Microlite Case Study Essay

Microlite S. A. is a company in Brazil that manufactures alkaline and zinc-carbon batteries. In 1992 the company was faced with a reduction of tariffs on imported manufactured goods which would mean that the international competition would increase significantly. Luiz Pinto, who was a Microlite manager at the time, was faced with the opportunity to reduce labor and manufacturing costs by closing down the plant in Guarulhos and move production to the plant in Jaboatao. The choices that Mr. Pinto was faced with were to move the Guarulhos equipment to Jaboatao or to purchase new and faster equipment. Moving the Guarulhos equipment to Jaboatao would minimize the capital investment and also increase the workflow due to the reliability of the equipment. Purchasing the new equipment would require more capital investment but reduce labor and increase production. The new tariff reductions were set to be implemented in 1995 and the problems were that Mr. Pinto had to reduce labor and increase productivity in an effort to maintain the large share of the Brazilian battery market that it currently owned. One non-production issue that Mr. Pinto is faced with is from a financial aspect. One option presented to Mr.  Pinto is to purchase new Pan-Orient equipment. The investment in new equipment would be approximately $2 million. It is unknown from the case study how the $2 million would be paid or financed. This, however, would have an impact on the decision of the stakeholders on whether to accept this proposal or not. The Current Situation The current bottlenecks in the operation of the AA battery operation at Jaboatao are the steps â€Å"add paste to cup† and â€Å"inspect carbon rods. † These two steps operate below the required rate of production and would need to be corrected to improve productivity. In an effort to increase productivity, the Jaboatao plant should add one machine from Guarulhos dedicated to â€Å"add paste to cup† production. While this solution will increase productivity, it will also increase labor required to operate the machine and additional labor would be required to inspect carbon rods. If the two bottleneck problems in the process are corrected, this would bring production up to the required 540 units per minute. One concern to Microlite is the amount of downtime that is experienced in Jaboatao. One obvious way to decrease downtime would be to simply add more machinery from Guarulhos. This would increase productivity but the company is still faced with the increased labor costs associated with the additional machinery. If I were the manager of the Jaboatao plant, I would be faced with a difficult decision. I ultimately would not want the addition al machines due to the associated costs. Instead, I would research the differences in operations of the two plants and determine what is factoring into the additional Jaboatao downtime. I would use the information to re-train employees and educate them on the Guarulhos processes and procedures. Justification  If the Guarulhos machines are installed it can cure the bottleneck at the â€Å"add paste to cup† portion of the process. Increasing the machinery will allow for the production to be increased to 540 units per minute and the bottleneck is corrected. The secondary bottleneck, â€Å"inspect carbon rods,† would require additional labor. It is estimated that the process would require one additional employee to increase the production of inspecting the carbon rods. The additional machinery and manpower would adequately make up for 1/8 of the production from the Guarulhos plant. Purchasing and installing the new Pan-Orient equipment seems extreme due to the significant amount of capital funds required as an initial investment. Microtel did not appear to be heavily in favor of this decision and I would imagine that stakeholders would be weary of the large investment. Moving the equipment from Guarulhos appears to be the wisest choice as it is the least expensive and drastic. The additional funds that are saved could also be used on training and machine modifications to improve machine productivity. The difference in annual expenses is large but the amounts are offset by the initial investment of the Pan-Orient equipment (See exhibit). During my evaluation I determined that the ideal transition would be to move the equipment from Guarulhos to Jaboatao to increase productivity and reduce downtime in the process. The Pan-Orient equipment is a good investment for the future but does not appear to be the right decision now. There could be a smoother transition in the future by introducing the Pan-Orient equipment at later time.

Line, Staff and Human Resources Management Authority

Line, Staff and Human Resources Management Authority What does it take to get the right organizational design for Human Resources? In today's constantly evolving environment, developing an organization that makes the right decisions, while directing others’ work and giving orders requires having line and staff authority in place. In this essay, we will explain what authority is and explain the difference from line authority and staff authority. Also we will explain what type of authority human resource managers have. So what is authority?Authority is â€Å"the power to determine, adjudicate, or otherwise settle issues or disputes; jurisdiction; the right to control, command, or determine† (Dictionary. com, n. d. ). Power is the ability to get things done either to enforce one’s own will or to enforce the collective will of an organization. This tells us that all managers have some form of authority. Now, let us distinguish between line authority and staff authori ty. Line authority gives management individuals the formal power to direct and control immediate subordinates. Staff authority gives managers the right to advise, recommend, and counsel other managers and employees.It is a communication relationship with management. It has an influence that derives indirectly from line authority at a higher level. According to Dessler (2008), line authority creates a superior-subordinate relationship and staff authority creates an advisory relationship. The authority of human resources is delegated by the top management of organizations. How much authority it derives from top management is a policy matter. With today's workforce becoming increasingly diverse and organizations doing more to maximize the benefits of the differences in employees, human resource managers are key players.Organizations are relying on managers to get the people who get the job done, and of course, make the company money. Human resource managers have three fundamental funct ions: 1) line function – directing activities within the department and related areas while having implied authority, 2) coordinative function – coordinating personnel activities and 3) staff functions – assisting and advising line managers. In conclusion, line, staff and human resources personnel must work together closely to maintain the efficiency and effectiveness of the organization.To ensure that line, staff and human resources personnel do work together productively, management must make sure all groups understand the organizational mission, have specific objectives, and realize that they are partners in helping the organization reach its objectives.References Authority. (n. d. ). Dictionary. com Unabridged. Retrieved July 18, 2010, from Dictionary. com website: http://dictionary. reference. com/browse/authority Dressler, G. (2008). Florida International University. In G. Dressler, Human Resources Management – 11th ed. (p. 4). Upper Saddle River, N J 07458: Pearson Prentice Hall.

ALGORITHM - MEANING

ALGORITHM MEANING In the most basic sense, an algorithm is a process- a set of detailed instruction that must be carried out in a particular order and follows logic to attain a given result. An algorithm is a well-defined procedure or set of rules guaranteed to achieve a certain objective. You use an algorithm every time you follow the directions to put together a new toy, use a recipe to make cookies, or defrost something in the microwave (personal algorithms). When the term algorithm used in math, it typically refers to a set of steps or procedures used to solve a mathematical computation. In mathematics, an algorithm is a specific series of steps that will give you the correct answer every time. For example, in grade school, you and your classmates probably learned and memorized a certain finite steps or procedures for addition, subtraction and multiplying etc. (standard algorithms). Algorithm are of two type: informal (personal) and formal (standard) algorithm. An informal algorithm is a procedure that the student him/herself figured out while a formal algorithm is a process and procedure that has been taught to them. It may or may not be similar to a conventional algorithms (formal algorithms). Examples on Informal Algorithms Examples on Formal Algorithms 1. ADD the given numbers 109 + 207 Jimmy did like this. David did like this. =100+9+200+7 109-9=100 =300+16 207-7=200 =316 200+100=300 9+7=16 300+16=316 2. Multiply the given number 25Ãâ€"13 25(20+5) x13(10+3) ————– 15 60 50 + 200 ————— 325 1. ADD the given numbers 109+207 1 109 + 207 ——– 316 ——– 2. Multiply the given number 25Ãâ€"13 1 25 x13 ———— 75 +25x ———— 325 MERITS OF INFORMAL ALGORITHMS They learn to think and use their common sense, as well as new skills and knowledge. Students who invent their own procedures: Learn that their intuitive methods are valid and that mathematics makes sense. Become more proficient with mental arithmetic. Are motivated because they understand their own methods, as opposed to learning by rote. Become skilled at representing ideas with objects, words, pictures, and symbols. Develop persistence and confidence in dealing with challenging problems. ADVANTAGES OF THE FORMAL ALGORITHMS Plunkett (1979), Thompson (1997), Usiskin (1998) and other writers offered several reasons for this. These included :  ¢ Standard algorithms are powerful in solving classes of problems, particularly where the computation involves many numbers, where memory may be overloaded.  ¢ Standard algorithms contracted, summarizing several lines of equation involving distributivity and associativity.  ¢ Standard algorithms are automatic, being able to be taught to, and carried out by, someone without having to analyze the underlying basis of the algorithm.  ¢ Standard algorithms are fast, with a direct route to the answer.  ¢ Standard algorithms provide the written record of computation, enabling teachers and students to locate any errors in the algorithm.  ¢ Standard algorithms can be instructive.  ¢ For teachers these are easy to manage and assess. DISADVANTAGES OF THE FORMAL ALGORITHMS Kamii and Dominick (1998), McIntosh (1998), and Northcote McIntosh (1999) have potential dangers that can be summarized as follows :  ¢ They do not correspond to the ways in which people tend to think about numbers.  ¢ They encourage children to give up their own thinking and creativity, leading to loss of ownership of ideas .  ¢ The traditionally-taught (standard) algorithm may no longer be the most efficient and easily learned.  ¢ They tend to lead to blind acceptance of results and over-zealous applications. Given the focus on procedures that require little thinking, children often use an standard algorithms when it is not at all necessary.  ¢ There is a high probability that the students will lose conceptual knowledge in the process of gaining procedural knowledge. There is also the use of relevance. Students use standard algorithms for only a small proportion of their calculation.

Using Cell Phone While Driving Assignment Example | Topics and Well Written Essays - 1250 words

Using Cell Phone While Driving - Assignment Example Thus, when drivers are seen dialing or talking on the cell phone while driving, people especially their passengers cannot be comfortable just sitting in their seats but are more than irritated and react. When cell phone use is mixed with driving, people support the idea of giving penalties to motorists who are ignoring the law of its prohibition while their wheels are in motion. This is deemed necessary especially for younger age drivers as they are the group who most uses cell phones while driving either at night or during the day (Vivoda, et al. 1). In Virginia, when a teen is caught speeding with a cell phone on her hand, she could be fined an additional of $50. In New Jersey, She is fined $ 100 to 250 (Rusell, Michael 1). To the careful drivers and concerned citizens, additional fines are just and necessary to remind drivers to get rid of the cell phone while driving for them to concentrate on the road. Doing two things well at the same time is impossible as claimed by Douglas Al exander, a transport secretary (Topsfield, James 3). Divided attention may distract the driver’s ability to recognize or react appropriately to any number situations which could happen on the road such as the crossing of pedestrians from elsewhere, speeding, or the change of traffic lights and the likes. In addition, fines may tell the driver that the consequence of his negligence use of the cell phone on the road is too great to ignore. Penalties are said to reduce this form of offense. Although this may be true, there are still many motorists who violate the law of cell phone use. Many believe that the fine is not enough to have teeth on violators. They could easily pay the amount and be freed of the offense.

