Psychology and New Technology Program Essay Example for Free

Psychology and New Technology Program Essay ABC Corporation has made a decision to purchase a new technology program for their employees. Because this technology program is new, employees ranging from age 17- 70 needs to be train. Training must be complete with six months. Before training is implement, four fundamental principles of adult education, including psychological, sociocultural, biological, and cognitive must be analyze. Because of the age range it would feasible to divide the employee into two groups. First group is Young learners (YL) age group 17-25 and the second group is Adult learners (AL) age group 26-71. The AL group will require multiple sessions because of the number of employee in this group. Before training begins, both groups must prepare for learning, therefore an open discussion regarding the new technology program, training plan process and how it will affect the employees will be discuss, this discussion will gain support and full participation from the employees. After analyzing both groups, the biological factor for the YL group will not have a strong impact. Most young learner between the ages of 17-25 is computer knowledgeable and is familiar with the 21st century social media and is open for change with new technology. YL group would benefit from Web-Based Training (WBT) instead of the traditional classroom forum. Many young leaners prefer a teaching method that would keep them engaged, and eager. WBT is the delivery method for the YL group. The adult learners (AL) ages 26-70 may not be a computer literate and would benefit from the traditional classroom approach. The AL group would require the adult educator to have patience, slow lecturing, plenty of hands on exercise, and frequent breaks. Hands on exercise are a memory factor that would benefit the AL group two months after been train. Most adults learners tend to forget what they have learned. Information that goes into adult leaner memory is memorize if the learner practices remembering the information soon after he or she learns it. Psychological factors deals with individuals’ way of thinking and learning. Separating the groups would allow the employees to learn and collaborate within their age group. Developing two groups will allow the learners to relate to each other, and feel comfortable learning. Training both groups together would be challenging for the adult educator as well as the employees. The possibility of redundant questions would slow down the class, which could result in less participation. Cognitive factor is the process of obtaining knowledge through experiences. The Adult learner (AL) is in charge of their own learning. They focus on what will advance their career and life circumstances. The Young learners (YL) rely on others to tell them what they should learn. Both groups learning environment has an impact on how well they comprehend the new technology program. The YL group would benefit from a self pace, web base training module or a stimulation module with active interaction of practical and theory scenarios. Each module will require an assessment and a passing score of 90% or higher to advance to the next module. This learning style would allow the YL group to continue to make use of 21st technology. The AL group would not benefit from web base training. Most adult learners are not comfortable learning new technology, in this case the employees does not have an option. The AL group who is not adaptive to change would find it challenging to learn a new technology program via a computer; this would be an internal factor that may take time to overcome. The job of the trainer is to make the learner apart of the learning process, by asking for volunteers, or asking experiences related questions. The AL groups are concern with why and how to apply this new technology. Sociocultural deals with how adults deal with individual learning and how learning takes place. Dividing employees into separate groups will be beneficial at the end of training. Both groups can relate to their own learning team. The YL group want experience classroom group interaction with their team. Web-based training (WBT) is similar to distance learning. There will be online discussion, and e-mail dialogue. The AL group will build possibly new relationships, interact more, discuss challenges, and success. In conclusion, in order for the ABC Company to be effective with the new technology program, the recommendation is to divide the employees into separate groups, and categorize them as Adult Learner (AL), Young Learners (YL). This approach would be beneficial from the adult learner perspective and applying the four fundamental principles, simplifies the training plan and the assurance that training will be complete successfully within six months. Afterward employees will be able to apply the new concepts, and best practices of the new technology program.

Conflict Management in the Workplace

Conflict Management in the Workplace Introduction Conflict management in the workplace is an issue that every leader, manager, or employee has to deal with at one time or another. The basics of conflict management include improving communication, teamwork, and a systematic approach to solving the disagreement. This paper explores various techniques that can be utilized to manage conflict in the workplace. Workplace Conflict Management Conflict is defined by Hellriegel, Slocum and Woodman as â€Å"the process in which one party perceives that its interests are being opposed or negatively affected by another party† (p. 362). Sometimes conflict that be a positive force within an organization, while at other times it is a negative force. An example of conflict as a positive force is that the creation and resolution of conflict may lead the company to constructive problem solving. It may also lead people to search for ways of changing how they do things. The conflict resolution process can ultimately be a stimulus for positive change within an organization (Hellriegel, Slocum and Woodman, p. 364). However, conflict may also have serious negative effects on an organization. For example, conflict may divert efforts from goal attainment or it may deplete resources (particularly time and money) (Hellriegel, Slocum and Woodman, p. 364). Conflict also may negatively affect the psychological well-being of employees and cause stress (Hellriegel, Slocum and Woodman, p. 364). Indeed, conflicting workplace ideas may lead to anger, tension, and anxiety. Deep and lasting conflicts that continue without conflict management may even lead to violence between employees and others (Hellriegel, Slocum and Woodman, p. 365). Therefore, it would be fair to say that conflict may sometimes be advantageous and at other times destructive. Workplace managers must be sensitive to the consequences of conflict. These consequences range from negative outcomes (such