Psychology Essays Amnesic Syndrome Amnesia

Psychology Essays Amnesic Syndrome Amnesia Amnesic Syndrome Amnesia Hypothetical amnesic syndrome single case intervention: Clive Wearing Amensia Amnesic Syndrome Amnesia is a general, classically used term essentially to describe the partial or total loss of memory. Due to the complexity of human memory functioning, several different types of amnesia exist, in particular, Amnesic Syndrome (A.S.) which, in its most coherent, is a cluster of amnesic symptoms. Amnesic syndrome is characterised by the permanent memory impairment which can occur in anterograde form the syndrome’s defining feature and retrograde form. Unlike general amnesic condition, the diagnostic origin of A.S. excludes degenerative disorders, for example Parkison’s; transient amnesias; and psychogenic disorders. The aetiology of A.S. include those brought on by (direct or indirect) injury to the brain and damage to any number of neuroanatomical locations responsible for memory functioning, namely subcortical areas the diencephalon, a major region of the brain that includes the third ventricle, thalamus, hypothalamus, and pituitary gland; and also cortical areas covering the medial surfaces of the temporal lobe, especially the hippocampus. Understanding the effects of this damage is possible in no small part to using the modular memory system approach and observing the pattern of preservation and loss in other words, what the patient is and is not capable of. It is understood that long term memory (LTM) is structured as to distinguish declarative memory of what we know to be as ‘fact’ from less explicitly accessible memory functioning such as those implicitly stored and that which is not pertaining to factual information, referred to as non-declarative memory. Aggleton Brown (1999) reported that both the subcortical and cortical locations, as mentioned above, are components of the same memory system concerned with the explicit, declarative memory. This declarative memory is made up of the subcategories episodic personal events one experiences; and semantic relating to vocabulary, language ability and object recognition. It is therefore clear that the damage suffered to part or all of these areas of the brain would largely affect the declarative memory of a patient, whilst leaving the implicit, non-declarative memory relatively unimpaired. This is true in cases of both anterograde and retrograde amnesic syndrome. There are also several non memory related characteristics of amnesia which appear in A.S., degrees of which depend on the origin of the syndrome, for instance the location of injury and which parts of the brain are affected. Characteristics include orientation, intellectual deficit and confabulation. Confabulation, sometimes referred to as ‘islands of confabulation’, describes the attempts made to rationalise memories (or voids in memory) in order to make sense to the self and others, which may involve the production of false information. Single Case: Clive Wearing Clive Wearing is considered by many to be the most sever case of amnesia. Once a renowned and eminent musician and musicologist, Clive was struck by an inflammatory brain infection herpes encephalitis, in March of 1985. An initial CT and subsequent MRI scan reported major and significant damage to the left temporal lobe, also extending into the inferior and posterior frontal lobe as well as damage to the medial side of the right temporal lobe. This was accompanied by indications of involvement of the left lateral ventricle and third ventricle part of the diencephalon, along with the almost complete destruction of the hippocampus. It is believed that these areas of damage are the cause of several behaviours Clive Wearing exhibited and continues to do so today. It is well reported that Clive (CW) has severe episodic memory dysfunction, resulting in retrograde amnesia for virtually the whole of his adult life and much of his childhood along with anterograde amnesia demonstrated by his incapacity for explicit learning. CW has become synonymous for his moment to moment consciousness whereby the period of seconds is lost in a perceptual time void and where perceived information is lost as soon as his eyes close quite literally in a blink only to be confronted with the experience of a completely new ‘awakening’ repeated many times. CW’s semantic memory, though generally preserved in A.S., showed evidence of impairment as he is unable to produce object names, define words and comprehend written material, instead lending himself towards confabulation. CW’s pattern of deficits in declarative memory can be explained by the neurological damage that he suffered. The major damage to the hippocampus (relatively destroying it) is the most likely cause of the severity of his amnesia, whereas the retrograde amnesia is attributed to the diencephalic damage, and semantic memory impairment adheres to the more widespread temporal lobe damage. Functioning and Indications for Intervention Contrary to CW’s deficit in declarative memory, his non declarative memory is left relatively unimpaired. There are many reports of CW’s implicit memory functioning, most notably his procedural memory for reading, playing, conducting and singing music which are practically preserved. Clive has, on more than one occasion, denied seeing a piece of music or even playing the piano, only to (when directed), sit down and play the piece and add â€Å"I remember this one†. Additional evidence for CW’s implicit memory comes from the first few years of his condition where he began to abbreviate his questions, he would only need to ask his wife ‘How long?’ to be understood as to what was meant, ‘How long have I been ill?’ suggesting an awareness, on some level, that the question has been asked before, as well as the knowledge of the fact that she knows what it means. Evidence for implicit learning comes from the report after eighteen months of his new home, where he has been taken for daily walks to feed the ducks, now asks ‘do the ducks want their tea?’ when prompted to put on his coat, ceasing to