Family Law Essay Example | Topics and Well Written Essays - 2250 words

Family Law - Essay Example are treated slightly better than unmarried fathers when it comes to issues regarding the children, however when relationships break up it is generally the father that loses contact with the child or is restricted in the amount of contact they can have. Infrequently fathers are given preference over mothers in residence orders6. In general terms the courts have to have substantial proof that the mother is incapable of looking after the child before an order is made for the father to have care and control of the child. In the UK fathers can acquire parental responsibility either by being married to the mother of the child at the time that the baby is born or by the registering of the child jointly with the mother. Married fathers are entitled to register the birth of the baby without the mother being present and will be automatically entered onto the birth certificate of the child even if they are not present when the child is registered. Unmarried fathers will only appear on the birth certificate if the mother of the baby agrees to the father’s name been entered on the birth certificate. Since the introduction of the Adoption and Children Act 2002 an unmarried father can have parental responsibility if his name appears on the register of births. The effect of the 2002 Act led to the Children Act 1989 being amended so that there is no longer a requirement that the father has to prove his genetic fatherhood in order to be entered on the birth register. The acquisition of parental responsibility entitles the father to the right of consultation with regard to any decisions that are to be taken in respect of the welfare of the child7. In cases were the mother is incapable of caring for the child a father with parental responsibility can apply to the courts for a residence order whereby the court can insist on the child residing with the father8. In such cases the court can sometimes grant a joint residence order which giving the mother and father equal rights over

International Developments of Accounting Essay Example | Topics and Well Written Essays - 4750 words

International Developments of Accounting - Essay Example After complete analysis it was observed that British airways have been in trouble deeply due the problems of loss in revenue, cheap air line competitions and others. On the other side Emirates enjoys good amount of profits and reputation and its free from problems. Recommendation is being made for British Airways to actively change their approach towards customer management and give special discounts and promotion apart from other advertising techniques in order to take care of current crises. In the last an analysis of performed in between US GAAP and IFRS and it was concluded that IASB and FASB should actively coordinate with each and try to get a reasonable solution for this dilemma so that the world of accounts is uniformed with IFRS and being followed by all the countries in the world. Introduction After the incident of 9/11 there were many things which got changed. One of the major changes which the companies have seen is the Airline industries falling from the Sky to earth. Th is was due to the fact that the aero planes were used for terrorism purposes. People avoided to travel by Air instead they use other means of getting from one place to other. Further to increase the problem recent recession gives all the businesses in the world a tough time. Airline industry was given further tough time and got financial crunch. In order to get our purpose we have selected British Airways as one of the Company and other airline selected is Emirates (A UAE based airliner). The Financial Data was compared using the Ratio Analysis. About The Airlines British Airways The flag carrier of Britain is known as British Airways. Headquarter of the airline is based in Waterside which is near the hub of the Airline at London Heathrow Airport. This is the largest airline of United Kingdom in term of Fleet size, international flight and international destination. Emirates Emirates airline is the national airline of Dubai, United Arab Emirates. Emirates are the largest airline of Middle East. It carries around 2,400 passengers per week. Headquarter of the airline is based in Dubai. (British Airways) (Emirates n.d.) Financial Statements Analysis We will analyze the financial statements ratios in the following criteria. 1. Profitability 2. Liquidity/Solvency 3. Working capital efficiency 4. Long term financial structure 5. Investors’ perspective Profitability Return on equity In case of British Airways, the return on equity their percentage of return to equity holder is on a declining trend. The return on equity in the year 2009 was in the negative zone at 19% and the losses further increases in the year 2010 which makes the return on equity to further negative zone by 1% i.e. 20% in total. (Emirates) Whereas, in case of Emirates Airline is stated at 5% in the year 2009

The Link Between Productiveness And Motivation Essay

The Link Between Productiveness And Motivation - Essay Example Some things that happen in life come as surprise and bring happiness while some others happen and cause serious distress because their outcome is a loss of an important aspect of life. In case of the issues that happen in the life of a person, how that person responds to it becomes an important way because it enhances his or her participation in the society. In the same way, a person may have various opportunities within his or her capability but the choice to participate in any of them should not be influenced by what other people may have an opinion about it but rather what he or she feels is the best thing to do. This means that a person needs to do something he or she will be passionate so that he will be able to be productive even without motivation from other people. Neil Pasricha presents a talk about The Three A’s of Awesome in which he describes the need for exploration of the opportunities that are available to a person to make life good. In some instances, he uses t he example of the things that happened to his family when his father and mother started living in Toronto in the late 1960s in their mid-twenties and how his sister and he grew to be mature individuals. Pasricha narrates how the early life his sister and he lived was with little care about the things that were otherwise important to his parents and how they perceived the different things that they experienced. He narrates how some of the things in his life shaped his life through triggering a sense of happiness and others triggered a lot of pain in his life. Pasricha faced the effects of the economic meltdown that happened in 2008 and 2009 and he had to suffer other things but later he did the things that he liked the most in his life and it brought a lot of benefit to him. He made a blog site that he observed grow from just a single reader to an award-winning blog that was attracting millions of readers from all over the world.

Theorization & Generalization of Findings Article

Theorization & Generalization of Findings - Article Example Thus, Social Work Research is a means of providing a flexible system through which targets of a given Social Work projects can be analyzed, critiqued and evaluated in order to provide an opinion or view of the existing state of affairs in the status of a given community. The purpose of this paper is to critique a given article on the basis of standards, conventions, and ethics of Social Work Research presented by authoritative academics and researchers in the field. This will include a thorough review and analysis of the content of the article and how it meets the standards in the absolute and relativist sense. The article selected for this study is titled â€Å"Violence Exposure Among Children of Incarcerated Mothers† by Dana, D. DeHart and Sandra J. Altshuler which was published in the Child Adolescent Social Work Journal in 2009. As the title suggests, the article focuses on the social welfare of a class of people in society who need the help of social service providers and other social workers to gain a normal life – children of incarcerated women. Clearly, when a woman gives birth to a child in prison, the child is in a less than ideal social setting. Hence, there is the need for social workers in the community to find ways of ensuring that the child in question gets the right level of care and attention in order to grow to become a responsible adult. The title makes it easier for people searching the web to locate it because the words â€Å"violence†, â€Å"children† and â€Å"incarcerated mothers† are likely to be searched when anyone with a research interest needs to find an article with these features. This implies that it is conveniently titled and can be easily located. The title is also direct and straightforward because most thinkers can easily understand it and deduce a lot of meaning from it when they first see it.

How are the causes of the french revolution portrayed through the Essay

How are the causes of the french revolution portrayed through the visual arts - Essay Example Popular violence defined the French Revolution whose slogan was Liberty, Equality and Fraternity. Violent turmoil, which included the trial and execution of the king, warfare involving every major European power, vast bloodshed and repression during the Reign of Terror marked these changes. Napoleonic Wars, two separate restorations of the monarchy, and two additional revolutions are the subsequent events that one can trace to the Revolution as modern France took shape. Many causes brought about the French Revolution one major cause being the disputes between the different types of social classes in French society. The social structure of France was divided among three groups that included the First Estate, the Second Estate and the Third Estate. Each of these social groups had different types of people who presented the different views of the people within their structure. The Church or the Clergy was the First Estate, which during the ancient regime was equal in terms of its economic, social and spiritual power. Being the first estate, the church owned approximately 10 per cent of all the land in France. It paid no taxes but collected a tax on income or a tithe to support church activities such as running schools and caring for the poor. Of the entire clergy in France, about one-third of them served as parish priests who usually lived a hardworking life. They lived in luxury in Versailles, Paris and other major cities in France. Having approximat ely 1 to 2 per cent of the population, this Estate was the minority of the people in France. However, there were many poor clergymen in this Estate, and they too were going to support the Revolution. The Second Estate in French life was the nobility who made up less than 2 percent of the population and enjoyed extensive rights and privileges. Like the First Estate, they hardly paid any taxes but they taxed the peasantry. Nobles were generally the

National Criminal Justice Reference Service Research Paper

National Criminal Justice Reference Service - Research Paper Example History and General Overview of NCJRS The National Criminal Justice Reference Service (NCJRS) was established in 1972. It is a federally funded resource offering justice and drug-related information to support research, policy, and program development worldwide. The NCJRS Federal Sponsors include the U.S. Department of Justice, Office of Justice Programs (OJP), Office of the Assistant Attorney General (OAAG), Bureau of Justice Assistance (BJA), Bureau of Justice Statistics (BJS), National Institute of Justice (NIJ), Office for Victims of Crime (OVC), Office of Juvenile Justice and Delinquency Prevention (OJJDP) and the National Institute of Corrections (NIC). It has such sections as About NCJRS, A-Z Publications/Products, Library/Abstracts, Search Q & A, Grants & Funding and Justice Events each with a distinct web link. (NCJRS Website) Its services and resources are available to anyone interested in crime, victim assistance, and public safety including policymakers, practitioners, re searchers, educators, community leaders, and the general public. NCJRS offers a range of services and resources, balancing the information needs of the field with the technological means to receive and access support. For instance, it offers extensive reference and referral services to help answer questions about crime and justice-related research, policy, and practice. Under the Search Questions & Answers section, one can access questions related to juvenile and criminal justice, victim assistance, substance abuse, and NCJRS services as found under the web link, https://www.ncjrs.gov/App/QA/SearchQA/aspx. (NCJRS Website) Further, it has an option for registering online to join the information network for receipt new publications, grants and funding opportunities, and other news and announcements. This can be accessed under the web link, https://www.ncjrs.gov/App/Secure/Registration/Register/aspx. After registration one receives Justinfo, a bi-weekly electronic newsletter that inclu des links to full text publications, notices of upcoming trainings and conferences, funding announcements, and other resources. This is found under the web link, https://www.ncjrs.gov/justinfo/dates.html. In addition, the one receives E-mail notifications on new publications and resources, periodic mailings of publications and invitations to subscribe to other topical listservs based on one’s interest areas. The NCJRS also holds conferences and promotes the conferences of others, so people can use the NCJRS website to find out about events they may wish to attend. (NCJRS Website) The NCJRS sponsoring agencies publish hundreds of reports and other information products each year to share with the public. Most of the titles are available online for order through https://www.ncjrs.gov/App/Publications/AlphaList.aspx. It has an abstracts database which is one of the largest criminal justice libraries in the world and contains information from the 1970s to the present. Available bo oks, reports, articles, and audiovisual materials include congressional hearing transcripts, research findings, unpublished research, statistics, training materials and program descriptions. Topics covered in the materials in the abstracts database include juvenile justice, victims, law enforcement, courts, corrections, crime statistics, drugs and domestic preparedness. The NCJRS provides a subject-specific thesaurus and English