as loss of skilled employees, sabotage, low quality of work, stress and even violence) to positive outcomes (such as creative alternatives, increased motivation and commitment, high quality of work, and personal satisfaction) (Hellriegel, Slocum and Woodman, p. 365). Conflicts (whether they are negative or positive) will arise in organizations whenever interests collide and when these differences affect the relationship between interdependent people, they must be constructively managed (Hellriegel, Slocum and Woodman, p. 365). According to Hellriegel, Slocum and Woodman, some ways to manage conflict include: the â€Å"forcing style†, the â€Å"accommodating style†, the â€Å"compromising style†, and the â€Å"collaborating style†. The forcing style refers to â€Å"assertive and uncooperative behaviors and reflects a win-lose approach to interpersonal conflict† (Hellriegel, Slocum and Woodman, p. 374). This forcing style relies on coercive power and dominance to resolve the conflict. In the forcing style, the person who is trying to resolve the conflict feels that one side must win and that one side must lose (Hellriegel, Slocum and Woodman, p. 374). The accommodating style, according to Hellriegel, Slocum and Woodman, refers to â€Å"cooperative and unassertive behaviors† (p. 376). The accommodation style manifests itself as a long-term strategy to encourage cooperation by others, or as a submission to the wishes of others. The accommodator tries to reduce tensions and stresses by reassurance and support (Hellriegel, Slocum and Woodman, p. 376). This style shows concern about the emotional aspects of conflict, but does not deal with substantive issues this style simply results in covering up or glossing over the issue (Hellriegel, Slocum and Woodman p. 376). According to Hellriegel, Slocum and Woodman, the compromising style refers to â€Å"behaviors at an intermediate level of cooperation and assertiveness† (p. 377). This style is based on give and take, which usually involves a series of concessions. This technique is commonly used and widely accepted as a means of resolving conflict. A collaborating style refers to â€Å"strong cooperative and assertive behaviors. It is the win-win approach to interpersonal conflict handling† (Hellriegel, Slocum and Woodman, p. 376). In this stylistic approach to workplace conflict management, it is sharing, examining and assessing the reasons for the conflict that leads to the development of an alternative that is fully acceptable to everyone involved. This effectively resolves the conflict (Hellriegel, Slocum and Woodman, p. 377). Studies on the use of these different interpersonal conflict handling styles indicate that collaboration is the best approach to managing workplace conflict (Hellriegel, Slocum and Woodman, p. 378). The collaboration style tends to be characteristic of (1) More successful individuals and (2) High-performing, rather than medium- and low-performing organizations (Hellriegel, Slocum and Woodman, p. 378). Furthermore, the use of the collaboration style of conflict management appears to result in positive feelings from employees (Hellriegel, Slocum and Woodman, p. 378). So, it appears that the best style to resolve conflict is the collaborative style. Another suggestion for workplace conflict management is to take a step-by-step approach no matter what style the manager is employing. Author Rudy M. Yandricks article, â€Å"Integrating Behavioral Strategies: A Solution to Workplace Problems†, suggests that a systemic approach to workplace issues by management is essential in todays workplace environment. For example, a step-by-step process can be taken to resolve any workplace conflict. This enables the leader to follow a systematic approach to resolving a conflict. A detailed example of a step-by-step systemic approach is the following: First, the employee reports an issue to his supervisor. Second, the supervisor gathers information in order to gain the best understanding possible of the potential hurdle. Third, the supervisor identifies possible causes of the conflict by collecting information from the team members and from anyone else impacted by it. Fourth, the supervisor meets with a Human Resources specialist who will build a list of potential solutions to the conflict. Fifth, the Human Resources specialist, in conjunction with the supervisor, decides on an appropriate solution to the problem. Sixth, the Human Resources specialist and the supervisor present the solution to the workers. And, finally, the solution must be administered. Additionally, there are exercises that can be done to resolve conflict and tensions in the workplace. For example, in the article by Boss and McConkie, the authors suggest an exercise for situations of conflict where there are contradictory personalities. They suggest a writing exercise where the people in conflict write answers to three questions: What does he or she do well? What do I think I do that bugs him or her? What does he or she do that bugs me? (p. 50) This exercise, according to the authors, gives those in conflict time to get used to an explicitly confrontational situation before either of them has a chance to â€Å"pop off† at the other. It forces some rationality into an emotionally charged situation. Also, those in conflict are forced to look at their own behavior before making any accusations against the other. Completing this exercise will create a non-contentious atmosphere for continuing the conflict resolution. Frequently, after doing an exercise such as the aforementioned, it will become clear that neither person involved in the conflict is intentionally causing problems for the other. Each of the foregoing systemic techniques and styles regarding workplace conflict management can be utilized either separately, or in conjunction with each other, in order to promote a more cohesive work environment. Conclusion Conflicts are part of individual relationships and organizational development, and no†¦organization can hope to mature to productivity and be successful without being able to resolve conflicts effectively (Cottringer, p. 6). Thus, conflict resolution is an integral part of maintaining a thriving workplace and the techniques and systemic approaches discussed in this paper should be utilized to resolve differences in the workplace. Bibliography Boss, Wayne R. and Mark L. McConkie. â€Å"Conflict Management in Surgery: Third-Party Intervention†. 5/1/2000. Public Administration Management: An Interactive Journal. Available at:. Retrieved May 22, 2003. Cottringer, William. â€Å"Conflict Management.† Executive Excellence Magazine, 14.8 (1997):6. Hellriegel, Don, John W. Slocum, Jr. and Richard W. Woodman. Organizational Behavior, 8th Edition. Cincinnati, OH: South-Western College Publishing, 1998. Yandrick, Rudy M. â€Å"Integrating Behavioral Strategies: A Solution to Workplace Problems.† Competere Consulting Group. Available at: . Retrieved May 22, 2003.