ask how long he has been ill a seven-year obsessive habit. Though his apparent disorientation, he has also gained other (purely) implicit memories like the layout of his residence where he is able to go to the bathroom, kitchen and dining room unsupervised. However, if he stops, gets distracted, or thinks en route he becomes lost. And though not able to describe his residence, his wife Deborah has reported how he will undo his seat belt and offer to get out and open the gate as they draw near. He is unable to explicitly identify the locations but is capable of action. The role of music in CW’s implicit learning is certainly an interesting one, as not only is his procedural memory relatively unimpaired but he is also capable, providing someone puts the music before him to get him into action, of learning and practicing new pieces. It is also reported that he also hummed something which he had not played for half an hour. This discovery is of great relevance to the following section on intervention as it suggests that this is could be down to rehearsal of it subvocally, perhaps reflecting use of the phonological loop process in memory encoding. Broca’s area is a relatively contained section in the inferior frontal gyrus of the frontal lobe and is namely responsible for the production of speech and sounds. There is little evidence to suggest of a deficit in CW’s ability to produce speech and sound and therefore any relative damage to this area, which in turn enables the seeming subvocal rehearsal that has been reported. Seeing as CW appears to have some phonological functioning and fairly preserved implicit memory, this seems a rational starting point for rehabilitative intervention. Proposed Intervention Whereas in previous clinical approaches where rehabilitation was usually based on a broad range of therapies (CBT, psychotherapy, etc), neuropsychological therapy tackles small areas either to test theories or to increase the understanding of a particular subject area. In the case CW, it is the impairment experienced involving disorientation that will be the focal point of this intervention. The intervention will operate at the level of impairment the specific problem being disorientation. In terms of the intervention mechanism restoring or reinstating the original function this seems very unlikely to be possible. The alternative therefore, is to instate an intervention mechanism that will utilise and develop existing capacities with the use of external aids and strategies to overcome the problem. Implicit learning of routes through basic repetition would not be recommended in this case. Instead, it would be preferable to use the available existing/surviving capacities (i.e. subvocal rehearsal and procedural memory) as this approach, if sufficiently effective, could be transferred for other possible applications in different situations. CW’s procedural memory of music lends itself extremely neatly to the notion of journeys and routes due to its formulative and progressive nature. CW’s wife Deborah speaks of the â€Å"momentum of music† where it is said that music, much like any route has steps, phrases, beginnings and ends (Wearing and Wilson, 1995). In an article, author and neurologist Oliver Sacks (2007) provides a compelling narrative of this momentum indicating the link of memory and melody: There is not a process of recalling, assembling, recategorizing, as when one attempts to reconstruct or remember an event or a scene from the past. We recall one tone at a time, and each tone entirely fills our consciousness yet simultaneously relates to the whole. It is similar when we walk or run or swim—we do so one step, one stroke at a time, yet each step or stroke is an integral part of the whole. Indeed, if we think of each note or step too consciously, we may lose the thread, the motor melody. (Sacks, 2007) In normal automatisation of procedural information which can range from making a cup of tea to driving a vehicle, the memory trace of each encounter is encoded and strengthened with each practise so that in future cases relevant information is retrieved quickly. In the case of CW this report suggests that a method of auditory mnemonic reduction encoding be used, set up with vanishing retrieval cues, gradually removed so as to encourage the strengthening of the mnemonic information in an errorless learning environment. Encoding with visual and auditory mnemonics has been shown to be very effective in the development of creating links and encoding memorable retrieval cues (e.g. Burrows Solomon, 1975; Sharps Price, 1991; Haan et al., 2000) and provides a supported approach to the proposal intervention. The use of vanishing cues enables a ‘length’ of information to be divided into a number of relevant cues that are subsequently and gradually removed, thus resulting in a scope of learnt information which may require very few or even no recall cues. Errorless learning has been effective in a number memory-impairment cases (e.g. Tailby Haslam, 2003; Page et al., 2006), where errorless learning employs a 100% correct response technique in strengthening memory traces. Single Case Design Proposal Neuropsychological intervention of any sort would usually naturally happen once the patient starts to demonstrate gaining a sense of normal functioning, that is after the initial period of spontaneous recovering has occurred, as initiating intervention during this time of innate recovery is not suggestible results may show absent or false improvement. In the case of CW however, this is not an area of concern. The intervention will operate with auditory mnemonics and vanishing cues. It will be a tri-level multiple baseline design as to assess its effectiveness across and between situations. Three routes / journeys will be decided upon in relation to CW’s most important or habitual preferences. For the purpose of this proposal the three routes will be that from his room: (a) to the dining room (b) to the hall the location of his piano and (c) outside via fire escape route. The initial phase of the intervention will be reporting the baseline