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Management Information Systems Topics For Research Paper
Friday, September 4, 2020
Jewish art history Essay Example | Topics and Well Written Essays - 1250 words
Jewish workmanship history - Essay Example The Dura Europas Temple began as a basic private home. The Jews changed over the home to a gathering place during the second Century. The Jews are a strict people. As strict people, the individuals frequently go to supplicate in their sanctuaries. The Dura Europus is one of the well known sanctuaries of the Jews. Be that as it may, the sanctuary was decreased to sand beginning in 244 CE. The Jews filled the sanctuary with divider artistic creations. The artistic creations incorporated the well known Tanakh stories. The peopleââ¬â¢s lives spin around the templeââ¬â¢s lessons. The clerics give the strict standards on the most proficient method to carry on with life by executing the strict lessons. The pictures on the sanctuary dividers add to the strict intensity of the individuals. A few people didn't accept that the brightening cycle canvases reflected educational pictures. The pictures incorporate accounts of the Ark situated in the place that is known for the Philistines. The pictures incorporate the significant story of the Tabernacleââ¬â¢s sanctification. The Dura Europasââ¬â¢ roof was loaded up with great pictures. The pictures had Roman subjects. The sanctuary incorporated the Torah Shrine picture, the Menorah Image, and the Akedat Yizchak (restricting Isaac as he is set up for the Sacrifice). The Paintings situated inside the Dura Europas had Eastern, Roman, and Hellenic subjects. The Lower East side of New York Movie shows how the Jews lived (Riis 1). The Jews were needy individuals. Thus, they lived firmly pressed as tight as possible under one rooftop. In certain homes, six people rested on one bed, firmly grasping each other. A few Jews lived respectively under one little room in Shtelt and different networks. Thus, the rooms were clogged with individuals. Firmly stuffed, the Jews, particularly the kids, regularly played together in the city and inside their living arrangements or networks. At the point when the Jews come out of their sanctuaries, they are either grinning or crying. They are grinning since they are glad to hear the priestsââ¬â¢ new
Monday, August 24, 2020
John Ray - An Evolution Scientist
John Ray - An Evolution Scientist Early Life and Education: Conceived November 29, 1627 - Died January 17, 1705 John Ray was conceived on November 29, 1627 to a metalworker father and a cultivator mother in the town of Black Notley, Essex, England. Growing up, John was said to have invested a great deal of energy at his moms side as she gathered plants and utilized them to recuperate the wiped out. Investing such a great amount of energy in nature at an early age sent John on his way to get known as the Father of English Naturalists. John was a generally excellent understudy at Braintree school and before long enlisted at Cambridge University at 16 years old in 1644. Since he was from a poor family and couldn't bear the cost of the educational cost for the lofty school, he functioned as a hireling to the Trinity College staff to take care of his charges. In five brief years, he was utilized by the school as an individual and afterward turned into an undeniable speaker in 1651. Individual Life: A large portion of John Rays youthful life was spent considering nature, addressing, and progressing in the direction of turning into a priest in the Anglican Church. In 1660, John turned into an appointed cleric in the Church. This drove him to reexamine his work at Cambridge University and he wound up leaving the school in light of clashing convictions between his Church and the University. At the point when he settled on the choice to leave the University, he was supporting himself and his presently bereaved mother. John experienced difficulty making a decent living until a previous studentâ of his requested that Ray go along with him in different research extends that the understudy subsidized. John wound up making numerous excursions through Europe gathering examples to consider. He led some examination on life systems and physiology of people, just as considered plants, creatures, and even shakes. This work managed him the chance to join the renowned Royal Society of London in 1667. John Ray at last wedded at 44 years old, not long before the passing of his examination accomplice. In any case, Ray had the option to proceed with the exploration he began because of an arrangement in his accomplices will that would keep on subsidizing the examination they had begun together. He and his significant other had four girls together. Account: Despite the fact that John Ray was a steadfast adherent to the hand of God in the changing of an animal varieties, his incredible commitments to the field of Biology were extremely compelling in Charles Darwins starting Theory of Evolution through Natural Selection. John Ray was the main individual to distribute a broadly acknowledged meaning of the word species. His definition clarified that any seed from a similar plant was similar species, regardless of whether it had various characteristics. He was additionally a furious rival of unconstrained age and frequently composed regarding the matter about how it was a skeptics made up jabber. A portion of his most acclaimed books inventoried the entirety of the plants he had been concentrating throughout the years. Many accept his attempts to be the beginnings of the ordered framework later made via Carolus Linnaeus. John Ray didn't accept that his confidence and his science negated each other in any capacity. He composed numerous works accommodating the two. He bolstered the possibility that God made every single living thing and afterward transformed them over the long haul. There were no coincidental changes in his view and all were guided by God. This is like the present thought of Intelligent Design. Beam proceeded with his examination until he kicked the bucket on January 17, 1705.