Food Chemistry Options Report Essay Example for Free

Food Chemistry Options Report Essay Food Chemistry What is food chemistry? Food chemistry is the application of the actual science that goes into the production, development, and actual creation of the foods we frequently consume. In reality, much more thought as well as actual science goes into the food production and consumption that we as a society divulge in so regularly. It is up to the food chemists to design the most efficient and fastest way to make and preserve both the appeal as well as the nutrition of the food. With that being said, not only must the food meet the standards of the consumers, but the chemistry behind it must also be in line with the guidelines set up by organizations such as the FDA. Perhaps the most important factor when looking into a food is its chemical composition. For example, typical lipids include phospholipids, sterols, and vitamin D which because of their structures remain soluble in organic solvents but insoluble in water. A common lipid makeup of a fatty food contains an intricate mixture of many different molecules. A large part of these lipid makeups are usually a good amount of triacylglycercols which are literally the esters of three fatty acids bonded to a glycerol molecule. Variation in fatty foods are then caused by differences in chain length, degree of unsaturation, and position on the glycerol molecule(ACS). Another prominent factor when considering the different types of fats is that the unique profile of lipids present determines the exact nutritional as well as physiochemical properties. As the discussion of food fat and oils continues, it is important to distinguish that the difference between the two is that a â€Å"fat† is a lipid that is solid at room temperature whereas an â€Å"oil† is a lipid that is liquid at that same temperature. Along with lipids, carbohydrates also have a very different chemical structure that contributes to their unique qualities. Carbohydrates exist in combinations of carbon, oxygen, and hydrogen which really shows how simple the base structure of a carbohydrate is. In the presence of animals, carbohydrates can be seen as starches whereas in plants they are most commonly noticed as cellulose. Carbohydrates can be most commonly identified in their base state as simple sugars but they can quickly combine to form complex structures as more of the simple sugars combine. A common structure for a simple sugar or monosaccharide is a carbon chain ending with a carbonyl group that also has hydroxyl groups spread out over the molecule. The main difference from some simple sugars to others is the specific orientation of the hydroxyl groups around the simple sugar chain. As the talk of lipids goes more into depth, it is important to distinguish between the different types of fat and in this case the differences between saturated and unsaturated fats. It has long been common knowledge that unsaturated fat is better for you and that saturated fat is just horrible for you but it has never really been explained at all. However, when examining into the actual chemical effects that these two fats can have, it becomes much easier to see why one would be considered so much healthier over the other. As the chemical structure of saturated fats are examined it can be seen that since the molecule is so concentrated with hydrogen atoms, there is no double bonds contained between the atoms. These saturated fats have been known to raise cholesterol levels because of the more dense fat that must be consumed. When the structures of unsaturated fats are looked at, it can be seen that there is a huge difference between its chemical structure and that of the saturated fat. This difference is shown by the presence of double bonds between some of the atoms. This presence of double bonds then shows that the atom has a much less concentrated state in comparison to the saturated fats which also explains why it remains at a liquid at room temperature instead of a more dense solid. As a result, these unsaturated fats take much less of an effort by the body to consume since they are less dense which is really what helps them in being considered so much healthier. Shelf life, the length of time a product can be stored without becoming unsuitable for use or consumption(Gyesley S. . There are many factors that go into the preserved shelf life of foods and many of which that have to do with the actual chemical composition of the food in question. These factors include the foods exposure to light, heat, water content, as well as exposures of the food to air in general which can lead to slow but actual chemical changes over time. The main problem associated with the exposure of light onto foods is how strong the affect of light can manage to be. Too much light will cause a loss in the presence of vitamins as well as the overall appearance since the excess of light can lead to a much faster deterioration of the food. There can really be a problem with the amount of water content in packaged foods today too, as that can affect the rate at which that food undergoes chemical changes however if the food comes dry and then begins to pick up moisture it can drastically change the rate at which microbial spoilage will take place. These chemical changes in the food is really what leads to the sharp decline in shelf life as well as the quality of the food and it is influenced in a very strong way by the temperature at which the food is stored. A gallon of milk left out at room temperature spawns microbial growth much faster than one that is left in the refrigerator. It is important to realize how important the preservation of food becomes after reading about how easily food can spoil. The first of these is one of the most obvious that involves storing dairy products at low temperatures which usually encompasses using a refrigerator. There are also some techniques that change the packaging such as many foods these days that are packaged in reduced oxygen. The growth of the traditional spoilage organisms can be prevented by the application of this new method at a higher rate than ever before. The use of these new packaging techniques really differs from the past when one of the most common forms of preservation in meats was to salt them very heavily. As that is now still an option, it is used way less often because of how unhealthy that has become to be considered by our society today. What is sometimes simply overlooked in foods is the appearance by which they come. Foods have color because of their ability to reflect and absorb the different wavelengths of visible light. When considering where these colors actually come from the answer usually involves one of the natural pigments of either anthocyanins or carotenoids. Anthocyanins are more commonly known to be present among plants. The colors they produce range from pink, red, and purple to blue. Carotenoids are considered to be more of a general igment as they are virtually found everywhere. These colors involve red, orange, and yellow which are typically most seen through nature. As to the presence of Anthocyanins in plants, it is important to realize that along with it comes the commonly known natural pigment of chlorophyll that is typically found in any plant that shows green. As the conversation onto the appearance of food continues, another aspect of food that would have to be considered is the texture of f oods. In liquids, one of the most common ways that is used to change texture or the look is through the process of emulsion. This involves combining two liquids that would normally be insoluble to each other by means of adding one to the other drop by drop. This process of emulsion can really be sped up by the addition of an emulsifying agent as well which allows for the two liquids to combine faster. When the actual term of â€Å"emulsifier† is used, this just describes the actual substance that allows small droplets of one liquid to become suspended into the other. In conclusion, food chemistry involves a large amount of organic and chemical structure knowledge in order to maintain and improve upon the food production and processing techniques that are already out there. Much more thought is often put into food chemistry then most people would think which shows why it is often not known or understood by the common person. However, as food development and preservation becomes even more prominent in our society today, common food chemistry knowledge should become more well known.

Holocaust Museum Essay Example for Free

Holocaust Museum Essay The scary and historical holocaust museum in the United States gives a memorable and unforgettable lesson in the fragility of freedom. During World War II,where the time of which the Nazi Germany operate and murdered all European Jews because of their sense of racial inferiority. The word holocaust derived from the Greek word meaning sacrifice by fire. In January 1933, the Nazis came to lead the Germany. And they used different terms to hide the true nature of their crimes. Moble killing units also called Einsatzqruppen operated mass murder to European words,Roma and Soviet state and communist party officials through mass shootings. The wars ending Europe with the unconditional surrender of German armed forces in 1945. Holocaust museum prevent mass killing, promotes leaders, and strengthen democracy. It is used for educational activities and global outreach program. which headed and supported by pubic partnership and federal support. Holocaust museum with its unique power and authenticity its educate millions of people regarding the dangers of very strong dislike and the need to prevent mass killing. It encourage to act and develop a sense of moral responsibility among every citizens so that they will react to the monumental challenges to face the world. The horror of Holocaust was the unforgettable memory of American people. The site of Auschwitz,Dachau ground wet because of the rain and other death camps,shards of bone and layers of ash work their way to the surface. This process is at work in the memory of the Holocaust. The national institution condition in a well known location near to the National Mall in Washington, DC is the United States Holocaust Memorial Museum. It is supported by the government of United States by giving funds for the constructiion of the building and for the continous operations of the museum. Jewish movie director Steven Speilberg contribute lot for the museum. It is located in the Raoul Wallenberg Place, after the Swedish diplomat who saved 100,000 Jews in Hungary during World War II. The land which the museum was build was owned by the United States Department of Agriculture and which the two of the three annex buildings of this prosperity was demolished in order to build a museum whose design was patterned or more about holocaust. Progressively more, discriminatory measures in Nazi Germany led many Jews and others targeted by the Nazis to try to leave their country. Between the 1933, Nazi party lead and 1939, more than 300,000 Jews migrated from Austria and Germany. However, for many, finding a safe haven proved difficult. Western nations feared an influx of refugees, especially in the wake of the Kristallnacht (Night of Broken Glass, November 9-10, 1938) pogroms. Although 85,000 Jewish refugees reached the United States between March 1938 and September 1939, due to American immigration Evian \ Conference restrictions on the number of immigrants this level of immigration was far below the number seeking refuge. At the 32-country convened in 1938 to consider the plight of refugees, no country except the Dominican Republic was prepared to increase immigration quotas. In 1939, both Cuba and the United States refused to admit over 900 Jewish refugees who had sailed from Hamburg, Germany, on the St. Louis. The ship was Progressively more, discriminatory measures in Nazi Germany led many Jews and others targeted by the Nazis to try to leave their country. Between the 1933, Nazi party lead and 1939, more than 300,000 Jews migrated from Austria and Germany. However, for many, finding a safe haven proved difficult. Western nations feared an influx of refugees, especially in the wake of the Kristallnacht (Night of Broken Glass, November 9-10, 1938) pogroms. Although 85,000 Jewish refugees reached the United States between March 1938 and September 1939, due to American immigration Evian Conference restrictions on the number of immigrants this level of immigration was far below the number seeking refuge. At the 32-country convened in 1938 to consider the plight of refugees, no country except the Dominican Republic was prepared to increase immigration quotas. In 1939, both Cuba and the United States refused to admit over 900 Jewish refugees who had sailed from Hamburg, Germany, on the St. Louis. The ship was forced to return to Europe where, ultimately, many of the passengers putrefied in concentration camps or killing centers forced to return to Europe where, ultimately, many of the passengers putrefied in concentration camps or killing centers. EXPERIENCE IN THE MUSEUM As I went in on the museum ,I felt so emotional because I cant believe that in the old generation,they can kill as many people as they want I felt sympathy to the Jews. I cant understand why they have to kill the people, because for me as a Christian believes that God our creator is the only one who have the right to get back our lives. I was also impressed because as the years passed by ,many historical buildings can be take care and supported by the government and the citizens of our community. And as I went out of that museum,theres a hope that as a new generation comes,life would be meaningful and all of the people would respect the life of each other . It will serve a big lesson to each and everyone who think negative to others. It shows how it was happened and the unjusticed action of Nazi for the Jews. Because of this,it helps individuals realized that there is no good effect in having a negative perception to other people it may caused war and violations . Always think positive ,communicate well to others and avoid any inferiorities. In preventing Holocaust museum in the present time gives a big contribution specially in the teen agers mind, they can avoid violence and know how to show kindness to other people. It can build a harmonious relationship to each other. And they can act as good human beings ,with fear to GOD and concern to the feelings of others. This historical museum is a very good symbol to end wars and to avoid violence. It is very impressive that American government support the funding for the museum in order to preserve ths documentary and historical event that is very useful in showing to people the importance of human relationship and useful value of this Holocaust museum. It is a very good place to visit by different schools for their educatinal activities and their outreach programs. BIBLIOGRAPHY Shandler Jeffrey,1999 While America Watches: Televising the Holocaust,New York Saidel,Rochelle G. ,1996 Never Too Late to Remember: The Politics behind New York Citys Holocaust Museum, New York