measurement for each route. This will be the amount of time it takes CW to get from his room to the each of the destinations, observations will also be made as of any experiences of disorientation and if so note down where along the route and how often they occur, using several measures maximise the stability of the assessment as they will be compared with the results of the intervention phase. The measurement phase will continue for 1 month before the first-level intervention is employed. The second phase will start with the implementation of the first-level intervention for the first situation (a). The route that CW takes will be marked off using posters showing a coloured symbol (e.g. a green triangle) at significant points. CW will also have accompanied with him a device that allows him to play a single relatively short melody, one that he is familiar with. This will then be set to repeat, although it is assumed that one piece played from start to finish should last for more than sufficient time than it takes him to reach his destination in this case the dinning room. During this time CW is encouraged to hum or sing the melody out loud. This first-level intervention for the first situation will continue for 2 months and measurements will be taken following the same concept as those in the baseline phase. Following this will be the second-level intervention where the visual cues (green triangles) are gradually removed in suitable order so that there are no significantly unequal ‘gaps’ in cues along the route. CW will at this time still be encouraged to play and hum to the chosen melody along the route. This phase will be carried out over a total of 2 months, again, whilst measurements are taken. The third-level intervention will entail CW not having access to the melody playing device, however he will still be encouraged to hum or sing what could be referred to at this point as the ‘dinning room melody’. Measurements will be carried out as previously done. This stage will continue for 1 month and then conclude the second phase of the intervention. After which the additional two routes will be initiated in sequence following the example of the first situation. A summarised list of the programme will look as follows. Phase 1 Multiple baseline recording Measurements are taken across all situations (length: 1 month) Phase 2 Intervention of first situation (a) to dinning room Level 1 melody played with cues (length: 2 months) Level 2 cues gradually removed (length: 2 months) Level 3 melody device removed (length: 1 month) Phase 3 Intervention of second situation (b) to hall Level 1 melody played with cues (length: 2 months) Level 2 cues gradually removed (length: 2 months) Level 3 melody device removed (length: 1 month) Phase 4 Intervention of third situation (c) fire escape route Level 1 melody played with cues (length: 2 months) Level 2 cues gradually removed (length: 2 months) Level 3 melody device removed (length: 1 month) Phase 5 Assessment of results The appendix includes graphs that represent three possible outcomes of the intervention. The first in Appendix 1 demonstrates a successful intervention, evaluation of which will be discussed below. The second in Appendix 2 illustrates a clearly unsuccessful intervention whereas the third in Appendix 3 illustrates the possible results of a temporary positive effect of intervention followed by a decline in improved performance. Signs that the intervention is successful will be a significant improvement in performance compare with baseline measurements. That is not necessarily to say that route-taking will be quicker, but that incidence of disorientation would have been significantly reduced. The proposed evaluation of the intervention will consist of checking whether it has been successful in its aim and the reasons behind this outcome. If an improvement has been demonstrated it must be examined as to the source of change. Sources of change vary in terms of the circumstances of the case, for instance spontaneous recovery and innate brain recovery at this stage of the condition is highly unlikely and would have been captured in baseline measurements. General treatment effects i.e. what happens in CW’s home such as care and interactions are also another source of change which, in other cases may be an affect. The length of the intervention may allow changes in circumstance to affect performance. Major changes of this sort are unlikely however it would still be advisable to report any relevant changes. If an improvement has not been affirmed the intervention will be seen as not effective. This doesn’t necessarily that the theoretical basis was at fault, the judgement of available case information may not have been sufficient. Problematic methodology could also be a cause. If the phases (and containing levels of aid) of the intervention were not carried out for long enough, or correctly the effectiveness of the proposed intervention would be compromised. Providing the intervention was successful and improvement was made, it would be critical to examine the genuine extent to which the person’s life had changed for the better. This could take the form of improved functioning, increased independence and improved sense of well-being. It would also be relevant to examine the capacity to generalise the principle for application in other situations. The nature of the proposed multiple baseline design allows, on demonstration of positive results, that the intervention could be applied to similar situations and even for use in other cases of similar patients with A.S. References Aggleton, J. P., and Brown, M. W. (1999) Episodic memory, amnesia, and the hippocampal-anterior thalamic axis. Behavioral and Brain Sciences. 22 (4). pp. 425-440 Burrows, D. and Solomon, B. A. (1975). Parallel scanning of auditory and visual information. Memory and Cognition. 3 (4). pp. 416-420. Haan, E. H. F., Appels, B., Aleman, A. and Postma, A. (2000). Inter-and intra-modal encoding of auditory and visual presentation of material: Effects on memory performance. The Psychological Record. 50 (3). pp. 577-86. Page, M., Wilson, B. A, Shiel, A., Carter, G. and Norris, D. (2006) What is the locus of the errorless-learning advantage? Neuropsychologia. 44 (1). pp. 90-100 Sacks, O. (2007) The Abyss; A Neurologists Notebook. The New Yorker. New York. 83 (28). pp.100. Sharps, M. J. and Price, J. L. (1991). Auditory imagery and free recall. The Journal of General Psychology. 119 (1). pp. 81-87. Tailby. R. and Haslam C. (2003) An investigation of errorless learning in memory-impaired patients: improving the technique and clarifying theory. Neuropsychologia. 41 (9). pp. 1230-40. Wilson, B.A. and Wearing, D. (1995) Prisoner of Consciousness: A state of just awakening following Herpes Simplex Encephalitis, In Campbell, R. Conway, M. Broken Memories: Neuropsychological Case Studies. Oxford: Blackwell. pp. 15-30

