - 1662 Words

CHAPTER-3 RESEARCH METHODOLOGY The research methodology adopted for this project is exploratory in nature as there is no hypothesis that has to be tested. The conclusions for this project have been drawn by exploratory research work. TYPE OF DATA The data used in this project is secondary data mainly from Internet. SOURCES OF DATA ïÆ'Ëœ Internet ïÆ'Ëœ Airtel’s website CHAPTER-4 DATA ANALYSIS MARKETING STRATEGIES ADOPTED BY AIRTEL Bharti Airtel has used a considerable sum on promoting its cellular telephone office. Notwithstanding print publicizing, the organization has set up an expansive number of hoardings in and around Delhi. The reason behind outlining an advancement fight for the Airtel administrations is to advertise and upgrade brand mindfulness and to fabricate the brand inclination. It is attempting to situate up a fight to manufacture stronger brand value for Airtel. Since the cell classification itself is excessively confined, likewise the way that a PDA is a high association item, cost doesn t qualify as a successful differentiator .The picture of the administration supplier numbers an incredible arrangement. Given the Cell telephone class, it is the system proficiency and the nature of administration that gets to be paramount. This additionally serves as a compelling differentiator Brand mindfulness is spread through the crusades and brand inclination through brand stature. 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Review Of The New Yorker Essay - 1892 Words

Thirteen year old Megan Meier befriended and began exchanging messages with someone who she thought was a cute 16 year old boy named Josh Evans on Myspace. The messages from Josh started out complimentary but quickly became hostile, soon leading to other forms of cyberbullying. Meier, already struggling with depression, grew even more depressed as the online harassment continued. On October 16, 2006, Meier hanged herself in her bedroom closet, dying a day later. Soon after, news surfaced that the â€Å"Josh Evans† Meier had been communicating with was not an actual person, but simply a fake account. A mother in Meier’s neighborhood ran the account, claiming that she made it in order to ascertain how Meier felt and what Meier was saying about her daughter. Due largely in part to a mother’s deep entrenchment in her daughter’s personal life, Megan Meier committed suicide, serving as an extreme example of the dangers of an overbearing parent. 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Maslow s Hierarchy Of Needs - 1536 Words

Nothing may define us more in life then our behavior. They are the actions that become of our feelings, thoughts, and our experiences in life. As a whole the study of what people think, feel and do in and around an organization is referred to as Organizational behavior or OB. (McShane Glinow, 2016) .In an organizational structure, our behaviors can affect many aspects of business like moral and profit gain or loss. The ability to understand and properly manage many different types of people and behaviors inside a business structure allows the business to operate like a well-oiled machine. That also requires an understanding of how to motivate different personality types. In the research I am going to compare Maslow’s hierarchy of needs against Lawrence and Nohira’s 4 drive theory in an attempt to better understand their possible uses inside an organizational structure. Let’s first take a look a look at the two theories before discussing their potential benefit. Maslow’s Hierarchy of Needs. We need to keep in mind that Maslow’s field was phycology, so his research was done from a medical viewpoint more so than a business one. In business, we understand that everyone is motivated differently so one approach will not work on all people. Maslow’s theory was that the needs or â€Å"drives† that motivated people could be condensed from the long list of needs that could potentially exist into 5 basic categories starting with the lowest; Physiological as in the need for food, air,Show MoreRelatedMaslow s Hierarchy Of Needs1741 Words   |  7 PagesMaslow’s hierarchy of needs and Herzberg’s. The Maslow’s hierarchy of needs include five levels, and at the certain extent, reflect the rule of human s activities on psychological and behavior. Herzberg’ describe the more details of worker agree or disagree about working. In this essay, more related knowledge details and effects will de described, then, analysis the two theories individual, choose a better one. II. Describe the two theories. 