Results Chapter on CMV Infection Research

Results Chapter on CMV Infection Research Results This study has been conducted on 366 patients with suspected CMV infection attending pediatric department at Zagazig University Hospital. Table (1): Age distribution of the studied patients (except for neonates with congenital anomalies) (N=344)       Studied patients (N=344) No. % Age (years) Mean  ± SD 9.9  ± 3.4 Median (Range) 10.0 (3.5 18.0) The mean age and standard deviation (SD) of ages of the studied patients (except for neonates with congenital anomalies) in years as shown in table (1) was 9.9  ± 3.4. Table (2): Age distribution of neonates with congenital anomalies (N=22) Studied patients (N=22) No. % Age of neonates with congenital anomalies group (days) Mean  ± SD Median (Range) 4.1  ± 1.6 4.0 (2.0 7.0) Table (2) shows that The mean age and standard deviation (SD) of ages ofneonates with congenital anomalies were 4.1  ± 1.6 days Table (3): Sex distribution of the studied patients (N=366) Studied patients (N=366) No. % Sex Male 202 55.2% Female 164 44.8% Table(3) shows that 55.2% (202 out of 366) of the studied patients were males, while 44.8% were females. Figure (1): Pie diagram showing sex distribution of the studied patients (N=366) Table (4): Distribution of the risk factors among the studied patients (N=366) Risk factors Studied patients (N=366) No. % Malignant hematological disease with chemotherapy 43 11.7 % Receiving repeated blood transfusion 164 44.8 % Fever of unknown origin 16 4.4 % Critically ill patients lying in the ICUs with prolonged hospitalization 28 7.7 % Receiving corticosteroids or other immunosuppressives for long period 22 6 % Chronic renal failure with haemodialysis 64 17.5 % Fever with pancytopenia 7 1.9 % Neonates with congenital anomalies 22 6 % As shown in table (4) and figure (2),44.8% of the studied patients were receiving repeated blood transfusion, 17.5% were suffering from chronic renal failure and receiving haemodialysis, 11.7% were suffering from Malignant hematological disease and receiving chemotherapy, 7.7% were critically ill patients lying in the ICUs with prolonged hospitalization, 6% were receiving immunosuppressive agents for long period, 6% were   neonates with congenital anomalies, 4.4% had fever of unknown origin, and 1.9% suffered from fever with pancytopenia. Figure (2): Pie diagram showing Distribution of the risk factors in the studied patients (N=366). Table (5): Results of ELISA IgM and IgG for CMV in the enrolled patients (N=366) ELISA results Studied patients (N=366) IgM Positive 60 16.4 % Negative 306 83.6 % IgG Positive 93 25.4 % Negative 273 74.6 % Over all seropositivity Positive both IgM and IgG 109 29.8 % As shown in table (5), out of the 366 studied patients, 60 (16.4%) and 93 (25.4%) were positive for CMV IgM and IgG in an ELISA test respectively. Table (6): Agreement between ELISA IgM and IgG in the studied patients (N=366) ELISA IgM ELISA IgG Total #Test P-value Negative Positive Negative No. 257 49 306 0.469 0.000* (HS) % 94.1 % 52.7 % 83.6 % Positive No. 16 44 60 % 5.9 % 47.3 % 16.4 % Total No. 273 93 366 % 100.0 % 100.0 % 100.0 % #  Ã‚   Kappa measure of agreement P< 0.05 is significant. Statistical Significance Standards for strength of agreement for the kappa coefficient: ≠¤0=poor, .01-.20=slight, .21-.40=fair, .41-.60=moderate, .61-.80=substantial, and .81-1=almost perfect. Table 6 shows that there is a moderate agreement between ELISA IgM and IgG in the detection of CMV in children with high statistical significance. Table (7): Prevalence of CMV IgM seropositivity among different risk groups Risk Factors No. Studied patients (N=366) Positive IgM No. % Malignant hematological disease with chemotherapy (43) 8 18.6 % Receiving repeated blood transfusion (164) 36 21.9 % Fever of unknown origin (16) 8 50 % Critically ill patients lying in the ICUs with prolonged hospitalization (28) 0 0 % Receiving corticosteroids or other immunosuppressives for long period (22) 0 0 % Chronic renal failure with haemodialysis (64) 8 12.5 % Fever with pancytopenia (7) 0 0 % Neonates with congenital anomalies (22) 0 0 % Table (7) and figure (3) show that the highest prevalence (50%) of CMV IgM seropositivity was reported from patients suffering from fever of unknown origin. Figure (3): Bar chart showing prevalence of CMV IgM seropositivity among different risk groups Table (8): Association between CMV IgM seropositivity and different risk factors Risk factors No. Studied patients (N=366) Test p-value ELISA IgM Positive (N=60) Negative (N=306) No. % No. % Malignant hematological