Spectrophotometric Assay for Lipase Activity

Spectrophotometric hear for Lipase employmentDecomposition of human and animals bodies depends on numbers of factors. One of these factors is the front of bacterium, dickens endogenous and exogenous of the body. They work fall out the purlieual factors to drive the decomposition of the tissues in the body. The various tissues be degraded at several(predicate) evaluate by diverse bacteriuml cubicles. As it was striken in the model burial of a devour that is the early stages of decomposition guanine negative bacteriuml were in general demonst tramp in the decaying body. But later on 6 7 hebdomads later on the Gram negative bacterium started to fall down as the number of Gram positive bacteria record in the decaying body started to affix.The bacteria fatigue enzymes which tumble galvanic pile any(prenominal) tissue in the body. In the greasy tissue bacteria produces lipases which is secreted in to he tissue and slowly starts to break tear the fat.Lipa ses producing bacterial has been collected from a model burial environment without any environmental factors to see if thither is a going away in the natural action of the lipase enzyme which atomic number 18 produced by una handle bacteria species. These bacteria were employ in two of the spectrophotometric checkout that has been described in the literature. The turbidness try out shows how quickly the lipase enzyme lowlife break polish up the lipide in the photographic emulsion firmness. On the other hand the BALB (dimercaprol Tri exceptyrate) DTNB (5, 5- dithiobis (2-nitrobenzoic window pane)) method shows the step-up in the crossroad that is produced by the lipase.INTRODUCTIONLipases ar arrange natur wholly(prenominal)y as it is produced by plants, animals and micro-organisms. In the uttermost(a) few decades, the micro-organism crosswayion of lipases has been studied for commercial use, which leads to bacterial lipases being studied a great deal. Lipase enz ymes breakdown and mobilize lipids which be present within the jail cell of the organism and the breakdown of lipid is alike present in the environment. except there atomic number 18 many questions static unanswered. For example, is the activity of the lipases various when they are produced by assorted crinkles or species of bacteria? Hope effectivey in this research paper, this question will be answered.bacterial LipasesWhen bacteria is pornographic in a surrounding of hydrophobic media, the bacterial cell releases lipase for the breakdown of fats in the environment for a source of energy. bacteria produce lipases during the late phases of log phases and in the stationary phases. Lipases are hydrolases which hydrolyzes triacylglycerols in aqueous conditions to form fatty acids and glycerol. The chemical reaction releases energy which is utilise for harvesting of the bacteria which is why the bacterium produces lipases within these phases. The substrates of the lipases are triacylglycerols which are hydrophobic and the reaction occurs in aqueous condition and this leads to the reaction occurring in lipid-water embrasure. about lipases force out as well catalyze the synthesis of gigantic chain fatty acids.Lipases contains / fold, which has eight sheets in the middle which are par every(prenominal)el unpack for the encourage sheet and the sheets are surrounded by hel nuts. This fold offers a hold for the participating place in the lipase mote. The industrious come in or rachis site of the lipase molecule is where the interface occurs. This is where the chains of the enzyme are subdivided at the buns of the active site is where the ester bond deems to which means this region is hydrophilic. Towards the surface of the enzyme is where the molecule binds to the fatty acids and therefore this region is hydrophobic. Within the -sheets there is an area which is extremely conserved which is make up of the triad which is a nucleophile and histidine. The nucleophile is do up several amino acids, which are Serine, Cysteine or aspartic acid. The nucleophile is present on 5 and the histidine is present on 7. The histidine is the un little highly conserved area of the active site/enzyme that differs in shape and twist from ane type of lipase enzyme to a nonher. or so other area of the active site that is important but only present in some type of lipases is the lid. This area is what gives the lipase enzyme the structural explanation of the interface property. When the substrate comes into contract with the lid, it opens the lipid water interface where the substrate binds to for the reaction to occur. nearly lipase molecules are only active in the presence of Ca2+ and this is imputable to the subdivisions of the active site being bound together by the Ca2+ion. The hydrophobic region of the active site leads to less inhibitors that brush off bind to and deactivate the enzyme.Since lipases are extracellular enzym es, the secretion/production of these enzymes is affected by a number of factorsNutritional enzymes are produced when the bacteria is in the presence of a lipid environment such as oil, tweens, hydrolyzable esters and triacylglycerols. These are the of import sources of lipid but many bacteria bum produce lipases in the presence of various sources of substrates. For example genus Pseudomonas aeruginosa produce lipase in the presence of long chain fatty acids such as oleic and linoleic acid.Temperature the temperature at which take best production of lipase can occur depends on the optimum temperature for growth of bacteria. The temperature normally ranges from 30 60C, but some can survive at colder or warmer temperatures. on that forefrontfore it depends on the type of bacteria in question.pH normally bacterial lipases are active in soggy pH or alkaline pH. that there are a few exceptions like Pseudomonas fluorescens lipase has an optimum pH of 4.8, whereas most bacteria l species possess stability all over a broad range of pH of 4 10.Effect of ion cardinal type of lipase which is produced by Pseudomonas species is actuate by the presence of Ca2+ ion in the environment.Growth of bacteria if the bacterial cell is present in the log phase thusly the production of lipase is reposition magnitude in the bacterial cell.Inhibitors inhibition of lipases does not affect the production or the secretion of the enzyme but affects the activity of the enzyme. in that respect are two types of inhibitors permanent or reversible. The reversible inhibitors are split into two types. The get-go of which are non specific as they bind to the enzyme but not at the active site. When the inhibitor binds to the enzyme, the active site diversifys and therefore prevents the lipases from binding to the substrate as the structure of the active site has been changed. An example of this type of inhibitor is freshness salts. However bile salts can activate some lipas es such as the lipase produced by the pancreas. The indorsement type of reversible inhibitors is specific inhibitors as they bind to the active site of the lipase enzyme. They can also be irreversible as the interaction between the inhibitor and the enzyme is so strong that it cannot be broken. An example of this type of inhibitor is boronic acid which can bind to the active site for a long clock conviction but can still be removes leaving the active site unchanged. These types of inhibitors bind to the triad of the active site, which means that when they bind to the triad, the interaction is irreversible.There are three major types of microbial lipases depending on the substrate they bind to.Nonspecific these enzymes act haphazardly on the lipid substrate molecules which thus completely breakdown the molecule. For example with the triglyceride molecule, the enzyme will break the ester in random fashion until the molecule is complete broken down to fatty acids and glycerol.Reg iospecific these enzymes only hydrolyze the primary ester bond, these are the C1 and C3 bonds in the triglyceride molecule , which means that when hydrolyzing triglycerides the closing products are turn fatty acids, 1, 2(2,3)-diacylglyceride and 2-monoacylglyceride.Fatty acid-specific there are some bacteria that only produce this type of lipase and they bind to fatty acids which are thusly broken down by the lipase. One type of bacteria that can produce lipases that only bind fatty acids is the Achromobacterium lipolyticum. Other bacteria that produce this type of enzyme are Bacillus species which loosely bind to long chained fatty acids. However other bacteria like Pseudomonas species produce lipases that can bind to short or medium duration of fatty acids. Staphylococcus aureus can produce a lipase molecule that can bind to unsaturated fatty acids.Lipase in DecompositionThe bacteria that are going to be use in the research project are bacteria that were purified from a mode l burial environment. The bacteria that were present in the model burial environment must crap been already been present in the pigs body, which means that all the bacteria that are going to be used are endogenous bacteria that are part of the pigs microflora. The bacteria ingest had been taken out of the fluid from the decaying organism in a steel box which was free from all external environmental factors except from oxygen. The exemplar of bacteria was taken two times a week and thus towards the end it was reduced to once a week. It was discovered that at the beginning of the decaying process the bacteria that were present were Gram negative bacteria. However later on week 9 the bacteria that were ontogenesis in the decaying pig changed from Gram negative to Gram positive. These bacterial cells can release lipases which can break down fats in the body which leads to the formation of adipocere. Adipocere is made up from a mixture of saturated fatty acids which have been produ ced during decomposition of the fatty tissue in the body. These adipoceres are formed straight away later on death