Acne Essays - Acneiform Eruptions, Acne Vulgaris, Pimple, Comedo

Acne Almost everyone has acne at one time or another in life. Acne is a skin condition that can cause pimples such as, white heads and black heads to appear on the face, chest, back, neck, and shoulders. Most teenagers have acne for about five years, but for others it clears up much faster. Not only teenagers go through acne, but women that did not experience acne during puberty, can also get acne in there twenties and thirties. Women can also get minor acne before there menstrual period. All of us are affected by acne at one point in time or another, and some less than others, but all of us experience it and just have to deal with it because the best remedy for getting rid of acne is time. Acne begins in the upper part of the hair follicle, where sebaceous glands discharge sebum, an oily substance that keeps skin from drying out. During puberty, the sebaceous glands enlarge dramatically. If pores near these glands become clogged with dead skin cells or oily cosmetics, the sebum accumulates underneath, causing inflammation in the surrounding skin. The acne is further aggravated when bacterial enzymes break down the sebum into irritating substances that add to the inflammation and swelling. If several follicles in the same area become inflamed, scarring can also occur. There are several forms of acne, but the most common is vulgaris, found mostly in teenagers, whose hormonal changes cause a large increase in the size of the sebaceous glands and in sebum production. As stated before the best remedy for acne is time, and just letting acne go away on its own is the best. People with moderate cases of acne may use topical antibiotics, and also take small doses of antibiotics given orally over long periods of time. Other therapies that have been found effective include the topical use of retinoic acid or benzoyl peroxide. Most experts agree that greasy or oily cosmetics should not be used, and that water-based cosmetics should be used instead. The best way to cleanse your skin is by washing often with plain soap and water. Use a washcloth, and work the soap into your skin gently for a minute or two, and then rinse well. But make sure that you use a clean washcloth every day because bacteria thrives on wet and warm wash clothes, which in end can actually cause more acne. Acne should not be picked or squeezed because this may result in scarring. After calling the Portland Information Guide and doing a lot more extra research on the Internet, I have learned how acne actually comes about. Before I thought that acne just happened due to the fact of over-active hormones during puberty, but I learned that there was much more to acne than just that. Another thing that I learned was hot to better take care of my face and to lessen the amount of acne that I will get. Before I knew that washing your face was good, but I wasn't aware that there were actual perscriptions for acne that are taken orally in a pill form. Another thing that I learned was that antibiotics also could help decrease the amount of acne. All in all I though that this call and research was very valuable to me because now I am a teenager and that's when I will need this information the most, and I am glad that I made the call and did the research. Sources on Internet for Research: 1. WWW.Lycos.COM 2. WWW.WebMD.COM 3. WWW.Yahoo.COM Medicine Essays

Uncovering the Archaeological Remains of Tipis

Uncovering the Archaeological Remains of Tipis A tipi ring is the archaeological remains of a tipi, a dwelling type constructed by North American Plains people between at least as early as 500 BC up until the early 20th century. When Europeans arrived in the great plains of Canada and the United States in the early 19th century, they found thousands of clusters of stone circles, made of small boulders placed at close intervals. The rings ranged in size between seven to 30 feet or more in diameter, and in some cases were embedded into the sod. The Recognition of Tipi Rings The early European explorers in Montana and Alberta, the Dakotas and Wyoming were well aware of the meaning and use of the stone circles, because they saw them in use. The German explorer Prince Maximilian of Wied-Neuweid described a Blackfoot camp at Fort McHenry in 1833; later plains travelers reporting the practice included Joseph Nicollet in Minnesota, Cecil Denny at the Assiniboine camp at Fort Walsh in Saskatchewan, and George Bird Grinnell with the Cheyenne. What these explorers saw was the people of the Plains using stones to weigh down the edges of their tipis. When the camp moved, the tipis were taken down and moved with the camp. The rocks were left behind, resulting in a series of stone circles on the ground: and, because the Plains people left their tipi weights