Dylan Thomas Essay -- Dylan Thomas Poetry Poets Biography Essays

Dylan Thomas Dylan Thomas was born on October 27, 1914 in Swansea, Wales. His father was a teacher and his mother was a housewife. Thomas was a sickly child who had a slightly introverted personality and shied away from school. He didn’t do well in math or science, but excelled in Reading and English. He left school at age 17 to become a journalist. In November of 1934, at age 20, he moved to London to continue to pursue a career in writing. His first collection of poems called 18 Poems was released in 1934. Many people loved his work, and he gained instant recognition. His second collection released in 1936, 25 Poems, was also popular. The year he released his second collaboration of poems was also the year that he met his future wife, Caitlin MacNamera. They decided to get married in July of 1937, and moved to Laugharne, Wales in 1938. One year later, they had their first child, Llewelyn. He was followed by Aeronwyn in 1943 and Colm in 1949. Thomas’ poetry reflected much about his life style and outlandish way of thinking. He was particularly interested in writing about death, and most of his poems have hidden messages relating to death and his fascination with it. Thomas went back and forth with religion, the meaning of life, and what happens in the after life. His fickle beliefs went from joyous faith in God to extreme religious doubt. Thomas’ vacillating religious beliefs had a lot to do with his reckless lifestyle and love for the drink. He would often go out to the bars and be gone for hours at a time, leaving his worried wife and children oblivious to what he was doing. His wife soon found out about his problem, and became concerned. His drinking began to get out of control when he would get ... ...ink Dylan Thomas set out to convey a message about not giving up on anything but especially not on and he certainly gets this point over meaning his poem is very successful. Christina Rossetti tries to get a very different message across and she's trying to help people accept the death of people they loved. Her poem is also effective as it calms and tries to soothe the reader into accepting dying is a part of life and yes we may be sad but we have to learn to live with it, to accept it and to cope with it as life goes on Dylan Thomas' poem made more of an impact on me because it is so much more powerful and I can feel the atmosphere he creates. Also I agree with how he feels and what his poem says which always helps when trying to create an impact. I like the narrator's perspective in Thomas' poem, which is effective in enabling me to empathize with him. Dylan Thomas Essay -- Dylan Thomas Poetry Poets Biography Essays Dylan Thomas Dylan Thomas was born on October 27, 1914 in Swansea, Wales. His father was a teacher and his mother was a housewife. Thomas was a sickly child who had a slightly introverted personality and shied away from school. He didn’t do well in math or science, but excelled in Reading and English. He left school at age 17 to become a journalist. In November of 1934, at age 20, he moved to London to continue to pursue a career in writing. His first collection of poems called 18 Poems was released in 1934. Many people loved his work, and he gained instant recognition. His second collection released in 1936, 25 Poems, was also popular. The year he released his second collaboration of poems was also the year that he met his future wife, Caitlin MacNamera. They decided to get married in July of 1937, and moved to Laugharne, Wales in 1938. One year later, they had their first child, Llewelyn. He was followed by Aeronwyn in 1943 and Colm in 1949. Thomas’ poetry reflected much about his life style and outlandish way of thinking. He was particularly interested in writing about death, and most of his poems have hidden messages relating to death and his fascination with it. Thomas went back and forth with religion, the meaning of life, and what happens in the after life. His fickle beliefs went from joyous faith in God to extreme religious doubt. Thomas’ vacillating religious beliefs had a lot to do with his reckless lifestyle and love for the drink. He would often go out to the bars and be gone for hours at a time, leaving his worried wife and children oblivious to what he was doing. His wife soon found out about his problem, and became concerned. His drinking began to get out of control when he would get ... ...ink Dylan Thomas set out to convey a message about not giving up on anything but especially not on and he certainly gets this point over meaning his poem is very successful. Christina Rossetti tries to get a very different message across and she's trying to help people accept the death of people they loved. Her poem is also effective as it calms and tries to soothe the reader into accepting dying is a part of life and yes we may be sad but we have to learn to live with it, to accept it and to cope with it as life goes on Dylan Thomas' poem made more of an impact on me because it is so much more powerful and I can feel the atmosphere he creates. Also I agree with how he feels and what his poem says which always helps when trying to create an impact. I like the narrator's perspective in Thomas' poem, which is effective in enabling me to empathize with him.