Saturday, August 22, 2020
The Turn Of The Screw By Henry James (1843 - 1916) Essays - Fiction
The Turn of the Screw by Henry James (1843 - 1916) The Turn of the Screw by Henry James (1843 - 1916) Sort of Work: Early suspenseful thrill ride Setting Britain; nineteenth century Chief Characters The tutor, an anonymous twenty-year-old lady Mrs. Grose, a more established maid Greenery, an eight-year-old young lady Miles, a ten-year-old kid Story Overveiw At Christmas time, a gathering of individuals in an old nation home traded phantom stories. One story tl)at especially chilled tl-te bunch included the appearance of a phantom to a little fellow. At the point when it was done, a man in the gathering, Douglas, asked: If the youngster gives the impact, another turn of the screw, what do you say to two kids? Weeks after the fact, when Douglas had the option to get the composition containing this subsequent story, he read the account to his audience members, in the wake of introducing it with a touch of foundation. The story's creator was a lady who had been his sister's tutor, and Douglas was the main individual to whom she had uncovered her shocking story before her demise ... On a lovely June evening, a youngster of twenty, the most youthful of a few little girls of a poor nation parson, shown up in London to answer a notice for the situation of tutor. The publicist was a lone ranger who had been left gatekeeper to his young nephew what's more, niece. The uncle, a well off and enchanting courteous fellow, dumbfounded the young lady in a split second The particulars of her business were very straightforward: she was to assume responsibility for the two kids on his nation home of Bly in Essex, and to never inconvenience him . . . neither show up nor whine nor expound on anything. She would supplant the previous tutor, a youthful woman who had kicked the bucket under inquisitive conditions. While the riddle encompassing the earlier tutor's demise caused the lady to Pause and consider, she in any case acknowledged the position and took the mentor to Bly. The new tutor before long met strong Mrs. Grose, the Bly chateau's head servant, and little Flora, the lone ranger's niece. The young lady was a dream of other-worldly excellence, and the tutor looked forward to instructing and shaping the kid. Miles, the young man, was expected home in a couple of days for his school occasion, and as per Mrs. Grose, the tutor would be similarly taken with Miles. The two kids appeared to be unequipped for giving any difficulty. Notwithstanding, before Miles showed up, the tutor gotten two letters. The first was from her boss, training her to deal with the subtleties of the subsequent letter, sent from the dean of Miles' school. This subsequent letter as a result expressed that Miles was excused from school, for all time. This news stressed the tutor, however Mrs. Grose, after hearing the report, could barely handle it, and encouraged her to hold up until she met Miles before shaping a judgment. A couple of days after the fact Miles showed up, and the tutor observed his positive aroma of immaculateness. In private she told Mrs. Grose that the dean's allegation was abnormal. Together they chosen not to trouble Miles' uncle further about the issue. The tutor appreciated the late spring days in the nation. It was the first run through in her life that she had known space also, air and opportunity. At that point, while walking around the nursery one day as the kids rested, the tutor permitted her creative mind to meander. She envisioned how enchanting it is meet an attractive youthful man around the turn of the way. Still somewhere down in dream, she adjusted the corner of the nursery and it was as if her creative mind had, instantly turned genuine. On one of the towers of the old manor stood a figure; not the man she had been longing for, yet an unusual individual who gazed at her menacingly for a moment, at that point vanished. The following Sunday evening as the tutor entered the downpour covered lounge area, she got mindful of an individual on the opposite side of the window and glancing straight in. It was the equivalent man she had seen before, yet right then and there she understood that he had want another person. She surged out of the house to the spot where he stood, yet again he had disappeared. She glanced in through the window, as he had done, and there she saw Mrs. Grose, peering out similarly as she herself had stood a second prior. At the point when the maid requested a clarification, the tutor revealed to her the entire story. As she portrayed the slippery outsider, a glimmer of acknowledgment crawled into Mrs. Grose's face. The man the tutor had seen, she stated, was Peter Quint, their manager's previous valet, who had passed on some time previously. The tutor felt that Quint's floating nearness boded