behind, we have one of the few ways that domestic life on the Plains can be archaeologically documented. In addition, the rings themselves had and have meaning to the descendants of the groups which created them, beyond the domestic functions: and history, ethnography, and archaeology together ensures that the rings are a source of cultural richness belied by their plainness. Tipi Ring Meaning To some plains groups, the tipi ring is symbolic of the circle, a core concept of the natural environment, the passage of time, and the gloriously endless view in all directions from the Plains. Tipi camps were also organized in a circle. Among Plains Crow traditions, the word for prehistory is Biiaakashissihipee, translated as when we used stones to weigh down our lodges. A Crow legend tells of a boy named Uuwatisee (Big Metal) who brought metal and wooden tipi stakes to the Crow people. Indeed, stone tipi rings dated later than the 19th century is rare. Scheiber and Finley point out that as such, stone circles act as mnemonic devices linking descendants to their ancestors across space and time. They represent the footprint of the lodge, the conceptual and symbolic home of the Crow people. Chambers and Blood (2010) note that tipi rings typically had a doorway facing east, marked by a break in the circle of stones. According to Canadian Blackfoot tradition, when everyone in the tipi died, the entrance was sewn shut and the stone circle was made complete. That happened all too often during the 1837 smallpox epidemic at the Akà ­Ãƒ ­Ã¢â‚¬â„¢nisskoo or Many Dead Kà ­nai (Blackfoot or Siksikà ­tapiiksi) campsite near present-day Lethbridge, Alberta. Collections of stone circles without door openings such as those at Many Dead are thus memorials of the devastation of epidemics on Siksikà ­tapiiksi people. Dating Tipi Rings Untold numbers of tipi ring sites have been destroyed by Euroamerican settlers moving into the Plains, purposefully or not: however, there are still 4,000 stone circle sites recorded in the state of Wyoming alone. Archaeologically, tipi rings have few artifacts associated with them, although there are generally hearths, which can be used to gather radiocarbon dates. The earliest of the tipis in Wyoming date to the Late Archaic period circa 2500 years ago. Dooley (cited in Schieber and Finley) identified increased numbers of tipi rings in the Wyoming site database between AD 700-1000 and AD 1300-1500. They interpret these higher numbers as representing an increased population, increased use of Wyoming trail system and the migrations of Crow from their Hidatsa homeland along the Missouri River in North Dakota. Recent Archaeological Studies Most archaeological studies of tipi rings are the results of large scale surveys with selected pit testing. One recent example was in the Bighorn Canyon of Wyoming, the historic home of several Plains groups, such as the Crow and Shoshone. Researchers Scheiber and Finley used  hand-held Personal Data Assistants (PDAs)  to input data on tipi rings, part of a developed mapping method combining remote sensing, excavation, hand-drawing, computer-assisted drawing, and Magellan Global Positioning System (GPS) equipment. Scheiber and Finley studied 143 oval tipi rings at eight sites, dated between 300 and 2500 years ago. The rings varied in diameter between 160-854 centimeters along their maximum axes, and 130-790 cm on the minimum, with averages of 577 cm maximum and 522 cm minimum. Tipi studied in the nineteenth and early twentieth centuries were reported as 14-16 feet in diameter. The average doorway in their  dataset  faced north-east, pointing to the midsummer sunrise. The internal  architecture of the Bighorn Canyon group included fire hearths in 43% of the  tipis; external included stone alignments and  cairns thought to represent meat drying racks. Sources Chambers CM, and Blood NJ. 2009.  Love  they  neighbour: Repatriating precarious Blackfoot sites.  International Journal of Canadian Studies  39-40:253-279. Diehl MW. 1992.  Architecture as a Material Correlate of Mobility Strategies: Some Implications for Archeological Interpretation.  Cross-Cultural Research  26(1-4):1-35. doi: 10.1177/106939719202600101 Janes RR. 1989.  A Comment on Microdebitage Analyses and Cultural Site-Formation Processes among Tipi Dwellers.  American Antiquity  54(4):851-855. doi: 10.2307/280693 Orban N. 2011.  Keeping House: A Home for Saskatchewan First Nations Artifacts.  Ã‚  Halifax, Nova Scotia: Dalhousie University. Scheiber LL, and Finley JB. 2010.  Ã¢â‚¬â€¹Domestic campsites and cyber landscapes in the Rocky Mountains.  Antiquity  84(323):114-130. Scheiber LL, and Finley JB. 2012.  Situating (Proto) history on the Northwestern Plains and  Rocky Mountains. In: Pauketat TR, editor.  The Oxford Handbook of North American Archaeology. Oxford: Oxford University Press. p 347-358. doi: 10.1093/oxfordhb/9780195380118.013.0029 Seymour DJ. 2012.  Ã¢â‚¬â€¹Ã¢â‚¬â€¹When Data Speak Back: Resolving Source Conflict in Apache Residential and Fire-Making Behavior.  International Journal of Historical Archaeology  16(4):828-849. doi: 10.1007/s10761-012-0204-z

