Two variables Speech or Presentation Example | Topics and Well Written Essays - 500 words

Two variables - Speech or Presentation Example Thus, we expect that our inequality will have the symbol ≠¤ or ≠¥ If our boundary line would be a dashed line instead, then we would have used the symbols After obtaining the equation of the boundary line, we will choose a test pint that will be true when substituted in the equation. This test point must exist within the required region for the values to be true. We chose the origin (0, 0) In order to find the maximum number of TVs that will also be carried, we substitute 60 in the inequality to find the maximum number possible that will satisfy the inequality. hence,substituting 60 for x, In order to find the maximum number of refrigerators that will also be carried, we substitute 200 in the inequality to find the maximum number possible that will satisfy the inequality. Hence, substituting 200 for y, Since 130 is not divisible by 3, we have to get a number closest to 130 that is divisible by 3. The number is 126. In order to obtain 126 on the left hand side of the inequality, we must adjust the number of TVs. We thus introduce a linear

Unconditioned Response And Conditioned Response Physical Education Essay

Unconditioned Response And Conditioned Response Physical Education Essay According to Pavlov, specific terms begin to be used to describe conditioning such as unconditioned response and conditioned response. Based on Ivan Pavlovs experiment, the natural response to food for a dog is to salivate. This is called unconditioned response (UCR) to the unconditioned stimulus (UCS), which in this case is the food. Then, a neutral stimulus (NS; bell) accompanies the process. By repeating this process, there will be a conditioned response (CR) of salivating with the mere sound of the bell. This way the clicking stimulus now has become conditioned stimulus (CS), which is able to draw a conditioned response. According to Martin and Pear (2005), there are several features that increase the effectiveness of classical conditioning. One of it is that there has to be multiple pairings only between the CS and the UCS in order to increase the effectives of the CS to provoke response from the CR (highest potency). Moreover, the CS and UCS have to be stimuli that are presente d in its maximum power so that the conditioning will be stronger. Morsella (2010) explains that classical conditioning can be found around us from the time we were born. She describes that the liking we have for food that looks artificial and does not have any odour such as lollipops and certain types of candies are due to the effects of classical conditioning. Another application of classical conditioning is to treat toddlers and adults with Enuresis, and managing phobia using systemic desensitization in psychotherapy. Apart from that, classical conditioning is also applicable in the advertising sector. The application of the principles of classical conditioning in the three sectors will be further discussed in this paper. One of the most pioneer contributions of classical conditioning in the medical setting is to treat children and adults who are suffering from enuresis. According to Gross and Dornbush (1983) one form of enuresis that is common among children who are between 5 and 14 years of age is nocturnal enuresis, affecting mostly boys than girls. They explained that nocturnal enuresis is the act of constant bed-wetting at night during sleep despite being potty trained. This behaviour is considered an enuresis if it occurs at least a few times in a month without identifiable physiological cause. It has been discussed that nocturnal enuresis causes many communal and psychological dilemmas as the children will not want to spend the night away from home due to fear of embarrassment. Lemelin and Lemelin (1989) describes the results of using many forms of treatment in dealing with nocturnal enuresis and have identified that enuresis alarm is the best treatment available. According to Schmitts explanation (as cited in Lemelin Lemelin, 1989) explained how enuresis alarm works and its association with the principles of classical conditioning. An enuresis alarm is attached to the front portion of the childs underwear making it convenient to be carried along even during travelling. When a few urine droplets fall on the device, the two electrodes get connected triggering the alarm. The sound created awakens the child, which automatically prompts the child to control the bladder and stop the process of urinating. Then, the child can go to the toilet to complete the urination process. The effectiveness of this treatment will only be seen with multiple trials similar to the case of Ivan Pavlovs dogs. Initial stages (several weeks), the child would only be awake once he or she has completely urinated. Several weeks after that, the child would wake up half way through the process of urinating due to the alarm, thus enabling the child to contract the bladder muscles to stop urination, and continue in the toilet. As a result of repeating this process, in the long run the child will wake up by the mere feeling of wanting to urinate rather than the sound produced by the alarm after urination. The condition improves in one month and complete cure is achieved within three to four months. However the child will have to put on the underwear with the enuresis alarm until dry nights are achieved consecutively for three weeks. 1st Step Unconditioned Stimulus (UCS) Alarm (sound) Unconditioned Stimulus (UCR) Waking up 2nd Step UCS (multiple times) paired with Alarm (sound) Neutral Stimulus to Conditioned Stimulus (CS) Full bladder (need to urinate) Conditioned Response (CR) Waking up Many studies have found that the use of enuresis alarm has helped children suffering from any form of enuresis such as nocturnal enuresis and monosymtomatic nocturnal enuresis. Ozgur, Ozgur, Dogan and Orun (2009) has conducted a study on the effectiveness of enuresis alarm in helping 40 children ages 6 to 16 years old with monosymptomatic nocturnal enuresis to the extent of bed-wetting at least three times in a week. All the participants were told to use the alarm for 12 weeks. The parents and children were shown how the alarm reacts to urine. They only considered a persons treatment as being successful if they managed to keep their bed dry for 14 days continously. Meanwhile, a person is said to have relapsed if they wet their bed one night or more in a week. The results after the initial 12 weeks of using the alarm showed that 27 out of 40 patients kept their beds dry successfully. During the three-month follow-up of still using the alarm at bed-time, it was found that only 9 of the initial achievers stayed dry, while 18 of them relapsed. In the subsequent three- month follow-up, 7 of the 18 relapsed participants showed