Argument For And Against Anti Social Behaviour Criminology Essay

Argument For And Against Anti Social Behaviour Criminology Essay What are the main arguments for and against the use of Anti-Social Behaviour Orders? In this essay I will focus on the main arguments against Anti Social Behaviour order (ASBO). This essay will focus on statistic and examining whether or not ASBO been successful in punishing and deterring the criminal behaviour in society by looking at the official statistics of (Home Office 2007) and the effect of media on ASBO. I will first explore what actually anti social behaviour is and what ASBO are. The Anti Social Behaviour (ASBO) has actually been receiving too many attentions in Britain. People in Britain have not faced anything like this before and ASBO led to wider criticism. ASBO came under the crime and disorder act 1998 it is a community based order and that can apply for by the police or local authorities to young people whose behaviour is anti social that causing or likely to cause trouble in community. For many years the number of argument has arisen that the law enforcement agenci es were not enough supportive in dealing with groups of young badly behaved in Britain. The current interest in ASBO may be influenced by the popularity of a rights culture that is peoples right to behave how they like and others to behave they would expect them. It is very important that prevent the ASB from occurring in the first place for example according to the statists the young children like six years old and nine years old they starting to follow the older ones footsteps and start copying them as well as start smoking. When it comes to the positive side they do seem to work. Resident in areas affected by what viewed as yobbish and ASB have reported improvements in their neighbourhood when ASBOs have been issued to young people. In UK the British government has introduced a number of interventions to reduce the anti social behaviour this included the ASBO and the local curfew scheme (Newburn 2007). The ideas was to control youth crime in society with their behaviour that will cause or likely to cause problems. The local curfew schemes declare designated public spaces as places that young people cannot enter at certain times unless accompanied by an adult. According to the recent news a boy who is fourteen year old who was given an ASBO only for kicking footballs against the wall of a neighbours house. He has been forbidden to kick a football in his local area (BBC ). This is led to a demonization and criminalisation of youth and the evidence of the (BCS 2008) showed that youth crime has gone up rapidly. When you talk about the strain theory it suggest that the crime is the result of individuals being blocked in terms of mainstream society from reaching certain goals and under the consequent strain they seek deviant or criminal ways to reach those goals. According to the statistic of Home Office shows that the ASBO have been issued to people who had mental health problems there was an argument for that treatment would be more appropriate to people with m ental health problems. According to the date of home office that shows that young people who had mental problems and learning disabilities was given an ASBO in the UK. The survey of youth offending teams showed that the ASBO had a long term effect on young people and this is led to mental disorders problems includes depression, suicidal problems and personality disorder. ASBO is a considerable cost a lot of money to the state this is because ASBO has to be imposed in court by a magistrate and consequently police, prosecutors and lawyers time is required to prepare the cases and present the case in court this is wasting the governments time and their budgets. The statistics shows that the victims of ASB are often the elderly people, poor and the vulnerable young children. Breach of ASBO is a criminal offense and conviction may result imprisonment of five years. In general most of ASBOs are issued because of regarding the types of behaviour indicated earlier and there have been a inci dent where ASBO have been issued in more unusual circumstances and this led to argument for example in February in 2003 a 16 year old boy was banned from showing his tattoos and wearing a single golf glove this is led to criticism (Home Office 2008). The ASBO makes even more negative perceptions towards on young people in society and classing them as trouble makers in society and worsening relations between young people. Young peoples misbehaviour is becoming more extreme theorists argue that this is a moral panic more a matter of increased media coverage and a growing law and order political agenda (Homel 2005). Critics argue that these prioritise public order to the detriment of young peoples friendship and community networks their opportunities and their quality of life according to the human right everyone has right to live and ASBO as taken their civil liberties rights. Arguments against them include concerns that young peoples rights to anonymity are undermined if they are named and shamed that they demonise young people and unnecessarily bringing more teenagers into the criminal justice system and they stigmatise families (Newburn 2005). The ASB of a few damages the lives of the many it is argued on broken window theory. When there is a broken window and has not been fixed this will increase the number of graffiti and when cars are left abandoned this will affect the vandalism measures as a well as intimidating the elderly people and fear of crime will follow fear will go up and people will trapped at home all the time (Roberts 2005 ). One of the main arguments was that the wide of ASBO has led to discrimination and targeting certain groups of young people in society. According to the survey on young people and children that they havent had any knowledge of ASBO and they felt that ASBO is targeted towards them. Young people between 8 and 14 were ensure about behaviour that they should use to avoid in order to escape having measures used against them by police or local authority. Young people who commit anti social behaviour they are the most vulnerable in society because of their drug and alcohol addiction and mental problems young offenders institutions have argued that the transition from child to adult can be difficult in this situation rather than issue the ASBO to them young people need support to address and manage their behaviour (Smith 2003). According to the survey most of the young people when they been given an ASBO they did not that their behaviours was a anti social in society in this point the government have to educate the children and young people about the definitions of ASBO in schools. Because children take time to learn to abstract sense of right and wrong they may know that they will get into trouble if they behave in a certain way but abstract values develop as they mature into adults. If young children are labelled as criminal only because they have committed minor offences which they know that most of their friends do anyway they will start to believe that they are evil and should be put away or they will feel unfairly treated. A police officer is in the front line and c an have considerable influence on youthful misbehaviour. It is important for the police officer to discriminate between the average childish misdemeanour and the really anti social offender is not an easy task in any situation. Because over reaction to childish misdeeds limits the options for more serious misbehaviour. In todays society the ASB is becoming concerning therefore the government should be looking seriously to amend the laws in order to protect all the population. There is a media effect on ASBO and from TV news and from movies people are getting the wrong. Media plays important role here in my opinion media shows the criminal act and report them to the public in a negative way rather than report them in a positive way. One more importing thing as well as this if the media giving the news related to crime with fascination in this case the crime ratio of that specific crime will increase for example the news always report on ASBO and interviewing young children with them this likely to encourage the young children to become anti social in the community. According to the statistics and evidence the short term prison sentences doesnt work in terms of increasing someones behaviour and when the young children come out of prison it really could be worse. The ASBO may destroy welfare when it is being wrongly applied to vulnerable young children such as the children with mental problems, drug users and prostitutes (Slapper Kelly 2009). On the other hand ASBO may contradict to other social policy such as safety in a community. People mostly get confuse about ASBO that how they should be behave in order to avoid ASBO and most people dont know that what it actually prohibits and what it allows. People who really help like drug addicts e.g. ASBO bans those people with drug addicts , mental problems and instead of using rehabilitation centres and funding educational programs in community it is ridiculous to ban these people from things that they have been addi cted in.

Graduation Speech -- Graduation Speech, Commencement Address

Well, this is it, the day all of us have been waiting for has finally arrived. It seems like only yesterday we were picking our noses and flicking them at innocent bystanders or yelling childish phrases like, "Liar, liar, pants on fire!" or, wait, that was yesterday. Never mind. Anyways. What I'm trying to say is the years, have flown by and it's not going to be long before we're in the stands watching our kids graduate. You know, there is a lot more to graduating than leaving Rufus and getting a diploma. It's more than that. I mean, why do you think we get to wear these cool robes? Our infantile days of wandering into first period half asleep and living off the school's cheesy burritos and ranch dressing are over, it's time now for us to grow up and head into the real world. R...

Essay --

The development of the heart is a complicated process that implicates cell specification and differentiation, including tissue formation, shaping and alteration, to create a functional organ. The zebrafish has become a potential model system to disentangle the fundamental genetic, molecular, and cellular mechanisms of cardiac development and function. The liver is one of the essential organ in mammals. It performs many functions such as help the body digest food, store energy, and remove poisons. The liver also completes many regulatory functions that are critical to fetal development and to life in general. However, failure to perform theses function can result in many mammal liver diseases. Hepatomegaly is a symptom that associate with several liver disorders. Surveys had shown that a large number of the death in the US is caused by chronic liver disease. Liver cancer is another type of liver diseases that is one of the main cause of cancer-related death worldwide. For the past decades, zebrafish has been used as an experimental model to study human liver diseases because of the ability of zebrafish to study vertebrate development. There are many advantages on using zebrafish to study human diseases and using the embryos to grow models of liver diseases. First, there are a lot of benefits such as genetic and embryological-based of zebrafish and the embryonic hematopoiesis does not locate in the liver as it is in mammals. Therefore mutants that has liver size or structure will not have the perplexing phenotype of hematopoietic dysfunction. Second, it takes the zebrafish embryo approximately 3-4 days of development and survives on yolk. After the developmental period, the digestive system of the embryonic fish is fully functional... ...ape formation, movement of cardiac progenitor cells, heart tube, and heart function. A novel development of more specific assays, advance genetic screen efforts will provide new knowledge on cardiac development in the following years. Additionally, because of the zebrafish distinct features and its similarities to vertebrae, the zebrafish might become many researchers preferred model organism to study many mammal organs. Recently, the zebrafish has been used to study mechanisms that cause human cardiac and liver diseases and to model human hereditary and developed cardiac diseases. Due to the increase in sequencing efforts, the developing interest to study human liver and cardiac diseases. Also, the increase of resource and the more availability of the zebrafish model used in clinical and basic researchers involved in studying the liver, as well as cardiac diseases

?The Wreck of the Hesperus? and The Perfect Storm :: essays research papers

The More Powerful Sea Disaster Story   Ã‚  Ã‚  Ã‚  Ã‚   Some of the most intriguing stories of today are about people’s adventures at sea and the thrill and treachery of living through its perilous storms and disasters. Two very popular selections about the sea and its terrors are The Perfect Storm by Sebastian Junger and â€Å"The Wreck of the Hesperus† by Henry Longfellow. Comparison between the two works determines that â€Å"The Wreck of the Hesperus† tells a more powerful sea-disaster story for several different reasons. The poem is more descriptive and suspenseful than The Perfect Storm, and it also plays on a very powerful tool to captivate the reader’s emotion. These key aspects combine to give the reader something tangible that allows them to relate to the story being told and affects them strongly. A common person’s knowledge about sea disasters comes from what they have read in books and articles, and what they see on TV and in movies. The average person does not get to experience the fury of a hurricane while on a boat. In order to capture the audience’s attention, consideration to details and vivid descriptions are needed to paint a realistic picture in their minds. For this reason, the stories have to provide all of the intricate details. In The Perfect Storm, the story starts out with a radio call, not a dramatic scene that immediately foreshadows the possibility of danger. Rather than describing the storm and its fury, the only mention of the setting is of the visibility and the height of waves. However, in â€Å"The Wreck of the Hesperus†, the poem begins by stating there is a hurricane possible right away. The current weather conditions are pointed out to the reader as shown in the following quote.   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"Colder and louder blew the wind,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  A gale from the Northeast,   Ã‚  Ã‚  Ã‚  Ã‚  The snow fell hissing in the brine,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  And the billows frothed like yeast.†   Ã‚  Ã‚  Ã‚  Ã‚  (Longfellow 125) The realistic adjectives paint a picture that the average person can relate to and understand. As shown from the word choice in The Perfect Storm, the poem is easily seen to evoke more powerful imagery. One quality a story needs to possess in order to keep the reader eager and captivated to read is suspense. Both stories have elements of suspense, but utilize it in different ways. â€Å"The Wreck of the Hesperus† does an excellent job of foreshadowing, so one can predict the sequence of events that will happen.