Impact of Affordable Care Act on North Carolina Uninsured Population

The Affordable Care Act (ACA) is in vigor since January 1, 2014, and hospitals and health care providers are not sure about how many people will knock at their door for health care. So far, according to Camp (2014) â€Å"More than two million people across the country have signed up for healthcare under the ACA and hospitals are bracing for a wave of newly insured patients†. How does that affect the uninsured people in North Carolina is an unanswered question. Seventeen percent of North Carolina’s residents are uninsured, according to Kaiser Foundation (2012).Health Care reform brings controversial and uneasy ethic issues to the population as well as to legislators. North Carolina can opt to expand Medicaid coverage to all individuals that have a household income less than 138% of the federal poverty level, but the question in the air is how NC will make it happen?. Financial Impact of ACA on North Carolina North Carolina has one of the highest index of the uninsured po pulation when compared to States at the same size, 17% accruing to 1,604,300 residents.Michigan has 12 percent; New Jersey has 15 percent; Virginia has 13 percent, according to Kaiser Foundation (2012). Milstead (2013) assures â€Å"Based on the Affordable Care Act, beginning in 2014 adults can qualify for Medicaid if their income is no greater than 138 percent of the Federal Poverty Level ($30,429 for a family of four in 2010)†. Besides of what the ACA says each State has its own policies for Medicaid eligibility, being it a joint initiative between State and Federal funds.According to American College of Physicians (2013) â€Å" Unfortunately, the state has chosen not to expand its program at this time. The Urban Institute estimates that about 632,000 uninsured North Carolinians with incomes under 100% FPL would be denied coverage if North Carolina chooses not to expand its Medicaid program†. Governor McCrory is committed to envigorate the Health Care program in his budget delivance for 2013-2015 in North Carolina (NC,) and assures that $575M will be added to Medicaid budget, $7.2M will be given for Drug Treatment Courts, and $30M to open a new psychiatric hospital, all to be delivered in two fiscal years period (Newsroom, 2013).Overall NC’s State economy seems to be picking up with an underemployment rate dropping from 17 percent in October 2011-2012, to 14. 9 percent from October 2012-2013 (Robesonian News, 2013). In addition, Murawsk (2013) assures â€Å"the economy is indisputably building up steam and moving in a direction we haven’t seen in years†. With NC State biannual budget investing $612.2 M in three important areas of health care and the general economy steaming up it seems that more of NC uninsured community will be able to have an employer sponsored health care insurance, or be able to afford health insurance in the marketplace. It looks like a promising situation, that will surely help to banish the ghost of unfunded mandates, but if 100 percent of NC uninsured population will get what ACA proposes is something to be checked in the future.Ethics and Quality of Health CareA citation of Frederick Douglass’ delivery for the Civil Rights in October 1883 comes in hand he said â€Å"Only base men and oppressors can rejoice in a triumph of injustice over the weak and defenceless, for weakness ought itself to protect from assaults of pride, prejudice and power†. As health care reform proceeds to its implementation around the country many issues come to our mind such, are there enough resources to attend everyone or we will have an incoming chaos? Will American society finally have an equally health care system distribution?How are 32 million new health care system’s users fit into an already deficient system? Will there be enough nurses and doctors to deliver the quality of care that everyone is entitled? Is it a fair system for the society, is everyone getting what is dese rved? Many people would like to speak up what they think about health care: What do Americans want from their health care system? Four fundamental goals have shaped our system. First, we want high quality health care that can provide the greatest benefits.Second, we want freedom of choice so that we can decide the â€Å"who, when, and where† for our health care. Third, we expect our health care to be affordable so that we have resources for all of the other things we need or want. Fourth, we want our fellow citizens to share in the costs and also benefits of health care† (Sorrell, 2012). At one hand Franklin Roosevelt (1944) in the â€Å"Second Bill of Rights† mentions â€Å"the right to adequate medical care and the opportunity to achieve and enjoy good health†.At the second hand who is paing for the good health care that everyone wants? Health care providers would they be nurses or doctors have their part to do in the delivery of quality health care, but a health care system that makes justice to everyone depends on the whole society. I believe adopting a modern system of nationwide assessment and intervention such â€Å"Population Health Model† (Kovner & Knickman, 2011,) would have a high impact on the financial and workforce redistribution, a great tool that can bring results using the integration model.Summary ACA’s implementation has started and hospitals and health care providers are ready to receive new customers. North Carolina’s steaming up general economy and government’s budget can greatly help the population to get the health care they need. The right to health care comes to play when talking about health care reform, and we wonder if the new system will deliver the quality of care it proposes. Adopting Population Health Model for health assessment and intervention can be a solution for the health care issues in the