Internationalization Strategies Questions Essay

Internationalization Strategies Questions - Essay Example The reasons why a business may seek to pursue an internationalization strategy as part of its growth and expansion plans are strongly contextual. In particular, they will reflect the economic and political features of the country or region of the investing firm, and of the country or region in which the company seeks to invest. Other factors at that will determine this decision include: the industry and the nature of the value added activity in which the firm is engaged and the characteristics of the individual investing firm, including its objectives and strategies in pursuing these objectives. Dunning (2000) identified four major types of internationalization activities: (1) market seeking or demand oriented activities that are geared towards satisfying a particular foreign market, or set of foreign markets; (2) resource seeking or supply oriented activity that targets gaining access to natural resources; (3) efficiency seeking activity which is designed to promote a more efficient division of labour; and (4) strategic asset seeking, which aims to protect or augment the existing specific advantages of the internationalising firm and/or to reduce the advantages of its competitors. These activities also mirror the advantages that organisations gain by pursuing internationalisation strategy such as greater market share, brand awareness and revenue, accessing more resources or technology for competitive advantage, efficiency and economies of scale which lowers cost of production, spreading of business risk and creation of entry barriers to one’s industry. Factor conditions refer to the inputs that are necessary for a firm to compete such as capital, infrastructure, land and labour. According to Porter (1990) the stock of factors in a country at any given time is less important than the extent to which they are upgraded and deployed. In reference to Dunning's resource seeking internationalisation objective, a company may therefore be attracted to a part icular country where its key resources are generally rapidly upgraded for example the strong government support experienced in China’s manufacturing industry. Home demand conditions refer to the level of demand of a particular product locally in comparison to its level of demand abroad. It is largely influenced by size, number of independent buyers, sophistication of local buyers, rate of demand growth, early demand and early saturation. A more demanding local market leads to national advantage and a strong, trend-setting local market helps local firms anticipate global trends. Early saturation of the local market also motivates firms to continue innovation and to reduce cost and/or pricing of products for example Japan’s TV industry saturated early and forced home players to seek new markets in Europe and North America. Finally, the home firms will be forced to enter foreign markets, Dunning’s market seeking international activity, in the search for more busine ss and sustainable growth. Porter’s third determinant, related and supporting industries reflects the importance of the link between businesses within a value chain. Related industries refers to those industries that share certain elements of their business for example the US has a vibrant information systems industry that

Continuing Professional Development Assignment Example | Topics and Well Written Essays - 1000 words

Continuing Professional Development - Assignment Example The aim of this paper is to analyze the importance of CPD for individuals and organizations in the hospitality industry. The main theory surrounding CPD is Boyatzis’s Theory of Self-directed Learning. The theory works on a model where learning is based on a self-directed self-analysis. This includes analysis of the ideal oneself and actual oneself then assessing gaps. The person then looks at their strengths and sets out on a learning agenda aimed at building on the strengths while minimizing the gaps. Finally, the person experiments and practices with the new knowledge, skills and behavior. Trusting relationships that encourage and support each step should be developed (Boyatzis 1999). Core concepts of CPD There are some concepts that mark out CPD from other types of professional development and training. First is that in CPD, the learner is in control hence CPD finds its starting point from the learner’s dreams. Handy (1997), states that these dreams can also be