by lipases which are present at bottom the body. These lipases are mostly produced by the bacteria in the body of the pig which breaks down triglycerides to free fatty acids. If in a suitable environment, bacteria release lipases for hydrogenation of unsaturated fatty acids to its saturated form.Lipase AssaysThere are two analyses that will be performed to find out the activity of the lipase which are present in the origin. The first is based on BALB DTNB method and it uses dimercaprol tributyrate (BALB) and 5, 5 dithiobis (2-nitrobenzoic acid) (DNTB). The lipase enzyme binds to BALB and cleaves it to form an SH company which so binds to DNTB. The product pastcece forms a yellow product which then increases the absorbance which can be deliberate using a spectrophotometer. The colour intensity is metrical at 412 nm the colour change is proportional to the ac tivity to lipase at to 11 ratio.The south sample also uses the spectrophotometer but this time it measures the ocular assiduity of the declaration instead of measuring the amount of product that is formed. Tributyrin and olive oil is emulsified in the dissolver which gives a turbid appearance. As the lipase breaks down the lipid in the analyse upshot, the visual density of the ascendent decreases which can be measured. The optical density of the solute ion can be measured at 450nm. Both searchs measure the activity of the lipase but in two contrasting ways. The first measures the amount of product that is formed while the randomness measures the breakdown of the substrate.AIMS AND OBJECTIVESDecomposition of human or animal bodies is dependent upon a number of factors. Bacteria which are endogenous (in the body) and exogenous (in the environment) are the refer comp unrivalednts of decomposition. Different tissues in the body degrade at diametric rates and are degrad ed by different bacteria.Previously it has been shown that bacteria in the model burial environment can produce lipases which breakdown the lipids found within the tissues of the body. However it does not tell you if there are different lipases that are secreted by different bacterial cells. Lipase production was demonstrated by using scurf hear when lipase breaks down tween 20. Therefore it does not study the different lipases produced and the activity of different bacterial species.There have been different spectrophotometric tabs that have been described in the literature to calculate the activity of lipase enzymes, but only two of these will be used. The bacteria that is going to be used in the assay has been purified from fluid from a decaying pig in a steel box which is free from all external environmental factors expect oxygen.Two assays are going to be preformed to find the activity of lipase, the first superstar similar to the BALB DTNB method. Lipase forms a SH group on BALB which then binds to DTNM to give a yellow product. The amount of product that is formed in a ancestor is related to the activity of lipase in a 11 reacting ratio which is a direct measurement of the activity. The colour change is measured at 420 nm.The second assay is also measure the change in the solution but this time it measures the decrease of the substrate that is go forth in the solution. It measures the density of the solution, as the substrate (olive oil) is denser than the product. The density is measured 450 nm. The change magnitude of the substrate is related to the activity of lipase.At first forwards anything can be make we need to see if the bacteria cells produced lipase is by growing them in a racing shell which contains Tween 80. If the Tween is broken down then the bacterial cell produces lipase.MATERIALS AND METHODSThe bacterial strains that were given to me were extracted from fluid from a pig that was decaying in a steel box which had a controll ed environment that was free from all external environment factors expect fresh air.Bacterial MediaThe bacterial strains were bragging(a) in half nutrient agar which was made from 2.6g of nutrient stock certificate (OXOID, Basingstoke, England) and 4.8g of nutrient agar bacteriological (OXIOD) in 400ml of water which was autoclaved and then poured in to 20ml Petri dish. The bacterial strains were dentured and unexpended in a 30C incubator overnight. by and by the bacteria were s surfaceed on undecomposed half nutrient agar, they were then grown on half nutrient agar with 4ml of sterile Tween 80 (SIGMA ALDRICH, UK) and 400l of 10% of CaCl2 (scientific equipment, Loughborough, England). Again the headquarterss were displace in a 30C incubator.The bacterial strains were also grown in marginal medium agar which contained 2.8g of Potassium Hydrogen Orthophosphate (BDH Laboratory Supplies, Poole, England), 1.2g sodium Dihydrogen Orthophosphate (BDH LS) and 0.04g of Magnesium Su lphate (BDH LS) in 200ml of sterile water and 2.4g of Agar bacteriological. by and by the solution came out of the autoclave, 2ml of Tween 80 was added and 200l of 10 % CaCl2.For the bacterial strains to be used in spectrophotometric assay, the strains had to be grown in liquid media. The bacterial strains were grown in two different types of media, Tryptic soybean plant Broth and tokenish Medium.The Tryptic Soy Broth (TBS) was made from 30g/L Tryptone soja Broth (OXIOD) which was autoclaved. After the bacteria were added to the media, the bottle was placed in a shaking incubator at 37C over night.The Minimal Medium contained 14g/L of potassium hydrogen phosphate, 6g/L sodium dihydrogen orthophosphate and 0.2g/L of magnesium sulphate. 100l of Tributyrate (SIGMA ALDRICH) was added to 10ml of the Minimal Media. The bacteria were added to the media and then placed in a shaking incubator at 37C over night.Sample SolutionsAfter the bacteria are odd to grow, the media is used to make up three different samples of bacteria to use in both of the assays. The first sample is purified bacterial strain from the media and this was obtained when 1ml of the media was placed in a sterile eppendorf tube which was then centrifuged at full speed for 2 minutes. The supernatant was replaced with 500l of 150mM of CaCl2 and 500l of 200mM of Tris cowcatcher (12.11g of Trizma base in 150ml of water and then 0.1M of HCl was added to make the pH of the solution 8, this to make 0.5M Tris Buffer which was then diluted to make 200mM solution) (SIGAM ALDICH).The second sample was make in the same manner but instead of adding Tris buffer and CaCl2 to the pellet, PBS (Phosphate buffered saline) solution is utilized to re-suspend the pellet and 2ml of the media solution is used. each suspension was transferred in to a different Bijou Bottle which is kept on ice. The suspension in the Bijou Bottle is sonicated twice for 30 seconds at 30W.The finish sample was made when the media solutio n is filtered with the use of a sterile syringe and sterile 0.2m pore syringe filter and placing the filtered solution into a sterile universal bottle. 3ml of the media was only filtered.The samples were ready for the assay and two different that were used. They both measured the absorbance of the solution at different wavelengths. One measured the turbidity of the solution while the other looked at the change in the absorbance of the solution.Turbidity AssayFor the turbidity assay an emulsion solution is made and it is made from 100mM of Tris buffer (4.975ml), 50mM of CaCl2 (4.975ml) and 50ml of lipid source (either olive oil or Tributyrate or both). The solution was sonicated for 3 minutes at 40W. The solution is left in a water bath until it is used for the assay. The emulsion solution is used in three different ways as the assay was performed in a cuvette, Petri dish or 96 well place. When done in a cuvette, 40mg of low melting point agarose (SIGMA ALDRICH) is added and the boi led forward sonication. The agarose stabilises the emulsion. If the assay was done in a 96 well case, then no agarose is necessary. The last try out that is performed is in 20ml plates 20ml of the emulsion solution is made up with 80mg of agarose to made a solid media (INVITROGEN, Paisley, UK) which is then boiled before and after sonication.For the 96 wells plate, 200l of the emulsion solution was placed in each well and then 20l of the sample solution was added. As soon as the sample was added the absorbance is measured at 450nm to measure the optical density of the solution. The absorbance was then measured all(prenominal) 15 minutes up to 60 minutes. Here the samples that were used were grown in the Minimal Medium. The lipid source in this part of the assay was 25l of olive oil and 25l of Tributyrate in 10ml of the emulsion solution.For the assay that was done in the cuvette 1L of the emulsion solution was added to a micro cuvette and 100l of the sample solution. The absorba nce was also measured at 450nm as soon as the sample is been added and then every 5 minutes up to 45 minutes. The lipid source is 50l of olive oil in 10ml of emulsion solution.For the plate assay after the solution was boiled for the second time, the solution was poured in to a plate for the agarose to set. After the agarose was set, wells were made in the agarose using a mindless punch about 8mm in diameter which was filled with 10l of the sample solution and the plate was left at room temperature over night. In 20ml of the emulsion solution the lipid source was 50l of each olive oil and Tributyrate.Colour Assay (BALB DNTB Method)The second assay measures the absorbance change in the working solution. The working solution is made from BALB (SIGMA ALDRICH) and DNTB (SIGMA ALDRICH) and Tris buffer solution. The working solution was made from 1 ml of BALB is added to 17.5ml of 0.5M of Tris Buffer at pH 8.5 and 625mg of DNTB. 150l of the working solution is added to the well after ad ding 150l of water. To this 10l of the sample was added. When the assay was done in 96 well plate the absorbance was measured after the sample was added at 405nm and then every 10 minutes for 30 