Rheumatoid Arthritis Exercises Essay Example | Topics and Well Written Essays - 1250 words

Rheumatoid Arthritis Exercises - Essay Example The onset of the disease is most frequent in fourth and fifth decades of life (Luqmani et al., 2006). The aetiology of the disease is not specifically known and has been suggested to be multifactorial. The class II major histocompatibility complex allele HLA-DR4 and related alleles are known to be major genetic risk factors for RA. It has been suggested that RA might be a manifestation of the response to an infectious agent in a genetically susceptible host. Activation of autoimmune mechanisms is the key aetiologic event in sustaining the chronic inflammatory process so characteristic of RA (Scott et al., 2000). The main event in pathophysiology is inflammatory synovitis. Subsequently through a cascade of multiple immune events through mediation of a host of immune cells, the synovial fibroblasts are activated. Added to cartilage degradation, osteoclasts are activated that leads to erosion of bone. The chemokines and cytokines lead to synovitis, cartilage and bone damage, and systemic manifestations of RA (Luqmani et al., 2009). Altman (2008) notes that these immunologic abnormalities arise from various immune complexes, which originate from the inflamed synovial cells that serve as a target for such immune injuries. The plasma cells that are recruited produce antibodies known as rheumatoid factors. These actively contribute to these complexes which ultimately lead to joint destruction. With further inflammation chemotaxis ensues leading to recruitment of macrophage cells with associate vasculitis. Primarily CD4+ lymphocytes infiltrate the synovial cells. These together produce inflammatory cytokines and chemokines, namely tumor necrosis factors, granulocyte-macrophage colony stimulating factors, interleukins, and gamma-interferon. These are known inflammatory mediators leading to further joint inflammation and systemic manifestations of the disease. When the disease is chronic, the synovial membrane is very much thickened and is projected into the joint cavity. The synovium is the seat of inflammation, which produce collagenase and stromelysin leading to further degeneration of joint cartilage. Interluekin-1 and tumor necrosis factor-alpha contribute to this process and stimulate osteoclasts, thus leading to bone erosion. Prostaglandins are released. With the maintenance of inflammation, fibrous tissue is deposited within the joint. The synovial tissue appears very much proliferates and highly vascular, leading to pannus which further potentiates release of inflammatory chemokines leading to all round erosion of the joint structures such as cartilage, bone, articular capsule, and the periarticular ligaments. Most of the inflammatory cells are neutrophils. In some patients rheumatoid nodules develop (Altman 2008). Clinical Features Clinically RA presents as chronic polyarthritis of symmetrical synovial joints of hands, wrists, knees, and feet with an insidious onset of fatigue, generalised weakness, and vague musculoskeletal symptoms for weeks or months. Pain, tenderness, and swelling in the affected joints get aggravated with movement. Generalised stiffness of joints noted in the mornings for about duration of greater than 1 hour is invariable. Swelling and tenderness in the joints lead to motion limitation and hence impairment of physical function. These lead to fibrous or bony ankylosis of the joint leading to fixed deformities (Scott et al., 2000).

Spacial topic Essay Example | Topics and Well Written Essays - 1250 words

Spacial topic - Essay Example 2. Operational decision makers- After creation of the business strategy, the objectives for the operation business process are established. 3. Reporting, controlling and analytical processes- The necessary information and data for the desired changes in operational managers’ behavior are identified and specified by the business analysts. 4. ELT developers and data base specialists- The data from data warehouses is gathered by the database specialist or the ETL (extract, transformation, and load) developer who make it assessable and usable to the front-end application of the business. 5. IT Professionals- In this layer, infrastructure run and develop the primary data is developed by generating sources or creating new data by the IT professionals. (Laursen & Thorlund, 2010) Chapter 2 Question1. Explain the process of business analytics at strategic level. Answer. The process of business analytics at strategic level could be explained by integration between the BA function and th e company’s strategy. There are four different scenarios showing the degree of integration between business strategy and strategy: 1. Where no formal link exists between strategy and BA, the BA function is used on an ad hoc basis. 2. When the link between BA and strategy is coordinated, the BA function is purely reactive and there is no feedback procedure from BA to strategy. 3. When there is a formal feedback procedure from BA to strategy and strategy innovation is supported by BA. 4. Where the information is used as a strategic resource. It enables the information to be used to determine the strategy. (Laursen & Thorlund, 2010) Chapter 3 Question1. Explain the process of establishing a new business processes with the Rockart model? Answer. The process of establishing a new business processes with the Rockart model consists of the following stages: 1. Objectives- The first step is the identification of the objectives, i.e. to identify the aim and purpose of the information t o be developed. 2. Operational Strategy- The operational strategy to fulfill the objective is identified and implemented. 3. Critical Success Factors- A large number of activities are initiated by implementation of a strategy. Some of these activities are more critical than others. All such critical success factors should be identified. 4. Lead and Lag Information- The information at functional level can be broadly classified as: Lag information- The information which we choose to register on an ongoing basis is the lag information. Lead information- Lead information is created on the basis of lag information. It helps in monitoring and improving the existing or initiating processes. (Laursen & Thorlund, 2010) Chapter 4 Question1. What are the required competencies of a business analyst? Answer. A business analyst is a provider of methodology. A business analyst must meet the following requirements: 1. Business competencies- A business analyst must have the business competencies and should understand the business process properly. He or she must have the business insight. 2. Tool Kit must be in order- A business analyst should be able to deliver multiple information in same data and should be able to visualize the information as the user. 3. Technical understanding- The business analyst should have the technical understanding of the information which could be used in collection and presentation of data. (Laursen & Thorl