Summary of the Achillesââ¬â¢ heel free essay sample
Writing audit recommends that Harmonious and composed associations are liable for giving financial and key advantages to the two accomplices. In spite of the fact that, it likewise gives a brilliant picture that trust and duty are the two fundamental instruments which can prompt fulfillment between the two accomplices, it isn't accurate, all things considered. The examination expects to concentrate on the factor which decreases the chance of accomplice changing from global point of view. Exact information proposes that responsibility, advantage and devotion are missing from work. From global point of view, if these qualities are missing in work, they can hamper the longest and best relationships[1]. A merchant needs to focus on the manufacturerââ¬â¢s credit duties so as to grow his points of view. In this way, it might be important to expand the leave cost. The investigation means to examine duty, social responsiveness; openings and the chance of exchanging accomplices and believes them to be basic part of connection between the maker and the merchant. We will compose a custom paper test on Rundown of the Achillesââ¬â¢ heel or then again any comparative theme explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page Duty diminishes the chance of accomplice exchanging as the submitted accomplices cooperate to persevere through better operational and vital outstanding burden. Social responsiveness is important to keep up strength in the solid, serious market in light of the fact that a responsive merchant will work viably with the maker to arrive at shared objectives. Pioneering conduct whenever demonstrated unreasonably is well on the way to end the connection between the wholesaler and the maker. Exchanging accomplices is destined to happen when the maker is disappointed with the wholesaler. Be that as it may, maker fulfillment is in all likelihood decreasing the chance of evolving accomplices. The investigation gathered a few examples and studies organizations which were arranged by size. In excess of 700 respondents were examined. The outcomes were examined and it reasoned that distributorââ¬â¢s key influence negatively affects the manufacturerââ¬â¢s fulfillment, duty impacts fulfillment, the responsiveness of the wholesaler additionally has positive effect on manufacturerââ¬â¢s fulfillment, advantage doesn't impact fulfillment and manufacturerââ¬â¢s fulfillment with the merchant diminishes the likelihood of exchanging partners[2]. Be that as it may, this examination has a few limitations. Since it was directed in United States, it doesn't cover the whole world. Additionally trust is another limitation which has not been broke down in this examination. End The writing focuses on accepting favorable circumstances of open doors when evolving accomplices. The examination uses a muddled, multifaceted framework where endorsement, satisfaction and understanding in appropriating rent expands the likelihood of accomplice exchanging. The idea that time based consistent, steady relationship is a misnomer since powerlessness subject to time. So as to make agreeable cross-fringe relationship, it is fundamental to build up a significant, significant dependable and solid relationship without annihilating chances. The raised ventures and involved acquaintance is the way to bring fulfillment between the two accomplices. In excess of 700 examples were thought about. The examination investigated Commitment, social responsiveness, openings and the chance of exchanging accomplices and arrived at the resolution that these are fundamental variables which can decide the connection between the maker and wholesaler. References: Deligonul, Seyda, Daekwan, Kim, Roath, Anthony S. what's more, Cavusgil Erin, ââ¬ËThe Achilles impact point of a suffering relationship: Appropriation of rents between a maker and its outside distributorââ¬â¢, Journal of Business Research, 2006, vol. 59, issue 7, pages 802-810(2006) [1] Deligonul, Seyda, Daekwan, Kim, Roath, Anthony S. what's more, Cavusgil Erin, ââ¬ËThe Achilles impact point of a suffering relationship: Appropriation of rents between a producer and its remote distributorââ¬â¢, Journal of Business Research, 2006, vol. 59, issue 7, pages 802-810(2006) [2] Deligonul, Seyda, Daekwan, Kim, Roath, Anthony S. what's more, Cavusgil Erin, ââ¬ËThe Achilles impact point of a suffering relationship: Appropriation of rents between a maker and its outside distributorââ¬â¢, Journal of Business Research, 2006, vol. 59, issue 7, pages 802-810(2006)
Friday, August 21, 2020
General Principles of Ecology Essay Example for Free