minutes.When the assay was done in a cuvette, at first 400l of water was placed in the cuvette then 380l of the working solution was added to the water. Then the 20l of the working sample was added into the cuvette. The absorbance was the measured at 412 nm for the 20 minutes. The reason why there is a difference in the wavelength in which the absorbance is measured is referable to the plate reader not being able to read the absorbance at 412nm. For this assay the samples that were used were alert from the bacteria that were grown in TSB.RESULTSWhen the bacteria colonies were grown on the agar plate which had Tween 80 and CaCl2, around the colonies there was the presence of skirts or the colonies has a gang this can be seen in manikin 1a. The arrow shows the halo colonies of the bacteri a species. The bacteria colonies that were placed on other plates was not as clear as 16C but the halo can only be seen when the plates are held up by the light ( case not shown).Turbidity AssayThe first assay that was done was the turbidity assay in a cuvette, the optical density of the solution did not increase or decrease, and it just stayed the same. But when the assay was done in the 96 well plate the optical density change magnitude when the bacteria were added to the well, and then decrease and persevere decreasing even after 60 minutes ( practice 2a).Then the filtered media was added to the emulsion solution in the 96 well plate, the optical density over once again decreased. However not all the bacteria were filtered to see if there was a decrease in the optical density (figure 3). Only some of the bacteria were used to see if it was an enzyme that was decreasing the optical density and not the bacterial cells. However the general result showed a decrease in the optical density except for 2 bacterial strains (1A and 4A) which showed an increase in the optical density after 30 minutes and then it optical density again.Then the bacteria cell free lysates were added to the welled plate and the same result appeared as the optical density takes decreased once again. The bacteria that were used were the same bacteria that were used in the filtered part of the assay (figure 4). After 45 minutes the optical density is starting to direct off. The gradient of the line for all the bacteria strains are the same as they all decrease at the same rate expect for bacteria strain 5 which has flatter gradient than the rest.For the plate test in the turbidity assay, the bacterial solution in the well was not present and no zone of headway was noticeable in any of the plates (figure 1b). Only one of the plates is shown in the figure and the rest of the plates looked the same as no zone could be seen.Colour Assay (BALB DNTB Method)In the BALB-DNTB method, the abs orbance increases when bacteria strain 6 was added to the working solution in a cuvette and measured for 20 minutes. The increase was slow for the first 10 minutes and then increased at a faster rate for the next 10 minutes, figure 5.When the assay was done in the welled plate, the absorbance increases for all the strains but some increase more than than others. For example strain 5 increased from 4.204 to 4.412 while strain 1 only increased from 4.241 to 4.265. This is shown in a table in figure 2b.When only the media in which the bacteria grew in was added as the sample, the absorbance also increased for most of the bacterial strains but not as much as when the bacterial cells were added. For some of the strains the absorbance decreased. For example in strain 1 there was a decrease from 4.241 to 4.235, figure 2c. The same happened when the content of the bacterial cell was added to the working solution. But when the absorbance increased, the increase was rangyger than the increa se when media was added (figure 2d). However there were still some strains in which the absorbance still decreased in 20 minutes but the absorbance increased from 0 to 10 minutes and then decreased from 10 to 20 minutes.Figure 1, (a) the plate has been plated with strain 16C (left) and 16B (right) the halo can be seen clear by the arrow which is the colonies of bacteria 16C. However the halo can not be seen clearly in the colonies of bacteria. (b), the plate contain solid emulsion solution with well which contain lipases from different bacteria, and there is no presence of zone of clearance from any of the well. There were 3 plates in total and all look the same (only one is shown) but the well had different lipases from different bacteria.Figure 2, A is a table that shows the optical density change when bacterial was added to emulsion solution for the turbidity assay. The optical density decreases when the bacterial cells were added to the emulsion solution. The next 3 tables are s howing the absorbance change when the strains were added to the working solution for the colour BALB-DNTB method, (B) has bacterial cells added to the working solution (C) has only filtered media, which had bacteria growing in, was added and lastly (D) had bacterial cells free lysates added. In the colour assay the absorbance increased in all three cases.DISCUSSIONBacteria produce lipases that can break down or hydrolyse lipid molecules such as fats and oils. They produce lipases in the log phase of growth when there is a high take of lipid source for energy. There are different lipases which can break down different lipid molecules. The bacterium produces lipases to break down lipid for energy as adequate amount energy is present in lipids. As most of the lipids cannot cross the cell membrane, the lipid has to be catabolised into little lipid molecules which can then enter the cell where it is broken down further. Lipases from bacteria are studied for industrial uses. Here it was studied to see if the lipases that were produced from different bacteria are different and if there was any revolution in the activity of the lipases.When the bacterial cells were grown on agar plate without any Tween 80 the bacterial colonies do not have any halos or precipitate around the colonies. But when some of the bacteria were grown in agar that contained Tween 80 and CaCl2 the colonies had halo colonies 3 to 8 days after they were inoculated. In the past Tween has been used for lipase activity to see if the bacteria produce lipase. If lipases are produced then it binds to the Tween and breaks the Tween down to fatty acids. The fatty acids then bind to the Ca in the media which forms crystals. These crystals then become soluble in the media which can then be seen by eye as halos. Some of the colonies had halos which meant that the cell produced lipases.Figure 6, the turbidity plate assay should have looked like this but what the figure 1b shows. There the one of clearance can be seen very clearly where as in the plate in figure 1b there are no clearing at all what meant the assay did not work at all.The turbidity assay that was done is the plate which showed no zone of clearance, it should have had zone of clearance around the well which contained the sample of bacteria. The bacteria in the wells should have diffused out of the well and in to the agarose media in which the bacteria should have released lipases to break down the olive oil and Tributyrate. When the lipids were broken down the media would have become clear. The plate should have look like figure 6 from, the zone of clearance is shown very clearly.The other assay that did not work was the same assay that was done with the cuvette. This is when the absorbance levels did not decrease but just stayed the same. The absorbance levels should have decreased and the reason in why this did not occur is not known. It power have been due to the stability of the solution as the agarose must have be en concentrated which meant that the bacteria solution was not able to diffuse by the media.The concentration of agarose might be the problem because when agarose was not added like in the 96 well plate part of the assay, the absorbance of the emulsion solution decreased. This was due to the emulsion solution being turbid by lipid in the solution when sonicated, when the bacteria sample was added the optical density increased about as the bacteria cell scatter the light which leads to the increase in the optical density absorbance levels. The bacteria cell then releases lipase in the solution or lipase that are inside the cell break down the lipid in the emulsion solution which then leads to the decrease in the level of lipid in the emulsion solution which then means that less light is scattered.The well plate assay was done to 3 different type of sample solution, one of which contained bacteria cell, one of which contained the filtered media solution and the last contained the ba cteria cell free lysates. The bacterial cells were used to see if the bacterial cell produced lipases. The filtered media was used to see if the bacterial cell released lipase in to the media and if it was in fact the lipase that was decreasing the absorbance and not anything else. The bacteria content was used after the bacteria cell were sonicated for one minute, to use all the lipases that had been produced by the bacterial cell but not secreted. As not all the bacteria cells release the lipase in to the media and sometime the lipid molecule is too big to cross the cell membrane and wall of the bacteria.To see if there are any differences in the activity of the different lipases which are produced by different bacterial cells, cannot be done by adding the sample to the emulsion solution as different concentration of lipase must have been in the sample for each of the strains. In order to make the test fair, the amount of bacterial cell and the lipase concentration must be the sam e for each of the bacterial strain. But still it might be a fair test as some of the bacterial cells can still divide inside the emulsion solution and then increase the concentration of lipases. The lipases produced by the bacteria are