Cognitive Impairment And Alzheimers Disease Health And Social Care Essay

Apathy is one of the commonest symptoms in Alzheimers disease and is associated with frontal lobe disfunction. Apathy is associated with high health professional load and has several negative effects.Purposes:The primary purpose of this survey is to analyze an association between apathy and frontal lobe disfunction in patients with memory jobs. We besides aimed to look into the association between apathy badness and health professional load along with the relationship between apathy and practiceMethods:This was a retrospective cross sectional survey. We selected 162 back-to-back patients diagnosed with Alzheimer ‘s dementedness and Amnestic Mild Cognitive Impairment who had comprehensive battery of neuropsychological trials and a behavior evaluation graduated table of involvement for this survey recorded in the database. Correlation between apathy with and without depression were tested against frontal lobe trial including Trail doing A, Trial doing B, Letter Fluency, Ideationa l Fluency, Category eloquence, Abstract Thinking and Executive working subtest of CAMGOG-R. Similarly correlativity analysis was besides done to look into association between apathy and caregiver load every bit good as practice.Consequences:Statistically important relationship were found between apathy and executive map tonss, conceptional eloquence tonss, abstract thought and class eloquence tonss. Relationship between apathy and health professional load were extremely important. Further bomber analysis, found apathy to be significantly associated with health professional load in both AD and aMCI patients.DecisionsApathy is associated with frontal lobe disfunction particularly impaired executive map and conceptional eloquence even when controlled for depression. It is extremely associated with health professional load both in AD & A ; aMCI.Hence early acknowledgment and direction of apathy is of import bettering the forecast of patients with AD & A ; aMCI.Table OF CONTENTSABSTRACT 3Chapter 1: Overview OF APATHY 5- 18Chapter 2: Introduction 19 – 20Chapter 3: AIMS & A ; OBJECTIVES 21Chapter 4: Methodology 21 – 28Chapter 5: RESULTS 28- 40Chapter 6: DISCUSSION & A ; CONCLUSIONS 40 – 44REFERENCES 45 -48APPENDIX A: Clinical RESEARCH PROTOCOLAPPENDIX B: ETHIC APPROVAL LETTERAPPENDIX C: NHS R & A ; D APPROVAL LETTEROVERVIEW OF APATHYDefinitionApathy is derived from the Grecian term apatheia intending deficiency of poignancy, or passions, and is normally referred as absence of feeling, emotions, involvement, or concern. ( Marin, 1990 ) Marin was the first to gestate apathy at both symptomatological and syndromal degrees and defined apathy as â€Å" deficiency of motive non attributable to decrease degree of consciousness, cognitive damage, or emotional hurt † ( Marin, 1990 ) .Motivation is a psychological construct and therefore it hard to quantify and measure up it.Hence to do it more clinically qualifiable and quantifiable, Apathy was proposed as a behavioral alteration from the person ‘s baseline and measured as a decrease in spontaneous and purposeful activity. ( Levy and Dubois, 2006 ) . A Starkstein and co-workers have developed a set of diagnostic standards for apathyA these standards specify the undermentioned as nucleus characteristics of apathy: lessened motive, inaugural and involvement, and blunting of emotions ( Starkstein and Leentjens, 2008 ) . In malice of assorted definitions of apathy being proposed, confusion continue to reign sing the nosological place of apathy.Nevertheless progressively apathy is being recognised as an of import constituent of neuropsychiatric research and that ‘s why dependable instance description and designation is necessary, to help communicating, research and intervention. This led to the development of consensus diagnostic standards for apathy in Alzheimer ‘s disease and other neuropsychiatric upsets ( Robert et al. , 2009 ) .DIAGNOSTIC CRITERIAThe revised consensus standards for apathy follow the same general construction as the standards proposed by Starkstein et Al in 2001 ( Robert et al. , 2009 ) . For a diagnosing of Apathy the patient should carry through the standards A, B, C and DStandards ALoss of or diminished motive in comparing to the patient ‘s old degree of operation and which is non consistent with his age or civilization. These alterations in motive may be reported by the patient himself or by the observations of others.Criteria BPresence of at least one symptom in at least two of the three following spheres for a period of at least four hebdomads and present most of the clipDomain B1: Loss of, or diminished, purposive behavior as evidenced by at least one of the followers: Loss of self-initiated behavior ( for illustration: starting conversation, making basic undertakings of daily life, seeking societal activities, pass oning picks ) Loss of environment-stimulated behavior ( for illustration: responding to conversation, take parting in societal activities )Domain B2: Loss of, or diminished, purposive cognitive activity as evidenced by at least one of the followers: Loss of self-generated thoughts and wonder for modus operandi and new events ( i.e. , disputing undertakings, recent intelligence, societal chances, personal/family and societal personal businesss ) . Loss of environment-stimulated thoughts and wonder for modus operandi and new events ( i.e. , in the individuals abode, vicinity or community )Domain B3: Loss of, or diminished, emotion as evidenced by at least one of the followers: Loss of self-generated emotion, observed or self-reported ( for illustration, subjective feeling of weak or absent emotions, or observation by others of a dulled affect ) Loss of emotional reactivity to positive or negative stimulations or events ( for illustration, observer-reports of unchanging affect, or of small emotional reaction to exciting events, personal loss, serious unwellness, emotional-laden intelligence )Criteria CThese symptoms ( A-B ) cause clinically important damage in personal, societal, occupational, or other of import countries of operation.Criteria DThe symptoms ( A-B ) are non entirely explained or due to physical disablements ( e.g. sightlessness and loss of hearing ) , to drive disablements, to decrease degree of consciousness or to the direct physiological effects of a substance ( e.g. drug of maltreatment, a medicine ) .PrevalenceApathy is an of import and often happening symptom in a assortment of neuropsychiatric upsets. Dementia and schizophrenic disorders are among the common causes of apathy ( ref ) . The prevalence for apathy in Alzheimer ‘s disease ranged between 32.1 % ( Holthoff et al. , 2005 ) and 93.2 % ( Sr ikanth et al. , 2005 ) . Point prevalence for apathy in Alzheimer ‘s disease ranged from 32.1 % 19A to 58.7 % ( Aharon-Peretz et al. , 2000, Holthoff et al. , 2005 ) . Table 1: Prevalence of Apathy Across Disorders ( Ishii et al. , 2009 )DisordersPrevalenceMild Cognitive Impairment 14.7 % a?’39.8 % Parkinson ‘s disease 17.0 % a?’45.7 % Progressive supranuclear paralysis 22 % a?’91 % Huntington ‘s disease 59 % a?’82 % Corticobasal devolution 40 % A Frontotemporal dementedness 89 % a?’100 % Dementia with Lewy organic structure 52 % Multiple induration 20 % a?’31 % Stroke 15.2 % a?’42 % Vascular dementedness 22.6 % a?’93.6 % Traumatic encephalon hurt 20 % a?’70 % Amyotrophic sidelong induration 55.6 % Hiv 12 % Cardiovascular disease 29 %CONDITIONS ASSOCIATED WITH APATHYApathy can be a symptom in a figure of neurological or psychiatric syndromes. Neurological Disorders include Traumatic encephalon hurt, Stroke affecting the frontal-subcortical circuit, Alzheimer ‘s disease ( AD ) , Dementia with Lewy organic structure ( DLB ) , Creutzfeldt-Jakob disease, Frontotemporal dementedness ( FTD ) , HIV dementedness, Parkinson ‘s disease ( PD ) , Progressive supranuclear paralysis, Anoxic brain disorder, Cerebral tumor, Chronic subdural haematoma, Huntington ‘s disease, Limbic phrenitis, Multiple induration, Bingwanger ‘s encephalopathy, Wernicke-Korsakoff syndrome, Kluver Bucy syndrome, Hydrocephalus, Delirium Psychiatric Disorders such as Depression, Schizophrenia, Psychoses and Adjustment upset Psychotropic drugs: . Dopamine adversaries are by and large associated with lessened motive, whilst agonists can increase it. Cannabis dependance, pep pill and cocaine backdown have all been implicated as a causative factor. An amotivational, or apathy, syndrome has been reported in a figure of patients having selective 5-hydroxytryptamines reuptake inhibitor ( SSRI ) intervention over the last decennary. This inauspicious consequence has been noted to be dose-dependent and reversible, but is frequently unrecognised ( Garland and Baerg, 2001 ) . Medical Disorders such as Apathetic thyrotoxicosis, Drug intoxications/withdrawal, Hypothyroidism, Lyme disease, Pseudoparahypothyroidism, Chronic weariness syndrome, Testosterone lack, Vitamin B12 lack, Other enfeebling conditions ( eg, malignance, CCF, nephritic or hepatic failure ) .IS APATHY AND DEPRESSION THE SAME?Apathy has frequently been treated as a portion of depression and it can frequently be diagnostically disputing to distinguish between the two due to frequent carbon monoxide morbidities and a considerable convergence in cardinal symptoms. However they are different concepts and it is of import to distinguish them because of predictive and intervention deductions. Apathy can besides ensue from the intervention for depression. There are theoretical concern that serotonergic re-uptake inhibitors ( SSRIs ) may impact the counterweight of 5-hydroxytryptamine and Dopastat, which can take to apathy, and SSRI-induced apathy has been progressively reported.Table 2: Differences and convergences in the clinical symptoms of apathy and depression ( table adapted from Landes et al. , 2005 )Apathy SymptomsDepressive SymptomsShared SymptomsLack of emotional response Indifference Diminished motive Lack of productiveness Poor Persistence Low societal & amp ; occupational battle Person is by and large satisfied Low temper Feelingss of guilt, Suicidal ideations Insomnia Reduced appetency Pessimism Self-criticism Hopelessness Worthlessness Loss of involvement Psychomotor deceleration Fatigue/hypersomnia Lack of penetrationEffectss of ApathyApathy has important negative effects and therefore early designation and diagnose is critical. In Alzheimer ‘s Disease ( AD ) patients, apathy is associated with hapless penetration into cognitive and behavioral alterations ( Derouesne et al. , 1999 ) along with greater cognitive every bit good as functional diminution ( Holtta et al. , 2012 ) . Apathetic patients are frequently misperceived as lazy by the household taking to increasing resentfulness. Apathy may impact patient perceptual experience of quality of life ( Gerritsen et al. , 2005 ) and is significantly associated with activities of day-to-day life ( ADLs ) damage ensuing in increased patient and health professional distress.. It is besides significantly associated with older age and a higher incidence of depression and craze ( Holtta et al. , 2012 ) . Apathy has been shown to be associated with frontal lobe disfunction particularly executive map in dementedness ( Ready et al. , 2003 ) and these frontal lobe maps are indispensable to a individual ‘s ability to transport out mundane planning and determination devising along with health-promoting behaviors, such as medicine direction, dietetic and lifestyle alterations, self-monitoring of responses, and follow-up with wellness attention professionals ( Kuo and Lipsitz, 2004 ) . Apathy affects the quality and degree of familiarity in a relationship and hence enjoyment of each other ‘s company. This leads to impairment of the relationship, increased health professional load and an increased the hazard of institutionalisation ( Spruytte et al. , 2001 ) ( de Vugt et al. , 2003 ) . Apathy besides has of import diagnostic and intervention deductions.It may forestall patients from seeking an early formal appraisal and may interfere with attachment to pharmacologic intervention for memory loss and engagement in compensatory schemes, such as keeping an accurate and up-to-date memory notebook ( Ready et al. , 2003 ) . Apathy may hold important predictive value.Apathy has been described to increase the hazard of patterned advance from MCI to dementia. In nursing place patients with Alzheimer ‘s dementedness, apathy has been associated with physical damage, dependence, hapless nutritionary position and significantly increased 2-year mortality rates ( Holtta et al. , 2012 ) .PATHO-PHYSIOLOGY OF APATHYApathy has been shown to be associated with a break of the frontal-subcortical neural circuit. Assorted surveies have concluded that the neural circuit that originates from the anterior cingulate cerebral mantle, so proceeds to the ventral striate body, globus pallidus, and thalamus, with a concluding cringle back to the anterior cingulate cerebral mantle is related to apathy ( Bonelli and Cummings, 2007 ) .Autopsy surveies have shown that neurofibrillary tangles load were significantly higher in the anterior cingulate cerebral mantle in apathy ( Marshall et al. , 2006 ) .Similarly structural magne tic resonance imagination ( MRI ) surveies have shown that apathy badness correlated with wasting of bilateral anterior cingulate and left auxiliary motor country ( Apostolova et al. , 2007 ) .Studies with Single photon emanation imaging have besides shown that apathetic AD patients had significantly decreased perfusion in the anterior cingulate, the inferior and median convolution frontalis and the orbito frontal convolution ( Robert et al. , 2006 )FigureA 1.A Behavioural and cognitive alterations associated with break of specific frontal-subcortical circuits ( Ball et al. , 2010 ) .Dopamine is the principle neurotransmitter of purposive behaviour, modulating motive, rousing, motor response, and sensorimotor integrating. There is a strong relationship between D2 receptor stimulation and anterior cingulated cortex metamorphosis. The anterior cingulate cerebral mantle appears to be of importance in motive and wages ( Devinsky et al. , 1995 ) and receives exceptionally heavy dopaminer gic ( DA ) excitation originating from ventral tegmental country ( VTA ) nerve cells ( Williams and Goldman-Rakic, 1998 ) . Cholinergic and serotonergic tracts besides play a neuromodulatory function in the motivational circuitry. Acetylcholine ( ACh ) and DA systems appear to organize striatal wages map in a feed-forward, complementary mode ( Williams and Adinoff, 2008, Zhou et al. , 2003 ) . Serotonin is chiefly an repressive neurotransmitter can straight impact frontal lobe activities and they can indirectly modulate frontal lobe activity by suppressing the release of Dopastat ( Daw et al. , 2002 ) . Positron Emission Tomography surveies have important decreases of 5-HT2AA receptor densitiesA in the frontal lobe in patients with apathy ( Franceschi et al. , 2005 ) .ASSESSMENT OF APATHYThere are assorted graduated tables available to determine and quantify apathy. A recent literature reappraisal has identified around 14 graduated tables of which seven were full apathy graduated ta bles and eight were apathy subscales embedded in larger graduated tables ( Clarke et al. , 2011 ) . The most widely used graduated table were the Apathy Evaluation Scale AES ) and the Neuropsychiatric Inventory ( NPI ) .Neuropsychiatric Inventory ( NPI )The NPI is a graduated table that assesses and quantifies neurobehavioral perturbations in dementedness patients and besides quantify health professional hurt caused by such behaviors ( Clarke et al. , 2011, Cummings et al. , 1994 ) . The NPI has an apathy subscale, which consists of a general screen point rated on a yes-versus-no footing. If the symptom is found to be present, seven extra apathy inquiries are administered and scored on a yes-versus-no footing. The overall frequence ( rated as 1-4 ) and badness ( rated as 1-3 ) of apathy is so rated. Tonss on the NPI apathy subscale scope from 0 to 12 with higher tonss bespeaking more terrible apathy ( Cummings et al. , 1994 ) . The NPI, and therefore the NPI-apathy subscale, is depe ndable, widely used, and has been validated in many different scenes.Apathy rating graduated table ( AES )The AES is an Eighteen-item graduated table capturing symptomatology over last 4 hebdomads. This scale buttockss and quantifies the affectional, behavioural, and cognitive spheres of apathy. It specifically assesses apathy and discriminates it from depression. Each point can be rated on the 4 point likert Scale. It takes around 10-20 min to be completed by a trained interviewer. This trial has a good interrater dependability and is widely usedPOTENTIAL TREATMENT OPTIONS FOR APATHYNonpharmacologic Treatment of ApathyThere are many non pharmacological intercessions that have anecdotal and qualitative grounds of effectivity in the apathy but merely a few of them has quality research confirmation in footings of effectivity ( Brodaty and Burns, 2011 ) . Open-label surveies have shown that multisensory behavior therapy and music therapy have positive consequence in cut downing apathy and could hike the consequence of anti dementedness drugs ( Ferrero-Arias et al. , 2011, Staal et al. , 2007 ) . Cognitive stimulation therapy that provides activities affecting cognitive processing, within a societal context, with an accent on enjoyment has been shown to be effectual in cut downing apathy in early Alzheimer ‘s Disease ( Buettner et al. , 2011 ) . Treatment of apathy requires multidisciplinary attack along with health professional psycho instruction about the pathological nature of apathetic province. The health professionals should besides be encouraged to present new beginnings of pleasances, involvements and stimulation along with increasing chance for socialization. It is besides of import that the patient ‘s general medical conditions are assertively treated and centripetal shortages corrected along with environmental alterations such as usage of adaptative devices such as wheelchair, seeable Clocks, calendars and equal lighting to increase the reward potency of the environment and thereby enhance motive. Although there is presently lack of research grounds, it is possible the other non pharmacological intercessions such as originative activities, cookery, Montessori methods, and behavioural elements, frequently separately tailored, exercising, multisensory stimulation, favored therapy, and particular attention unit s have the possible to cut down apathy ( Brodaty and Burns, 2011 ) .Pharmacologic Treatment of ApathyAcetylcholinesterase InhibitorsAChIs are chiefly used for handling cognitive symptoms in dementedness but recent surveies have shown positive effects on noncognitive symptoms such as apathy, depression, anxiousness, and purposeless motor behaviours. Consequences from randomized controlled tests have shown that AChIs including donepezil, galantamine and rivastigmine are clearly good in the intervention of apathy. There is no clear indicant that any one AChI is superior.NDMA Receptor AntagonistMemantine is a specificA N-methyl-D-aspartate receptor adversary and is the lone drug approved for handling terrible AD.A It appears to work by modulating the activity of glutamate, leting a controlled sum of Ca to flux into nerve cells ( enabling information processing, storage, and retrievalA 98 ) protecting nerve cells against glutamatergic excitotoxicity and, potentially, holding a neuroprote ctive consequence by cut downing toxic Ca inflow. There is grounds from randomized, double-blind, placebo-controlled tests, which indicated important betterments in apathy degrees for patients treated with MemantineMajor tranquilizersTypical Consequences from Randomized, double-blind, placebo-controlled test in nondepressed inmates with dementedness found no alteration in apathy degrees Atypical Surveies look intoing the effects of untypical major tranquilizers on apathy have reported important betterments in symptomsA farther 12-week open-label survey 130 of risperidone in 135 patients with AD showed increasing and important betterment in apathy. An RCT of 652 nursing place occupants with terrible AD reported betterment in apathy for occupants treated with olanzapine 5 mg/day but non with 1, 2.5, or 7.5 mg/day, and there was no accommodation for multiple comparingsAntidepressantsBupropion is aA dopamineA andA norepinephrine re-uptake inhibitorA and releaser. It is approximately twice as potent an inhibitor of Dopastat re-uptake than of norepinephrine reuptake.A Besides reuptake suppression of Dopastat and noradrenaline, bupropion besides causes the release of Dopastat and noradrenaline. Hence theoretically should profit apathy but there have been no good quality tests with Bupropion. There is grounds signifier clinical instance series that bupropion may profit apathy ( Corc oran et al. , 2004 ) Assorted tests of antidepressants in the interventions of apathy have mostly been negative, supplying extra support that depression and apathy are different concepts. There is good quality grounds from assorted randomised controlled trails that antidepressants do no alteration in apathy degrees. Interestingly apathy syndrome has been reported in a figure of patients having selective 5-hydroxytryptamines reuptake inhibitor ( SSRI ) intervention over the last decennary and hence SSRI must be used with cautiousnesss clinicians need to be proactive in supervising for this inauspicious consequence ( Barnhart et al. , 2004 )PsychostimulantsEvidence from instance studies and little open-label surveies in non demented populations suggests that psychostimulants such as dextroamphetamine and Ritalin may be effectual in the intervention of apathy.Results from a recent double-blind, randomized, placebo-controlled crossing over test of Ritalin for the intervention of apathy suggest modest benefit s in a subset of AD patients, but that tolerability may be a concern in this population ( Herrmann et al. , 2008 ) .A There are instance studies that have reported that Modai ¬?nil may profit apathy syndrome in the older patients and is more tolerable ( Camargos and Quintas, 2011 )Dopaminergic agentsThere are merely few surveies on the effectivity of dopaminergic agents as a intervention for apathy and such surveies have been chiefly focussed on Parkinson ‘s disease and station shot conditions.Bromocriptine, aA Dopastat agonist, in case-series studiesA have been found to be effectual in cut downing apathy symptoms in shot and hypoxic encephalon hurt patients ( Barrett, 1991, Debette et al. , 2002, Krishnamoorthy and Craufurd, 2011 ) . There is nevertheless no good quality research grounds of their effectivity in handling apathy in Alzheimer ‘s disease ( van Reekum et al. , 2005 ) .Amantadine is aA N-methyl-D-aspartic acid receptor adversary, which may indirectly height en dopaminergic transmittal and confer neuroprotective effects, similar to its parallel, memantine has been shown to be effectual in bettering executive map and apathy symptoms in chronic encephalon hurt, dementedness and Parkinson ‘s disease ( Drayton et al. , 2004, Wu and Garmel, 2005 ) . Levodopa/carbidopa besides appears to better motive in assorted neurological and psychiatric upsets harmonizing to instance surveies of patients ( Bakheit et al. , 2011, Drubach et al. , 1995 ) Pramipexole, another Dopastat agonist with D3-preferring receptor adhering profile, is used in the early-stage Parkinson ‘s disease ( PD ) .A meta-analysis of placebo-controlled surveies have shown good consequence on temper and motivational symptoms in PD patients ( Leentjens et al. , 2009 ) . Similarly Ropinirole, Dopastat D2/D3 receptor agonist been reported to better apathy and temper in patients with Parkinson disease ( Czernecki et al. , 2008 )IntroductionApathy is a neurobehavioral syndrome which is defined as quantitative decrease of voluntary, purposive behavior ( Levy and Dubois, 2006 ) .It extremely prevailing across a big assortment of neurological, psychiatric, and medical conditions and is the most common neuropsychiatric symptom of Alzheimer ‘s disease with an mean point prevalence of 60 % in outpatients with Alzheimers Disease. ( Clarke et al. , 2011, Robert et al. , 2004 ) Apathy is a major hazard factor for transition to dementia in MCI topics and follow up surveies have shown that rates of transition to dementia in MCI with apathetic symptoms were up to 60 % as compared to 24 % for MCI without apathy and depression ( Vicini Chilovi et al. , 2009 ) . Apathy was thought to be upset of sub cortical encephalon construction but interestingly it appears to be really commoner in cortical encephalon upsets with averaged point prevalence of about 60 % as compared to 40 % in upsets of sub cortical constructions ( van Reekum et al. , 2005 ) . The frontal lobes play an of import function in back uping higher-level cognitive map, dwelling of executive accomplishments and working memory. Executive maps are higher-order cognitive procedures that orchestrate simple thoughts, motions and actions into complex purposive behaviors. They include be aftering, induction, coincident information processing, ordinance, judgement, abstraction, and job resolution. Damage of executive working consequences in disinhibition, concrete thought, perseveration, deficiency of enterprise, apathy, and loss of cognitive i ¬Ã¢â‚¬Å¡exibility ( Tsoi et al. , 2008a ) . A significant organic structure of grounds suggests that apathy typically occur following harm to prefrontal cortical-striatal circuits in the encephalon, and are seen in many neurological and psychiatric upsets, including all of the common signifiers of dementedness: Alzheimer disease ( AD ) , vascular dementedness ( VaD ) , and Frontotemporal dementedness. ( Craig et al. , 1996 ) .Studies have shown that Apathy in AD patients was associated with more terrible hypoperfusion in frontal parts on functional imagination ( Craig et al. , 1996 ) . A few surveies have tried to look into the relationship between apathy in dementedness and frontal lobe disfunction. Apathy in AD has been shown to be significantly associated with hapless public presentation on executive map trials, such as the Trail-Making Test and the Stroop colour intervention trial ( McPherson et al. , 2002 ) . Executive disfunction, particularly shortages impacting verbal eloquence and conceptional eloquence, was a important forecaster of apathy in dementedness ( Tsoi et al. , 2008a ) . There has been really small literature about relationship between practice and apathy in Alzheimer ‘s disease. It is known that frontal systems behavioral jobs are associated with higher health professional load after commanding for dementedness badness and health professional depression. There has been conflicting studies about part of apathy towards caregiver burden. Few surveies have shown that apathy was associated with greater grade of health professional load ( Chow et al. , 2009 ) ( Leroi et al. , 2012 ) while another survey showed that it was the behaviors associated with executive disfunction and disinhibition that were prognostic of load and apathy was considered less troublesome to health professionals ( Davis and Tremont, 2007 )AIMS & A ; OBJECTIVES:The primary purpose of this survey is to analyze the association between apathy with or without depression and frontal lobe disfunction in patients with memory jobs. The secondary purpose is to look into association between apathy badness and the health professional load In add-on, this survey will look into the association between apathy and practice in AD and MCI as there are presently limited surveies that have looked into association between them.DESIGN/ METHODOLOGY:Ethical motives Approval: A The survey was approved by The National ResearchA EthicsA Service ( NRES ) Committee for East of England, King College London every bit good as the NEPFT NHS R & A ; D officePutingThe survey was done at the West Essex Neurocognitive Clinic which is third referral Centre and is based at three locations viz. St Margaret ‘s Hospital, Epping, Princess Alexandra Hospital, Harlow and Rectory Lane Health Centre, Loughton. The catchment country serves population of aged people of greater London and Essex, UK. The Clinic provides a specialised, multidisciplinary, hospital-based appraisal for people with cognitive jobs Majority of the patient ‘s referred are those with mild cognitive damages or patients hard to name due to combination of medical, neurolog ical, societal and neuropsychological factors. The clinic is focused on research and preparation and is involved in assorted imagination, cognitive