General Principles of Ecology Essay The term biology alludes to the investigation of wealth and dispersion of living creature in a biological system, together with the cooperation that exists among them and the indigenous habitat. The appropriation of living beings is normally impacted by the adjustment of a specific living being to the earth. An adjustment alludes to an organismââ¬â¢s capacity to exist effectively in a given domain. In this manner, living beings can just exist in situations that they are adjusted to. At the point when a given types of creature or plant is adjusted in a given regular habitat, at that point it gets conveyed in that condition thickly and in high numbers. Those that come up short on the capacity to adjust well are ineffectively disseminated, since they can't adapt to the weights or stress that exude from the natural conditions. Various types of plants can be adjusted to low and high ââ¬nutrient situations. Plants consistently attempt to adjust to the conditions in a few different ways. The plants that occupy low ââ¬nutrient territories develop at a moderate rate, as an adjustment to the shortage of supplements. These plants likewise can reuse supplements inside. Those in high supplement zones then again develop quick. They can control the ingestion of supplements at least levels. The breakdown of dead natural issue in the dirt experiences a few procedures. The main procedure of breakdown includes the adjustment of the natural issue concoction segments. This is then trailed by another procedure, whereby the compound parts are part or divided. In the wake of experiencing these two procedures, the natural issue mineral supplements are then discharged into the dirt and they are then changed over into more straightforward segments that can be consumed by the plants. The day length impacts the regular movement of plants and creatures, in light of the fact that the length of the day length triggers certain changes. These progressions remember the climatic examples for a territory. The two plants and creatures synchronize their social and physiological exercises with the regular changes. By doing this, they can do certain exercises dependent on the period of the year. For instance, the movement in creatures is once in a while synchronized with the occasional changes. Plants then again, synchronize exercises, for example, fertilization with seasons when the movement can be effectively encouraged by the pollinators. Temperature conditions in a given characteristic biological system influence the reaction of both the homeotherms and the poikilotherms. While the homeotherms can keep up their inner condition temperature at a steady level, the poikilotherms then again can't manage their interior condition temperature. Changes in temperature triggers conduct changes in poikilotherms as they attempt to control their internal heat level contingent upon the outside temperature. For instance, a few poikilotherms may luxuriate out in the sun to manage internal heat level by warming their bodies. The homeotherms attempt to manage their internal heat level utilizing input instruments in their body frameworks. For example, their veins may experience dilatation or narrowing as their bodies attempt to save heat. Climatic changes may trigger an idle state in creatures, particularly during the virus season or winter. Hibernation and torpor are two models conduct adjustments in creatures to low temperatures. In both, creatures go into a condition of inertia and they bring down their body digestion as a technique of saving vitality . Nonetheless, there is one significant contrast between the two. In hibernation, the animalsââ¬â¢ internal heat level at a noteworthy level. Creatures that rest become inert for a significant stretch of time. Torpor then again is whereby creatures bring down their internal heat level yet at negligible levels when contrasted with that in hibernators. Creatures that experience torpor might be dormant however as a rule wake up a few times. The Black Bear isn't considered as a genuine hibernator on the grounds that its internal heat level doesn't decrease essentially as that of a genuine hibernator . Moreover, the bear stays alarm and dynamic during the time of ââ¬Å"hibernationâ⬠. References Odum, E. P. (1971) . General Principles of Ecology, Third Edition W. B. Suanders Company. Smith, T. M. , and Smith, R. L. (2005). Components of Ecology. (sixth Edition). Benjamin Cummings Publishers
Thursday, July 23, 2020
Grammar Mistakes Even The Best Magazine Writers Make