successful results. Finally after another three months, out of the 7 successful participants, 4 of them achieved dry nights. In total, 13 of them stayed dry and managed to get their enuresis treated. This system works in the same way as explained by Schmitts explanation (as cited in Lemelin Lemelin, 1989). The results of this study are considered to be good by Rocha, Costa and Silvares (2008). They explained that during a long-period of treatment using alarm, the familys level of motivation, socio-economic status and circumstances at home play a huge role in keeping things consistent given that the alarm has to be used daily without fail. Enuresis can be better managed without the reliance of medication as urinating is a normal bodily function that needs to be controlled everyday during sleep and as such the use of enuresis alarm is a better l ong term solution as it is carried out for long period of time. Eventually the child will learn to wake up from sleep the very moment the feeling of voiding appears, which is the normal response expected from the human physiological system. In addition to the study above, Berg, Forsythe and McGuire (1982) conducted a study on 54 children (35 boys and 9 girls) on how they responded with the pad and bell system for initially 4 weeks before extending their treatment for another five months. The pad and bell system works in the same way as the enuresis alarm where the alarm, which is the unconditioned stimulus provokes a response of waking up (unconditioned response). Over time, when full bladder (neutral stimulus) is paired with the bell sound produced by the pad and bell system, the full bladder becomes the conditioned stimulus for the conditioned response of waking up. They were also interested to study the effects of Maximum Functional Bladder Capacity (MBC) and the childs affective issues using the Rutter A (parent) Scale to determine the outcome of the treatment for enuresis. Before the pad and bell system was introduced to the children, they were wetting their beds at nights at an average of 20 times in 28 days. Howe ver, after the pad and bell approach, on average the children were found to only wet their beds approximately 11 times in four weeks. Their treatment approach in dealing with the childrens enuresis worked for 34 out of the 54 children, which could be considered as a 63% success rate. They also found that those children who had failed in responding to the treatment had higher scores on the Rutter A Scale indicating the level of the childrens emotional instability. Therefore it could be understood that the remaining 20 children who did not respond to the treatment may be affected emotionally, thus preventing them to respond like the other children who are suffering from nocturnal enuresis. Although it has been proven that enuresis alarm has been effective for many children, the fact that every child is undergoing difference circumstances must be taken into consideration, and therefore expecting a generalised response may not be accurate. Given the right approach and environment, every child will be able to respond positively towards the treatment for enuresis using the alarm system. The parenting style is also equally important, given the role of parents in waking up the child when the alarm starts in the beginning stages. In families that practise neglectful parenting, it is unlikely for the parents to take the initiative to wake up and alert the child. As such, these factors should also be considered to assess the effectiveness of the treatment of enuresis using the alarm system. The next area that widely uses the principles of classical conditioning is the advertising sector. Gorn (1982) conducted a study on 244 college students to understand the effects of external factors such as background music and setting to influence the marketability of a product. He explains that people tend to respond positively towards a product that is being advertised if the advertisement catches their attention and creates a pleasant feeling by way of eye-catching colours, lovely music and hilarity. Therefore, the features of the advertisement act as unconditioned stimulus, while, the product acts as a conditioned stimulus after observing them together multiple times to produce a good feeling (unconditioned and conditioned response). In his study he made sure that the information of the product is minimally exposed to the participants to ensure that the unconditioned features were the ones that captured the participants attention and not the information. In the experiment, there were four conditions created. The first condition involved the pairing of a piece of favoured music with a pen of light blue colour. The next condition was to match a piece of favoured music with a pen of beige colour. The third condition was to match a piece of unfavoured music with a pen of light blue colour and the forth condition was to match a piece of unfavoured music with a pen of beige colour. It was found that a majority of the participants (74%) chose the pen that was presented with their favoured music. He explained that the participants with the favoured piece of music selected the pen based on the good feeling it created. To further support the positive outcome of classical conditioning, Tsai (2012) conducted a study on 172 undergraduates to understand the effects of classical conditioning in using movie stars to promote a product. He also mentioned that using celebrities as part of an advertisement is a popular practice in the United States and Britain. Tsai used an actor named Ethan Ruan as the celebrity to leverage on his popularity to promote an orange juice brand called GARRA. No additional information was added to the advertisement. The celebrity acts as the unconditioned stimulus that naturally draws a positive response from people (unconditioned response). The celebrity is paired five times with the conditioned stimulus, which is the virtual brand to produce a positive response to the brand (conditioned response). When respondents opinion on GARRA was compared between those who were put through conditioning and without conditioning, the results showed that the conditioned group (Ethan Ruan) ha d higher or more positive attitude towards GARRA. The attraction that people have for the actor was able to be transferred to the product or brand that the actor was promoting. Hence, after repeated exposure to the same unconditioned stimulus, GARRA (conditioned stimulus) automatically drew a positive response from consumers. Tsai also found that the appearance of celebrities in advertisements leads to a higher value in promoting a particular brand regardless whether the celebrities have done other advertisements before. While, the research involving celebrity such as Ethan Ruan was successful in this Taiwan study, the same approach might not be workable in a