Cell-based Therapy For Myocardial Regeneration

Cell-based Therapy For Myocardial Regeneration ABSTRACT Myocardial infarction is one of the main cause of mortality in many countries. Therefore, an effective therapy for myocardial infarction is required. Reperfusion and other conventional therapy have been the mainstay therapy for myocardial infarction. However, many patients remain refractory to this therapy. Cell-based therapy is considered a novel therapy, in which stem cells are used for cardiac repair. Stem cells are potential therapeutic and promising option that could be the alternative solution for salvaging damaged cardiomyocyte. Based on current studies, stem cells are a promising therapeutic approach for myocardial infarction. However, some challenges need to be answered by future studies before this novel therapy can be widely applied. This essay provides an overview of the progress in stem cell therapy for myocardial infarction. INTRODUCTION The robust potential of stem cells were still a mystery, but today, we are constantly getting new information on this particular topic. One of the prospects of stem cell therapy is to treat damaged cardiomyocyte (Fischer, et.al, 2009; Beltrami, 2003).Acute myocardial infarction is one of the main causes of mortality and morbidity in many countries. Not only this disease causes a massive socio-economic burden, but also reduces the quality of live for patients who survive the attack (Hamm, 2016). Currently, one of the mainstay therapy for myocardial infarction is rapid revascularization to limit ischaemic damage. Reperfusion and other conventional therapy have undoubtedly saved so many lives, yet there are patients remained refractory to this therapy and left with no other treatment options. In addition to that, many patients who have underwent reperfusion strategy and survived, often left with significant impairment of left ventricular systolic function. One big question remain unansw ered. Is there any other treatment option for these patients? Medical therapeutic approach to reduce damaged cardiomyocyte and generate new functioning muscle is the current unmeet need. Stem cells emerge as the novel procedure to restore damaged cardiomyocytes, and this procedure is popularly known as cellular cardiomyoplasty (Pendyala, et.al, 2008; Reinlib, 2000). Many preclinical and clinical trials have documented the potential use of stem cells to generate viable cardiomyocyte and improve cardiac function (Bergmann, et.al, 2009). To date, there are many different types of adult stem cells and progenitor cells used for this procedure, some of which are bone marrow derived stem cells, hematopoietic stem cells, mesenchymal stem cells and so on. Since the advance of stem cells technology is faster than ever before, this essay aimed to give an evidence based update on stem cells use for myocardial infarction, what we have achieved so far, and what does the future hold for this breakthrough. CELL-BASED THERAPY FOR MYOCARDIAL REGENERATION After an ischaemic attack due to occluded coronary vessels, heart muscle usually left damaged and nonfunctioning. However, recent evidence suggested that the cardiac muscle could actually undergo a limited amount of renewal. A prospect of inducing muscle cell to undergo division for cardiomyocyte replacement, or generating new muscle by stem cells are certainly intriguing (Roell, et.al, 2002; Santoso, et.al, 2011). Stem cells are capable to proliferate in the same state (self-renewal) and differentiate into multiple cell lineages. On the other hand, progenitor cells are more specific and have limited differentiation potential. Mechanism on how stem cells work are as follows: firstly, these stem cells need to be extracted from the source (eg. bone marrow), after that these stem cells need to be delivered to the injured area. These cells are implanted in the myocardium, and due to the nature of these cells, they would grow and differentiate/transdifferentiate into cardiomyocyte. To achieve the goal of cardiac repair, these cells should also have the ability to fuse with the surrounding tissues that their harmonious contraction increases the heart contraction. Furthermore, these newly-formed cardiomyocyte should also express the appropriate electromechanical properties required for contraction to yield a synchronous contraction (Templin, et.al, 2011; Makino, et.al, 1999). Many clinical studies have documented the feasibility and safety of cellular cardiomyoplasty in patients with coronary artery disease (Makino, et.al, 1999; Strauer, et.al, 2002). To date, there are some different types of adult stem cells and progenitor cells used for this procedure, some of which are bone marrow derived stem cells, hematopoietic stem cells, mesenchymal stem cells and many others (Jackson, et.al, et.al, 2001; Kamihata, et.al, 2001; Bolli, et.al, 2011) POTENTIAL SOURCE AND TYPE OF STEM CELLS Bone Marrow Derived Stem Cells Bone marrow derived stem cells (BMCs) are the most widely studied type of stem cells. Orlic et al. (2001) first describe the ability of bone marrow cells to regenerate infarcted myocardium in mouse models. The transplanted cells showed transdifferentiation into cardiomyocyte which eventually lead to improved left ventricular ejection fraction (Orlic, 2001). The three types of stem cells derived from bone marrow are hematopoietic stem cells (HSCs), mesenchymal stem cells (MSCs), and endothelial progenitor cells (EPCs) (Orlic, 2001; Piao, et.al, 2005; Badorff, et.al, 2003). The role of BMCs for acute myocardial infacrtion