produced in the log phase.The same can be give tongue to for the BALB-DNTB method. This assay is not like the other assay because the absorbance does not decrease but increase. This is due to the lipase bind to the BALB in which is cleaved to form a SH group. The SH group then binds to DNTB which is in excess in the working solution, to form a yellow substance. The complex then absorbs light hence increasing the level of absorbance. The bind of the BALB with the new SH group binds to the DNTB in a one to one reacting ratio, this means that increases is absorbance is proportional to the reacting activity of the lipase.When bacterial cells were mixed to the working solution the absorbance for most of them increase. This meant that lipases that were pre sent in the well were cleaved BALB. The same thing also occurred when filtered media was added to the working solution but the increase were small and this must be due to the fact that not a lot of lipases were released by the bacterial cells in to the media solution. However, when the bacterial cell free lysates is added not all of the absorbance levels increase but in fact some of them decrease and then increase. It whitethorn mean that the lipases need time to start working since they had been on ice before the experiment. To see if this was true, the test needs to be done again but for a longer period of time.In the cuvette test, only one strain, it was used when the first assay was done it had the largest change in absorbance. It was used to see a general increase of the solution over 20 minutes and the absorbance was measured every minute to see the turning point when the rate of enzymatic activity change from being slow to a steady normal rate. The graph in figure 5 shows tha t the rate was slow during the first 10 minute this meant the bacteria cell necessary to adapt to the new environment before the activity of the enzyme can to spine to normal. If the test was done longer then the graph would start to level due to the substrate concentration starting to decrease.From the results, there is not rich evidence to conclude that there any differences in the activity of the different strains of lipase. To see if it is true then the both of the a

Absurdism In The Stranger And Metamorphosis English Literature Essay

Absurdism In The Stranger And Metamorphosis English Literature screenThe theme of sloshedism used by Franz Kafka and Albert Camus does full justice to bring come to the fore the pathos in both The Outsider and The Metamorphosis by Albert Camus and Franz Kafka. They run aground the unsettling cosmea of the both the protagonists. The present situation of the narrators brings to life incidents that justify their dreadful situations and what they are difference through in their respective lives. Where existentialism questions human beingitys existence in a particular social system absurdist investigates characters that are pose in society that is devoid of God and how syllogism and parody loom handsome over the entire situation. Hence The Outsider and Metamorphoses have existentialism and absurdism as the philosophical tools that take these stories ahead.Camus concretizes an absurdly dramatic chronicle of a man who has no emotions in him evidently in the opening lines fix d ied today. Or maybe yesterday, I dont deliver by. I had a telegram from the home Mother passed away. Funeral tomorrow. Yours sincerely. That doesnt mean some(prenominal)thing. It may have been yesterday. He- does non until now aroma consume to justify his reason behind such odd and discourteous avoiding of some(prenominal) emotional involvement. Speaking briefly with the director of the home, Mersault tells him that he did not feel any guilt at having sent his commence away. He even declines an invitation to view the body, further keeps vigil with it overnight, in accordance with the custom. When asked by the funeral director how old his mother was, he replies Fairly, for in truth he doesnt know her exact age. His going for a swim with a woman of his indecorum at an inopportune time proves once again futility of his life.As an pattern of absurdism, Mersault doesnt see any need to fulfill or dispel the self-consciousness from the minds of the people as his nature was ve ry offending to other people. He seemed completely inhuman, and never intrustd it was big to live up to the expectations of others and follow etiquette. harmonise to me, every human being goes through the kind of unpleasant and gluey situations Mersault and Gregor face but it principally depends on how a writer decides to degree and sketch these characters.There is a funeral procession, in the heat of the day, across the parched, sun-drenched landscape, and once again, Mersault is disturbed by the light, the sun, and the heat, and feels unable to concentrate. This un dejectionny effect to the gratuity of blinding ones vision evinces unjustifiable discomfort Mersault exudes towards the society.The Outsider is set in Algiers, where our protagonist Mersault, who was a bachelor, is leading a life that questions his existence. He does not show any interest in his job and does not believe in socializing with other people around him. As the story goes ahead, the reader gets to see th e quirkiness of Mersault towards the founding with conflicting emotions that make him point a deadly crime. This marked nature of Mersault is brought discover in the account in many incidents in the book one of them being in chapter four where he is not at all concerned active Raymond torturing his wife. He responds matter of factlyAt about 3 in the aurora there was a knock on my door and Raymond came in. I didnt get up. I sat at the edge of my bed. He didnt say anything for a minute and I asked him how it had gone. He told me that he had done what he cute to do but shed slapped him and so hed beaten her up. Id seen the rest. I told him I thought that this time shed really been punished and he ought to be pleased. Mersaults brusque attitude towards other people around him reckons him as an outcast.I feel that the writers philosophical stance is unique, as he puts immense emphasis on the belief of absurdism and we need to understand what absurdism is ? Absurdist fiction is the manifestation of indisputable beliefs that dominated the works of a number of playwrights during the middle of the 19th century. This institute of fiction implies that in a world that is devoid of God, the existence of human being shall have no strong foundation, it would be meaningless. The absurd elements in such plays and fiction were the fact that man has been thrust into a world where he cannot survive on his own instincts but is maneuvered by a force invisible to him. He is caught up in paradoxical situations and finds no reprieve by communicating or logical action. His actions and dialogues turn out to be a mockery of his own existence.The best part about the narrative is that it does not preach with a message but at the homogeneous time does tend to ask us some important questions about humans and their social existence. The narrative is kept simple but is compelling nevertheless. Therefore, the work is a reflection of Camuss moral axiom.Like Camus, Kafka too was exis tentialist and adapted to an absurdist way in carrying the narrative of his stories ahead as traces of his style are evident in his letter to Max Brod.In Franz Kafkas The Metamorphosis, the absurdist and existentialist elements form the main parts of Kafkas narrative. The story begins with the line When Gregor Samsa awoke from turbulent dreams one morning he found that he had been transformed in his bed into an enormous bug. After realizing that his life would never be the same again Gregor starts realizing certain truths about his existence which had not come to his fruition forrader. He starts to reflect on his own being. Till the day before he had been a hardworking salesman who looked after his family but now he cannot continue the same life anymore. Now after Gregors transformation his parents and infant realize that they shall now have to look after Gregor and start do a living of their own. This leads Gregor into a state of depression which he can only observe but cannot do anything about it. His family is robbed of happiness and normalcy and though they are trying their best to cope with it, their disparity is clearly evident in these lines of the second chapter- Now his sister working with her mother had to do the cooking too of course that did not cause her oft trouble since they hardly ate anything. Gregor was always hearing one of them plead in vain with one of the others to eat and getting no say except thanks, Ive had enough or something similar. They all knew the unpleasantness they had to confront but no(prenominal) of them had an answer to it.I think that both the stories are existentialist and absurd in their narratives, and they both create a long lasting impaction on readers and create a serious sense of debate about human existence and the acceptance of social rules. The Outsider is a wellhead juxtaposed prose of absurdism and existentialism. Mersault is a social outcast and his further actions only make him an object of ridicu le in his own society. One cannot see any kind of redemption for Mersault in his predicament he is doomed and destine for a fatal end. The parts of the story where Mersault is wallowing in self dubiousness are existentialist in theme and the parts where he is unsuccessfully trying to find out the answers that can legitimize his actions are absurdist. Kafkas Metamorphoses sees Gregor going through an amalgamation of emotional, physical and mental dilemmas. His physical transformation into a vermin is the main culprit. This transformation creates an emotional and mental mayhem in him. It can be said about Gregor that he has the answers but is in search of the questions. So, the Metamorphoses begins in an existentialist way but ends with an absurdist plot.