equat ed to thirst. First, the professional becomes thirst for new skills, knowledge and experiences and the role of CPD is to respond to the type and extend of the thirst presented. Secondly, CPD is a holistic process capable of addressing every aspect of life as well as the balance between these aspects. This means that one aspect of a learner’s life for example, their work, family, or social life does not have to suffer much during the process of CPD. Therefore, we can say that the process is integrative to every aspect of the learner’s life (Daniel 2002). Thirdly, the learning and working in CPD is power and direction oriented hence the achievement of its purposes and objectives are easy. This is because CPD involves regularly reflecting how we are, looking ahead to where we want to be then taking a step from our current position towards the desired future position. Lastly, someone can benefit from CPD with or without the support of the employer. This is to say that it w orks for those employees who have financial backing and total support from their employers and as well as for those whose employers are hostile (Daniel 2002). The need and relevance for CPD From its definition, the need for CPD is hinged on the necessity for professionals to broaden, improve and maintain their specific professional skills and knowledge they have already acquired. The core reason for this is that security for professionals no longer lies in the organisation they work for or the job they do but on the knowledge, skills and experience they posses within themselves (Brett and VandeWalle 1999). There is also a need for professionals to acquire some special qualities that are needed for them to perform well in their profession. CPD is very relevant to professionals and their organisations as well. For example, it enables professionals to be updated in terms of their professional skills and knowledge and this puts them at a good position of working under the latest relevan t information. Constant updating and enhancement of skills enables an individual to improve in terms of their professional competency. Because CPD is continuous, the improvement in professional competency for the individuals also becomes continuous throughout their professional lives (Cooperrider 1990). Benefits of CPD for individuals and organisations According to Schon (1983), CPD makes professionals to be committed to their professionalism. This is because it entails a continuous process of

Marketing Concultancy Coursework Example | Topics and Well Written Essays - 1250 words

Marketing Concultancy - Coursework Example This is a big problem potentially for Apple because the new firms can tank iTunes music revenues, and seriously undermine Apple’s business model. The proposed solutions therefore rely on leveraging the formidable strengths and assets of Apple, including its large cash hoard and its venerable name, to come up with alternatives to Spotify in order to check the latter’s rise and to shore up Apple’s revenues in music subscription sales. This solution leverages key strengths, and also leverages emerging trends in cloud computing and the benefits to be had from harnessing technological progress in cloud computing. This report makes use of external environmental analytical frameworks such as PESTLE and Porter’s Five Forces frameworks, as well as a SWOT analysis, to properly assess the extent of the market problem and Apple’s condition relative to the external market challenge (Hunt 2011; Goldman 2010; Ausick 2013; Google Finance 2014; Schaefer 2014; Hinks 2014; McDuling 2014). Apple needs no introduction. The maker of the iPhone and the iPad is the most influential and the biggest name in technology, and its smartphone business and the ecosystem of apps, software, music and other digital content is the biggest in the world in terms of revenues and traction in the premium markets all over the world. The company is described as being in the business of providing both portable devices and computing devices for mobile communication and personal computing, together with the digital content, platform and apps that go with the hardware. Apart from the iPhone and the iPad, the company is also the maker of the Mac and the Apple TV platforms, together with software such as iOS and OS X, and iCloud. Content is aggregated via iTunes and the App Store. With a market capitalization of $ 661.67 billion, Google is the biggest tech firm

Current Diagnostic Methods for Human Immunodeficiency Virus