U. S.. Impact of Affordable Care Act on North Carolina Uninsured Population The Affordable Care Act (ACA) is in vigor since January 1, 2014, and hospitals and health care providers are not sure about how many people will knock at their door for health care. So far, according to Camp (2014) â€Å"More than two million people across the country have signed up for healthcare under the ACA and hospitals are bracing for a wave of newly insured patients†. How does that affect the uninsured people in North Carolina is an unanswered question. Seventeen percent of North Carolina’s residents are uninsured, according to Kaiser Foundation (2012).Health Care reform brings controversial and uneasy ethic issues to the population as well as to legislators. North Carolina can opt to expand Medicaid coverage to all individuals that have a household income less than 138% of the federal poverty level, but the question in the air is how NC will make it happen?. Financial Impact of ACA on North Carolina North Carolina has one of the highest index of the uninsured po pulation when compared to States at the same size, 17% accruing to 1,604,300 residents.Michigan has 12 percent; New Jersey has 15 percent; Virginia has 13 percent, according to Kaiser Foundation (2012). Milstead (2013) assures â€Å"Based on the Affordable Care Act, beginning in 2014 adults can qualify for Medicaid if their income is no greater than 138 percent of the Federal Poverty Level ($30,429 for a family of four in 2010)†. Besides of what the ACA says each State has its own policies for Medicaid eligibility, being it a joint initiative between State and Federal funds.According to American College of Physicians (2013) â€Å" Unfortunately, the state has chosen not to expand its program at this time. The Urban Institute estimates that about 632,000 uninsured North Carolinians with incomes under 100% FPL would be denied coverage if North Carolina chooses not to expand its Medicaid program†.Governor McCrory is committed to envigorate the Health Care program in his b udget delivance for 2013-2015 in North Carolina (NC,) and assures that $575M will be added to Medicaid budget, $7.2M will be given for Drug Treatment Courts, and $30M to open a new psychiatric hospital, all to be delivered in two fiscal years period (Newsroom, 2013). Overall NC’s State economy seems to be picking up with an underemployment rate dropping from 17 percent in October 2011-2012, to 14. 9 percent from October 2012-2013 (Robesonian News, 2013). In addition, Murawsk (2013) assures â€Å"the economy is indisputably building up steam and moving in a direction we haven’t seen in years†.With NC State biannual budget investing $612.2 M in three important areas of health care and the general economy steaming up it seems that more of NC uninsured community will be able to have an employer sponsored health care insurance, or be able to afford health insurance in the marketplace. It looks like a promising situation, that will surely help to banish the ghost of u nfunded mandates, but if 100 percent of NC uninsured population will get what ACA proposes is something to be checked in the future. Ethics and Quality of Health CareA citation of Frederick Douglass’ delivery for the Civil Rights in October 1883 comes in hand he said â€Å"Only base men and oppressors can rejoice in a triumph of injustice over the weak and defenceless, for weakness ought itself to protect from assaults of pride, prejudice and power†. As health care reform proceeds to its implementation around the country many issues come to our mind such, are there enough resources to attend everyone or we will have an incoming chaos? Will American society finally have an equally health care system distribution?How are 32 million new health care system’s users fit into an already deficient system? Will there be enough nurses and doctors to deliver the quality of care that everyone is entitled? Is it a fair system for the society, is everyone getting what is dese rved? Many people would like to speak up what they think about health care: What do Americans want from their health care system? Four fundamental goals have shaped our system. First, we want high quality health care that can provide the greatest benefits.Second, we want freedom of choice so that we can decide the â€Å"who, when, and where† for our health care. Third, we expect our health care to be affordable so that we have resources for all of the other things we need or want. Fourth, we want our fellow citizens to share in the costs and also benefits of health care† (Sorrell, 2012). At one hand Franklin Roosevelt (1944) in the â€Å"Second Bill of Rights† mentions â€Å"the right to adequate medical care and the opportunity to achieve and enjoy good health†.At the second hand who is paing for the good health care that everyone wants? Health care providers would they be nurses or doctors have their part to do in the delivery of quality health care, but a health care system that makes justice to everyone depends on the whole society. I believe adopting a modern system of nationwide assessment and intervention such â€Å"Population Health Model† (Kovner & Knickman, 2011,) would have a high impact on the financial and workforce redistribution, a great tool that can bring results using the integration model.Summary ACA’s implementation has started and hospitals and health care providers are ready to receive new customers. North Carolina’s steaming up general economy and government’s budget can greatly help the population to get the health care they need. The right to health care comes to play when talking about health care reform, and we wonder if the new system will deliver the quality of care it proposes. Adopting Population Health Model for health assessment and intervention can be a solution for the health care issues in the U. S.