2.1Maslow’s hierarchy of needs The Maslow’s hierarchy of needsRead MoreMaslow s Hierarchy Of Needs1295 Words   |  6 PagesMaslow’s hierarchy of needs (p. 379 in EP)? Outline each level and discuss how it relates to motivation. Abraham Maslow was born in 1908 in Brooklyn, New York. He originally studied law because of the influence of my parents, but after marrying his first cousin, Bertha Goodman, and moving to Wisconsin, he became interested in psychology. After achieving his Masters in Psychology, Maslow moved back to Brooklyn and started teaching at a school there. â€Å"One of the many interesting things Maslow noticedRead MoreMaslow s Hierarchy Of Needs1524 Words   |  7 PagesSummary of Maslow’s The Hierarchy of Needs Abraham Maslow developed the theories of motivation because he felt that the sophistication of human behavior could not be portrayed through reinforcement or rewards. He felt that human action were directed toward realization and fulfillments and that behavior could be gratified while using multiple types of needs at the same time. Maslow wanted to find positive motivation as to why people react or engage in certain behaviors. He felt that basic survivalRead MoreMaslow s Hierarchy Of Needs982 Words   |  4 PagesAbraham Maslow was one of the most influential and important educational psychologists and is recognized by many for his theory on mankind’s hierarchy of needs. Maslow’s theory which is known as â€Å"Maslow’s Hierarchy of Needs† is best explained as a pyramid of needs that we as humans must meet in order to progress to another stage of needs. There are five stages in the pyramid of needs and they go as follows: physiological, safety, love and b elongingness, esteem, and finally self-actualization. MaslowRead MoreMaslow s The Hierarchy Of Needs1769 Words   |  8 Pages Summary of Maslow’s The Hierarchy of Needs Jennifer Thompson Arkansas Tech University Author Note This individual research paper is being submitted on October 13, 2014 for Loretta Cochran’s Management [BUAD 3123] course. â€Æ' Summary of Maslow’s The Hierarchy of Needs Abraham Maslow developed the theories of motivation because he felt that the sophistication of human behavior could not be portrayed through reinforcement or rewards. He felt that human action were directed toward realizationRead MoreMaslow s Hierarchy Of Needs1498 Words   |  6 Pagesjust want to survive in life they want to flourish. Maslow s hierarchy of needs explains to us a ranking of needs for most essential to the least. While the interactionist point of view explains how humans are social creatures and social interaction is just as important as all of the other needs listed on Maslow’s Model. Maslow s hierarchy of needs is a ranking of needs for most essential to the least. Corrections Today explains that Abraham Maslow was an American psychologist born in New York, heRead MoreMaslow s Hierarchy Of Needs Essay1527 Words   |  7 Pages This international technology company demands strong motivation, stupendous leadership and great understanding between workers. Leaders need to create willingness amongst the employees to operate at their highest potential; this willingness is referred to as motivation. This report is based on a content/needs theory of motivation (Maslow’s hierarchy of needs). It consists of two pieces of primary research on the theory. The first one summarises worker motivation on selected construction sites inRead MoreMaslow s Hierarchy Of Needs1388 Words   |  6 Pages Abraham Maslow was an American philosopher who was born in the early 1990 s in Brooklyn, New York. He was one of the leading theorists that promoted humanistic psychology during his era. Maslow sought to understand what motivates and inspires individuals. He theorized that individuals possess and hold a group of motivation and incentive systems not related to plunder or insensible desires. Maslow declared that people are motivated and provoked to attain certain needs. When one need is fulfilledRead MoreThe Maslow s Hierarchy Of Needs Essay1014 Words   |  5 Pages Maslow’s hierarchy of needs Submitted by: Deepali Kotecha (student number: 4288370) Submitted to: Mr Simon Bishop Date: 14th November 2016 Introduction to management University of Nottingham First year coursework Table of contents Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦3 Introduction Running and managing a successful company requires strenuous efforts. Organisations are forced to be flexible, efficient and productive to excel at their performance. ThisRead MoreMaslow s Hierarchy Of Needs1846 Words   |  8 PagesAbraham Maslow developed the Hierarchy of needs (HON) to try and explain human psychological developments and how these manifest themselves into a worker’s life. We will explore some issues brought up by the model and why it may lack a certain the degree of unification and how it could potentially work better if entwined with other views. Motivation is the â€Å"word derived from the word ’motive’ It’s the process of stimulating people to actions to accomplish the goals† (guide, 2017) Also, Maslow

Case Study on Orthopaedic Trauma for Surgery-myassignmenthelp