has been reported to improve left ventricular ejection fraction (LVEF), both in REPAIR-AMI and BOOST trial (Meyer, et.al, 2006; Schachinger, et.al, 2006).BOOST trial demonstrate an acceleration of LVEF after intracoronary BMCs transfer (ejection fraction increased by 6.7% in the BMCs group as compared to 0.7% in the control group), and significant result was sustained until 18 months (Meyer, et.al, 2006). While in REPAIR AMI trial, improvement of LVEF, infarct size and wall thickening of infarcted segments were reported at two years follow up. At two years, the cumulative end point of death, myocardial infarction, or necessity for revascularization was significantly reduced in the BMC group compared with placebo (hazard ratio, 0.58; 95% CI, 0.36 to 0.94; P=0.025) (Assmus, et.al, 2010; Perin, et.al, 2012). Skeletal Myoblast Skeletal muscle has the ability to regenerate under certain circumstances. Skeletal resident stem cells are usually known as satellite cells, and these cells would differentiate to new myocytes in response to injury. However, whether this ability can be translated to a different condition, as in cardiomyocyte repair, should be further studied (Taylor, 198; Reinecke, et.al, 2002). MAGIC trial, a randomized controlled phase II trial, showed no significant changes in terms of global and regional LV function in skeletal myoblast- treated patients (Mensche, et.al, 2008). Another study performed by Dib et al.(2005) showed an increased in LV ejection fraction in the group treated with transepicardial injection of autologous SMs. Mesenchymal Stem Cells Mesenchymal stem cells (MSCs) are another potential option for cellular cardiomyoplasty. Mesenchymal stem cells can be found in various tissue, such as bone marrow and adipose tissue (Pittenger, 2004). One interesting mechanism by which MSCs mediate cardiac function improvement is the paracrine effect. MSCs may secrete soluble cytokines and growth factors that would eventually influence adjacent cardiomyocyte (Gharaibeh, et.al, 2011). Hare JM et al. (2009) studied the efficacy of intravenous allogenic human mesenchymal stem cells in patients with myocardial infarction. According to this study, intravenous MSCs were safe as showed by the similar adverse event rates in both intervention and control group. MSCs injection favorably affected patient functional capacity, quality of life and LV remodeling (Hare, et.al, 2012). Endothelial Progenitor Cells Endothelial progenitor cells (EPCs) have been linked with neovascularization in ischemic tissue. This interesting finding lead to the use of EPCs for another therapeutic purpose like cellular cardiomyoplasty (Isner, et.al, 1999). The human peripheral blood-derived EPCs would be a potential approach because those cells can be easily isolated without the need of major surgical intervention (Lin, et. Al, 2000). This assumption was later confirmed by Badorff et al. In this study, Badorff et al. (2003) reported that EPCs from healthy volunteers and Coronary Artery Disease (CAD) patients can transdifferentiate into functionally active cardiomyocytes when co-cultivated with rat cardiomyocytes. However, this finding was later opposed by Gruh I et al. According to this study, there was no significant evidence of transdifferentiation of human EPCs into cardiomyocyte (Gruh, et.al, 2006). Resident Cardiac Stem Cells Until recently, we believe that heart is a fully mature organ with no capability of self-renewal. However, the adult heart is not a terminally   differentiated organ, but harbors stem cell with regenerative capacity, namely resident cardiac stem cells (CSCs). Although the origins of CSCs are yet unclear, they can be isolated from heart tissue and expanded ex vivo for use as a cell-based therapy. There were many types of CSCs have been described in previous studies, like: epicardium-derived cells, cardiosphere-derived cardiac cells, and cardiac Sca-1+ cells. These resident stem cells have the potential to differentiate into different types of cells like vascular smooth muscle and myocardial cells (Tang, et.al, 2013; Tang, et.al, 2006; Fazel, et.al, 2006). Embryonic Stem Cells and Induced Pluripotent Stem Cells (iPS) Embryonic stem cells (ESC) are derived from the blastocyst (inner cell mass) of human embryo prior to implantation. ESCs are pluripotent cells, which means they have the capability to differentiate into any cells, one of which is cardiac myocytes. Due to the source of these cells, there are ethical issues regarding the use of ESC (Kofidis, 2005).The huge potential of ESC comes with a price. The pluripotency of ESC made these cells predisposes to tumor formation including teratomas. Amariglio N et al. (2009) documented the occurence of a human brain tumour following neural stem cell therapy. A boy with telangiectasia was treated with intracerebellar and intrathecal injection of human fetal neural stem cells. Four years later, he was diagnosed with a multifocal brain tumour. After thorough analysis, the tumor was of nonhost origin, indicating it was derived from the transplanted neural stem cells (Amariglio, 2009). To date, due to the scarcity of studies on ESC and negative experiences of previous studies, the significance of ESC as cell-based therapy for myocardial infaction remains elusive. The above-mentioned limitation would hopefully be elucidated in future research. Human Umbilical Cord Blood Cells Human umbilical blood cells (hUCB) contains a large number of non-hematopoietic stem cells which rarely express human leukocyte antigen (HLA) class II antigens, thus reducing