Intercultural Sensitivity.

Intercultural Sensitivity. The developmental stage of intercultural sensitivity that best fits me at this point in my life is the one listed as number five, Adaptation. I feel this way because I can evaluate other's behavior from their frame of reference in most instances, and can adapt my behavior to fit the norms of their culture, if needed. I am a very flexible person when it comes to cultural values. I know what I value, but I also know that the things I value are not always the same as other cultures. I can easily and quickly adapt to others needs in most situations. I think that being able to do this will help me tremendously in dealing with parents from different cultures. I think it will show them that I have a respect for them and their way of life, and will encourage them to be more respectful when dealing with me.Authors considering attachment in non-western cult...I think that respect is a big issue with almost all cultures and I want to make sure that I am always treating others with respect. I al so would not want parents to feel uncomfortable talking to me about any issue that they may be having.The main reason I see myself in the adaptation stage is that I have grown up working with and playing with and dealing on a daily basis with people from different cultures. I wouldn't say that I could integrate with any other culture completely, but I am able to adapt to their ways of doing things at least for small periods of time when needed. I was never really in the denial stage because I have always know that there are cultural differences in people, and I am able to recognize them fairly quickly. Also I have never really looked at the difference...

Detecting Signs of E.T.

Detecting Signs of E.T. From time to time, the news media falls in love with stories about how aliens have been found. From the detection of a possible signal from a distant civilization to tales of an alien megastructure around a star observed by the Kepler Space Telescope to the story of the WOW! signal detected in 1977 by an astronomer at Ohio State University, any time theres a hint of a puzzling discovery in astronomy, we see breathless headlines that aliens have been found.   In point of fact, there hasnt been an alien civilization found...yet. But, astronomers keep looking! Finding Something Weird In late summer 2016, astronomers picked up what seemed like a signal from a distant sun-like star called HD 164595. Preliminary searches using the Allen Telescope Array in California showed that the signal picked up by a Russian telescope was not likely from an alien civilization. However, more telescopes will check out the signal to understand what it is and what could be making it. For   now, however, its problem not little green aliens sending us a howdy.   Another star, called KIC 8462852, was observed by Kepler for more than four years. It appears to have a variability in its brightness. That is, the light we perceive coming from this F-type star dims periodically. Its not a regular period of time, so its probably not caused by an orbiting planet. Such planet-caused dimmings are called transits. Kepler has cataloged many stars using the transit method and found thousands of planets this way. But, the dimming of KIC 8462852 was just too irregular. While astronomers and observers worked on cataloging its dimmings, they also talked to an astronomer who had been thinking hard about what we might see if a distant star had planets with life on them. And, in particular, if that life was technologically able to build superstructures around their star to harvest its light (for example).    What Could it Be? If a big structure orbited a star, it could cause the variability in the stars brightness to be irregular or even random-seeming. Of course, there are some caveats with this idea. First, distance is a problem. Even a fairly large structure would be difficult to detect from Earth, even with very strong detectors. Second, the star itself could have some strange variable pattern, and astronomers would need to observe it for longer periods of time to figure out what it is. Third, stars with dust clouds around them can also have fairly large planetary structures forming. Those planetesimals could also cause irregular brightness dips in the starlight we detect from Earth, especially if they were orbiting at staggered distances. Finally, catastrophic collisions between clumps of material around a star could deliver huge groups of objects such as cometary nuclei in orbit around the star. Those could also affected the perceived brightness of the star.   The Simple Truth In science, theres a rule that we follow called Occams Razor - it means, essentially, for any given event or object you observe, generally the most plausible explanation is the simplest one.   In this case, stars with clumps of dust, planetesimals, or roving exo-comets are more likely than aliens. Thats because stars FORM in cloud of gas and dust, and younger stars still have material around them left over from the formation of their planets. KIC 8462852 could be in in a planet-forming stage, consistent with its age and mass (its about 1.4 times the mass of the Sun and a bit younger than our star). So, the simplest explanation here is NOT an alien megacomplex, but swarms of comets.   The Search Protocol The search for extrasolar planets has always been a prelude to a search for life elsewhere in the universe. Each star and planet system discovered to have worlds has to be examined carefully so that astronomers understand its inventory of planets, moons, rings, asteroids, and comets. Once thats done, the next step is to figure out if the worlds are friendly to life -- that is, are they habitable? They do this by trying to understand if the world has an atmosphere, where it is in its orbit around the star, and what its evolutionary state might be.   So far, none have been found hospitable. But, theyll be found. Odds are, there is intelligent life elsewere in the universe. Eventually, we will detect it - or it will find us. In the meantime, astronomers on Earth continue to search for habitable planets around likely stars. The more they study, they more theyll be ready to recognize lifes effects elsewhere.