Identifying factors contributing to high readmission of diabetic patients

Identifying factors contributing to heights readmission of diabetic affected role ofsINTRODUCTION.Diabetes Mellitus (DM) is a chronic indisposition. Where the melodic line circulation contain of high scar level, it mess occurs when the pancreas does non produce enough insulin, or when the body can non effectively routine the insulin it produces (WHO).Diabetes is a progressive disease that can lead to a familyificant form of wellness complications and pro formly reduce quality of life. eyepatch m both diabetic tolerants man long time the wellness complication with diet and model and require musics to improve un turn backled gillyflower glucose level.Diabetes has been trea confuse since insulin became available in 1921, and target 2 diabetes may be controlled with medical checkup specialtys. Preeti (2008). Both type 1 and 2 ar chronic insures that usu on the wholey cannot be cured. Acute complications include hypoglycemia, diabetic ketoacidosis, or nonketotic hyp er osmolar coma. Serious long-term complications include cardiovascular disease, chronic nephritic failure and retinal damage. Adequate treatment of diabetes is important, to control argument pressure level and salubrious lifestyle such as smoking cessation and maintaining a body weight. intercession of diabetes involves diet, exercise, teaching, and medicines. If people with diabetes strictly control blood excoriation levels, complications ar less potential to develop. The goal of diabetes treatment, therefore, is to keep blood dulcorate levels within the normal range as such(prenominal) as possible. Treatment of high blood pressure and cholesterol levels can block virtually of the complications of diabetes as well.A good health grooming from the medical round in the hold can give a good check out to enduring health and prevent forbearing from admit again to the ward. The health education in the ward should begin from day 1 diligent admit to the ward until the tolerant of enter from the ward. This health education should not stop when the patient of is discharge from the ward but it must be go on from the health community to make sure that the patient is healthy. riddle STATEMENT.General ObjectiveTo identify factors contributing to high readmission of diabetic patients gage discharge.1.2.3 Specific objective.To identify why the patient is not deport their medication by and by discharge from the ward.To pick up relationship between hunchledge and medication to the patient.In Malaysia, the Third National wellness and unwholesomeness Survey showed that the preponderance of type 2 Diabetes Mellitus (DM) for adults aged 30years and above was found to be 14.9% in 2006. Salwa et. al., ( 2010).Patients with diabetes should know that how importance their health later on they has confirm progress to diabetes. wellness education to patients and families were given continuously by the nurses when these patients were admitted for stabi lisation of their DM, from day 1 of admission and continued until they carry through with(predicate) with(predicate). With proper health education, the patient should be able to take commission for them self until follow up in the clinic.The health education must include dietary usance and medication. The talk is given by the nutritionist and medication by clinical pharmacist. Nurses should take part in the dietary and medication talk when the patient attends the talk to ensure the compliance by the patient continuously after(prenominal) they discharge from the ward.In January 2011, there are 4 patient has been readmitted to the manlike and female medical ward within 2 weeks after discharge from the ward. To prevent from this admission, health education should be given continuously to the patients both in the ward or by the community health armorial bearing provider when the patient is discharge from the infirmary.CHAPTER 22.1 LITERATURE REVIEW.The literature freshen has been searched from internet.Diabetes mellitus is now a major global public health problem. The relative incidence and prevalence of diabetes are escalating eespecially developing and newly industrialized nations. In Malaysia, diabetes is a growing c erstwhilern. Through the Ministry of Healths six year thematic thinking(a) Lifestyle Campaign which began in 1991, diabetes mellitus was the theme for the year 1995. Here, the promotion of adopting healthy lifestyle practices relating to the prevention of diabetes namely creating knowingness and balance diet, maintain specimen body weight and physical activities were encouraged. The campaign emphasized on creating, awareness of the disease and its complications to the public. Rugayah ( 2007)According to Zook et.al (1980). Hospitalizations account for about one-half of all health grapple expenses, and it has been estimated that 20% of the inpatients in Malaysia and 13% in the USA use more than half of all hospital resources through r epeated admissions. During ultimo decades, hospital readmissions arrest been the subject of retrospective come afters and prospective trials with a notion to their prevention. The objective is to review these studies and focus on the frequency of readmissions of diabetes mellitus patient, their causes and validity as a measure of quality of carry off, and the attempts for their prevention.The recent literature on hospital readmissions and found that most of them are believed to be ca apply by patient frailness and progression of chronic disease. However, from 11% to 52% of all readmissions control been judged to be preventable because they were associated with indicators of substandard care during the hospital care, such as poor resolution of the main problem, unstable therapy at discharge, and inadequate post discharge care and advice. Furthermore, randomized prospective trials hold in shown that 15% to 85% of all readmissions can be prevented by patient education, pre dis charge assessment, and domiciliary aftercare. However, high readmission rate of patients with diabetes mellitus may identify quality-of-care problems. A focus on the specific needfully of such patients may lead to the creation of more responsive health care systems for the chronically ill.Most complications are the resolve of problems with blood vessels. uplifted sugar levels all over a long time cause narrow of both the small and large blood vessels. The narrowing reduces blood menses to many parts of the body, leading to problems. there are several causes of blood vessel narrowing. Complex sugar-based substances build up in the walls of small blood vessels, causing them to thicken and leak. Poor control of blood sugar levels as well as tends to cause the levels of fatty substances in the blood to rise, resulting in atherosclerosis.Poor circulation to the jumble can lead to ulcers and infections and causes wounds to heal slowly. People with diabetes are particularly possi ble to stimulate ulcers and infections of the feet and legs. Too often, these wounds heal slowly or not at all, and amputation of the foot or part of the leg may be needed. shortly there are at least 4-5 patients go away be readmission for stabilization then discharged. Upon admission of a patient, this would cause overpopulation of ward, increase expenses and uncontrolled condition of the patient in the ward. Nurse also must provide health education to the patients, their relative and refer patients to nutritionist and education unit for counseled. mug (2000) conducted a scientific investigate on factor for diabetes patient on knowledge and the diabetic drugs for diabetic patients. The major goal of the research are to identify the important factors for patient compliance in the usage of diabetic drugs, specific knowledge on the run drug, the correct dosage and unbecoming side effects..From Browne (2000), noted that only 15% of the patient knows the action of the drug they ar e consuming, where as 62% of them consume at the adept time and 23% of patients gained a proper knowledge on medication or drug that they are consuming.In summary it is concluded that the diabetes patient has the more knowledge and information on the adverse effect of the drug compared to the action of oral hypoglycaemic drugs.According to Ranjini et al,(2003) done a research on knowledge, attitude and practice from patient diabetic at Klinik Kesihatan Seri Manjung, Perak. The findings showed correlational statistics between knowledge, attitude and practice. The finding showed that increases knowledge for patients who contract education is br each(prenominal) from the patient who does not have any education.Hospitalizations account for about half of all health care expenses, and it has been estimated that 20% of the inpatients in Malaysia and 13% in the USA use more than half of all hospital resources through repeated admissions. Zook et al (1980). For past decades, hospital rea dmissions have been the subject of retrospective surveys and prospective trials with a view to their prevention. The objective is to review these studies and focus on the frequency of readmissions of diabetes mellitus patient, their causes and validity as a measure of quality of care, and the attempts for their prevention.Soeken et al (1991), done a research on readmission rates according to demographic, social, and disease-related characteristics. researcher Wray et al (1988), done a meta-analysis of 44 studies published in the lead 1990 revealed that age, duration of stay during the index hospitalization, and previous use of hospital resources were among the main self-reliant predictors of readmissions. These findings prognosticate that patient-specific factors predict readmissions.A essay of a national audition of patients with chronic obstructive pulmonary disease or dementia revealed that after adjusting for severity and clinical and demographic characteristics, patients discharged to nursing fellowships were less likely to be readmitted within 30 days after discharge than those discharged to personal homes. According to Comberg et al (1997) Finally, just about studies have found an connexion between readmission rates and inappropriate care during the index hospitalization. A case-control study revealed that 5 criteria of inpatient care (resolution of main problem, adequacy of the post discharge destination, stability of doses of therapy, and appropriate timing of the first follow-up visit) predicted readmissions within 30 days. Ashton et al (1987) Another case-control study found that a set of disease-specific, uttered criteria of appropriateness of care predicted readmissions. It has been suggested that 1 of 7 readmissions in patients with diabetes, 1 of 5 readmissions in patients with pith failure, and 1 of 12 readmissions in patients with obstructive lung disease were attributable to substandard care. Absence of documentation of discharge pl anning, increased temperature, intravenous fluids on the day of discharge, or unaddressed abnormal test results at discharge were related to an increased subsequent mortality. Ashton et al (1997). A meta-analysis of 29 studies published from 1975 through 1993 confirmed that low-quality inpatient care during the index hospitalization increased the risk of subsequent readmissions. Wei et al (1995). At least some readmissions, therefore, are associated with modifiable factors.Readmission rates have been reported to decline after the implementation of pre-discharge reviews and improved follow-up after discharge. Bean et al (1995) However, non-experimental, before-after study designs are subject to confounding and to regression toward the mean. Confounding refers to changes beyond the think intervention that occurred over time