multi racial country like Malaysia where a celebrity who is well known to the Indian community may be completely unknown to the other races in the country. Thus, celebrity endorsement may not have a generalised outcome across the Malaysian population. Another point to note is that celebrity endorsement without a good quality pr oduct will not result in repeated purchases. If people are not satisfied with the quality of a product, they will not buy it the second time even if Brad Pitt or Jonny Depp advertised it. The next big sector that uses the principles of classical conditioning is psychotherapy in the management of phobia. Wolpe (1958) developed a method of dealing with phobia using a behavioural approach. He explains that a person has to be conditioned to develop unnecessary fear on a particular stimulus such as cockroach, snake, heights or even social engagement. The classic experiment conducted by Watson and Rayner (1920) on a small boy known as Little Albert is a good example to explain the development of phobia. They found that loud noise produces fearful feelings. Thus, the loud noise acts as an unconditioned stimulus to provoke an unconditioned response of fear. They tested their finding by pairing a white rat (conditioned stimulus) with a loud noise that was created using a steel bar and a hammer behind Little Alberts head multiple times, which produced fear (conditioned response; making Albert cry and move away). After multiple times of doing the same thing to Albert, he eventua lly developed fear (phobia) at the mere sight of a white rat. Based on this principle, Wolpe derived the idea of counteracting the phobia with a contradicting stimulus such as relaxation, which is called counterconditioning. Counterconditioning can be explained using a classic study by Jones (1924) on a child named Peter. He was afraid of rabbits (conditioned stimulus). She placed a rabbit in the same room but at the distance from Peter during the time that Peter was eating some cookies (unconditioned stimulus) which made him feel good (unconditioned response). This process was conducted multiple times resulting in Peter overcoming his phobia for rabbits. At the end of the counterconditioning period, Peter was able to have a rabbit on his lap happily (conditioned response). Wolpe (1958) explained that the process of counterconditioning should be carried out in several stages and conducted at a slow pace and this process is known as systematic desensitization. He explained that a person is usually asked to make a list from the lowest to the highest fear causing stimuli. The process of desensitization starts from the lowest first before moving slowly to the higher level of fear. The stimulus that causes fear is put forward to the person together with relaxation to produce a good feeling either through imagination or in vivo. To provide research evidence on the effectiveness of systematic desensitization, McCroskey, Ralph and Barrick (1970) conducted a study on 24 university students taking the public speaking class who were found to have an elevated level of anxiety to give speeches. The participants were randomly assigned to 3 groups with five members each, an hour of systematic desensitization session, for twice in a week almost three and half weeks. In the first session, the underlying principles of systematic desensitization were explained and the participants were also taught deep muscular relaxation. In the next sessions, beginning from the lower level of anxiety present in the hierarchy, the participants watched a video recorded session of public speech presentations. At any point of time when the participants displayed anxiety, they were told to raise their right index finger as that will cue the trainer to instruct all the participants within that group to stop the imagination of giving speech a nd focus on the deep muscular relaxation before resuming the session. The deep muscular relaxation was the unconditioned stimulus, which was paired with the speech presentation (conditioned stimulus) to eventually produce a relaxed state (unconditioned to conditioned response). For successfully completely each stage of the speech anxiety hierarchy, the participants were required to complete the first presentation of 15 seconds and second presentation of 30 seconds free from any signs of anxiety before proceeding to the next one. At the end of each session, the trainers presented the previous completed level of the speech anxiety hierarchy so that the participants level of anxiety is kept at a minimum level. This is done until all the stages within the hierarchy are completed. The last session ends with the repetition of the highest speech anxiety stimuli for one minute. At the end of the complete session, the participants level of speech anxiety was measured using Personal Report of Confidence as a Speaker (PRCS; Paul, 1966). According to the results, the groups that received systematic desensitization had a decreased level of anxiety by 54% while the control group only had a decreased level of 18%. Therefore, it can be concluded that the anxiety level for speech giving or any other phobia can be significantly reduced using the systematic desensitization method. This study is reliable given that the sessions were conducted continuously every week to ensure the effectiveness of the counterconditioning. However, the fact that it was done in a group could disrupt the flow of desensitizing an individual as each participant would have different level of phobia in terms of speech anxiety throughout each session. To further support the effectiveness of systematic desensitization in treating phobia or high level of anxiety, Johnson and Sechrest (1968) conducted a study on 41 psychology students. They used the Alpert-Haber Achievement Anxiety Test to measure the level of test anxiety at pre and post systematic desensitization. Those who had high test anxiety and scored low ( This paper discussed the use of classical conditioning in three different sectors, which are treating enuresis, advertising products and managing phobia in psychotherapy sessions. In treating enuresis, the use of classical conditioning is an ideal method as it is non-invasive and the results have been found to have a high reliability and validity value. In the advertisement sector, classical conditioning has been proven to increase the marketability of the product. It is a common practice for businesses to use celebrities to advertise their products to increase the amount of sales. Meanwhile in the psychotherapy sector, systematic desensitization is one of the most prominent methods of dealing with phobia, as it helps to deal with difficult irrational fear which has affected people for a long period of time. In a nut shell, classical conditioning is effectively used in many other sectors apart from those discussed in this paper.