and intervention surveies, every bit good as encephalon contribution programme. Referral standards are based on a history of cognitive damage, which is likely to be caused by degenerative alterations of the encephalon with the MMSE mark of at least 20/30, complex presentations due to interplay of varying degrees medical, neurological and neuropsychological factors and hard to name instances. Patients must be aged in surplus of 40 old ages ( reflecting appropriate referral of people with possible immature onset dementedness ) and must be able to give informed consent. The appraisal is done by a trained and experient clinician along with a psychologist/assistant psychologist. Assessment encompasses a assortment of trials aimed at set uping diagnosing and badness of unwellness. The appraisals of involvement for this survey includes A standard psychiatric interview Behavioural Pathology in Alzheimer ‘s Disease Scale ( BEHAVE-AD ) sum 75 where higher mark indicates more disturbed behavior ; Apathy/Indifference sub-scale ( NPI ) total/12 – higher mark indicates greater apathy ; Hospital Anxiety and Depression Scale ( HADS ) -total on each scale/21 -score of 7 or less indicates no important symptoms, mark of 8 – 10 indicates mild symptoms, mark of 11 + indicates moderate symptoms ; Instrumental Activities of Daily Living Scale ( IADL ) total/31 -higher tonss indicates increased dependence upon the source or ‘carer ‘ ; Clinical Dementia Rating ( CDR ) total/5 -higher mark indicates more badly affected cognitive and occupational/social operation ; Screen for Caregiver Burden ( SCB ) total/100 – higher mark indicates client is perceived to be a greater load by the source or ‘carer ‘ ; Neuropsychometric Assessment is done by the Psychologist/Assistant psychologist. The battery of neuropsychometric trials done of involvement to this survey includes: Estimated pre-morbid rational operation ( National Adult Reading Test – NART ) , Cambridge Cognitive Examination-Revised ( CAMCOG-R ) Trail doing A & A ; Trial devising B Letter Fluency, Category eloquence, Ideational Fluency Abstract Thinking, Executive working subtest of CAMGOG-R ( eloquence + Similarities+ Ideational eloquence + Visual logical thinking ) Subjects: This was a retrospective Cross-sectional survey. The survey population comprised 160 back-to-back patients with newly-diagnosed Alzheimer ‘s disease and amnestic-MCI, All the patients at the clip of their initial neurocognitive clinic appraisal had a thorough neurological and psychiatric scrutiny by a trained and experiences clinician along with extended neuropsychometric appraisal by a psychologist. Health professionals and next-of-kin were besides interviewed.At the clip of the appraisal all patients had capacity to give an informed consent to undergo the appraisal. Their capacity was assessed by a member of clinical squad familiar with, and trained in usage of the Mental Capacity Act. In add-on, patients have either agreed or disagreed to hold their informations entered into unafraid database maintained by North Essex Mental Health Partnership NHS Trust, for the intent of supplying wellness attention and set abouting medical research and statistical analysis. Eligibility standards: All patients diagnosed with Alzheimer ‘s disease and amnesic Mild Cognitive Impairment who had the undermentioned probes recorded on database: NPI apathy mark, frontal lobe map trial i.e Trail doing A, Trial doing B, Letter Fluency, Ideational Fluency, Category eloquence, Abstract Thinking, Executive working subtest of CAMGOG-R ( eloquence + Similarities+ Ideational eloquence + Visual logical thinking, CAMCOG-R, age, gender, HAD Depression mark, Care giver load and Praxis. All these patients would be eligible to take a portion in the survey. Inclusion standards: Eligible patients who gave an informed consent to hold their informations entered into unafraid database maintained by North Essex Mental Health Partnership NHS Trust, for the intent of supplying wellness attention and set abouting medical research and statistical analysis. This is considered to be patients presumed wants. Exclusion standards: Patients who did non consent to hold their informations entered into unafraid database maintained by North Essex Mental Health Partnership NHS Trust, for the intent of supplying wellness attention and set abouting medical research and statistical analysis. This is considered to be patients presumed wants. Patients whose depression scores on HAD were more than 8 were besides excluded.MeasuresApathy will be measured as the apathy sub-score on the NPI. The NPI was developed to measure and quantify neurobehavioral perturbations in dementedness patients and to quantify health professional hurt caused by such behaviours. The NPI has an apathy subscale, which consists of a general screen point rated on a yes-versus-no footing. If the symptom is found to be present, seven extra apathy inquiries are administered and scored on a yes-versus-no footing. The overall frequence ( rated as 1-4 ) and badness ( rated as 1-3 ) of apathy is so rated. Tonss on the NPI apathy subscale scope from 0 to 12 with higher tonss bespeaking more terrible apathy. The NPI, and therefore the NPI-apathy subscale, is widely used and has been validated in many different samples such as ambulatory patients with dementedness, outpatients with AD, multicultural samples, and nursing place occupants. Cognitive damage will be measured by the mark on Cambridge Cognitive Examination-Revised ( CAMCOG-R ) . This neuropsychological battery steps cognitive shortage in a figure of cognitive spheres – mark & lt ; 80/105 suggests the presence of a dementedness, mark of 80-90/105 is fringy. Frontal Lobe disfunction will be measured by the tonss obtained from the undermentioned frontal lobe map trial i.e. Trail doing A, Trial doing B, Letter Fluency, Ideational Fluency, Category eloquence, Abstract Thinking, Executive working subtest of CAMGOG-R ( eloquence + Similarities+ Ideational eloquence + Visual logical thinking ) . The Trail Making Tests ( TMTs ) are popular neuropsychological instruments used either entirely as a showing instrument for observing neurological disease and neuropsychological damage or as portion of a larger battery of trials. The trials are believed to mensurate the cognitive spheres of treating velocity, sequencing, mental flexibleness and visual-motor accomplishments Part A is by and large presumed to be a trial of ocular hunt and motor velocity accomplishments, whereas portion B is considered besides to be a trial of higher degree cognitive accomplishments such as mental flexibleness. TMT-A requires chiefly visuoperceptual abilities, TMT-B chiefly reflects working memory and secondarily task-switching ability, while B-A minimizes visuoperceptual and working memory demands, supplying a comparatively pure index of executive control abilities.Average DeficientDrag A 29 seconds 78 seconds Trail B 75 seconds 273 seconds Letter Fluency undertakings require coevals of words get downing with specific letters within a limited clip it has been. Letters F, A, and S ( FAS ) version of the The Controlled Oral Word Association Test is used in this survey. The trial disposal takes about five proceedingss. The mark is the amount of all admissible words for the three letters ( Loonstra et al. , 2001 ) . Category Fluency undertaking require persons to bring forth examples of specific semantic classs such as the names of animate beings or fruits. CF trial is a really speedy ( normally taking 1 min ) , easy to administrate trial that proved to be utile in the diagnosing of mild AD. The most common version involves the semantic class of animate beings. Surveies have shown that tonss below 15 in the CF ( animals/min ) had a sensitiveness of 88 % and a specificity of 96 % , in distinguishing AD patients from normal controls, bespeaking that a 1-minute trial can be helpful to clinicians to place persons in the early phases of the disease ( Caning et al. , 2004 ) . Category Fluency and Letter Fluency require frontally mediated executive retrieval mechanisms. Both besides require entree to phonological/lexical shops. But, merely class eloquence besides requires entree to more widely distributed semantic shops as the topic searches for examples suiting the mark class ( Cerhan et al. , 2002 ) .Datas AnalysisDependent variable is Apathy mark. Independent variables are CAMCOG-R tonss, tonss of the undermentioned frontal lobe testsTrail doing A, Trial doing B, Letter Fluency, Ideational Fluency, Category eloquence, Abstract Thinking, Executive working subtest of CAMGOG-R ( eloquence + Similarities+ Ideational eloquence + Visual concluding ) every bit good as tonss of health professional load and practice. All these variables will be analysed as uninterrupted informations. The consequences will be graphed to look into if the distribution is about normal and the spread secret plan used to measure the one-dimensionality of the association. Correlation analysis, measured as a correlativity coefficient R, will be used to look into for the presence, the strength and way of a relationship between these variables. Cut-off point of 0.4 will be considered to be important. Depending on the one-dimensionality one of the two correlativity coefficients will be calculated. Ranked correlativity will be used in the statistical analysis if the relationship between the two variables in non-linear. Rank correlativity coefficients, such as Spearman ‘s rank correlativity coefficient measures the extent to which, as one variable additions, the other variable tends to increase, without necessitating that addition to be represented by a additive relationship. If, as the one variable addition, the other lessenings, the rank correlativity coefficients will be negative. If the two variables appear to hold additive relationship Spearman correlativity coefficient will be calculated. The closer the coefficient is to either a?’1 or 1, the stronger the correlativity between the variables. Correlation Negative Positive Small a?’0.3 to a?’0.1 0.1 to 0.3 Medium a?’0.5 to a?’0.3 0.3 to 0.5 Large a?’1.0 to a?’0.5 0.5 to 1.0 If the variables are independent so the correlativity is 0. However, the antonym is non true because the correlativity coefficient detects merely additive dependences between two variables.Power computationStatisticalA powerA analysesA wasA doneA byA usingA G*PowerA 3.1 ( Faul et al. , 2009 ) TypeA IA error=0.05A TypeA IA error=0.01A TypeA IA error=0.001 Power=80 % A 34A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 56A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 84 Power=90 % A 47A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 72A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 106 Power=99 % A 85A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 117A A A A A A A A A A A A A A A A A A A A A A A A A A A 159 ThisA indicatesA thatA inA orderA toA determineA aA correlationA ofA magnitudeA 0.4A atA P & lt ; 0.05A atA aA powerA levelA ofA 80 % , A thisA studyA needsA aA minimumA ofA 34A participants.AConsequenceOne hundred and 60 patients with AD or amnesic MCI who met the above-described standards were enrolled in the survey. Of these 68 patients had a diagnosing of Alzheimer ‘s disease and 92 had a diagnosing of amnesic MCI. The demographic information of the topics are summarized in Table 1. No statistically important differences in age, instruction, gender, premorbid intelligence, or old ages in instruction consequences were observed between the two groups. However as expected, there was statistically important difference in footings of the IADL, CAMCOG-R, CDR & A ; MMSETable 1: Demographic and clinical featuresAverage AD ( SD )Average MCI ( SD )P valueNIADL10.34 ( 5.52 ) 8.11 ( 3.42 ) & lt ; .001 160CAMCOG-R76.8 ( 12.66 ) 86.98 ( 8.71 ) & lt ; .001 156MMSE22.19 ( 5.13 ) 25.81 ( 2.55 ) & lt ; .001 158NART105.33 ( 10.00 ) 106.26 ( 12.23 ) .319 124CDR0.82 ( 0.41 ) 0.55 ( 0.17 ) & lt ; .001 159Age74.37 ( 8.61 ) 73.37 ( 8.70 ) .339 160Old ages Ed.11.14 ( 2.91 ) 11.16 ( 2.60 ) .655 154AdMCIChi SquareP valuePercent female51.5 47.8 0.21 .65Percentage with intoxicant history63.2 65.9 1.47 .69Percentage with smoking history42.6 50.0 2.33 .31 The frequence distribution box secret plan suggested that NPI apathy bomber graduated tables are non usually distributed. We did normalcy trials to find whether apathy informations set is well-modelled by a normal distribution or non. We used the Shapiro-Wilk trial as our numerical agencies of measuring normalcy and found that the apathy informations significantly deviate from a normal distribution. Shapiro-Wilk Statistic df NPI Apathy sub graduated table .624 160 As our information ‘s were non parametric, utilizing the Spearman rho correlativity coefficient, correlativities between variables for whole group and subgroups was generated. The Spearman rho correlativity was repeated with depressive subgroups removed. All trials were one-tailed since hypotheses were directional. The exclusion to this was the trial look intoing the relationship between gender and apathy. These hypotheses were non-directional and therefore two-tailed trials were used.Executive map markAbstract believing markCaregiver loadCAMCOG-R markLetter FluencyClass EloquenceTrail Making Test A ( seconds ) Trail Making Test B ( seconds )Conceptional eloquence markPractice Correlation Coefficient-.222**-.180*.477**-.136*-.071-.166*.009 .010-.213**-.102 Sig. ( 1-tailed ).003.012.000.045.189.019.456 . 