Question: Discuss about theCase Study on Orthopaedic Trauma for Emergency Surgery. Answer: The health care industry has improved significantly over the past few decades, and now the care plans and the strategies are more patient centered and targeted than ever. One of the most targeted patient centered care plans can be the ones focused on the trauma patients. There can be various types of trauma; however this assignment focuses on orthopedic trauma (Panteli, Pountos and Giannoudis 2016). Orthopaedic trauma can be defined as the severe injury of the musculoskeletal system that is often facilitated by any sudden accident and it demands emergency medical attention as well. It has to be understood in this context that orthopedic trauma can easily be life threatening if immediate and adequate medical attention is to given to the patient. And hence, it is very important for the health care initiatives to be taken on an urgent basis and all the while obtaining a clear understanding of the underlying pathophysiological interventions as well (Capone et al. 2014). This assignment w ill attempt to outline the pathophysiology critically with respect to the case study of a patient named Leigh Richards. This assignment focuses on the case study of a critical patient named Leigh Richards who had undergone a devastating accident. The patent in the case study, Leigh is a 39 year old man who had been an irrigation consultant working in the Murray bridge area. During the accident the patient had been a restrained passenger sitting inside the rally car, the car hit a tree because of travelling exceedingly over the permitted speed limit on a dirt road. His injury details as expressed in the case study include being trapped inside the car after the accident by a cabin intrusion that pinned his leg. Following the unfortunate event, the emergency care team cut through the car to rescue the patient and emergency care for his orthopedic trauma had been initiated. In this regard the patient had a daughter who is a second year nursing student who did not understand the use of pharmacology in the orthopedic trauma that her father had been facing (Rossaint et al. 2010). It has to be understood that in this case the patient had sustained a severe injury in his leg due to an accident that caused a cabin intrusion to pin his legs inside the car. Now orthopedic trauma comprises of severe injuries in the different parts of the musculoskeletal system including the bones, joints and the ligaments. The most common and frequently observed interventions for such conditions include surgical procedures however, in certain cases, especially for pain management, wound management and hemorrhage management purposes, the role of pharmacological interventions are also crucial (Zhang 2012). According to the signs and symptoms that has been discovered in the case study the most the patient has been suffering from pins and needles and functions in his legs as well, which is a very common condition with respect to compartment syndrome. In relation to the different signs and symptoms discovered in the case study the most probable diagnosis for the patient is compartment syndrome which can be a devastating condition if not rapidly diagnosed or properly managed in the patient. On a more elaborative note, it has to be mentioned that compartment syndrome is of grief medical condition that involves an acute increase in the pressure located in the muscle compartment which can be resolved it by a crush injury and can easily lead to muscle and nerve damage restricting the blood flow through the body surrounding the affected muscle tissue (Roscoe, Roberts and Hulse 2015). Compartment can be defined as the confined space in the thick layer of tissue called fascia present in between t he muscles separating the groups of muscles in arms and legs. In this case is the compartment syndrome caused by the car accident on the patient resulted to applying an acute pressure on the compartments in between the muscles leading to accumulated pressure on the muscles blood vessels and nerves leading to the excess pressure on the fascia. Due to the fact that the fascia are not capable of stretching the direct response of the pressure is exerted on the muscles, capillaries and nerves in the compartment obstructing the blood flow to muscles and the nerve cells. According to the Cone and Inaba (2017), compartment syndrome occurs when the pressure within any defined compartmental space increases past the critical pressure threshold leading to decreasing the perfusion pressure to that particular compartment. It has to be mentioned that compartment syndrome has a range of clinical manifestations, however pain and paresthesia is the most plausible type of compromise complications. Par esthesia can be described as the altered sensation, which generally begins with pins and needles sensation, numbness