Current Diagnostic Methods for Human Immunodeficiency Virus Abstract: Detection of human immunodeficiency virus (HIV) infection is essential for diagnosis and monitoring of the infection. There are several different types of diagnostic tools available that are based on detection of HIV-specific antibodies, virus antigen, or nucleic acid. Sensitivities and specificities of assays utilized for HIV detection have improved. Newer HIV testing technologies such as third-generation enzyme immunoassay (EIA) which detect HIV-specific IgG and IgM antibodies, fourth-generation EIA which detect both anti-HIV antibodies and HIV p24 antigen, and nucleic acid-based tests (NATs) for HIV RNA, have significantly decreased the window period. This review study provides an overview of current technologies for the detection and monitoring of HIV infection and recent advances in the field of HIV diagnosis. Keywords: HIV diagnosis; HIV antibody test; human immunodeficiency virus; Immunoassay; Polymerase chain reaction (PCR) Introduction: Diagnosis of HIV infection contributes to evaluating the progression of disease, monitoring the effectiveness of antiretroviral therapy (ART), and prevention and control of HIV/AIDS. The diagnosis of HIV is associated with decrease in risky behaviors, reduced HIV transmission, and improved survival linked to increased case detection, earlier care and treatment. HIV-negative persons can also protect themselves from HIV when making sexual decisions by engaging in safer sex behaviors and sometimes, taking pre-exposure prophylaxis (PrEP). Early diagnosis of HIV infection provides an opportunity for risk reduction counseling and preventing further transmission of the disease, while late diagnosis of HIV infection is detrimental to infected patients and to the public health, and is associated with an increased rate of morbidity, mortality, and healthcare costs. Since the start of the epidemic, it is estimated that 78 million people have become infected with HIV and 35 million people have died from AIDS-related illnesses. In 2015, 2.1 million people became newly infected, 36.7 million people were living with HIV and 1.1 million people died from AIDS-related illnesses. New HIV infections have fallen by 6% since 2010. Sub-Saharan Africa, which bears the heaviest burden of HIV/AIDS worldwide, accounts for 65% of all new HIV infections. Other regions significantly affected by HIV/AIDS include Asia and the Pacific, Latin America and the Caribbean, and Eastern Europe and Central Asia (Table 1) [9]. The present study aims to conduct a narrative review to summarize and discuss the current diagnostic methods for HIV and recent developments. We start with a brief overview of HIV infection, follow by a description on the development of virological and immunological markers following HIV infection. Thereafter, we introduce current algorithms for laboratory HIV testing with different kind of current diagnostics techniques including various generations of enzyme immunoassays, rapid or point-of-care tests, and qualitative/quantitative PCR assays. Overview of HIV Infection: HIV-1 causes chronic infection which is usually characterized by progressive immune deficiency, a long period of clinical latency, and appearance of opportunistic infections [1, 2]. Characteristics of HIV include infection and viral replication in T lymphocyte expressing CD4 antigen. Qualitative defects in CD4 cell response and a gradual decline in their numbers increase the risk of opportunistic infections like Pneumocystis carinii pneumonia, and neoplasms such as Kaposis sarcoma and lymphoma [3-5]. HIV infection can disrupt functions of blood monocytes, tissue macrophages, and B lymphocytes, and also increase the potential of encapsulated bacteria for developing infections [6, 7]. Direct invasion of CD4 cells in the peripheral and central nervous systems can cause meningitis, peripheral neuropathy, and dementia [8]. The prognosis is variable between people infected with HIV-1. In adults, the average time between HIV exposure to AIDS stage is 10-11 years, but a remarkable proportion of individuals (~20%) progresses rapidly to AIDS within 5 years after HIV exposure. On the other hand, it is estimated that 12% of infected individuals will remain free of AIDS for 20 years [10]. Prophylaxis and in particular antiretroviral therapy (ART) significantly enhanced the overall prognosis of HIV disease against opportunistic infections [11]. The most common route of HIV infection is sexual transmission at the genital mucosa via direct contact with infected body fluids, such as blood, semen, and vaginal secretions. Infection may also occur via inoculation of infected blood, transfusion of infected blood products, transplantation of infected tissues, from an infected mother to her infant during pregnancy, or by reuse of contaminated needles [12]. The probability of transmission after a single exposure with an uncontrolled HIV source has been estimated to be 1/150 with needle sharing, 1/300 with occupational percutaneous exposure, 1/300-1/1000 with receptive anal intercourse, 1/500-1/1250 with receptive vaginal intercourse, 