and that in and of themselves may have trim back readmission rates. Regression to the mean is the tendency of above-average rates to fall toward average over ti me. Since programs aiming to reduce readmission rates are likely to be implemented in institutions with high readmission rates, their favorable results may reflect a decline that would have occurred on subsequent determinations even without any specific interventions.The findings concerning the effect of interventions indicate that improved hospital and post discharge care are associated with less readmissions. Still, there is evidence that global readmission rates have a check value as indicators of quality of care. For example, about half of the studies failed to uncover any relationship between quality of care and readmissions. Ashton et al (1997). In all clinical condition readmission rates of patients who received poor-quality care were similar to those of patients whose care was judged acceptable. Thomas (1996). Similarly, assessed risk-adjusted outcomes after renal failure, gastrointestinal tract hemorrhage, stroke, myocardial infarction, and heart failure and concluded tha t length of stay, death, and unplanned readmission were predicted mainly by age, severity, and co morbidity. Roe et al (1996).Hospital readmissions raise concern among health care providers, and therefore efforts for their reduction are likely to be endorsed by clinicians and administrators.CHAPTER 3METHODOLOGY3.1 Introduction.This is a prospective study. The data is collect from the patient who admitted to the ward. The contrive was conducted in the one of the district hospital at Negeri Sembilan.Data on diabetes was obtained from adult comeings through interviews by trained nurses using a call into questionnaires. A 2-hour-post glucose load test was conducted by the nurses to the responders who self-professed that they were non-diabetics and have not been diagnosed by any, medical personnel. These non-diabetes were measured for their blood glucose level usingglucophotometer in a run dry non-wipe technique. Those who refused to be examined were classified as refused to be e xamined and those who could not tolerate glucose collectable to old age were classified as unable to be examined.For the purpose of analysis in this survey, the respondents were categorise into 3 categories. The known diabetes were the adult respondents who self-professed they were diabetics and diagnosed by medical personnel. Those non-diabetics who had undergone the 2 hour post glucose load test and whose blood glucose measurement level of 11.1 mol/1 or more were categorized as undiagnosed diabetes. Those with blood glucose measurement of 7.8 11.1 mmol/1 were classified as impaired glucose tolerance (IGT)The known diabetes were enquired about their treatment status, utilization purpose of health facilities and perceived complications associated with their diabetic condition.3.2 Research design.This is prospective study. Data volition be collected by reviewing medical records and completing a integrated data collection sheet. Data including admission diagnosis, the type of m edication that patient receive in the ward, sign and symptom of diabetic mellitus, the correct rumor for people with diabetic, when the patient feel hypoglycemia, the hypoglycemia condition, and no identifiers such as medical record numbers, patients names and gender will be used on the data collection instrument. In this study it will have a graphs, charts, table and summary.3.3 Sample size. at that place is 10 questionnaire was given to diabetic patient in the medical male and medical female ward at the district hospital at Negeri Sembilan. About 30 respondent involved in the interview.3.3.1 Inclusioni. How many years the patient have diabetes.ii. The patient should assure and can read in Bahasa Melayu or Bahasa English.iii. The age of the patients above 40 years 65 years..3.3.2 Exclusion.i. The patient who do not understand and can read in Bahasa Melayuor Bahasa English.Ii For patient who senile or psychiatric patient which they cannot givea cooperation and understand the ques tion during the interview.3.4 Instrument.There is 10 questionnaire about diabetes are given to the patient in the ward.The patient should give a correct answer when answer the question. There is time frame of the project. It starts from 1st contact to 31st March. 2011.There question are divided to part I and part II. There is 8 question on part I where the answer is to contain a, b, c or d. Part II has 3 question where the patient have to choose true or false in the statement.The question adopt from theDiabetes and Hormone Center of the Pacific Ala Moana Pacific Centerwww.testprepreview.com/modules/diabetes.htm 3.5 honorable Consideration.2.5.1 Letter from Head of Department, Health Sciencs UiTM to the HospitalDirector for the project. Appendic 1 acclaim garner from the Hospital Director to the Health Sciences for theproject. Appendic 22.5.3 Consent from patient, if respondent refused to be interview, therespondent should be droped from this project. Appendic 3.3.6. Limitation.2. 6.1 Receive late approval letter from the acedemic.2.6.2 Because this is the distric hospital the total number of admission into the ward is low.2.6.3 If the patient refused for the interview, the respondent should be droped from the project.2.6.4 The duration time to collect data from the patients should be conclusion in one month.CHAPTER 44.1 Result .A total number of 40 patients were admitted to the both male and female medical wards from 1st March to 31st March 2011. The gender distribution was 33.33% is female and 66.66% is male.There is 96.7% or 29 of the respondents give tongue to that they eat similarly much of sugar or sweat drink when they are young before they diagnose have diabetes mellitus. The patient was admitted to the ward for stabilization of sugar level. visualise table 1Table 1 absolute frequency portionCaused by eating too much sugar2996.66667Condition which the body cannot use the feed properly13.333333 sum30 cokeAbout 80% (24) of the respondents have the common symptoms of diabetes such as frequent urination specially at bed time, where they will get up 2 to 3 times to toilet. Hunger and thirsty specially in the morning before lunch time and 20% (6) of the respondents craving for sweets. See table 2Table 2Frequency percentFrequent urination, hunger, thirst2480Craving for sweets620Total3010070% (21) of the respondents utter the following statement is correct for people with diabetes that they should have snacks between-meal. Because they feel hungry and thirsty before they had their lunch in the afternoon or in the evening. They like to had drink and eat some snacks to prevent hunger. See table 3Table 3FrequencyPercentEveryone with diabetes should have between-meal snacks2170Changes lifestyle(meal, planning, exercise, medication, stress)413.33333Travelling should stave off taking insulin516.66667Total3010076.7% (21) patients who take insulin once a day give tongue to that they take the breakfast 30 transactions after the insulin injection. It show the patient understand why it is important to take breakfast after the medication to prevent from hypoglycemic attack. See table 4.Table 4FrequencyPercentAbout 30 proceedings before breakfast2376.66667I do not know723.33333Total3010046.7%(14) of the patients have the symptoms of hypoglycemia attack, 20% (6) have sweating, sudden weakness, 16.7% (5) have trembling or shaking, sudden weakness, and 16.7% (5) have trembling or shaking and sweating. It showed that the symptom is different between each patient. See table 5Table 5FrequencyPercent1 and 2516.72 and 36201 and 3516.7all of the above1446.7Total30100What is the reaction of the patient if they get hypoglycemic attack, 73.3% (22) of the patients utter that they will eat some pabulum that has sugar or stopper some sweet to prevent from severe hypoglycemia attack. They will exercise along the sweets if they on exercise, working in the farm or they on vacation. See table 6Table 6.FrequencyPercent abridge it a nd it will go away516.66667Eat some food that has sugar2273.33333lie down and see whether it will persist310Total3010050%(15) of the patients said that confusion is not an indicator of hypoglycemia.Because the patient know about the sign and symptom of the hypoglycemia and they will prevent from get this attack either in the house or out turn up of their house compound. They will bring some sweets along with them. See table 7.Table 7.FrequencyPercentFatigue723.3Poor Appetite723.3Tachycardia13.3Confusion1550Total3010073.3% (22) patients said that they are allowed to use as much sugar as they destiny because they use too and lack of knowledge of the diabetes symptom when they are young. wholly of the respondents (100%) said that they have greater change to get the complications such as hypoglycemic attack from a patient who does not have diabetes. 93.3% (28) patients said if they did not control the blood sugar level there is greater change of infection and illness. The infection will take time to heel. See table 8Table 8CHAPTER 55.1 Discussion.The World Health Organization (WHO) has estimated that in the year 2030, Malaysia would have a total of 2.48 one million million people with diabetes compared to 0.94 millions in 2000. In Malaysia, the First National Health and Morbidity Survey (NHMS I) conducted in 1986 reported a prevalence of diabetes of 6.3% and in the abet National Health and Morbidity Survey (NHMS II) in 1996, this had risen to 8.3%. The NHMS I and NHMS II involved subjects above 30 years. The third National Health and Morbidity Survey (NHMSIII) conducted between April to July 2006 and included the diabetes module in the survey on subjects above 18 years. Zanariah et al (2008).Diabetic is a costly, disorder. define the distribution of specific characteristics among diabetics can assist in the planning, implementing and evaluating diabetic programmers for primary, unessential and tertiary prevention and control of diabetes. In planning of ser vices for diabetes control, justness policies have to be considered. In this study it show that the patients know that they given to get diabetes because of take a sweet drinks and rich of sugar in their food.When the patient in the ward, the nurse should teach the patient how to do the insulin injection, where are the side of injection and tell the patient that he should change the site of the injection to prevent from boil. The nurse should observe the patient how he syringe out the insulin and how to inject to his body. The nurse should remind the patient about sign and symptom of hypoglycemic attack and the precaution of the disease.The health education should continuously given to the patients from day 1 they admitted until the patient discharge from the ward and continued by the health community by do a home visit to the patient if the patient cannot go to the clinic for follow up.Regarding the diet, health education from the nutritionist and the medication from the clinical pharmacist should be continued since the patient stay in the ward.5.2 Conclusion.Diabetes prevalence rate in Malaysia has risen much faster than expected, almost double over the last decade. Prevention and control of this chronic disease should be stepped up.Diabetes is certainly a diagnosis that nonexistence ever wants to receive. There is no cure, but it can be managed through diet, medication and exercise. Having high blood sugar level is out of control, the result in irreparable damage to the body, particularly with the kidneys, cardiovascular and blindness. Health education to patient on how to manage the disease and how to avoid or offer adverse effects on the body.