Grammar Mistakes Even The Best Magazine Writers Make After working as a copyeditor for a regional magazine for the past several years, Ive seen a wide variety of content come across my desk. Some of it has been a breath of fresh airâ"a writer that was as meticulous with grammar as he or she was spellbinding with word choice. Some of it was several notches below this category, with content that would have been appealing if it hadnt included multiple clichés and grammar mistakes.One would assume that freelance writers who have been chosen to write content for a magazine would be above such mistakes in their writing. This is far from the truth, as many magazines invite local bankers, real estate agents, mayors and celebrities to submit articles for a certain section, regardless of the level of their writing skills. Then, there are the freelance writers who, by some small miracle, write a piece about something interesting and catch the editors eye. These writers might be published once but as soon as the copyeditor complains about the la ck of professionalism and grammar skills, it is doubtful that the editor will invite another piece from the author.The easiest way to avoid seeming unprofessional in your craft is to hire a copyeditor or proofreader to ensure that your piece contains flawless grammar before you submit it to an editor for review. Polishing up a piece on the front-end is a lot better than being embarrassed about obvious grammar mistakes that are put into print and could have been avoidedâ"or attempting to salvage your career after being labeled as an unprofessional writer.Therefore, if you are attempting to break into the world of freelance journalism by writing for magazines, here are a few simple grammar mistakes that even the best writers make sometimes, but should be avoided, when possible.Who vs. WhomAt the risk of sounding like an overzealous grammar teacher, this is a pet peeve of many copyeditors that can be easily avoided. If you want the technical explanation, who is a subjective or nominat ive pronoun that goes into the same category as he, she, it, we and they. This means that it is used as the subject of the clause or to replace one of the aforementioned pronouns. Whom, on the other hand, is an objective pronoun, fitting into the same category as him, her, it, us and them. When a pronoun is the object of a clause, whom is the correct choice.But what if you never did well in English grammar and get confused when terms like objective and nominative are thrown at you? Dont worryâ"theres an easy way to know for sure if youre using who and whom correctly. Look at the following sentence:Who/whom will I ask to the dance?Since the who/whom choice is at the beginning of the sentence, your first impulse might be to use who, right? Well⦠dont. Whether its at the beginning, middle or end of the sentence makes little difference. The real questions you should be asking yourself are:How can I rephrase this question?Did I use a nominative pronoun (he/she) or objective pronoun (h im/her) when I rephrased the question?The answer to question 1 is:Will I ask her to the dance?The answer to question 2 is:I used an objective pronoun (her); therefore, whom is the correct choice here.That vs. WhichThis mistake permeates writing on multiple levels, from amateur to graduate-level writing and beyond. However, theres a simple way to ascertain which to use, and it all boils down to one question:Is the clause that follows necessary for the meaning of the sentence?If the answer is yes, then use that. If the answer is no, then use a comma, followed by which.Consider the following sentence:I only eat meat products that are free-range and hormone-free.If we take away the clause following that, namely that are free-range and hormone-free, would the meaning of the sentence change drastically?I only eat meat products.The answer is yes, it would change. There is a lot of difference between the meaning of the first example and the second example. Therefore, that was the correct ch oice here.Now, consider the following sentence:I only eat vegetarian, which is a lifestyle I enjoy.If we take away the clause following which, namely which is a lifestyle I enjoy, would the meaning of the sentence change drastically?I only eat vegetarian.The answer is no, it wouldnt change. The information that followed the comma and which was additional information but the meaning of the sentence stays the same: this person only eats vegetarian. Therefore, which was the correct choice here.Affect vs. EffectThe easiest way to avoid this grammar mistake is to look at how the word is used in the sentence. If the word is used as a verb, it is almost always affect. If the word is used as a noun, it is almost always effect.Consider the following sentences:I was affected by the words you used today.Those words had an effect on me.Its vs. ItsIve seen many editors make this mistake; its that common. However, the explanation for which to use is a simple one:Use its when you are showing posse ssion. For example:The dog bit at its collar all day.Use its when you are showing the contraction of it is. For example:Its a sad day when we cant even stand for the national anthem.