the risk of rejection. Many studies have reported the efficacy and safety of hUCB administration in acute myocardial infarction model, with conflicting result (Henning, 2004; Moelker, 2007).According to Henning RJ et al. (2004) hUCB administration reduce infarction size and improve ventricular function in rats without requirements for immunosuppression (Henning, 2004). Similar positive finding were documented by Kim et al. Circulating Blood-derived Progenitor cells Circulating blood-derived progenitor cells (CPCs) are similar to BMCs, which mainly composed of EPCs. Santoso T et al. (2011) studied the safety and feasibility of combined granulocyte colony stimulating factor (G-CSF) and erythropoetin (EPO) based-stem cell therapy using intracoronary infusion of peripheral blood stem cells in patients with recent anterior myocardial infarction. G-CSF is used to mobilized stem cells to the injured area, inhibits cardiomyocyte apoptosis, promotes neovascularization, and increase the production of nitric oxide. While EPO, that is originally thought to be a hematopoietic hormone only, also may inhibited apoptosis and induced angiogenesis. This phase I study concluded that this procedure is safe and resulted in improved endpoints for LV ejection fraction and cardiac viability (Santoso, 2011). Cardiopoietic Stem Cells Cardiopoietic stem cells are not a distinct type of stem cells but refer to the novel way of processing stem cells in order to get a lineage specification. Cardiopoietic stem cells are harvested stem cells that are treated with a protein cocktail to replicate natural cues to heart development, before being injected into the patients heart. The C-CURE trial studied the efficacy of bone marrow derived-mesenchymal stem cells in chronic heart failure. The isolated mesenchymal stem cells were exposed to a cardiogenic cocktail that trigger expression and nuclear translocation of cardiac transcription factors, before being injected to the patients heart. After six months follow up, patients in the treatment group significantly improved in terms of LVEF and fitness capacity. There was no evidence of increased cardiac or systemic toxicity induced by cardiopoietic cell therapy (Bartunek, 2013). Unfortunately, data comparing the efficacy and safety between cardiopoietic stem cells and ordinary stem cells without cocktail-based priming is still lacking. DELIVERY METHODS In order to make these stem cells reach the heart, a reliable delivery method need to be employed. The ideal method should be able to safely and efficiently deliver an optimal number of stem cells to the target tissue. Beside the high efficacy, this delivery method should be as minimally invasive as possible for the sake of patients comfort. There are some delivery methods worthy to know. Intracoronary Infusion As the name implies, intracoronary infusion is a process of delivering stem cells through coronary artery, usually through intracoronary catheterization. Stem cells are infused under pressure via a ballon catheter. The ballon was inflated in order to prevent anterogade blood flow that would compromize stem cells delivery. Catheter guided cell transfer has its unique advantage of safety under local anesthesia, and a part of routine cardiac catheterization. The intracoronary method provide a maximum number of cells to the target area, with good blood supply which is crucial for cell survival. Multiple studies have reported the use of intracoronary infusion for stem cells delivery (Strauer, 2002; Schachinger, 2006). Intravenous Peripheral Infusion Intravenous stem cells administration is one of the easiest method to be employed. Intravenous administration is possible through homing phenomenon of stem cells to the injured heart. Unfortunately, intravenous peripheral infusion comes with some disadvantages. First, only 3% of normal cardiac output will flow per minute through the left ventricle. This low amount of blood would limit the amount of stem cells delivered. Secondly, due to the passing of venous blood in the lung, many cells would trap in lung vasculature that eventually lead to stem cells reduction (Grieve et.al, 2012). Intramyocardial, Transendoccardial and Transpericardial Route As mentioned earlier, the downside of intravenous administration is the passing of the blood in certain organs that would entraped some of the stem cells. Unlike intravenous route, intramyocardial method is undoubtly provide direct access to the injured cardiomyocyte bypassing the need for mobilization, homing and any risk of cells entrapment in other organ, thus provide a more effective way to deliver abundant stem cells to the injured area. However, this method comes with its own expense of a more invasive method, not to mention the risk of ventricular perforation in the already damaged cardiomyocyte. Intramyocardial delivery usually performed during an open heart surgery or needle-tipped delivery catheter (Strauer, 2003; Forrester, 2003). Nelson et al.