Case Study: Urbanisation In Nairobi

Case psychoanalyse Urbanisation In capital of KenyaWith an ever-growing global commonwealth project write out changes in the way that cities emerge and rebel, with urbanisation being iodin of the more or less prominent. While completely 10% of the earthly concerns people lived in cities in 1900, this function has now b whollyooned to over 50% (Benton-Short Short, 2008, p. 66). During this period of urbanization, campaigns characterizing urbanizing cities hand real, each affect up their own unique ch each(prenominal)enges for urban planners. These trends include the outgrowth of predominant mount throngs, variations in the size and distri lonesome(prenominal)ion of cities, surroundal degradation, the introduction of institutional changes and democratic planning, and changes due to pitiful economical conditions.A urban center is largely be by its residents. While developed and transitional countries be characterized by senescent creations, it is estimated that 60% of residents in urban argonas of developing countries leading be below the era of 18 by the year 2030 (United Nations Human Settlements Programme UN-Habitat, 2009, p. 10). These countries testament similarly see their little urban populations grow by 50% within the next 40 old age (ibid, p. 10). A country defined by older citizens and a declining or detrimental growth judge has different priorities and needs than a rapidly growing country with a young populace. These distinctions create different ch all(prenominal)enges for urban planners. Urban planners of developed and transitional countries atomic number 18 faced with the problem of renewing cities now in their deindustrialization phase. They have to transform aras and structures that have been abandoned by redeveloping water supplyfronts and brownfields, supported by programs much(prenominal)(prenominal) as the Brownfields Initiative in the United States, so that these argonas can present to the fut ure growth of the city (Benton-Short Short, 2008, p. 83). They also need to ensure how new health systems and facilities for the elderly population can be updated and expanded to conform the aging baby boom population. Urban planners in the global south, however, are capered with developing floors to supply rapidly growing populations with housing, water, and sanitation. Systems need to be developed that will support the surge in young residents, providing facilities and programs that will service of process this age group as they begin to shape the future of the city. The number of predominant age groups challenges planners to bowl over the specific needs of that age group.As cities grow in population, they also tend to grow in sensible size and expand outwards. This expansion is apparent as the majority of the worlds urban population lives in cities and towns of less than 500,000 people alternatively than in megacities, which are planetary house to populations of at lea st 10 jillion (Benton-Short Short, 2008, p. 73 UN-Habitat, 2009, p. 11). In developed countries like Canada and the United States, this growth has manifested itself in the form of sprawl, creating suburbs that are made up of homogeneous segregated theatrical roles housing subdivisions, shopping centers, authorization/business parks, large civic institutions, and roadways heavily dependant on ga in that locationr roads (Randolph, 2004, p. 37). These suburbs are auto-centric, characterized by their residents tendency to travel by in-person vehicle. Planners must consider how to over conceive a citys growth and maintain its sustainability in the midst of the air pollution and spicy energy consumption associated with automobiles. contrary these developed countries, Hostovsky (2010b) notes that growth in the developing world has manifested itself as over-urbanization rather than sprawl (p. 19). Huge populations form cities in these countries, which are then skirt by in titular housing areas known as shantytowns or slums. Since shantytowns are considered illegal, there is much no government support to provide the infrastructure necessary for adequate water supply, sanitation, electricity, trash collection, etc. (Benton-Short Short, 2008, p. 90). Planners are challenged to consider how to keep up on these under dole outd communities as previous attempts to formalize these areas have resulted in progress deterioration in quality of life (UN-Habitat, 2009, p. 12). Urban planners must consider how sprawl and over-urbanization affect the countries in which they occur, and ensure that infrastructures reach the necessary distances and serve the huge numbers of underprivileged citizens that they need to.There is also an appall trend of environmental degradation and an increasing frequency of natural disasters. humor change is soon pass judgment to affect the worlds ability to access water, pull in food, and maintain healthy populations (ibid, p. 2). Exace rbating this issue of humour change is the proliferation of suburbs and industries that swan on oil as an energy source, leading to significant appends in greenhouse gas emissions (ibid, p. 3). The climate change issue is one that all countries must consider, be they developed, transitional, or developing. Countries are faced with the challenge of render their populations with access to food and water in an environment that will no yearner be able to sustain such large populations and rapid growth. If the entire globe were to live at the same standards as trades union Americans, two additional planets would be required to accommodate the increase in ecological load (Hostovsky, 2010a, p. 35). In addition to the degradation of the natural environment, has fall an increase in the frequency of natural disasters. The global rate of feature has increased fourfold since 1975, with a threefold increase in Africa in the past 10 years (UN-Habitat, 2009, p. 14). Of particular concern is the point that disasters have the superlative impact on the lowest of the poor. Of the 270 million people affected by disasters in 2002, 98% of those people were residents of low-income countries (Benton-Short Short, 2008, p. 125). This can be charged to the fact that these low-income countries simply do not have the financial energy to run through disaster preparedness programs like developed countries. Planners will need to use innovative ways to build infrastructures that will be able to withstand these natural disasters and mitigate the economic and homosexual life losses that ensue. By mitigating climate change and planning for natural disasters, urban planners have a significant role in ensuring that the expected population growth is sustainable with one planet.The trends of urbanizing cities are occurring not only amidst changes in the natural environment, but also changes in the political environment. Governments are no considerableer in the same form as when these cities were first founded. Citizens are demanding participatory approach to planning, no longer willing to merely accept the planning decisions of their leadership (UN-Habitat, 2009, p. 3). Planners will need to recognize that public consultations will partially guide their work and that their work will only be effective in a political environment that is stable (ibid, p. 3).All of the trends discussed above outlive in an economic context, one that has changed significantly over the past century. Economies of the world have become integrated through the process of economic globalization. As a result of this globalization, all countries are feeling the effects of the current recession. This recession is expected to decrease the amount of funding on tap(predicate) for urban development projects, increase un troth rates, and exacerbate current poverty levels (ibid, p. 12). All countries, disregarding of whether they are developed, transitional, or developing, will have to face th ese financial issues. Planners will be faced with the challenge of developing sustainable urban centres with circumscribed budgets.With the trends associated with urbanizing cities (the emergence of predominant age groups, variations in the size and distribution of cities, environmental degradation, the introduction of institutional changes and participatory planning, and changes due to poor economic conditions) come unique challenges for urban planners to ensure that this rapid urbanization is successful and sustainable. ploughshare 2 A Global City capital of Kenya, KenyaOverviewLocated in east Africa, capital of Kenya is the capital city of Kenya (see Figure 1). With 3 million residents, the citys population is growing at a rate of 3.8% per year (Department of Economic and well-disposed Affairs, 2007). The majority of the residents are between 15-64 years of age, with a median age of 18.7 (Central Intelligence Agency CIA, 2010).capital of Kenya was founded in 1902 by the Briti sh compound government and unceremonial housing has been developing there ever since (Warah, 2001, p. 1). The colonial government believed that Africans did not need, nor deserve, accommodation as they were the source of disease (Republic of Kenya, 2005, p. 4). stark regulations and planning laws restricted the Africans access to urban land in stage to isolate them from the Europeans and as a result, unceremonious housing began being make on the perimeter of the cities (ibid, p. 4). These areas were soon destroyed and the residents were forced to return to pastoral areas. When Kenya achieved independence in 1963, new legislation was introduced that provided subsidized housing, but these subsidies favoured bosom and upper income groups even though 70% of the demand for this housing came from the poor (ibid, p. 4). In the 1970s to early 1980s, the government provided minimal operate to the slum communities, but when Structural Adjustment Programmes were introduced in 1986, th e government no longer provided subsidies, causing life in the shantytowns to further deteriorate (Warah, 2001, p. 2). In the past, there have been attempts to upgrade these shantytowns but lack of affordability, high standards for infrastructure, land promote complication, misallocation and administrative inefficiency have caused mixed results (Republic of Kenya, 2005, p. 5). The Republic of Kenya and United Nations came together in 2000 to develop the Kenya Slum Upgrading Programme (KENSUP) which is in the process of implemented (ibid, p. 5).Sixty-percent of capital of Kenyas population lives in slums that cover 5% of the citys land (UN-Habitat, 2010). In these slums, only 20% of residents are connected to electricity and 4% have water connections, speckle solid waste tendency services are nearly nonexistent (ibid).EconomyNairobi began as a stop on the Kenya Uganda railway system (Mitullah, 2003, p. 1). Although it used to be a mere stop on the route, the city became a centre for commercial trade and business when the railways headquarters were locomote from Mombasa to Nairobi in 1899 (ibid, p. 1).Today, over 86% of Nairobis residents participate in the citys thrift (ibid, p. 4). The citys labour force is comprised of 67,900 individuals inthe manufacturing industry, 39,700 in building and construction 57,300 in trade, restaurants, and hotels, 42,200 in finance, insurance, real estate and business services while community, kind, and personal services employ 155,900 people (ibid, p. 4). Although so many residents are employed in these formal industries, the majority of people still engage in informal economic activities such as small trade because employment in the informal sector has grown by 176% while formal sector employment has contracted by 0.43% (ibid, p. 4, see Figure 3).As Kenyas capital city, Nairobi also plays a large role in the countrys economy, serving as the regional core for trade and finance (CIA, 2010). It is through this trading capab ility that Kenya can export almost $4.5 billion worth of tea, coffee, petroleum products, seek and cement to the United Kingdom, Netherlands, Uganda, Tanzania, the United States and Uganda (ibid) per year.Social IssuesNairobi is home to one of the largest slums in the world, Kibera (see Figure 2), which has a population of over 1 million residents (Amnesty International, 2009). Kibera is plagued by social inequities and issues, some of the most prominent being the high rate of human immunodeficiency virus/AIDS, the high levels of youth crime, and inequality for women.Youth in Kenya usually only receive ten years of schooling (CIA, 2010). With the final literacy rate in the country, Nairobi youth are not empower to solve their own problems and problems of the community (City Council of Nairobi, 2009, p. 7). This lack of education continues with them and affects the quality of decisions that they make in the future. For example, leaders fai direct to recognize the effectiveness of antiretroviral treatment programs in the legal profession and treatment of HIV/AIDS and it is estimated that their delay in making these programs available led to 3.8 million person-years lost in South Africa from 2000-2005 (Harvard School of cosmos Health, 2008). Over 1.2 million of the countrys population is estimated to be living with this disease with 150,000 anxious(p) each year, making Kenya 4th in the world in cost of the number of deaths attributed to this disease (CIA, 2010). There is a lack of education and social stigma surrounding this disease that prevents the country from mitigating its horrible effects.Crime is some other issue that proliferates throughout Kenya and Nairobi. The frequency of crimes such as armed robbery, murder, mugging, car-jacking, housebreaking, visible and sexual assault have all been increasing (UN-Habitat, 2007, p. 1). A trend is also occurring where the majority of crimes are committed by youth. In fact, over 50% of convicted prisoners ar e between the ages of 16 to 25 (ibid, p. 1). The Mungiki movement is a key case of this. The movement is considered the most organized criminal group in the country. They are responsible for the death of 23 residents in 2002, formal illegal taxes, and controlling the security, water and electricity in slums (ibid, p. 1).Although the residents of Kibera are all uncovered to the issues that face the shantytown, women are particularly affected by this negative environment. They are not given the same access to education, they are expected to care for their families, and they are not protected by the police force. Although women are given access to an education, they are often so burdened with home responsibilities that they drop out of school. They feel this burden because they not only take care of their own siblings and children, but they often end up feel for for orphans whose parents passed away from HIV. As a teacher in the area notes, Girls are not given time to learn and stud y at home. So that means they will eventually fail (Amnesty International, 2009). These women are not only underprivileged but they are also invisible to the systems that should be meant to protect them. The corridors of these slums are unsafe, especially at night. Should a woman be raped, her piece of music to the police would be useless unless she herself can find the perpetrator herself (ibid). As a result, fewer reports are filed and the vicious cycle that allows these acts to occur continues on.Nairobi residents, especially those of slums like Kibera, are often uneducated, without the knowledge to protect themselves from HIV/AIDS and the growing rates of youth crime. Women and girls are often the greatest impacted due to the social inequality towards women, without the opportunity to receive a proper education and subject to the apathy of the police force.Environmental Issues and basisAs mentioned previously, Nairobi is home to Kibera, one of the largest shantytowns in the wo rld (Amnesty International, 2009). These areas of informal housing are exposed to the environmental issues. Residents are plagued by issues in air pollution, solid waste management, and potable water supply and sanitation.the likes of many cities in North America, increased use of personal vehicles has caused an increase in air pollution in Nairobi. The pollution is also created from industries, charcoal-gray fire, and the incineration of waste in open pits (City of Nairobi, 2007, p. 8). This air pollution has already led to a loss of biodiversity, an increase in acid rain and climate change (ibid, p. 8).Nairobi only has one solid waste disposal dump at Dandora, which is believed to have already reached full capacity (City of Nairobi, 2007, p. 9). With nowhere to dispose of their waste, residents of Nairobi slums have resorted to illegal dump yards, residential backyards and commercial property (ibid, p. 9). Over 50% of the wastes are organic (ibid, p. 9), and when these materials decompose, residents are exposed to high levels of bacteria and vector borne diseases such as malaria and Rift valley fever (CIA, 2010).The most evident environmental issue in Nairobi is related to its water supply and sanitation. Water is crucial to the survival of all living things, and yet, only 42% of Nairobi households have access to white water (City Council of Nairobi, 2007, p. 11). Further exacerbating this issue of lack of clean water is the fact that contaminated water is not always treated. In fact, only two-thirds of Nairobi residents have access to sanitation, with many slum residents using a pit latrine that is shared by many people (ibid, p. 12). Forced to bring forth potentially unclean water from other sources, residents are exposed to breakneck water-borne diseases which are responsible for 30% of deaths in the global south (Benton-Short Short, 2008, p. 163). Residents are at a high degree of fortune for waterborne diseases such as bacterial and protozoal dia rrhea, hepatitis A, typhoid fever, and schistosomiasis (CIA, 2010).Part 3 ConclusionsAfrica is one of the regions experiencing the greatest rate of urbanization in the world (UN-Habitat, 2009, p. 10). Although this urbanization provides new opportunities for economic and social growth, it also poses unique challenges and issues for the development of cities such as Nairobi. Planners need to consider trends that are true of most urbanizing cities (the emergence of predominant age groups, variations in the size and distribution of cities, changes due to poor economic conditions, and an increasing susceptibility to disasters), but also focus on the issues that are specific to Nairobi.Nairobi has a growing population of young people. With the lowest literacy rate in the country, Nairobi youth are not empowered to solve their own problems and problems of the community (City Council of Nairobi, 2009, p. 7). These youth are also at a high risk for HIV/AIDS and are susceptible to being inf luenced by organized crime groups. If planners manage to develop systems that will educate and protect these young residents, they may reduce the risk of contracting such a deadly disease and the crime rate. like other urbanizing cities, Nairobi is growing in size as its population increases. However, unlike North America where this growth has been characterized by the emergence of suburbs, Nairobi has been over-urbanized. Since Africa is dominated by a few key cities, planners must be prepared to deal with the sprawl, congestion and environmental effects that are often associated with urban primacy (UN-Habitat, 2009, p. 12).While the entire world is experiencing more natural disasters, Africa is at the peak of this, experiencing a three-fold increase in the past 10 years alone (UN-Habitat, 2009, p. 14). Since lower-income countries are more susceptible to both capital and human loss due to the lack of disaster recovery programs, Nairobi will be faced with the challenge of building infrastructures and implementing programs that will help in the mitigation of loss during these disasters.Finally, these trends and issues faced by Nairobi are occurring in the worst economic recession since 1945 (UN-Habitat, 2009, p. 12). Planners will be faced with the task of building new infrastructures and implementing new programs with less financial support, and in an environment where unemployment and poverty levels are rising.Nairobi will encounter a long journey before it can become an ideal model of a global urbanizing city. Its greatest weakness is its lack of an official plan. The latest authorise city plan was developed in 1948, with a revised adaption submitted in 1973 that was never approved (City of Nairobi, 2007, p. 3). Without a plan, leaders and citizens can never expect to develop a city that is successful and sustainable.Figure 1 Map of Kenya (CIA, 2010)Figure 2 Kibera, a slum in Nairobi (Amnesty International, 2010)Figure 3 Comparison of formal and inform al sectors (Mitullah, 2003, p. 4)