disease with chemotherapy (43) 8 18.6 % 35 81.4% #11.17 0.010 (S) Receiving repeated blood transfusion (164) 36 21.9 % 128 78% Fever of unknown origin (16) 8 50 % 8 50% Chronic renal failure with haemodialysis (64) 8 12.5 % 56 87.5% #  Ã‚   chi square test P< 0.05 is significant. *statistical Significance Table (9): Prevalence of CMV IgG seropositivity among different risk groups Risk factors No. Studied patients (N=366) Positive IgG No. % Malignant hematological disease with chemotherapy (43) 0 0 % Receiving repeated blood transfusion (164) 63 38.4 % Fever of unknown origin (16) 0 0 % Critically ill patients lying in the ICUs with prolonged hospitalization (28) 0 0 % Receiving corticosteroids or other immunosuppressives for long period (22) 0 0 % Chronic renal failure with haemodialysis (64) 8 12.5 % Fever with pancytopenia (7) 0 0 % Neonates with congenital anomalies (22) 22 100 % Table (9) and figure (4) show that the highest prevalence (100%) of CMV IgG seropositivity was reported from neonates with congenital anomalies. Figure (4): Bar chart showing prevalence of CMV IgG seropositivity among different risk groups. Table (10): Association between CMV IgG seropositivity and different risk factors Risk factors No. Studied patients (N=366) Test p-value ELISA IgG Positive (N=93) Negative (N=273) No. % No. % Receiving repeated blood transfusion (164) 63 38.4% 101 61.6% 53.96 0.000* (HS) Chronic renal failure with haemodialysis (64) 8 12.5% 56 87.5% Neonates with congenital anomalies (22) 22 100% 0 0% #  Ã‚   chi square test P< 0.05 is significant. *highly statistical Significance Table (11): Results of real time PCR for CMV in the enrolled patients (N=366) Real time PCR Studied patients (N=366) Positive 36 9.8% Negative 330 90.2% Table (11) shows that 9.8% (36 out of 366) of the studied patients were positive for CMV in real time PCR test. Table (12): Results of nested PCR for CMV in the enrolled patients (N=366) Nested PCR Studied patients (N=366) Positive 29 7.9% Negative 337 92.1% Table (12) shows that 7.9% (29 out of 366) of the studied patients were positive for CMV in nested PCR test. Figure (4): Results of real time PCR and nested PCR for CMV in the enrolled patients. Figure (5): 1st run nested PCR showing band at 435 bp. Figure (6): 2ndrun nested PCR showing band at 159 bp. Table (13): Prevalence of CMV infection in the studied patients (using real time PCR as a gold standard test) Risk factors No. Studied patients (N=366) Positive No. % Malignant hematological disease with chemotherapy (43) 36 83.7% Receiving repeated blood transfusion (164) 0 0% Fever of unknown origin (16) 0 0% Critically ill patients lying in the ICUs with prolonged hospitalization (28) 0 0% Receiving corticosteroids or other immunosuppressives for long period (22) 0 0% Chronic renal failure with haemodialysis (64) 0 0% Fever with pancytopenia (7) 0 0% Neonates with congenital anomalies (22) 0 0% As shown in table (13), CMV infection (using real time PCR as a gold standard test) was only reported from patients suffering from malignant hematological disease and receiving chemotherapy, where   83.7% of these patients were positive for CMV. Figure (7): Figure (8): Table (14): Titer of CMV viremia in patients with malignant hematological disease receiving chemotherapy Quantitative PCR Studied patients (N=366) Mean  ± SD 6907.30  ± 15846.04 Median (Range) 623.50 (3.70 57500) The mean titer and SD of titers of CMV viremia in patients with malignant hematological disease receiving chemotherapy as shown in table (14) was 6907.30  ± 15846.04. Table (15): Results of Nested PCR for CMV among different risk groups Risk factors No. Studied patients (N=366) Positive No. % Malignant hematological disease with chemotherapy (43) 29 67.4% Receiving repeated blood transfusion (164) 0 0% Fever of unknown origin (16) 0 0% Critically ill patients lying in the ICUs with prolonged hospitalization (28) 0 0% Receiving corticosteroids or other immunosuppressives for long period (22) 0 0% Chronic renal failure with haemodialysis (64) 0 0% Fever with pancytopenia (7) 0 0% Neonates with congenital anomalies (22) 0 0% Twenty nine out of 43 patients suffering from malignant hematological disease with chemotherapy with a percentage of 67.4 were positive for CMV in a nested PCR test as shown in table (15). Table (16): Relation between ELISA IgM and real time PCR and nested PCR in the studied patients (N=366) Agreement between ELISA IgM and real time PCR and nested PCR in the studied patients (N=366) Laboratory findings ELISA Test P-value Positive IgM (N=60) Negative IgM (N=306) No. % No. % Real time PCR Positive (n=36) 8 22.2 % 28 77.8 % # 0.05 0. 