Pathology Arises Out Fo The Ex Essay -- essays research papers

Concepts of pathology, as treated by the traditions of clinical psychology and psychiatry, define what is ‘normal’ and ‘abnormal’ in human behaviour. Various psychological paradigms exist today, each emphasising diverse ways of defining and treating psyopathology. Most commonly utilised is the medical model which is limited in many respects, criticised for reducing patients problems to a list of pathological symptoms that have a primarily biological base and which are to be treated behaviourally or pharmacologically (Schwartz & Wiggins 1999). Such reductionistic positivist ways of viewing the individual maintain the medical discourse of ‘borderline personality’, schizoid’, ‘paranoid’ or ‘clinically depressed’, often failing to address the wider socio- ltural environment of the individual. Pilgrim (1992) suggests that such diagnostic pidgeon-holing does not enhance humanity, nor aid those who are dealing with the distressed individual to find meaning. It also neglects to consider life beyond the physical, failing to address the more philosophical questions that abound from our very existence. Existential psychiatry and psychology arose in Europe in the 1940’s and 1950’s as a direct response to the dissatisfaction with prevailing efforts to gain scientific understanding in psychiatry (Binswanger 1963). Existentialism is the title of a set of philosophical ideas that emphasise the existence of the human being, the lack of meaning and purpose in life and the solitude of human existence. Existentialism stresses the jeopardy of life, the voidness of human reality and admits that the human being thrown into the world, a world in which pain, frustration, sickness, contempt, malaise and death dominates (Barnes 1962). How one positions oneself in that world becomes the focus for existential notions of pathology, a responsibility that is present for every human being, not one confined to the ‘mentally ill’. In this sense the human being is ‘response-able’ to the existential predicament that is life and the necessary struggles that arise through negotiating these conditions in every lived moment. In this essay I will give a brief outline of the history of existential thinkers, then discuss how t... ...  Lowrie). Princeton: Princton University Press Laing, R. D. (1960). The Divided Self. Harmondsworth: Penguin Lewis, C. S. (1943). The Abolition of Man. Oxford: Oxford University Press May, R. (1969). Love and Will. New York: Norton. May, R. & Yalom, I. (1984). Existential Psychotherapy. In Corsini, R. J. (ed.), Current  Ã‚  Ã‚  Ã‚  Ã‚  Psychotherapies. Itasca Illinois: Peacock Owen, I. R. (1994). Introducing an existential-phenomenological approach: basic   Ã‚  Ã‚  Ã‚  Ã‚  phenomenological theory and research- Part 1. Counselling Psychology   Ã‚  Ã‚  Ã‚  Ã‚  Quarterly, 7, (3) 261-273 Pilgrim, D. (1992). Psychotherapy and Political Evasions. In Dryden, W. & Feltham,C. (Eds.) Psychotherapy and It’s Discontents. Buckingham: Open University Press Satre, J. P. (1951). Being and Nothingness. (Trans. H. Barnes) Methuen: London Schwartz, M. A. & Wiggins, O. P. (1999). The Crisis of Present-Day Psychiatry:   Ã‚  Ã‚  Ã‚  Ã‚  Regaining the Personal. Psychiatric Times, 16, 9. Yalom, I. (1989). Love’s Executioner: And Other Tales of Psychotherapy. New York:   Ã‚  Ã‚  Ã‚  Ã‚  Harper Collins

Case Study Primary Hyperaldosteronism Health And Social Care Essay

The patient presents with an elevated blood force per unit area. Our instance survey does non include extra critical marks. Elevated blood force per unit area is an of import portion of a diagnosing of aldosterone-secreting tumour. The tumour increases the sum of aldosterone in the blood watercourse, which has a direct affect on Na and H2O degrees. This status is called â€Å" primary aldosteronism † ( John E Hall, 2011, p. 220 ) . â€Å" Aldosterone increases the rate of resorption of salt and H2O by the tubules of the kidneys, thereby cut downing the loss of these in the piss while at the same clip doing an addition in blood volume and extracellur fluid volume. This addition in volume will increase arterial force per unit area. â€Å" There is a sequence of events that cause an addition in blood force per unit area: increased extracellular fluid volume additions blood volume. Blood volume increases the average circulatory filling force per unit area. This force per unit ar ea increases venous return of blood to the bosom. â€Å" The increased blood to the bosom will increase cardiac end product which in bends increases the arterial blood force per unit area † ( John E Hall, 2011, p. 217 ) . Therefore, the arterial blood force per unit area additions due to sodium and H2O concentrations. This can go a fatal state of affairs if left untreated.Reason the Lab Tests Were OrderedSerum osmolality is used to set up baseline for fluid position. Critical values to be cognizant of in respects to serum osmolality are values less than 265 mOsm/kg Ha‚‚0 and