Wednesday, June 24, 2020
Traumatic Brain Injury and Alzheimers Disease - Free Essay Example
Traumatic head injury increases effect of Alzheimer disease which disrupts activity of neurotransmitters and electrical charges travel within cells. Alzheimer disease is characterized by synaptic loss and neuronal death with gross brain atrophy. Falls are common in older population which lead to prolong hospital stay and serious medical complications such as traumatic brain injury. Traumatic head injury cause brain tissue to swell which prevent fluids from leaving brain and broken pieces of skull can rupture blood vessels in head. Effect of traumatic brain injury is crucial due to the association of cognitive impairment, decrease motor function, and neuroinflammation with Alzheimers disease, especially in women with the APOE genotype. Reducing the onset with preventative measures including diet modification, physical activities, and continuous intellectual stimulation constituting a medical management and care plan. Neuroinflammation and Cognitive Impairment Neuroinflammation and cognitive impairment role on the brain is critical to traumatic brain injury with Alzheimer disease. Brains immune cells play an important role in healing process, removal of dead, and damaged neurons which doesnt occur cause of the traumatic brain injury. Amnesia is memory loss and different types include retrograde amnesia and anterograde amnesia. Retrograde amnesia hinders ability to retrieve memories that were already stored in brain and limited to period before head injury or before Alzheimer disease develops. Anterograde amnesia lose capacity to make new memories and present for events that occur or information that is present after brain injury or Alzheimer disease. Aphasia is impaired communication and apraxia is deficit involuntary motor skills. Neuroinflammation is cellular damage and loss of neuronal functions occurring when brain or spinal cord become inflamed cause by irritation and swelling of brain tissue or blood vessels. Brain swelling cause increased intracranial pressure (ICP) which prevent blood flow to brain and deprived it of oxygen need to function. Brain fog occurs due to decrease communication between neurons leading to damaged brain cells and brain decelerating. Inflammation cause deficits such as memory loss, decrease alertness, change in concentration and behavior, confusion, mood swings, and distortions in thought. Chronic cerebral inflammation associated with increased proinflammatory cytokines capable of mediating neural protection and regeneration. Traumatic brain injury follows by oxidative stress and hypoxia which stimulate microglia and astrocytes. Continuing neuroinflammation and oxidative stress occur in existence of brain damage and functional impairments (OBrien, 2015). Cognitive impairment is act of knowing, thinking, ability to choose, understand, remember information. Problems include attention and concentration, speech and language, learning and memory, problem-solving, decision-making, and judgment. First, unable to pay attention and concentration resulting in restless, distraction, difficulty working on more than one task at a time, problem carrying on long conversation or sitting still for long period of time. Second, problem with processing and understanding information slow down and result in taking longer to grasp what other say, more time to understand and follow direction, trouble following tv, take longer to read and interpret written information, slow to reaction such as driving, slow to carry out physical task like getting dress or cooking. Third, language and communication problems include difficulty thinking of right words, trouble starting or following conversation, rambling, misunderstanding jokes, difficult with more complex lang uage, trouble communicating thoughts and feelings using facial expression, tone of voice and body language, reading others emotions. Fourth, problem learning and remember new information that occur recently but remember information from long time ago. Fifth, problem with problem-solving, decision-making, and judgment include difficult recognizing problem, trouble analyzing information, or change way of thinking, difficult deciding best solution, and quick decision without thinking about consequences. Sixth, inappropriate, embarrassing or impulsive behavior occur with lack of self-control and self-awareness including denying cognitive problems, say hurtful or insensitive things, act out of place and behave in inconsiderate way and lack awareness of social boundaries and others feeling. Adrenal cortex produces the hormone cortisol and shows a high level in people affective by mild cognitive impairment (Battino, 2016 APOE Genotype The sex difference varies by APOE genotype which regulate aggregation and clearance in brain, neuronal signaling, and neuroinflammation. Traumatic brain injury reduce ability to repair and remodel synapses or protect neurons with APOE gene. Patient carrying APOE gene have high tau level, low cerebral spinal fluid (CSF) and great brain atrophy particularly in hippocampal area cause loss in cortical thinness and hippocampal value leading to decrease cognitive performance. APOE- Ã µ4 gene more common in Alzheimer disease patient associated with increased risk for cerebral amyloid. Amyloid-related decline with presence of APOE- ?