320 (NS) Negative (n=330) 52 15.8 % 278 84.2 % Nested PCR Positive 8 27.6 % 21 72.4 % #0.082 0.090 (NS) Negative 52 15.4 % 285 84.6 % #  Ã‚   Kappa measure of agreement P< 0.05 is significant. Statistical Significance Standards for strength of agreement for the kappa coefficient: ≠¤0=poor, .01-.20=slight, .21-.40=fair, .41-.60=moderate, .61-.80=substantial, and .81-1=almost perfect. As shown in table 16, there is poor statistical agreement between ELISA IgM and PCR reactions in the detection of CMV in children with no significance. Table (17): Relation between ELISA IgG and real time PCR and nested PCR in the studied patients (N=366) Agreement between ELISA IgG and real time PCR and nested PCR in the studied patients (N=366) Laboratory findings ELISA Test P-value Positive IgG (N=93) Negative IgG (N=273) No. % No. % Real time PCR Positive (n=36) 0 0 % 36 100 % # -0.137 0.001* (HS) Negative (n=330) 93 28.2 % 237 71.8 % Nested PCR Positive 0 0 % 29 100 % #-0.165 0.000* (HS) Negative 93 27.6 % 244 72.4 % #  Ã‚   Kappa measure of agreement P< 0.05 is significant. *highly statistical Significance Standards for strength of agreement for the kappa coefficient: ≠¤0=poor, .01-.20=slight, .21-.40=fair, .41-.60=moderate, .61-.80=substantial, and .81-1=almost perfect. A high statistically significant non-agreement is present between ELISA IgG and PCR reactions in the detection of CMV in childrenas shown in table 17. Table (18): Relation between real time PCR and nested PCR in the studied patients (N=366) Agreement between real time PCR and nested PCR in the studied patients (N=366) Laboratory findings Nested PCR Test P-value Positive (N=29) Negative (N=337) No. % No. % Real time PCR Positive (n=36) 29 100 % 7 2.1 % # 0.882 0.000* (HS) Negative (n=330) 0 0 % 330 97.9 % #  Ã‚   Kappa measure of agreement P< 0.05 is significant. *highly statistical Significance Standards for strength of agreement for the kappa coefficient: ≠¤0=poor, .01-.20=slight, .21-.40=fair, .41-.60=moderate, .61-.80=substantial, and .81-1=almost perfect. Table 18 shows that there is an almost perfect statistical agreement between real time PCR and nested PCR in the detection of CMV in children with high significance. Table (19): Relation between real time PCR and nested

Leadership and governance Essay

Executive Summary The following essay will analyse two important elements in every organisation, leadership and governance, the interaction between them and how they influence in organisations outcomes. This paper will cite different journals and studies to support the ideas referents to this topic. Firstly this essay will discuss on leadership to understand why this culture of influence and motivation has become so important for nowadays organisations and explain the role of the modern leader, among all the perspectives and theories aroused about this subject. The second point is about governance; the term organisational governance is defined and evaluated to find out how governance enhances the management in organisation. Also is discussed what is the managers role in the governance scheme in order to expose the difference between leaders and managers. Look more:  research problem definition essay They are different but complementary, while leaders have a compromise with the vision on the long term, manager focuses on how to achieve the vision strategically. Furthermore the next logic step is to evaluate the relationship between these elements analysed previously. Leaders can affect positively and negatively the governance outcomes, basically if there is no self-control or lack of ethic among leaders even the best governance scheme would collapse. On the other hand collective leadership will have a beneficial effect in the board of director’s performance. The last point assesses how the leadership development and effective followership can affect the organisations outcome, being the relationship between leader and follower the most important key for leadership effectiveness and consequently a more effective organisation. It is clear that leadership play an important role in organisation path to succeed in this modern world where constant changes and uncertainty require more competitive and adaptable organisations. Introduction Nowadays, organisations are exposed to global uncertainty and they have to adapt rapidly and become more effective in order to survive in this competitive world. Major organisations invest millions in human capital and technology with the explicit objective of increase their