Hypervisor Term Paper Example | Topics and Well Written Essays - 2000 words

Hypervisor - Term Paper Example The server virtualization also allows the organizations to run different software applications on diverse operating system to fully utilize system resources of a single physical machine. The operating system can run in isolation and / or side by side on the same physical machine. Each virtual machine (operating system) has its own allocated virtual hardware (e.g. Random Access Memory, Central Processing Unit, NIC, etc.) to load one operating system along with software applications. It is vital to state that the operating system uses the allocated virtual hardware resources, consistently and usually regardless of the actual physical hardware components (Bento, 2012). Advantages of Hypervisor Several advantages can be availed by an organization utilizing the technology of server virtualization. The server virtualization facilitates the organizations to combine the workloads of the underutilized server machines onto a smaller number of fully utilized machines. Keeping in view the fact o f utilizing comparatively less number of servers for the multiple operating systems and software applications to manage the workload, it can be stated that the server virtualization can be cost effective for the organizations. ... The utilization of hypervisor in the hardware infrastructure of an enterprise provides features of securely splitting each virtual machine / operating system and supports the legacy software systems as well as new software applications on the same server (Shavit, 2008). Disadvantages of Hypervisor for an Organization For every advantage there exist one or several disadvantages, therefore, the hypervisor has disadvantages as well. Comparatively, one of the main disadvantages of utilizing the native hypervisor is that the hypervisor reduces the performance of the operating system as well as the installed applications run slowly. While using the host hypervisor limits the enterprise to install the operating systems as per the limitations of the host operating system. The disadvantages of utilizing hypervisor in the enterprises include but are not limited to the requirements of servers with high specifications (i-e Randon Acess Memory, Central Processing Unit etc.), it requires additiona l hardware components and difficult to use console interface. The type two (2) or host hypervisors lead to the loss of centralized management, it has lower density and therefore, it becomes difficult to install many virtual machines of the first type. The organizations have to suffer with less security while utilizing the host hypervisors. It is pertinent to mention here that there are few operating systems cannot be installed simultaneously utilizing the hypervisors. The hypervisor technology only supports the Intel operating systems, whereas, the type 1 or native hypervisor does not support Solaris SPARC, AIX, HPUX, and the high-End UNIX systems. Introduction to

Food Security Essay Example | Topics and Well Written Essays - 1000 words

Food Security - Essay Example Global warming has worked to exacerbate tensions rising over food insecurity concerns. The influence of climate on food supplies is so phenomenal that both entities are popularized as being inextricably linked to each other. Food shortage is the reason why people in many parts of the world are driven toward the practice of committing suicide. This is because hunger is a great punishment and many people are bound to suffer from this punishment at hands of heaven-kissing food rates. People from socioeconomically disadvantaged backgrounds suffer the most from this shortage of food supplies and resulting high food rates. The suicide rate is also particularly common among such groups. As food prices spiral out of control and agricultural practices get the worst of climate change, the world is advised to prepare for an upcoming dearth of many basic food products. What is so different now from the past is that masses of people have moved from calm rural areas to chaotic urban areas in respo nse to industrialization and these areas suffer from a climatic risk that is more deadly and influential. It is the result of such mass migration of as many as 650 million people to arid or semi-arid areas that problems like the flood, droughts, and skyrocketing food prices affect them the most. This small statistic helps to gain an insight into the awry situation of the food problem in present contemporary times.  Human numbers increasing at an unprecedented rate also serve to exacerbate food insecurity issues.