and tingling sensation. The patient in the case study, Leigh Richards, has been exhibiting pins and needles sensation as well in the injury site along with acute pain, hence it can be stated that for the patient acute compartment syndrome manifested as pain and onset of paresthesia (Von Keudell et al. 2015). Pharmacology can be defined as the branch of biology that focuses on drug interaction and their physiological effect on the body. It basically deals with the theories of pharmacokinetics involving ADME of the drug or pharmacon used, elaborating more, this theoretical concept discusses the absorption, distribution, metabolism and excretion of the drugs used with respect to the biological system of the body (Kier 2012). Another very important theory on which the ADME of the pharmacon are based includes the receptor theory. This theory serves as the operational model for exploring and analyzing the drug-receptor interaction in the functional system with respect to the G-protein coupled receptor behavior (Pan et al. 2013). These theories serve in helping to understand the sequence of physiological effect on the biological system of the patient and to understand the action on the disease pathology. In order to discuss the pharmacology of compartment syndrome, the major health issue of the patient in the present scenario, the primary focus needs to be on pain management. Analgesics are the most common medication type that is used to relive the patient of the acute pain that the patient had been suffering from, most of which have sedative properties, which is extremely beneficial for patients with trauma. In this case, the patient had already been given Fentanyl for pain management in the theatre, hence in the next phase the patient would require Oxycodon for pain management. Oxycodon is a narcotic medication that is used to relieve severe pain in the patients. It is either administered as extended release tablets or on the form of concentrated solutions. This drug belongs to the class of opioid analgesics and it is a semisynthetic derivative of derivative of codaine that acts as a narcotic analgesic with considerable effectiveness making it apt for the trauma patients. The mechanism of action of this medication can be best understood while correlating with drug receptor theory. According to Okura, Higuchi and Deguchi (2015), the active agent works as a weak agonist of the mu, kappa and delta opioid receptors of the central nervous system. It mainly targets the mu receptor which remains coupled with G-protein receptors and act as modulators of synaptic transmission. The opiate binds to the key receptor and stimulates the conversion of GTP into GDP in the G-protein complex. It helps in targeting the cyclic AMP system and as a result into closing the N type voltage operated calcium channels and results into hyperpolarization which reduced neuronal excitability of the patient. Considering the ADME of the drug, this drug is well absorbed in adults and the oral bioavailability of the drug is 60 to 87%. And the distribution volume is 2.6 L/kg. The protein binding capacity is 45% and metabolism is hepatic. The excretion mechanism of this medication and it's metabolites are primarily via the kidney. The most suitable dosage for Oxycodon in case of trauma patients are at least 20mg orally on a daily basis, however given the need for analgesia for Leigh Richards 40mg of extended release capsules will be the most suitable for the patient. The side effects of this medication include constipation, drowsiness, nausea, stomach pain, loss of appetite, sleepiness, tiredness, dry mouth headache and fatigue. This particular medicated against a varied range of different health conditions such as brain tumor, hypothyroidism, addison's disease, extreme loss of body water, depression, suicidal thoughts, addiction, alcohol intoxication, slow heartbeat, irritable bowel disease, liver problems etc. However oxycodone can be taken with any food item without any restrictions all the alcohol is contraindicated while taking oxycodone. Drug interaction of this meditation is associated with CYP3A4 enzyme activity, any drug group that apps on this particular enzyme activity has probability of interacting with oxycodone like antibiotics such as Erythromycin Fluconazole Erythromycin etc. Nursing consideration for patients that are taking oxycodone includes checking if the patient has applied allergy which can lead to hypersensitivity reactions after taking off the coat on and checking if the patient has any of the concentrated health conditions before administering the medication (Wirz et al. 2018). Another very important component of pharmacology of this particular disease and the present health conditions of latest depression in the case study, proper wound management and infection control has to be mentioned. Given