Ã µ4 by assessing memory, cognitive, and executive function in participants with Alzheimer pathology and no pathology. (Donohue, 2014) Amyloid-b (A) peptides becomes accumulate and aggression causing injury to synapse and neurodegeneration. Microtubule-associated protein tau appear as neurofibrillary tangles in Alzheimer disease brain caused by overproduction of A. Low level of gonadal sex hormones is associated with decline in neurogenesis with memory decline and executive function difficulties. Female sex-linked to decrease longitudinal cognitive, advance hippocampal atrophy, and lower cognitive testing. Women with APOE- Ã µ4 have more pronounced brain pathology than men showing more buildup of sticky plaques called amyloid beta protein. APOE- Ã µ4 in women cause worse performance, greater brain atrophy and lower brain metabolism due to higher level of biological markers. Women with low CSF have greater left hippocampal atrophy, quicker decline in memory, and function performance while women with higher CSF have decrease in function performance and advance right hippocampal atrophy (Koran, 2016). Estrogen important for hippocampal memory consolidation, hippocampal-dependent spatial navigation memory, object recognition, and object placement which decrease with age and associated with cognitive decline. Preventive Measure Diet modification, physical activities, intellectual stimulation to help decrease cognitive impairment, neuroinflammation, and increase motor function. Research has showed that wearing a seat belt while in an automobile can reduce injury from occurring during accidents. Secure rugs and loose electrical cord to minimize risk of tripping over them which could lead to falls. Brain cells critical for memory is lose as brain shrink with age, and large brain volume association include diet rich in fruits, vegetables, whole grains, dairy, nuts, fish, and low in sugary beverage. Diet modification include nutrition which is an environmental factor, and proper nutrition can change biomarker level. Decrease oxidation in the brain cause decrease deacetylase activity (Athanasopoulos, 2016). Vitamin D has neuroprotector properties such as antioxidative, calcium homeostasis, neurotrophic regulation and anti-inflammatory action which regulate DNA methylation and modulate gene expression leading to decrease risk for developing Alzheimer disease. Vitamins A, C, and E has antioxidant properties which can reduce abnormal histone acetylation modification. Vitamin A group include retinol, retinoic acid, and b-carotene which have beneficial effect on memory. Vitamin C group require for recycling ?Ã ±-tocopherol radical which acts as a reducing agent and induces epigenetic changes to protect against Alzheimer disease. Vitamin E group include tocopherols and tocotrienols associated with decreased risk for Alzheimer disease. Omega-3 fatty acids reduce cognitive decline in ol der adults by increasing the specialized pro-resolving mediators produce by peripheral blood mononuclear cells. Omega-3 fatty acids benefit heart and blood vessels, anti-inflammatory effects, and protect nerve cell membranes. Inflammation and cognitive decline can be physical reduced with alpha-lipoic acid, curcumin, fish oil, ginger, resveratrol, and spirulina. Physical activities help brain cells increase blood and oxygen flow in brain encouraging new cell growth which stimulate brains ability to maintain old connection as well as make new ones. Muscle, joints, balance, and heart help maintain higher level of functioning and reducing risk of falls. Adequate exercise reduces restlessness and prevent wandering and cognitive decline improve with supporting cardiac function. Improve sleeping habits by maintaining a good sleep-wake cycle and facilitate sound sleep at night. Walking shows improvement with memory and weight training show improvement in selective attention, memory, and conflict resolution. Yoga decrease blood pressure and decrease risk of cardiovascular which improve brain function and decrease risk of Alzheimer disease. Overall quality of life improves with yoga with increase processing speed, executive function, attention, memory, and mood. Stimulating Activities Certain stimulating activities can reduce risk of mild cognitive impairment and show improvement in complex thinking and memory skills by staying engage and alert while enjoying vigorous memory workout. People with APOE ?Ã µ4 genotype engage in intellectual activities show reduced risk of mild cognitive impairment and higher cognitive reserve is associated with cerebrospinal biomarker. Reduce risk of mild cognitive impairment by playing brain games, reading, using computer, and social activities. Puzzles or sorting object use hand-eye coordination to exercise problem-solving ability and make sense of shapes to complete pictures which help maintain neural connection of brain. Game encouraging verbal articulation of ideas strengthen mental capacity through word related activities, mental exercises, or question by stimulating mind to sharpen cognitive awareness. Reading stimulate both memories and emotion and more neurobiological demanding require vision, language, and associate learni ng all connection. Tackling new technologies is a way to learn new things. Remain interested, active and engage in life by staying social will keep brain active. Learn something