464.004.103 Nitrogen157157145156155157152 84156156ConsequencesTable 1: Correlations between variables for whole group and subgroupsCorrelations between variables for whole group and subgroups with depression removed.Executive map markAbstract believing markCaregiver loadCAMCOG-R markLetter Fluency Class Eloquence Trail Making Test A ( seconds ) Trail Making Test B ( seconds )Conceptional eloquence markPractice Correlation Coefficient-.169*-.125 .475** -.067 -.041 -.123 -.052 .089-.186*.019 Sig. ( 1-tailed ).027.077 .000 .223 .321 .080 .279 .229.017.417 Nitrogen131131 121 131 130 131 127 72130131Relationship between apathy and executive mapIn the combined sample ( AD and A-MCI ) , informations on executive map was available for 157 patients. In these patients, NPI apathy mark was significantly related to executive operation ( rs = -.222, P = .003 ) .When the group of patients with depressive symptoms were removed, the NPI apathy mark still remained significantly related to executive operation ( n=131, rs =-.169, p=.027 )Relationship between apathy and trail devising trialsIn the combined sample ( AD and A-MCI ) , informations on trail doing trial A was available for 152 patients. In these patients, NPI apathy mark was non significantly related to drag doing tonss ( rs = .009, P = .456 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to drag doing A tonss ( n=127, R -.052, p=.279 ) In the combined sample ( AD and A-MCI ) , informations on trail doing trial B was available for 84 patients. In these patients, NPI apathy mark was non significantly related to drag doing tonss ( rs = .010, P = .464 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to drag doing B tonss ( n=72, R.089, p=.229 )Relationship between apathy and verbal eloquenceIn the combined sample ( AD and A-MCI ) , informations on missive eloquence ( FAS ) was available for 150 patients. In these patients, NPI apathy mark was non significantly related to eloquence ( rs = -.047, P = .284 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to eloquence tonss ( n=130, R -.041, p=.321 )Relationship between apathy and class eloquenceIn the combined sample ( AD and A-MCI ) , informations on class eloquence ( animate beings ) was available for 157 patients. In thes e patients, NPI apathy mark was significantly related to category eloquence ( rs = -.166* , P = .019 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to category eloquence ( n=131, rs -.123, p=.080 )Relationship between apathy and conceptional eloquenceIn the combined sample ( AD and A-MCI ) , informations on conceptional eloquence was available for 156 patients. In these patients, NPI apathy mark was significantly related to conceptional eloquence ( rs = -.213** , P = .004 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained significantly related to on conceptional eloquence ( n=130, rs -.186* , p=.017 ) .Relationship between apathy and cognitive mapIn the combined sample ( AD and A-MCI ) , informations on CAMCOG-R was available for 156 patients. In these patients, NPI apathy mark was significantly related to cognitive operation ( rs = -.136* , P = .045 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained significantly related to on conceptional eloquence ( n=131, rs -.067, p=.223 )Relationship between apathy and abstract thoughtIn the combined sample ( AD and A-MCI ) , informations on abstract thought was available for 152 patients. In these patients, NPI apathy mark was significantly related to abstract thought ( rs = -.180, P = .013 ) .Relationship between apathy and health professional load.In the combined sample ( AD and A-MCI ) , informations on health professional load was available for 145 patients. In these patients, NPI apathy mark was significantly related to caregiver load ( rs = .477** , P = .000 ) . NPI apathy mark remained significantly related to caregiver burden even when the depressive subgroup of patient was removed ( n=121, rs =.475** , P = .000 ) . The correlativity between apathy and caregiver load were so tested in Alzheimer ‘s disease and amnesic MCI individually and in both subgroups NPI apathy mark was significantly related to caregiver loadNonparametric Correlations: NPI Apathy and Caregiver Burden in AD & A ; aMCIaMCIAdNPI Apathy sub graduated table Correlation Coefficient .458** .480** Sig. ( 1-tailed ) .000 .000 Nitrogen 68 53 A arrested development analysis was carried out to understand the relationship between a health professional load and MMSE, Depression Scores, Apathy, Behave -AD Scores, executive map mark, IADL.Arrested development Analysis CoefficientsaModel Unstandardized Coefficients Standardized Coefficients T Bacillus Std. Mistake BetaNPI Apathy sub graduated table1.130.240.3944.703IADL.360.167.1812.155Behave -AD mark .303 .211 .113 1.438 HADS-depression mark .016 .212 .006 .074 Executive map mark -.113 .200 -.047 -.566 MMSE mark .024 .193 .010 .125 a. Dependent Variable: Mark for ‘caregiver load ‘ questionnaire at baseline It is clear from the multiple arrested development analysis that merely NPI apathy tonss and IADL were significantly related to caregiver load. However the other variables which included Behave AD tonss, HADS depression tonss, Executive map tonss and MMSE were non significantly related to the health professional load tonssModel SummaryModel Roentgen R Square Adjusted R Square Std. Mistake of the Estimate Change Statisticss R Square Change F Change df1 df2 1 .542a .293 .288 7.668 .293 59.353 1 143 2 .592b .350 .341 7.377 .057 12.488 1 142 a. Forecasters: ( Constant ) , NPI Apathy sub graduated table b. Forecasters: ( Constant ) , NPI Apathy bomber graduated table, IADL at baseline ANOVAc Model Sum of Squares df Mean Square F 1 Arrested development 3489.675 1 3489.675 59.353 Residual 8407.663 143 58.795 Entire 11897.338 144 2 Arrested development 4169.290 2 2084.645 38.305 Residual 7728.048 142 54.423 Entire 11897.338 144 a. Forecasters: ( Constant ) , NPI Apathy sub graduated table b. Forecasters: ( Constant ) , NPI Apathy bomber graduated table, IADL at baseline c. Dependent Variable: Mark for ‘caregiver load ‘ questionnaire at baseline Further sub analysis suggests that NPI apathy contributes to about 29 % of the health professional load and IADL contributes to around 5 % of the health professional loadRelationship between apathy and practiceIn the combined sample ( AD and A-MCI ) , informations on executive map was available for 156 patients. In these patients, NPI apathy mark was non significantly related to praxis ( rs = -.102, P = .103 ) .When the group of patients with depressive symptoms were removed, the NPI apathy mark still remained non significantly related to praxis ( n=131, rs =.019, p=.417 )Relationship between apathy and genderMann-Whitney TrialRanksgenderNitrogenMean RankNPI Apathy sub graduated table male 81 85.38 female 79 75.50 Entire 160Test StatisticsaNPI Apathy sub graduated tableMann-Whitney U 2804.500 Wilcoxon W 5964.500 Omega -1.621 Asymp. Sig. ( 2-tailed ) .105 a. Grouping Variable: gender From the above saloon graph, with mistake bars, it appears that males have higher apathy tonss as compared to females. We used the Mann-Whitney U trial to look into if the relationship of apathy with gender is statistically important. However this did non accomplish statistically significance ( U = 2804.500, P = 0.105 )DiscussionApathy is one of the commonest symptoms in Alzheimer ‘s disease. Evidence from assorted clinical, radiological and neuropathological surveies suggests that apathy in Alzheimer ‘s disease is frontally mediated and has important negative deduction. Our survey is a realistic survey with moderate power affecting both Alzheimer Disease and Amnestic-MCI. This is the first survey as per our cognition in which the relationship of apathy with and without depression in a combined sample of AD & A ; aMCI were tested against a scope of frontal lobe map trials which included executive map mark, abstract believing mark, Category Fluency, missive Fluency, conceptional eloquence mark and test doing A & A ; B trials. Few surveies have at the same time investigated the relation of apathy with such a big scope of frontal lobe map trials.Relationship between apathy and executive mapWe found statistically important tie ining between apathy and executive map with and without depression corroborating findings from other surveies ( McPherson et al. , 2002 ) . Deficits in frontal lobe map were significantly worse when symptoms of apathy were combined with depression corroborating the determination from a Nipponese survey with a smaller figure of pati ents ( Nakaaki et al. , 2008 ) .This determination has of import clinical significance because hapless tonss in executive map influence memory abilities by forestalling people to use compensatory schemes that can assist them retrieve information and maintain functional abilities. It is besides associated with greater neuropsychiatric perturbations particularly a greater grade of agitated and disinhibited behaviors ( Chen et al. , 1998 ) . Assorted surveies have shown that impaired executive map is associated with increased pace variableness ensuing in higher incidence falls in patient with AD ( Allali et al. , 2010 ) . In Amnestic MCI, executive map damages is associated with early functional diminution in older grownups ( McGough et al. , 2011 ) . Badness of functional damage is good recognized forecasters of institutionalization ( Rozzini et al. , 2006 ) .Relationship between apathy and conceptional eloquenceSuccessful completion of Ideational eloquence undertakings require speede d productiveness every bit good as the accomplishments of self-monitoring, working memory, scheme coevals, and divergent thought ( Vannorsdall et al. , 2012 ) . We found statistically important tie ining between apathy and conceptional eloquence with and without depression.This is similar to the determination from another survey where Ideational Fluency was found to be significantly associated with apathy ( Tsoi et al. , 2008b )Relationship between apathy and Category FluencyWe found that NPI apathy mark was significantly related to category eloquence but when patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to category eloquence. There are conflicting consequences about the relationship between apathy and class eloquence. One survey ( n=72 ) found no important relationship ( McPherson et al. , 2002 ) but another more recent survey ( n=42 ) found statistically important relationship ( Tsoi et al. , 2008b ) .Relationship between ap athy and abstract thoughtWe found that NPI apathy mark was significantly related to abstract believing but when patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to abstract believingRelationship between apathy and cognitive mapSimilar to consequences from other surveies, NPI apathy mark was significantly related to cognitive working proposing that apathy was related to poorer cognitive map.However when the group of patients with depressive symptoms were removed, the NPI apathy did non stay score significantly related to cognitive map.Relationship between apathy and missive EloquenceNo statistically important relationship was found. This is consistent with current literature grounds ( McPherson et al. , 2002 )Relationship between apathy and test doing A & A ; B trialsNo statistically important relationship was found between apathy and both TMT- A & A ; TMT-B in our survey. However another survey had found a statistically important relationship between TMB trial and apathy tonss in Alzheimer ‘s dementedness ( McPherson et al. , 2002 ) In drumhead among the frontal lobe trial we found that statistically important relationship between apathy and executive map tonss, conceptional eloquence tonss, abstract thought and class eloquence tonss. When the groups were reanalysed after taking patients with depressive symptoms, the relation between apathy and abstract thought every bit good as category eloquence became non important.We think that this may be do the power of the survey has reduced when the depressive subgroups were removed.The 2nd possible ground is that apathy and depression portion many common symptoms and therefore the patients we removed utilizing a rigorous diagnostic standards of HAD depression standards were truly patients with apathy.Relationship between apathy and health professional loadIn our survey, series of explorative Spearman rho correlativity confirmed the important relationship between apathy and health professional load with and without depression. We did farther bomber analysis and found apa thy to be significantly related to caregiver load in both AD and aMCI patients. Our survey is the first as per our cognition that confirms that apathy is significantly related to caregiver load in amnestic MCI reverse to the popular belief. The relation of apathy to caregiver load was confirmed by other surveies ( Chow et al. , 2009, Leroi et al. , 2012 ) nevertheless another survey showed that it was the behaviors associated with executive disfunction and disinhibition that were most prognostic of load instead than apathy itself ( Davis and Tremont, 2007 ) . However we did a arrested development analysis and found that apathy approximately accounted for 30 % of health professional load but found no important relationship with behave AD tonss, HADS depression tonss, Executive map tonss and MMSE tonss We besides found a higher incidence of apathy in females as compared to males but farther statistical testing showed no important relationship. In our sample NPI apathy mark was significantly related to cognitive operation as confirmed by other surveies but when patients with depressive symptoms were removed the relationship with cognitive damage was nonsignificant. Our survey has few restrictions.First of all this was a retrospective cross sectional survey and so has its drawbacks, nevertheless it realistic, cross-sectional survey. Another possible job is that the subjective nature of the information ‘s nevertheless the information ‘s were collected as a portion of comprehensive neurocognitive appraisal in a third Centre by trained and experient clinicians. Prospective surveies would hold been better but would hold needed extended resources and clip. The sample size was moderate and consisted of assorted sample of Alzheimer ‘s disease and Amnestic MCI, nevertheless it was reasonably powered and amnesic MCI is considered as prodromic Alzheimer ‘s disease. We had used merely one graduated table for mensurating apathy.The NPI Apathy subscale is a portion of NPI devised to buttockss and quantifies neurobehavioral perturbations in dementedness and non specifically developed to mensurate apathy.AEP would hold been a better pic k as it is specifically developed to mensurate apathy, nevertheless the trial would necessitate preparation and would take a well longer period which would non hold been practical in a normal clinic scene This survey has shown high association of apathy with health professional load both in AD & A ; aMCI and given our anterior cognition of the significantly inauspicious effect, we would go on screen actively for apathy and utilize more specific apathy graduated table along with the NPI graduated table in future