greater than 320 mOsm/kg Ha‚‚O. This lab trial is ordered to look into into the fluid and electrolyte balance and regulation out possible issues for patients â€Å" with ictuss, ascites, hydration position, acid-base balance, and suspected antidiuretic endocrine ( ADH ) abnormalcies † ( Pagana & A ; Pagana, 1998, p. 314 ) . In healthy grownups the expected normal values are 285-295 mOsm/ kilogram Ha‚‚0. Our patient nowadayss with a serum osmolality value of 289 mOsm/L, and is within the recognized normal scope, nevertheless he is on the low terminal, which could bespeak â€Å" over hydration, syndrome of inappropriate antidiuretic endocrine secernment ( SIADH ) , or paraneoplastic syndromes associated with carcinoma † ( Pagana & A ; Pagana, 1998 ) . Urine osmolality is used to measure fluid and electrolye maps. It looks at the kidney concentrating abilities, and as a tool in measuring the patient for ADH abnormalcies. Normal degrees harmonizing to Pagana are 50-1400 mOsm/kg Ha‚‚O in a random specimen, and for the 12-14 hr fluid limitation, normal value is 850 mOsm/kg Ha‚‚0 ( Pagana & A ; Pagana, 1998 ) . Urine osmolality is of import in measuring the concentrating ability of the kidney, and is frequently evaluated along with blood osmolality consequences ( Pagana & A ; Pagana, 1998 ) . The patient nowadayss with the value of 520 mOsm/L, but the type of aggregation is non indicated. If this is a random specimen the consequences are within normal scope. If this consequence is from a 12-14 hr fluid limitation, the consequence is low, and could be bespeaking â€Å" diabetes insipidus, extra fluid consumption, nephritic cannular mortification, or terrible pyelonephritis † ( Pagana & A ; Pagana, 1998 ) . Blood Na is portion of a basic metabolic profile or serum electrolyte panel. This is a marker for fluid and electrolyte baseline. Normal findings are 136-145 mEq/L. Sodium is an of import portion of serum osmolality. Many factors regulate Na balance, including aldosterone secernment from the kidney, natriuretic endocrine, and ADH. Water and Na play a close interaction in the balance of the two ( Pagana & A ; Pagana, 1998 ) . Our patient nowadayss with a value of 142 mEq/L, and is within normal value scope. Urine Na is another trial to measure the fluid and electrolyte balance of the patient from the point of view of the kidney. Normal values for urine Na is 40-220 mEq/L/day or greater than 20 mEq/L in a topographic point cheque. This trial helps to measure sodium loss in the piss in comparing the the Na degree in the blood. In some incidences the Na degree is low in the blood and high in the kidney, and this is declarative of chronic nephritic failure or Addison ‘s disease ( Pagana & A ; Pagana, 1998 ) . Our patient nowadayss with a normal value of 60 mEq/L. Blood K is besides a portion of the basic metabolic profile ( BMP ) or serum electrolyte panel. It is frequently evaluated as a baseline for patients showing with cardiac symptoms. Normal values are 3.5-5.0 mEq/L in grownups. Our patient is under the critical low value of 2.5mEq/L ( Pagana & A ; Pagana, 1998 ) . Serum K degrees are regulated by many factors including aldosterone, Na resorption, and acid-base balance. Decreased degrees of serum K could be caused by several factors including ; â€Å" deficient dietetic consumption, lacking IV consumption, Burnss, GI upsets, water pills, hyperaldosteronism, Cushing ‘s syndrome, nephritic cannular acidosis, licorice consumption, alkalosis, insulin disposal, glucose disposal, ascites, nephritic arteria stricture, cystic fibrosis, injury, and surgery † ( Pagana & A ; Pagana, 1998 ) . Urine K is evaluated to find electrolyte balance, and is ordered in this instance to find if the patient is egesting K through the kidneys. The normal degrees are 25-120 mEq/L/day harmonizing to Pagana ( Pagana & A ; Pagana, 1998 ) . Our patient in the instance survey has a value of 55mEq/L and is documented as being high. There are many causes for urine K being elevated, including: chronic nephritic failure, nephritic cannular mortification, famishment, Cushing ‘s syndrome, hyperaldosteronism, inordinate consumption of liquorice, alkolosis, and diuretic therapy ( Pagana & A ; Pagana, 1998 ) . Blood chloride is besides portion of the BMP or serum electrolyte panel. Chloride is used in measuring the hydration province and acerb base balance of the patient. Normal values are 90-110 mEq/L in an grownup. Our patient ‘s value is within normal bounds. Over all the consequences of the ordered trials, give a image of the patient ‘s electrolyte position, and elimination of the electrolytes. This information guides the health professional to look at the cause for the patient ‘s symptoms, and find if they are related to the serum degrees or the excretory degrees.Necessity of Laboratory TrialsThe doctor ordered both a blood chemical science trial every bit good as a urine chemical science trial for our instance survey patient. An elevated blood force per unit area of 160/110 