(2009) documented that intamyocardial delivery of iPS originating from reprogrammed fiobroblast, yielded progeny that properly engrafted and resulted in restored contractile performance, increased ventricular wall thickness, and elec tric stability (Nelson, et.al, 2009). STUDIES USING STEM CELLS IN MYOCARDIAL INFARCTION Many studies have been carried out to investigate the efficacy and safety of stem cell therapy in patients with myocardial infarction. Each of these studies investigated different kind of stem cells with different delivery methods. The ultimate goal of these studies is to answer whether stem cell therapy could be a feasible therapeutic approach for patients with myocardial infarction. The result of these studies were not always positive, even some of the studies did not document any beneficial effect of stem cell therapy. However, this conflicting result need to be intepreted with caution due to the different study method, different type of stem cells used, and different delivery methods employed. Three meta- analysis on the efficacy of BMCs therapy for myocardial infarction have been published. In a meta-analysis by Delewi R et al, intracoronary BMCs infusion is associated with improvement of LV function and remodelling in patients after ST-segment elevation myocardial infarction. The benefit in terms of LVEF improvement was more pronounced in patients with a worse baseline LVEF (LVEF cut off: 40%) and younger age (age cut off: 55 years) (Delewi, et.al, 2013).   In a second meta-analysis by Clifford DM et al. (2012) which include thirty-three RCTs, there was no significant difference in hard end point like mortality and morbidity in the BMCs treated group. However global heart function, as represented by LVEF and infarct size, was improved significantly and was sustained long term (12 to 61 months) in the BMCs group (Clifford, et.al, 2012). The third meta-analysis by Long C et al. (2013) further confirmed the beneficial effect of intracoronary BMCs in patients with acute my ocardial infraction. According to this meta-analysis, BMCs therapy significantly improved LVEF, while mildly but not significantly reduced left ventricular end-systolic volume and left ventricular end-diastolic volume (Lond, et.al, 2013). These three meta-analysis synonymously agree that BMCs therapy is beneficial in terms of improved heart function and reduced infarct size. CHALLENGES AND THE FUTURE We have just entered the new era of stem cell therapy. When advanced therapy like primary PCI and thrombolytic showed more limited beneficial for patients with myocardial infarction, the concept of cell-based therapy is definitely appealing. This new approach could be the answer that have been waited for sometime. As we have discussed previously, there are many issues on stem cell therapy that need to be addressed in future studies. Firstly, what is considered to be the best stem cells to replace cardiomyocyte. Secondly, the right delivery method of these stem cells need to be determined. Whether different type of stem cells required certain delivery methods also need to be further elucidated. Another question is the right timing of delivery (acute, sub-acute or chronic), whether it contributes to the fate of stem cells. Fourth, the concentration of stem cells, dose-effect relationship and safety of stem cell therapy need to be further investigated. One particular topic in regard to stem cell safety is the tumorigenicity of ESC. We need to disentangle a way to reprogram these cells so they can differentiate into functional cells, but lack the ability to form tumours. Finally, novel diagnostic tools are required to detect and evaluate stem cells therapy. Future studies would hopefully provide s olid proof on hard end-points (eg. mortality), instead of surrogate markers like LVEF or infarct size. CONCLUSION Tremendous progresses were made in cell-based therapy, and future advances would further lead us to a new solution for ischaemic heart disease. Stem cells own robust potential in medicine, one of which is to replace damaged cardiomyocyte. More evidents are needed in advance to widely use of this modality. REFERENCES Amariglio N, Hirshberg A, Scheithauer BW, et al. (2009). Donor-derived brain tumor following neural stem cell transplantation in an ataxia telangiectasia patient. Assmus B, Rolf A, Erbs S, et al. (2010). Clinical outcome 2 years after intracoronary administration of bone marrow-derived progenitor cells in acute myocardial infarction. Circ Heart Fail, 3, pp.89-96. Assmus B, Schachinger V, Teupe C, et al. 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Arnolfini’s Marriage Essay -- Art

Arnolfini’s Marriage Jan van Eyck was â€Å"one of the greatest and most influential Flemish painters of altarpieces and portraits of the 1400's† (Hayes). van Eyck's paintings often include objects with hidden symbolic meaning. There are several different interpretations of the symbolic meaning concerning his portrait of Giovanni Arnolfini and his second bride often referred to as â€Å"The Arnolfini Marriage†. Marriage is a sacred union between man and woman. A wedding is one of the most important events in a woman’s life. Often a wedding occurs in the present of the wedding party, family members and friends. During the 1400’s a wedding ceremony was performed in the privacy of the home. van Eyck was hired to paint a portrait of this marriage union. â€Å"Some art historians, like Panofsky, claim that van Eyck was a witness to the Arnolfini wedding and the painting serves as documentation of their vows† (Kren). Jeanne de Chenany looks pregnant in her green wedding dress, this wedding was kept private because it was a secret or maybe this type of dress was very stylish during the 1400’s. The bride was definitely not a virgin, because white symbolizes pureness not green. Arnolfini is holding Jeanne de Chenany hand as an expression of his love for her. This wedding was held during the daytime because you can clearly see the light through the window in the painting. The single burning candle in the chandelier was not needed to light up the room. This candle symbolizes the union candle or...