organisations effectiveness. Organisational effectiveness is a broad concept represented by several perspectives, organisations are effective when they have a good fit with their external environment, when their internal subsystem are efficient and effective, when they are learning organisations and when they satisfy the need of key stakeholders (McShane, Olekalns & Travaglione 2010). There are many studies and theories about leaderships, due to its importance for organizations success. According with Rodsutti and Swierczek (2002, p. 250) different dimensions of organisational effectiveness including return on asset, most admired, job satisfaction and personal satisfaction are related to specific aspects of leader characteristics, organisational culture and multicultural management style. This is the main reason why leadership has become the base of modern organisations success. In order to understand the leader’s role in effective governance in organisations, it is necessary define leadership and governance separately and then analyse the correlation between then, this will help us to understand why leader and managers are different but complementary, they should reinforce and support each other, however this is not always the case (Lussier & Achua 2010). Organisations performance is measured constantly in order to value if the outcome satisfy the stakeholders goals, thus the influence of leaders over the governance outcomes need to be evaluated. The organisation outcomes it is also affected by effective fellowship as a result of a leadership development. Leadership behaviours are perceived as trustworthy through the observer’s mediating lens, trust increases and leaders are more likely to be viewed as ethical stewards who honour a higher level of duties (Caldwell, Hayes & Long 2010). Organisational leadership Everybody somehow have the idea of the leadership meaning that probably belongs to yesteryear image of command –and- control boss. The concept of leader is no longer the person that is seen as the company’s hero. Leaders exist throughout the organisation, not just in the executive suite. The first studies about leadership was published in 1904, the main researches in this field occurred while the First World War, it first interest was investigate the leadership characteristics and the mechanism of how the employees obtained promotions. A decade ago fifty-four leadership expert from thirty eight countries reached consensus that leadership is about influencing, motivating and enabling others to contribute to the effectiveness and success of the organisation of which they are members (McShane Olekalns & Travaglione 2010). Even today there is still considerable debate about the exact role and definition of a leader. Most parties agree that one of the primary functions of a leader should be to set a path towards a goal and then inspire and motivate others to follow (Prewitt 2003). Furthermore (Lussier & Achua 2010) brought a more simplified and brief concept defining leadership as ‘‘the process of influencing leaders and followers to achieve organizational objectives through change. There are many studies and theories about leadership and different perspectives of this concept, the most relevant of those perspectives in the last 20 years are charismatic and transformational leadership. Transformational leadership perspective explains how leaders change teams or organisations by creating, communicating and modelling a vision for the organisation or work unit and inspiring employees to strive that vision (McShane, Olekalns & Travaglione, 2010). The charismatic and transformational leader, according to many scholars and practitioners, represents a new paradigm of leadership that may be capable of steering organisations trough the chaos of the twenty first century (Lussier & Achua 2010). There is some confusion and controversy to define the distinction between charismatic and transformational leader. Many researchers either use the words as they would have same meaning or view charismatic leadership as an essential ingredient of transformational leadership. However there are managers that may lack of charisma but they can lead by applying transformational leadership behaviours, for example Alan Lafey, CEO of Proctor and Gamble or Sam Palmisano CEO of IBM. The point is that effective transformational leaders are not necessary charismatic (McShane Olekalns & Travaglione 2010). Leaders are particularly effective if they engage in transformational leadership behaviours, such as articulating a captivating vision for the future, acting as