millimeter Hg, particularly while the patient is in the supine place, is declarative of volume enlargement in the extracellular fluid. Volume enlargement is a consequence of increased Na content in extracellular fluid ( Costanzo, 2010 ) . The physician must measure the Na ion concentration in the blood every bit good as in the piss to find how the addition in blood force per unit area is related to a Na instability and the nature of the instability. The patient ‘s ailment of failing can be a important mark that the patient is enduring from hypokalemia. Harmonizing to Hall and Guyton ( 2011 ) , â€Å" When the K ion concentration falls below about one-half normal, terrible musculus failing frequently develops † ( p. 926 ) . With the patient ‘s ailment of failing during the doctor ‘s appraisal, it is necessary to measure his K ion concentration to find if so his failing is a symptom of hypokalemia. The rating of K ion concentration in the patient ‘s piss is a simple trial to let the doctor to find if the patient ‘s hypokalemia is related to an addition in potassium secernment taking to an addition in potassium elimination in the piss or if there is another cause for the low K ion concentration in the blood. In our instance survey, the patient ‘s serum Na ion concentration is 142 mEq/L and his urine Na ion concentration is 60 mEq/L, both values within normal scope. However, with such an lift in blood force per unit area without a perceptibly direct addition in serum Na ion concentration, it is declarative that the patient ‘s kidneys are resorbing more H2O with a proportionate addition of Na content ( Costanzo, 2010 ) . This combination of increased Na content and entire organic structure H2O content explains our patient ‘s high blood pressure ( Costanzo, 2010 ) . Our instance analyze patient ‘s serum K ion concentration is 2.1 mEq/L and his urine K ion concentration is 55 mEq/L. The serum K ion concentration is good below the normal scope of 3.5-5.0 mEq/L and the urine K ion concentration is high bespeaking that there is an addition of K secernment taking to a lessening in plasma K ion concentration and an addition in urine K elimination ( Costanzo, 2010 ) . Our patient ‘s serum chloride ion concentration is 98 milliequivalent and his serum osmolarity is 289 mOsm/L, which are both within their several normal scopes. His urine osmolarity concentration is 520 mOsm/L, which is besides within its normal scope. The research lab trials, including blood chemical science and urine chemical science, ordered for our instance survey patient were both necessary non merely to obtain baseline values for future follow up testing, but specifically to concentrate on the patient ‘s Na and K ion concentrations in both blood and urine specimens to find their relationship to one another given his presentation of supine high blood pressure and his ailment of failing.What are the physiological rules that explain the patient ‘s symptoms?A Our patient nowadayss with an elevated systolic and diastolic blood force per unit area and symptoms of weakness.A This is the organic structure ‘s response to an change in electrolyte instability caused by the loss of K together with increased keeping of Na and H ion secernment. â€Å" Primary aldosteronism is characterized by over production of aldosterone by the adrenal secretory organs † ( Conn, 1955, p. 6 ) . Aldosterone is the rule mineralcorticoid that is secreted by the zone glomerulosa in the adrenal cerebral mantle of the adrenal secretory organs. The primary map of aldosterone is the control of intravascular volume ( Ganong, 2005 ) . Aldosterone acts on the distal tubules and roll uping canals of the uriniferous tubule to originate the kidney to conserve Na, secrete K, increasing H2O keeping and increasing blood force per unit area. â€Å" Aldosterone binds the mineralcorticoid receptor ( MR ) and the complex interacts straight with the genomic DNA via a steroid response component ( SRE ) . Transactivation of cistron look leads to written text of the aldosterone induced proteins SGK ( serum and glucocorticoid inducible kinase ) , Ki-RAS and CHIF ( corticosteroid endocrine induced factor ) .A These proteins increase the activity of Na, K, and ATPase by increasing pump turnover and recruiting latent ATPase to the basolateral membrane † ( Gerhard Malnic, Matthew A. Bailey, Gerhard Giebisch, 2004, p. 484 ) . The first symptom to show is high blood pressure and occurs in a bulk of patients. â€Å" An aldosterone mediatedA addition in extracellular fluid volume enduring more than 1 to 2 yearss besides leads to an addition in arterial force per unit area † ( Guyton and Hall, 2011, p.925 ) . This status can be for every bit long as aldosterone continues to be secreted in abnormally high amounts.A Hypokalemia of & lt ; 3.0 milliequivalent in blood and elevated K degrees in urine suggest mineralcorticoid surplus. â€Å" Muscular failing is caused by the change of the electrical irritability of the musculus and nervus fibres which