new to challenge mind and stimulate brain stem growth such as new language, musical instrument, and painting which provide novelty, complexity, and challenge by disrupting brains habit and routines. Artistic hobbies such as drawing, and paint keeps senses fine-tuned by work part of the brain that might not have been utilized in past. Music stimulates specific part of the brain and has power to stir memories and elicit emotion. Practice memorization by creating rhymes and patterns to strength memory connection. Practice the 5 Ws. Who, What, Where, When, and Why by observing and reporting to capture visual details to keep neurons firing. Things already know how to do, try in new ways to create new brain pathways such as eating or styling hair with non-dominant hand and placing watch on opposite wrist. Medical Management and Care Plan Medical management and care plan help communicate and organize action needed for individuals needs. Neurological examination includes blood test, spinal tap, nerve function, electroencephalogram (EEG), and imaging test CT scan and MRI. Cognitive evaluated by neuropsychologist since many factors affect how cognitive can be improve and challenging to predict recovery. Cognitive rehabilitation focus on remediation focus on improving skills that have been lost or impaired and compensate learning new ways to achieve goal. Speech therapist to identify areas that need work Treatment Medication cant stop the damage Alzheimer disease cause brain cell but can lessen or stabilize symptoms by affecting certain chemicals involving with brain nerve cells. Neuroinflammation treatment include controlling inflammation with immunosuppressant. Cholinesterase inhibitors and memantine to treat cognitive symptoms such as confusion, problem with thinking and reasoning, and memory loss. Cholinesterase inhibitors prevent breakdown of chemical called acetylcholine essential for learning, memory, and support communication among nerve cells by increasing acetylcholine. Memantine regulates activity of a chemical called glutamate improved mental function and ability to perform daily activities. Oxygen therapy provide oxygen to help blood have enough oxygen and reduce amount of swelling. PROG treatment shows improved long-term cognitive and motor outcome with decrease brain damage (OBrien, 2015). MW 151 treatment Selective proinflammatory cytokine prevent cognitive impairment (Bachstet ter, 2015). Cognitive rehabilitation focuses on remediation by developing skills that have been lost or impaired and compensate for learning new ways to achieve goal. Ventriculostomy by drilling small hole in skull to drain cerebrospinal fluid from inside brain. Surgery to remove part of skull to relieve intracranial pressure or repair damaged artery or vein. Care Plan Cognition-focused evaluation is a comprehensive and interview with family member to obtain description of current issue, accurate patient history, exams, medication, and medical. Functional assessment includes activities of daily living, decision-making capacity, evaluation of safety and advances care planning with palliative care. Reminiscing will help with long-term memories and intellectual activities to keep cognitive skills active. Early detection can assist with more time to prepare for future, better chance of treatment such as increased chance of participating in clinical drug trials, participate in decision about care, transportation, living option, financial, and legal matters. Evaluation of safety and advance care planning with palliative care. Plans to help improve different changes that are occurring in mind and body. Attention and concentration problems improved by decreasing distraction, focus on one task at a time, practice attention skills, and take breaks when tired. Problem with processing and understanding improved with placing full attention on trying to understand, more time to think about information, re-read information, and ask to repeat themselves. Language and communication improved with using gentle tone of voice, dont speak quickly, limit conversation to one person at a time. Problems learning and remembering new information improved by putting together a structured routine of daily task and activities, be organized, review and practice new information, well rested and reduce anxiety, learn memory aids such as memory notebooks, calendars, daily schedules, and daily task list. Problem with problem-solving, decision-making, and judgment include teaching organized approach such as step-by-step problem-solving strategy, define problems, possible solution, pros and cons of solutions, pick solution, and evaluate success of solution. Inappropriate, embarrassing or impulsive behavior include think ahead about situation, clear expectation for desirable behavior, plan and rehearse social interaction, verbal and non-verbal cues. Conclusion Alzheimer disease is a complex neurodegenerative disorder which progressive due to traumatic brain injury. Effect of traumatic brain injury can be reduced by understanding neuroinflammation, cognitive impairment, APOE genotype, and sex hormones. Diet modification. Physical activities improve blood flow to brain and stimulate nerve cells growth. Ongoing intellectual stimulation improves complex thinking, memory, communication, and interaction.
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