charismatic role models, fostering the acceptance of common goals, setting high performance expectations, and providing individualized support and intellectual stimulation for followers (Menges et al. 2011). In the last years has been agreed that leadership it is not about rely in only a person as a leader, leadership can be considered as a collective practice, leaderful leaders develop sufficient trust in others to make leadership a shared and yet very powerful tool for action and responsibility (Raelin 2005). Understanding organisational governance There is not a specific definition for the term â€Å"organisational governance†, however as a first approximation, organizational governance refers to the instruments of governance that organizations deploy to influence organization members and other stakeholders to contribute to organizational goals (Foss & Klein 2007). This idea clearly is consistent with other more frequently used terms as â€Å"corporative governance†, â€Å"organizational control† and â€Å"governance structures and mechanisms.† Similar definition we found about strategic management. Strategic management is the set of decision and actions used to formulate and implement specific strategies that will achieve a competitively superior fit between the organisation and its environment, so as to achieve organisational goals (Lussier & Achua 2010). According with Commonwealth Australia (2009) governance may be described as â€Å"†¦the process by which agencies are directed and controlled. It is generally understood to encompass authority, accountability, stewardship, leadership, direction and control†. Top management plays an important role in firms’ achieving an orientation to quality creating values and establishing objectives and systems to satisfy customers’ expectations and improve performance in the organisation (Albacete-Sà ¡ez, Fuentes & Bojica 2011). Furthermore the aim of governance is not only improve the organisations performance but also achieve the stakeholders economic and social satisfaction. A firm that manages for stakeholders allocates more resources to satisfy the needs and demands of its legitimate stakeholders than would be necessary to simply retain their wilful participation in the firm’s productive activities (Harrison, Bosse & Phillips 2010). Theories of governance for many years had been based on assumptions about the leader as an agent who might act with opportunism to take advantage of superior information or self-serving personal interests however latest studies have demonstrated that corporate governance imposes on businesses and their leaders an instrumental duty to maximize long-term wealth creation to benefit all of the stakeholders served by the firm (Caldwell, Hayes & Long 2010). In the last few years due to scandals and financial crisis, board of director has gain especial interest in corporate governance debate. The corporate governance rely on the board of directors capabilities to conduce the companies and take the best decision for their stakeholders benefit. However organisations not only need managers they need leaders as well, and governance have to provide the conditions to promote both in their schemes as per Zaleznik (2004, p.74) suggest organizations need both managers and leaders to succeed, but developing both requires a reduced focus on logic and strategic exercises in favour of an environment where creativity and imagination are permitted to flourish. Leaders and governance Manager and leaders play different role in organisations, their personalities and attitudes towards goals are different as Zaleznik (2004, p.74) stated managers embrace process, seek stability and control, and instinctively try to resolve problems quickly-sometimes before they fully understand a problem’s significance. Leaders, in contrast, tolerate chaos and lack of structure and are willing to delay closure in order to understand the issues more fully. In previous studies on governance, board scholars have mainly limited themselves to a strict input-output approach in their studies, directly linking board demographic indicators (e.g., board size, age of directors, number of independent directors, etc.) to board and firm performance (Vandewaerde et al. 2011).Lately scholars focus is about leadership, examination of leadership processes and behaviours inside the board team. As stated before leadership can be considered as a collective practice, this is applicable for tams or board of director where every member has different capabilities and knowledge leadership influence based on knowledge and expertise