prevents the transmittal of normal musculus potencies † ( Guyton and Hall, 2011, p.926 ) . Other patient symptoms of concerns, nycturias and in really rare instances palsy may happen. â€Å" Numbness and prickling in the appendages are related to alkalosis that may take to tetany † ( Tyrell, 2000, p.555 ) . Metabolic alkalosis is a consequence of lessening in H ion concentration in extracellular fluid when H ions are secreted in exchange for Na ions in the cortical collection tubules of the kidney ( Guyton and Hall, 2011, p.926 ) .Why each trial consequence supports or repudiates the doctor ‘s preliminary diagnosingThe doctor ordered the undermentioned lab trials for this patient: serum Na, K, chloride, and osmolarity, and urine Na, K, and osmolarity. The patient was diagnosed with an aldsosterone releasing tumour of the zona glomerulosa of the adrenal secretory organ, ensuing in primary hyperaldosteronism ( Conn ‘s syndrome ) . McCance and Huether ( 2006 ) province primary hyperaldosteronism â€Å" presents a clinical image of high blood pressure, hypokalemia, nephritic K cachexia, and neuromuscular manifestations † ( p. 723 ) . The patient ‘s low degrees of serum K and high degrees of urinary K indicate the patient has increased K secernment, hence back uping the doctor ‘s diagnosing. High de grees of aldosterone cause the chief cells of the late distal tubule to increase Na resorption and increase K secernment ( Costanza, 2010 ) . Increased urinary elimination of K leads to reduced degrees of serum K ( Costanza, 2010 ) . The patient ‘s Na and osmolarity degrees in the blood and piss were within the normal scopes for an grownup. This entirely would non name this status. However, since these normal Na and osmolarity degrees are present with the patient ‘s elevated blood force per unit area, the patient has proportionally increased his sum of H2O in the extracellular fluid ( Costanzo, 2010 ) . This addition in extracellular fluid volume explains the patient ‘s high blood pressure, and supports the doctor ‘s diagnosing. Serum chloride degrees are frequently drawn with K and Na to look into the relationship between these ions ( Kee, 2009 ) . The chloride degrees were found to be normal in this patient and would non help in the diagnosing of Conn †˜s syndrome.If the intervention was successful, what was the ground?â€Å" Treatment of Conn ‘s syndrome consists of disposals of an aldosterone adversary such as Aldactone, followed by surgical remotion of the aldosterone-secreting tumour † ( Constanzo, 2010, p. 422 ) . Aldosterone stimulates the chief cells of the distal tubule and roll uping canal to resorb Na, which promotes H2O resorption, and increases the elimination of K and H ion ( Huether, 2008 ) . Our patient is placed on Aldactone, which is an aldosterone adversary, a steroid, and a potassium-sparing water pill, to barricade the effects of aldosterone on chief cells. This decreases sodium resorption, doing a decrease in extracellular fluid ( ECF ) volume, and besides decreases K secernment, leting the patient ‘s plasma K to increase ( Constanzo, 2010 ) . The patient ‘s blood force per unit area will diminish due to the decrease in the ECF volume. Our patient is placed on a sodium-restricted diet , which will besides assist to diminish blood force per unit area by diminishing the ECF volume. Our patient has surgery to take the adrenal tumour. With the remotion of the aldosterone-secreting tumour, aldosterone degrees return to normal. Our patient ‘s blood force per unit area and blood and urine chemical sciences return to normal. The interventions of Aldactone, Na restricted diet and surgery were successful for our patient.If the Treatment was Unsuccessful What was the ReasonThe intervention was successful for our patient. The adult male ‘s high blood pressure was treatable by remotion of the adrenal tumour. He was given spironalactone and his diet was modified to cut down his Na, while expecting surgery. His lab values and critical marks returned to normal.DecisionOur instance survey involved a 50-year-old adult male who presented to his doctor ‘s office with high blood pressure recorded in a supine place, failing, and electrolyte instabilities indicated in both his blood and piss. It was determined that he had an aldosterone-secreting tumour of the zon a glomerulosa of the adrenal secretory organ which had resulted in primary hyperaldosteronism, besides known as Conn ‘s syndrome. Trial consequences were closely examined and a intervention program was established for our patient. Surgery was suggested to take the tumour. He was placed on Aldactone and a sodium-restricted diet to handle his high blood pressure. Our patient opted to hold the tumour removed surgically, which was successful. Following surgery his blood force per unit area, blood, and urine chemical sciences all returned to normal degrees. He was encouraged to go on to eat a healthy diet and to hold one-year scrutinies with his primary doctor to guarantee optimum wellness.