Homosexuality in Robert Louis Stevenson The Strange Case of Dr. Jekyll and Mr. Hyde :: Dr. Jekyll and Mr. Hyde Essays

References to Homosexuality in Stevenson's Jekl and Hyde Stevenson's choice of certain words in the novel is extremely pertinent to a homoerotic reading of the text. In some Victorian circles (and most certainly not in others), certain words had very explicit homosexual connotations. The word "homosexual" seems to have come into the English language around 1869, introduced by a Hungarian named Benkert but not generally used by the British until the 1880s. Yet, according to Theo Aronson, there were other words used at that time to identify the love between the same gender. "Homogenic love," "similisexualism," and "Uranism" were apparently among the more common references to homosexuality. Within the novel, however, the word "homosexual" is never used. If it were, perhaps, then such a homoerotic interpretation as this would be redundant. There are, however, certain, rather ambiguous, words that Stevenson uses that have Victorian homosexual connotations. During their walk together, Utterson and Enfield come across the home of Edward Hyde. After relating his story about Hyde, Enfield refers to the place as "Black Mail House" (8). When asked if he ever inquired about the man who lived therein, Enfield replies, "No sir, I make it a rule of mine: the more it looks like Queer Street, the less I ask" (9). Both of these references to Hyde's home are more direct references to Hyde himself, made by a man who, at least publicly, must acknowledge the distinction between himself and the man who lives in Soho. Poole also makes a reference to Hyde's homosexuality: "Then you must know as well as the rest of us that there was something queer about that gentleman - something that gave a man a turn. . . " (57). During the 19th century, of course, homosexuality was acknowledged by heterosexuals (particularly of the upper classes) as an existing activity among the lower classes - an activity that thrived in London's own East End. Those who were thought to be homosexuals were often blackmailed. With the Labouchere Amendment in 1885, homosexuals faced a greater threat of exposure through blackmail. In fact, "the threat of exposure as a sodomite is the basis of more than half of the prosecutions throughout the eighteenth century" ("Jekyll & Hyde," par. 8). Other Victorian writers, like Oscar Wilde, faced this threat, which often damaged their reputations if the affair ever made it to a court. Enfield's reference to "Queer Street" also denotes a homosexual connotation.

Impact of Divorce on Children

The Impact of Divorce on the Family Sociology as defined by Sociology: exploring the architecture of everyday life is the systematic study of human societies (Newman, 2012). By studying human societies we can observe and understand how individuals interact with each other in society and the developing global system, but in order to understand these relationships we must look at society and the world at a different perspective. In turn a sociologist would be a scientist who studies human societies.A sociologist would be interesting in studying the topic of impact of divorce on children because it directly involves a relationship between two people. By studying divorce through a sociological perspective a sociologist can observe the causes that resulted in the divorce and the sociological implications it has on the nuclear family. Divorce is defined as the legal dissolution of marriage by a court or other competent body (Newman, 2012). The divorce rate in the United States is somewhere between 40-50 percent.The causes for divorce can vary greatly and can range anywhere from unhappiness with the marriage to extramarital relationships. In the 1950’s to the 1970’s divorce was only fault based meaning one spouse had to prove the other spouse committed a marital offense (Jolivet, 2012). Since the culture in the 1950’s was much different than it is now divorced couples were stigmatized, and their children were also labeled as outcasts from a â€Å"broken home†. It was also thought that children from a â€Å"broken home† had a higher chance of failing out of school or delinquency since there was an obvious lack of parenting.In the 1970’s divorce became more common and legislation changed, therefore, no fault divorce was introduced. Once divorce became more common, society became more accepting and divorce was not viewed as taboo anymore. Instead people now see divorce as another chance to be happy. Children of divorce were now v iewed as resilient instead of delinquents (Jolivet, 2012). The change in the way children were viewed comes from being able to cope with the loss of a family or growing up without living with a mom and dad.The effect of divorce on an individual’s life can be tremendous, it can impact almost everyone the individual interacts with. In an article by Greif and Deal (2012) they explained how friend networks would overlap with marriage and when that couple divorce that network is put at risk. It was found that after 8 months of separation men and women maintained 61% of that network but after 16 months only 50% of that network remained. The individual is important when it comes to observing effects of divorce.In a study done with 31 divorced women it was found that their physical appearance often changed as they struggled with their identity after divorce (Greif and Deal, 2012). This is most due to the high levels of stress before and after the divorce The impact parent arguing can have on the children could be very dramatic. A survey done by Dr. Robert Gordon that asked 1000 teenagers between the ages of fourteen and eighteen about their opinions on divorce concluded that the children wanted their parents â€Å"more than anything† to stay together (Jolivet, 2012).The survey also looked into children’s opinions’ on parent arguing and found that 50% of children think that parent arguing is â€Å"terrible† (Jolivet, 2012). There are different types of parental arguing, which can range from disagreeing, criticizing, screaming and physical confrontation. When children were asked about what arguing meant to them 39% said it involved disagreement, 26% said it was criticizing the other parent, but less than 35% said that arguing involved screaming or physical confrontation.Further research shows that most married couples agreed to occasionally arguing in front of their children. Dr. Gordon concluded that children are deeply affected by pa rental arguing and hopes that his research will make couples think twice about arguing or criticizing each other in front of their children (Jolivet, 2012). The social implications of parental arguing on children are mostly negative but in some situations can be positive. When children are exposed to a negative environment it threatens their emotional stability, which can result in depression, anxiety, and aggression.Although when parental conflicts are solved sensibly