in the team network will have a beneficial effect on the board’s problem-solving capabilities and, therefore, board task performance (Vandewaerde et al. 2011). Painter (2008, p.523) also supports this idea stating that ‘the capacity to take responsibility when and where needed should be nurtured throughout the organizational system and among all of its members, despite the existence of a formal organizational hierarchy and various specialized functional units’. In this context, governance provides support rather than limits to develop a better organisation. The fact that different people can play a leadership role does not mean that no structure is required for leadership to be exercised (Painter 2008). Leaders can fail, sometimes because of the rush to make decisions they relied too much in the intuition, or due to ethical or moral lapses in judgment. The ultimate goal of the strategic leader should be to build sustainable integrity programs into the strategic management framework that encourage positive self-regulation of ethical behaviour as a matter of routine within the organisation (Lussier & Achua 2010). Without ethic and integrity among the leaders, governance would be ineffective under this scenario. The key in successful governance relies in the role that leadership play in the organisations. As Lussier and Achua (2010 p.418) point out strategic leadership ensure that strategic management process is successfully carried out and yields the desired result for the organisations. Effective followership and organisation outcomes As defined previously, leadership is about influencing, motivating and enabling others to contribute toward the effectiveness and success of the organisation (McShane, Olekalns & Travaglione, 2010). When leadership in organisations is affected there is an immediate reaction in employees’ performance. For instance in some cases of merging there is a transition stage where employees lost the direction and leadership is replaced for uncertainty. When members of the community feel abandoned, trust in the organization and its new leader or leaders becomes an issue. During the change process, if the view of the organization becomes less positive, association with it may become less appealing (Curry, 2002). The major influential factors related to job performance can be found in the aspects of social and organizational cultural contexts, but leadership is one of the most critical factors affecting individual job performance. (Baek-Kyoo, 2012). Leadership create an environment where subordinates are more satisfied and have higher effective organisational commitment. They also perform their jobs better, engage in more organisational citizenship behaviours and make better or more creative decision. (McShane, Olekalns & Travaglione 2010). As stated leadership is one of the most important elements of organisation effectiveness. However to develop a culture of leadership in an organisation is not easy task. Effective leadership requires effective followership, because without followers there are no leaders. (Lussier & Achua 2010). In the way to success organisations need good followers to support and influence positively their leaders. In order to develop effective leadership in organisations there has to be a harmonic relationship between the leader and follower, this interaction is essential to reach organisational success. Regardless the structure or governance applies in organisations, the commitment between leaders and followers have to be clear and accepted in both sides. As Derue and Ashford (p.643, 2010) suggest, whether that leadership-structure schema is hierarchical or shared its strength as a norm should facilitate reciprocal claiming and granting and allow for the rapid development of well-defined leader-follower relationships. These norms are the rules game that will make leadership flourish easily among employees, otherwise the organisation effectiveness could be compromised, organizations without such norms organisations going through significant changes might experience greater conflict over leadership and within leader-follower relationships (Kan & Parry 2004), which, in turn, may distract from effective work performance (Derue & Ashford 2010). Conclusion Today’s work environment is characterized for uncertainty, volatility and global competition; organisations have to change constantly in order to survive and success. Thus nowadays organisations not only need managers, they need leaders as well. As explained leadership and governance in organisations are important for organisations