1/1000-1/3000 with insertive vaginal intercourse, and 1/3000 with insertive anal intercourse. The average risk is 12-50% for congenital (mother-to-child) transmission, 12% for breast-feeding, 90% for a contaminated blood transfusion, and 0.1-1.0% for nosocomial transmission [13]. The risk of HIV transmission during early or acute HIV infection appears to be greater than during chronic infection (251). Available data suggest that the viral load is an important predictor of the risk of heterosexual transmission, and patients with levels less than 1500 copies of HIV-1 RNA per milliliter are at lower risk of HIV transmission, whereas the probability of transmission is increased dramatically with increasing vira l loads (250). Laboratory markers for HIV-1 infection: Several immunological and virological blood markers can be monitored during the course of HIV infection. These markers appear highly consistent between different individuals in a chronological order and allows classification of HIV infection into distinct laboratory stages including eclipse period, seroconversion window period, acute HIV infection, and established HIV infection (Figure 1) [14, 15]. Shortly after exposure to HIV-1, no viral markers are consistently detectable in plasma, but low levels of HIV-1 RNA can be found intermittently [16]. This period is called the eclipse phase. About 10 days after infection, HIV-1 RNA becomes detectable by NAT in plasma and quantities rise to very high levels [17], which subsequently decline rapidly until reaching a set point, a stable level that may persist for years. This stable level of HIV RNA represents an equilibrium between HIV and host immune responses and is an important indicator of subsequent disease progression, and potential transmission of HIV. It has been shown that the higher HIV-1 RNA plasma level is associated with faster progression to AIDS [18]. The set point plasma HIV-1 RNA level can be a helpful clinical tool for determining the timing of initiation of antiretroviral therapy for HIV-infected patients. For instance, patients with high set point levels can be started on aggressive antiretroviral therapy and patient s with low set point levels can be monitored without initiating therapy [19]. HIV-1 p24 antigen is expressed and quantities rise to levels that can be measured by fourth-generation immunoassays within 17 days after infection (typical range 13-28 days) [15, 20]. Due to high titers of p24 antigen present in the sera of acutely infected patients during the interval prior to seroconversion, p24 Ag assay can be utilized to diagnose the primary HIV-1 infection [21]. Nevertheless, detection of p24 antigen is transient because, as antibodies begin to develop, they bind to the p24 antigen and form immune complexes that interfere with p24 Ag assay [22, 23]. The time interval between infection with HIV and the first detection of antibodies is known as the serological window period. The detection of HIV-specific antibodies indicates the end of the window period and the individual is known as seropositive [24]. The length of the window period depends on the design and the sensitivity of the immunoassay. Expression of IgM antibodies can be detected by immunoassays within 10 to 13 days after the appearance of viral RNA, 3 to 5 days after detection of p24 antigen, and peak between the 4th and the 5th week [15, 20, 25, 26]. Thereafter, the emergence of IgG antibodies occurs at about 3-4 weeks after infection and persist throughout the course of HIV infection [21]. Nevertheless, the immune responses are highly dependent on the ability of the individuals immune system to produce the antibodies. Approximately, 50% of patients within 3-4 weeks and about 100% of them within 6 months have detectable antibodies, although there are reports indicating that a small percentage of patients may require up to 6 months for the appearance of antibodies [27]. Laboratory HIV testing algorithms: Since 1989, the diagnostic algorithm for HIV testing recommended by CDC and the Association of Public Health Laboratories (APHL) relied on the confirmation of a repeatedly reactive HIV immunoassay with the more specific HIV-1 antibody test, either the HIV-1 Western blot or HIV-1 indirect immunofluorescence assay (IFA). The Western blot was previously considered to be the gold standard for the diagnosis of HIV infection by Clinicians [29, 30]. It should be noted that both the Western blot and IFA are first-generation assays that detect only IgG antibodies against HIV proteins. Retrospective testing of specimens from high-risk individuals pointed that antibody testing alone may miss a significant percentage of HIV infections detectable by virologic tests such as HIV antigen and nucleic acid assays. In 2013, the CDC and the APHL released new guidelines on HIV testing that have