the present conditions of the patient and the severity of compartment syndrome and taking oxycodone the most plausible and suitable antibiotics that can be given to the patient includes cefalotin and metronidazole. Considering cefalotin first, this particular medication is second generation derivative of antibiotics cephalosporin and is used to treat many kinds of infection as a potent broad spectrum antibiotic. The mechanism of action of this medication is based on the bacteriocidal activity of the agent. It is facilitated by cell wall synthesis in aviation with respect to the affinity of penicillin binding proteins. It has to be mentioned in this context that these proteins are vital in the peptidoglycan synthesis and their inhibition inhibits synthesis of vital cell wall components. The dosage for his medication that can be prescribed to leave Richards is 7.15 kg per mg single IV dose administered in a 6 hourly basis. Considering the ADME of this drug, this particular drug is absorbed rapidly from the site of injection. The distribution volume is 0.26 litre per kg and metabolism is hepatic (Sadleir, Clarke and Platt 2016). The medication is metabolized to a least active desacetyl metabolite which is excreted unchanged through the urine of the patient. All that has to be mentioned that the renal excretion of this medication is less than 65%. Considering the contraindications of this medication skeleton is contraindicated against health conditions including renal dysfunction, colitis, dialysis, and sodium restriction. Considering the drug interactions, cefalotin interacts with calcium gluconate, diphenhydramine, furosemide, penicillamine, probenecid and amikacin. Side effect of this medication includes local irritation such as Rash itching redness at injection site, hypersensitivity reaction such as bronchospasm fever anaphylaxis and urticarial or maculopapular rash. Renal insufficiency and nephrotoxicity are two least common side effects of this medication. Considering the nursing consideration it has to be mentioned that the nurse administering this particular medication must be where the patient has any allergic reactions to cephalosporin kind of antibiotics or if the patient has anyone else disorders with sodium restriction. This particular medicine also results in diarrhoea hence the nurse administering medication will have to educate the patient regarding the side effects and possible antique precautionary action for diarrhoea nausea and vomiting which can occur after taking his medication (Yang et al. 2015). The next suitable antibiotics for this patient should be metronidazole. It is a medication that is used to treat selective anaerobic bacteria infection. The mechanism of action for this medication is associated with the ability of selected anaerobic bacteria to reduce metronidazole to its active form which then binds to the DNA disrupting the helical structure and intern results in indicating bacterial nucleic acid synthesis and facilitates cell death. Considering the ATM of this particular medication it has to be mentioned that his medication is excellently absorbed 80% from the injection site. The distribution of this medication is 0.51 to 1.1 litre per kg in adults. The metabolism of metronidazole is hepatic facilitated by hydroxylation oxidation and glucoronudation (Jakobsson et al. 2017). The excretion is via urine in the form of nitro containing compounds which are the derivatives of this medication after metabolism. The dosage of this medication for an adult patient like Leigh Richards the patient the case study, is given in 15 mg per kg per single IV dose. The contraindication of this medication includes history of blood dyscrasias, active organic disease of the central nervous system, and hypersensitivity to this group of antibiotics. The adverse reactions include gastrointestinal such as candida growth, hematological including transient leukopenia, neurological such as convulsions seizure meningitis and optic and peripheral neuropathy. Along with that liver dysfunction and mild rashes have also been reported as side effects of this particular medication. This particular medication interacts with Other Drugs including cyclosporine, disulfiram, fluorouracil, phenytoin, cimetidine, bisulfan, corticosteroids and BCNU. Nursing consideration for this medication includes educating the patient regarding the precautions and side effects of this medication checking for any hypersensitivity reaction and whether the patient has any contraindicated diseases before administering this medication. While administering this medication the patient will also have to check if the patient has had the following complications such as aseptic meningitis long-term therapy Candidiasis sodium restriction, impaired functions, etc (Vardakas et al., 2012). These medications will help the patient