success, leaders and managers have different roles but they are complementary. Basically the difference between leaders and manager is defined by their behaviour toward organisations goal, while leader’s focus is on their organisation vision in the long term; managers are looking how to accomplish firm’s goals in the short term. It is clear the governance outcomes will define the success or failure of companies, in order to have effective governance, organisations need human resource capable of create, communicate and model a shared vision for the team or organisation, and inspire followers to strive that vision. Thus, governance has to provide the conditions to flourish not only good managers but leaders as well. Leadership is one of the most critical factors that affect job performance. It is important establish a scheme that promote followership among employees in order to develop a quality leadership culture in the organisation. To do so, leaders and followers roles have to be clearly defined and be accepted. Only if leaders and followers are committed with the organisation vision the organisation effectiveness would be enhanced generating a positive outcome for stakeholder benefit. Reference Albacete-Sà ¡ez, C, Fuentes, M & Bojica, A 2011,’Quality management, strategic priorities and performance: The role of quality leadership’, Industrial Management & Data Systems, Vol. 111, no. 8, pp. 1173 – 1193. Baek-Kyoo, J 2012, ‘Leader-Member exchange quality and In-Role job performance: The moderating role of learning’, Journal of Leadership & Organizational Studies, Vol. 19, no. 1, pp.25–34. Caldwell, C, Hayes, L & Long, D 2010 ‘Leadership, trustworthiness, and ethical stewardship’, Journal of Business Ethics, Vol. 96, pp. 497–512. Commonwealth of Australia 2009 fahcsia.gov.au/sa/disability/pubs/general/CorporateGovernanceHandbook/Pages/Concepts.aspx Curry, B. K. 2002, ‘The influence of the leader persona on organizational identity’ Journal of Leadership Studies, Vol. 8, no. 4, pp33, Online Expanded Academic ASAP. Derue, D & Ashford, S 2010, ‘Who will lead

Wealth Inequality Of The United States - 1283 Words

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While the Top 1% are living luxurious lives, the Bottom 99% is struggling to make ends meet. Inequality is nothing new to the United States. In fact, it is a serious problem for America’s Economy, Democracy and the Middle Class. Economic Inequality is the thing that makes the United StatesRead MoreEconomic Inequality And Political Inequality1647 Words   |  7 PagesEconomic inequality, also known as income inequality, is the interval between the rich and the poor. Economic inequality refers to how the total wealth in the United States is distributed among people in a social class. It is needed and it is important but due to the major gap difference, it affects the Democratic Party and in addition, it also affects Americans because they do not understand the actual wealth distribution. It is a major issue in the United States because it affects other economic

Report On Health Facilities And Health Professionals

REPORT ON HEALTH FACILITIES AND HEALTH PROFESSIONALS IN LINCOLN COUNTY, ARKANSAS This is a brief report on health facilities, and supply and distribution of health professionals in Lincoln County, AR, addressed to the Mayor of the County Seat. As an employee of the Arkansas Department of Health, it is a great pleasure to provide you with the information you have requested on Lincoln County. I appreciate your passion to improve the health of the people of this county. In this report, I will be talking about Health Facilities and Health Professionals in Lincoln County, AR, and will also give you a snapshot on Arkansas as a state, and the nationwide report. This will help in assessing the needs thoroughly, and there by helps in making suitable recommendations. Lincoln county is one of the 75 counties in Arkansas, with a population of 13,820, which accounts for less than 0.5% of the population of Arkansas. Before continuing any further with the county report, I would like to give a few rankings. In terms of health outcomes, Lincoln county has made a remarkable improvement since 2011 to 2015. In 2011, it was ranked 58 of the 75 counties, while in 2015, it made it to the 20th rank. This is a very positive sign, in terms of the health of the community. It is interesting to note that 70% of this county s population are of the age range 19 to 64. However, it is quite saddening to see, that the county is lacking in clinical care. 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