led to the earlier diagnosis of HIV infection when compared with the previous diagnostic algorithm. The new recommended algorithm starts with a fourth-generation HIV-1/2 Ag/Ab immunoassay to screen for HIV infection that detects both HIV-1/2 antibodies and the HIV-1 antigen. When the result of initial immunoassay is nonreactive, further testing is not required for samples. Instead, testing with an HIV-1/HIV-2 antibody differentiation test is needed when the sample is reactive on the screening fourth-generation assay. Reactive results with the initial fourth-generation assay and the HIV-1/HIV-2 antibody differentiation immunoassay should be considered as reactive for HIV-1 antibodies, HIV-2 antibodies, or HIV antibodies, undifferentiated. Reactive results with the initial fourth-generation assay and nonreactive or indeterminate on the HIV-1/HIV-2 antibody differentiation immunoassay should be tested with an FDA-approved HIV-1 NAT to differentiate early HIV infection from a false-positive screening result [28] (Figure 2). HIV diagnostic tests: Serological diagnostic assays: Enzyme Immunoassays (EIA):Significant advances in the development of HIV immunoassays have been created since the discovery of HIV in 1983. Based on different design principles, HIV immunoassays are generally classified into generations. The earliest immunoassays (first-generation) are indirect EIAs that used coated viral lysate antigens derived from cell culture on a solid phase for antibody capture and an indirect format that detected antibody utilizing an enzyme-conjugated antihuman IgG [36]. Antibody can be detected within 8-10 weeks postinfection by first generation immunoassay. These assays have 99% sensitivity and 95-98% specificity for HIV infection. Second-generation immunoassays use synthetic peptide or recombinant protein antigens alone or in combination with viral lysates to bind HIV antibodies, and they use an indirect immunoassay format that employs conjugated antihuman IgG, which binds to IgG with high affinity, to detect IgG antibodies [37]. Utilizing recombinant anti gens in the second-generation assays improves sensitivity for HIV-1, HIV-1 group O, and HIV-2, allowing earlier detection of IgG antibodies. The sensitivity and specificity of second-generation assays have been reported to be ˃99.5% and ˃99%, respectively. First and second generation immunoassays can only detect IgG antibody to HIV. The window period was decreased to 4 to 6 weeks postinfection by second-generation assays. Third generation immunoassays also utilize synthetic peptide or recombinant antigens to bind HIV antibodies, but in an immunometric antigen sandwich format; HIV antibodies in the specimen bind to HIV antigens on the assay substrate and to antigens conjugated to indicator molecules. This allows detection of both IgM and IgG antibodies which leads to increase in sensitivity and specificity of the test. Lower sample dilutions and the ability to detect IgM antibodies (which are expressed before IgG antibodies) further decrease the window period to 2-3 weeks postinfection [38]. The reported sensitivity and specificity of third-generation assays is ˃99.5%. Combination or fourth-generation tests use synthetic peptide or recombinant protein antigens in the same antigen sandwich format as third-generation assays for the detection of IgM and IgG antibodies, and also monoclonal antibodies for the detection of p24 antigen [39]. Inclusion of p24 antigen capture allows the detection of HIV-1 infection before seroconversion and further decreases the window period. Most fourth-generation antigen/antibody immunoassays (termed combo assays) do not distinguish antibody reactivity from antigen reactivity [39]. Recent published data has shown that the fourth-generation assay was able to establish HIV infection in more than 80% of patients who tested NAAT positive but either nonreactive or indeterminate by other tests like Western blot, first to third generation immunoassays, and rapid tests [40-42]. Delaney et al. found that the fourth-generation immunoassay are able to detect HIV infection 1-3 weeks earlier than the first, second, and third generation immunoassay which cannot detect p24 antigen. The results of their study revealed that the median duration of the eclipse period was 11.5 days and 99% of specimens from HIV-infected patients could be reactive with Ag/Ab combination tests within 45 days of exposure. Moreover, for detection of antibodies by the IgG/IgM-sensitive and other plasma screening assays, 50 days or longer were required and after 3 month of exposure, infection could be detected by all tests. Several studies have reported sensitivities of 100% for fourth-generation immunoassay, whereas other surveys reported transient sensitivities range from 62-89% when assessed against HIV RNA assays. This