India: Foreign Trade Policy

India: Foreign Trade PolicyAlthough India  has steadily opened up its economy, its tariffs continue to be high when compared with other countries, and its investment norms are still restrictive. This leads some to see India as a ‘rapid globalizer’ while others still see it as a ‘highly protectionist’ economy.Till the early 1990s, India  was a closed economy: average tariffs exceeded 200 percent,  quantitative restrictions on imports  were extensive, and there were stringent restrictions on foreign investment. The country began to cautiously reform in the 1990s, liberalizing only under conditions of extreme necessity. Since that time, trade reforms have produced remarkable results. India’s trade to GDP ratio has increased from 15 percent to 35 percent of GDP  between 1990 and 2005, and the economy is now among the fastest growing in the world.Average non-agricultural tariffs have fallen below 15 percent, quantitative restrictions  on import s  have been eliminated, and foreign investments norms have been relaxed for a number of sectors. India  however retains its right to protect when need arises. Agricultural tariffs average between 30-40 percent, anti-dumping measures have been liberally used to protect trade, and the country is among the few in the world that continue to ban foreign investment in retail trade. Although this policy has been somewhat relaxed recently, it remains considerably restrictive.Nonetheless, in recent years, the government’s stand on trade and investment policy has displayed a marked shift from protecting ‘producers’ to benefiting ‘consumers’. This is reflected in its  Foreign Trade Policy for 2004/09  which states that, â€Å"For India to become a major player in world trade †¦ we have also to facilitate those imports which are required to stimulate our economy. â€Å"India  is now aggressively pushing for a more liberal global trade regime, e specially in services. It has assumed a leadership role among developing nations in global trade negotiations, and played a critical part in the Doha  negotiations.Regional and Bilateral Trade AgreementsIndia  has recently signed trade agreements with its neighbors and is seeking new ones with the East Asian countries and the United States. Its regional and bilateral trade agreements – or variants of them – are at different stages of development:   * India-Sri Lanka Free Trade Agreement, * Trade Agreements with Bangladesh, Bhutan, Sri Lanka, Maldives, China, and South Korea. * India-Nepal Trade Treaty, * Comprehensive Economic Cooperation Agreement (CECA) with Singapore. Framework Agreements with the Association of Southeast Asian Nations (ASEAN), Thailand and Chile. Preferential Trade Agreements with   Afghanista, Chile, and Mercosur (the latter is a trading zone between Brazil, Argentina, Uruguay, and Paraguay). World Bank InvolvementAs a number of research i nstitutions in the country provide the Government with good, just-in-time, and low-cost analytical advice on trade-related issues, the World Bank has focused on providing analysis on specialized subjects at the Government’s request.In the last three years, the Bank has been working with the Ministry of Commerce in a participatory manner to help the country develop an informed strategy for domestic reform and international negotiations. Given the sensitivity of trade policy and negotiation issues, the Bank’s role has been confined to providing better information and analysis than was previously available to India’s policymakers.World Bank ReportsOver the last two years, the World Bank has completed two reports:Sustaining India’s Services Revolution: Access to Foreign Markets, Domestic Reforms and International Negotiation:  The study concludes that  to sustain the dynamism of India’s services sector, the country must address two critical challen ges: externally, the problem of actual and potential protectionism; and domestically, the persistence of restrictions on trade and investment, as well as weaknesses in the regulatory environment.From Competition at Home to Competing Abroad: The Case of Horticulture in India:  This study finds that the competitiveness of India’s horticulture sector depends critically on efficient logistics, domestic competition, and the ability to comply with international health, safety and quality standards. The study is based on primary surveys  across fifteen Indian States. A third study, dealing with barriers to the movement of professionals is under preparation.The Bank has also held a number of workshops and conferences with a view to providing different stakeholders with a forum to express their views on trade-related issues. | | | | | Permanent URL for this page:  http://go. worldbank. org/RJEB2JGTC0| | Publications| * Studies on India-Bangladesh Trade (Vol. 1 of 2)   * Studie s on India-Bangladesh Trade (Vol. 2 of 2)   * Sustaining India's Services Revolution  | | | | | | * Home  |   * Site Map  |   * Index  |   * FAQs  |   * Contact Us  |   * Search  |   *   RSS|