with the pain and the wound infection risk that the patient had been in the next 24-48 hours and will be able to help him to his recovery. However, in case the compartment syndrome, a few nonpharmacological interventions will be needed to applied such as proper dressing of the wound and the cutting the cast, followed by 10-20% pressure reduction. And in case the condition persists, fasciotomy is indicated to help the patient recover (Dalton et al. 2014). Conclusion: On a concluding note, it can be stated that the patient under discussion in the case study represented a unique and severe orthopedic injury. On further assessment of the patient condition, the patient was discovered to be having severe laceration injuries in the entire left side of his body facilitated by the accident and the cabin intrusion pining his leg that required inline extrication by the SAAS ambulatory services in order to rescue him. It has to be mentioned that for such severe orthopedic injuries there are various pharmacological procedures involved and each of them have a significant impact on the recovery of the patient and the hospital stays. Along with that, it has to be mentioned that for the care plan to be effective for the patient, a detailed idea of the pharmacology of compartment syndrome and how it impacts the patient after a musculoskeletal injury or trauma, is crucial for both the nursing professional and the patient family as well. This assignment outlined the key pharmacological use in orthopedic injury effectively and helped understand the pathophysiology of the key signs and symptoms exhibited by the patient and the targeted pharmacological interventions for the symptoms. Overall it helped attain a detailed understanding of the use of different pharmacological interventions after a traumatic musculoskeletal injury. References: Capone, A., Orgiano, F., Pianu, F. and Planta, M., 2014. Orthopaedic surgeons strategies in pharmacological treatment of fragility fractures.Clinical Cases in Mineral and Bone Cone, J. and Inaba, K., 2017. Lower extremity compartment syndrome. Trauma Surgery Acute Care Open, 2(1), p.e000094. Dalton, D.M., Munigangaiah, S., Subramaniam, T. and McCabe, J.P., 2014. Acute bilateral spontaneous forearm compartment syndrome.Hand Surgery,19(01), pp.99-102. Jakobsson, H., Jernberg, C., Sjlund, M., Jansson, J. and Engstrand, L., 2017. Molecular analysis of ecological changes in the human normal microflora after treatment with clarithromycin and metronidazole. Kier, L., 2012.Molecular orbital theory in drug research(Vol. 10). Elsevier. Okura, T., Higuchi, K. and Deguchi, Y., 2015. The blood-brain barrier transport mechanism controlling analgesic effects of opioid drugs in CNS. Yakugaku zasshi: Journal of the Pharmaceutical Society of Japan, 135(5), pp.697-702. Pan, A.C., Borhani, D.W., Dror, R.O. and Shaw, D.E., 2013. Molecular determinants of drugreceptor binding kinetics. Drug discovery today, 18(13-14), pp.667-673. Panteli, M., Pountos, I. and Giannoudis, P.V., 2016. Pharmacological adjuncts to stop bleeding: options and effectiveness.European Journal of Trauma and Emergency Surgery,42(3), pp.303-310. Roscoe, D., Roberts, A.J. and Hulse, D., 2015. Intramuscular compartment pressure measurement in chronic exertional compartment syndrome: new and improved diagnostic criteria. The American journal of sports medicine, 43(2), pp.392-398. Rossaint, R., Bouillon, B., Cerny, V., Coats, T.J., Duranteau, J., Fernndez-Mondjar, E., Hunt, B.J., Komadina, R., Nardi, G., Neugebauer, E. and Ozier, Y., 2010. Management of bleeding following major trauma: an updated European guideline.Critical care,14(2), p.R52. Sadleir, P.H.M., Clarke, R.C. and Platt, P.R., 2016. Cefalotin as antimicrobial prophylaxis in patients with known intraoperative anaphylaxis to cefazolin. British journal of anaesthesia, 117(4), pp.464-469. Vardakas, K.Z., Polyzos, K.A., Patouni, K., Rafailidis, P.I., Samonis, G. and Falagas, M.E., 2012. Treatment failure and recurrence of Clostridium difficile infection following treatment with vancomycin or metronidazole: a systematic review of the evidence. International journal of antimicrobial agents, 40(1), pp.1-8. Von Keudell, A.G., Weaver, M.J., Appleton, P.T., Bae, D.S., Dyer, G.S., Heng, M., Jupiter, J.B. and Vrahas, M.S., 2015. Diagnosis and treatment of acute extremity compartment syndrome. The Lancet, 386(10000), pp.1299-1310. Wirz, S., Ellerkmann, R.K., Soehle, M. and Wirtz, C.D., 2018. Oxycodone is safe and effective for general anesthesia. Journal of Opioid Management, 14(2), pp.125-130. Yang, M., Liu, H., Qiu, Y., Wang, X. and Zhang, W., 2015. Separation and characterization of a new isomeric impurity in cefalotin sodium by HPLC and MEKC. Journal of Liquid Chromatography Related Technologies, 38(7), pp.816-822. Zhang, Y., 2012.Clinical epidemiology of orthopedic trauma. Thieme.