children learn constructive ways to settle arguments. Children learn to compromise and use compassion instead of aggressive behavior to solve disagreements. The overwhelming message that children of divorced parents try to convey is that they want more than anything for their parents to stay together. When teenagers were asked about what they would want their parents to know the majority said that it’s â€Å"Not easy for all of us† and â€Å"they don’t want to be blamed for it† or â€Å"ca ught in the middle† (Jolivet, 2012).This shows that the impacts of divorce and stress levels are not only felt by the individuals involved in the relationship but are felt almost as equally by the children. Children of divorced parents in present times are seen as resilient and being able to cope with difficult times. In a study done by Dr. Robert Gordon about teenager’s opinions on divorce found: Seeing parents divorced or growing up without mom and dad living together makes our whole view of life different.We become more independent and strong. Marriage and kids are not such a positive thing anymore/7 Kids also wanted their parents to know that, simply, they can handle the truth of the situation. (Jolivet, 2012) As a result of viewing marriage and kids differently teenagers who come from divorced families are more likely to have trouble with their own marriage. This is because children do not know what caused their parent’s marriage to collapse, therefore, are unable to maintain a successful relationship.The immediate effects of divorce on children is evident but there are usually no long term effects as they usually fall into the normal range of psychological and social adjustment (Jolivet, 2012). Although, the way the parents handle the divorce is the determining factor for long-term effects on divorce. The number one factor that puts a child at risk for long-term effects of divorce is the intensity and level of parental conflict prior, during, and after the divorce. For example, battles for custody can put high levels of stress on children as they have little control of the legal events and outcomes.If a child has to suffer through a high- conflict divorce it can double the rate of behavioral and emotional adjustment problems along with many more potential effects. Studies have also examined the effect of divorce on boys and girls as different groups. Data shows that the effect on boys was more immediate and dramatic. Boys were also mo re vulnerable to aggression and disruption. However, the effect on girls culminated over time and resulted in increased sexual promiscuity, skipping school, and acting out (Jolivet, 2012).This research concludes that the effect of divorce on children can be predicted by the conditions that existed before the separation. As children go through the stages of divorce with their parents they are observing everything that is going on, these observations could have a negative effect on how these children view marriage and divorce later in life. In a study of divorce done by Dr. Amato and Dr. DeBoer found that divorces were more common in children whose parents divorced than among children whose parents stayed married (Jolivet, 2012).When parents divorce the child is familiar and used to the subject and is more likely to view it much less benignly than a child who did not grow up with divorce in the household. This results in those children being more open to divorce if they are unhappy wi th their marriage. Children could also view marriage as an unpredictable relationship and love and commitment can come and go (Jolivet, 2012). Although adult children with divorced parents are more likely to get divorce does not mean they are doomed for an unsuccessful marriage, they just need to work a little bit more to keep their relationship strong and interesting.Divorce is a difficult topic for many people and can affect almost everybody connected to an individual in the relationship. In a family the individuals who opted for the divorce are obviously greatly affected as well as the children. Divorce can have many negative implications on children including social and behavioral problems as well as problems with their own marriage later in life. Unfortunately, everyone involved feels the negative results of divorce but the degree of that effect can be lowered if certain measures are taken prior to a divorce.Dr. Lisa Strohschein suggests that instead of focusing on helping chil dren after divorce, paying attention to what happens to the kids leading up to the divorce could lower levels of anti-social behavior (Jolivet, 2012). She also states that parents who help children cope with divorce and shape their attitude toward more positive associations could have a great effect on their mental health (Jolivet, 2012). Even though the negative implications of divorce are very prevalent I believe that they can be reduced to a degree where the effects are minimal.

I am Legend Essay

Traditionally, bookstores categorize various books based on their respective contents – horror, fiction, literature, or science fiction. Horror texts invoke feelings of fear in readers due to their bizarre or macabre content. Science fiction or fiction books describe imaginary concepts of either scientific or general nature respectively. Conversely, literature books comprise of texts that are neither fictional nor horror-based. Matheson’s I am Legend novel thus belongs to the category of horror owing to the ghoulish events described therein. For example, the vampirism that is evident in the novel instills fear among readers, thus rendering the work a horror literature. Although ‘good’ or ‘bad’ are purely subjective terms, people sometime use these terms to describe different texts. Such categorization relies heavily on persons’ subjective judgment, for example, regarding the emotions that such texts invoke in readers. To illustrate, horror, mystery, or romance books may be termed as ‘bad’. Conversely, science fiction books are labeled as ‘good’. Since such classification is very subjective and unstable owing to persons’ varied preferences and views, there is essentially no entire class of books that can be categorically termed as either ‘bad’ or ‘good’. After studying Matheson’s I am Legend novel, I cannot help but view it as a subjectively ‘bad’ book based on the ghastly scenes that the author describes. For example, Robert Neville – the novel’s main character – is consistently described as being engaged in a futile rush to beat some seemingly insurmountable bigger forces. The character is thus clearly destined for death as is evident through his obviously futile attempts to fight against a vampire curse on earth. Eventually, Neville dies a sad and regretful death after spending a great deal of his time trying to outdo the evil that lurks on the earth. Through the somewhat unnecessary and martyr-like death of Neville, the author makes the book appear as a ‘bad’ one because a character is unjustly punished by death.