decreased sensitivity can be attributed to the presence of a second diagnostic window. This situation is rare but it can happen. Second diagnostic window period lies between the p24 antigen detection and the anti-HIV antibody detection, and is associated with reduction in the p24 antigen and antigen/antibody complexes levels, as well as a delay in HIV-specific antibody development which totally may affect the sensitivity of fourth-generation immunoassays. So, it is possible that many acute HIV infections have been missed using fourth-generation assays. Despite negative results from a fourth-generation immunoassay in high-risk populations with suspected acute HIV infection, it is needed to repeat the test on new blood samples obtained several days later, as well as testing for HIV anti body alone, p24 antigen or use of an HIV RNA assay. In 2015, an improved version of immunoassay, BioPlex 2200 HIV Ag-Ab screening test system, received FDA approval in HIV screening which detects both HIV antibody and the HIV-1 p24 antigen by providing separate results for each analyte. This test also provides separate results for HIV-1 and HIV-2 antibodies, so there is no need for a HIV-1/2 differentiation assay for antibody reactive samples. It was reported that the sensitivity and specificity of BioPlex 2200 HIV Ag-Ab assay were 100 and 99.5%, respectively [43]. HIV Confirmatory Tests:Screening tests must be highly sensitive to produce few false-negative results, whereas confirmatory assays are characterized with high specificity to produce few false-positive results [44]. If the result of a screening test is repeatedly reactive, this has to be confirmed by (at least) one confirmatory assay. Western blot or indirect IFA traditionally have been employed as confirmatory assay due to their higher specificity. The probability that both ELISA and Western blot would give false-positive results is extremely low (

Pressures Of Industry On Education :: essays research papers

With the high rate of adolescent unemployment an economic reality, the secondary education system needs to concern itself with the occupational future of the youth of America. Vocational education provides students with an alternative to a college degree. When vocational education is used in conjunction with local industries, a unique relationship is formed in which both institutions can benefit. These benefits include the following: 1. Educational institutions offer quick and ready access to facilities and trained personnel. 2. An exchange of goods for services rendered allows for savings to industry and an opportunity for the institution to provide important community service. 3. A cooperative effort between education and industry is time efficient and cost effective. 4. Community, educational, and industrial interchange are enhanced and appreciated. 5. Opportunities for expanded cooperation between education and industry on future occasions are enhanced. 6. Opportunities for more active counseling roles in industry are expanded. Furthermore, the United States Office of Education 1975 policy paper states the following: †¦while initial implementation of career education†¦ will be relatively inexpensive, total educational reform is going to be expensive†¦ the days of educational isolationism are past. It is time that our formal education system join forces with all other segments of the total society†¦ to meet the varied and continuing educational needs of both youth and adults†¦ all must collaborate in providing appropriate educational opportunities for all citizens.   Ã‚  Ã‚  Ã‚  Ã‚  During times of slow economic growth and high technological change, many industrial firms find themselves needing fewer employees or are forced to replace their workforce with individuals who have updated technological skills. With this in mind, the education system should find ways to adapt to the current employment needs of the society. Of the several kinds of process-oriented approaches to educational change (e.g. year round education or acquiring a higher counselor-student ratio), career education represents the most logical and certainly the most available approach for consideration by career guidance professionals.   Ã‚  Ã‚  Ã‚  Ã‚  By joining forces, schools and industries can find ways to benefit one another. Teaching job-specific skills in the classroom can provide students with the necessary background for participating in summer internships. These internships will provide students with valuable work experience that will make them much more marketable upon graduation, not to mention give them extra money to save for college if they so desire. Summer work programs can also benefit the instructors so that they can keep up-to-date with the current advances in technology that influence the industries which they support.