U can choose a topic by urself Essay Example | Topics and Well Written Essays - 1500 words - 1

U can choose a topic by urself - Essay Example In such cases, SMEs will always find it more affordable to let such processes be handled externally instead of them being handled within the business organisation at a higher cost. This paper aims at discussing the extent to which outsourcing enables entrepreneurs to be flexible. Outsourcing can be used by entrepreneurs in successfully handling various projects. In business management different projects usually require different resources. In any case a business organisation will decide to fully invest in a project independently, they will have to invest in all the resources that are needed for the project to be successful. However, things are different when a business organisation decides to use outsourcing. With outsourcing, they would not have to invest in all the processes that are involved in the project. They can find a third party to carry out some of the process that seems to be so costly that they can be able to reduce the general cost of the project. Therefore, it can be concluded that through outsourcing entrepreneurs can be able to undertake different types of project without having fears of whether or not they have the full capability of handling the project. If they choose to ignore outsourcing then they will have to stick to the projects that they are able to undertake independently. Outsourcing can also enable entrepreneurs to be flexible by reducing the risks involved in their undertaking. In business management the risks that require management include market, technologies, financial conditions, competition, government regulation, and many others. Through outsourcing business organisations are always able to relegate some of their functions to other business organisations with speciality is such areas (Corbett 101). When a business organisation delegates a certain function of their activities to another organisation, they also delegate the risks that are

Morality of Management Earnings Essay Example for Free

Morality of Management Earnings Essay The term â€Å"Earnings Management† is a form of â€Å"number smoothing† used by a company’s management to manipulate or influence the companys earnings to match a pre-determined dollar amount. This is done in an attempt to keep financials stable, as opposed to showing financial fluctuations. When a company appears to be stable it has a greater chance of attracting investors, which in turn demands higher share prices. When a company is able to have higher share prices, the more likely they are to draw new investors. Likewise, a company that has low share prices is often a reflection of a company that is not doing well financially (Investopedia, 2009, para 2). Often, companies perform abusive earnings management practices in an effort to â€Å"make the numbers† (Inevestopedia, 2009, para 4). In order to do this, management may be tempted to â€Å"make up† numbers as a means of drawing investors or to make their company appear financially stronger than what it actually is. The methods used in earnings management can be varied, and may be done through manipulation of financial numbers or operating procedures (As cited by Gibson, 2013, p. 84). In a study conducted by the National Association of Accountants, a questionnaire was prepared which described 13 observed earnings management situations (As cited by Gibson, 2013, p. 83). Below are five listed generalizations that can be made by the study findings regarding short-term earnings management practices. 1. Respondents of the survey felt that earnings management practices utilizing accounting methods to be less acceptable than methods of operating procedure manipulation (As cited by Gibson, 2013, p. 84). Manipulation of operations can include something as simple as pushing shipping to the last day of the fiscal quarter or asking customers to take early delivery of goods (As cited by Gibson, 2013, p. 85). Another example is when companies make â€Å"Unusually  attractive terms to customers† or â€Å"Deferring necessary expenditures to a subsequent year† (Rosenzweig ; Fischer, 1994, para 5). According to survey responses, practitioners had fewer ethical dilemmas when using operational earnings management tactics compared to those involving accounting methods (Rosenzweig ; Fischer, 1994, para 7). 2. When it came to accounting, survey respondents felt that increasing earnings reports to be less acceptable than the decreasing of earnings reports (As quoted by Gibson, pg. 84). Managers appear to be more comfortable in reducing the overall company profit when reserves show elevated numbers (As cited by Gibson, p. 85). It would seem that management might assume that if their reserve numbers are high, then reducing them to show lessor profitability acceptable. If the money is genuinely there, then what is the harm in reducing the profit amount to meet a designated number? However, when it came to reporting profit increases, managers were hesitant in determining what earnings management methods would be ethical and which would not. 3. Generalization #3 is similar to generalization number two where ethics are concerned. Respondents felt that if earnings management tactics were kept small that it was more acceptable than if the effects were large (As cited by Gibson, p. 84). When manipulations of numbers or operating procedures are kept to smaller changes, managers seem to feel it more justifiable and acceptable. For instance, if management were asked to show an increase of sales by $12,000.00, such manipulations would be more ethical than if asked to increase sales by $120,000.00. Likewise, if production costs were delayed for advertising to meet a quarterly budget it would be more acceptable than if production costs for advertising were delayed to meet the end of year fiscal budget. This also ties in to generalization #4, the time period of the end effect. 4. Time periods play a large part in determining how ethical earnings management practices are. As described above, when asked to alter numbers or operating procedures in an effort to make quarterly forecasts, managers seemed to feel this practice to be more acceptable. When asked to alter numbers or operating procedures for annual reports, however, the line between ethical and questionable is blurred. 47% of respondents to the survey felt that earnings management practices that were made to meet an interim quarterly budget to be ethical, while only 41% felt that such manipulations in order to make an annual budget to be ethically sound (As  cited by Gibson, 2013, p. 85). 5. When asked whether it was acceptable to offer special extended credit terms to customers in an attempt to increase profits, only 43% of survey respondents felt the practice to be ethical. However, when asked if the same end result would be ethical if achieved through ordering overtime to ship as much product as possible at years-end, 74% of respondents felt this manipulation to be ethical (As cited by Gibson, 2013, p. 85). A staggering 80% of survey respondents felt that selling excess assets as a means of realizing a profit to be ethical, while only 16% felt it would be questionable (As cited by Gibson, 2013, p. 85). Short-term earnings management procedures, while questionable, are often legal. The alteration of financial information in an attempt to meet budgets or as a way to show profitability is often alluring and an â€Å"easy† way to draw investors. Managers who use earnings management tactics must take into consideration the impact such actions may have with key stakeholders (As cited by Gibson, 2013, p. 86). When numbers are skewed favorably, it gives stakeholders a false sense of security in their investments. Companies who engage in short-term earnings management practices often set themselves up for losses over time. When numbers are adjusted to make a quarterly or yearly dollar amount, chances are the following quarter will find the company in the negative. Such practices are rarely foolproof and care must be taken when making earnings management practice decisions. Focusing on long-term earnings management practices are ultimately more favorable, but in order to be effective management must remain committed to consistent operational procedures. Forecasting the product needs of customers and looking ahead are key strategies for keeping sales income at a consistent level. Waiting until the last minute to offer customers generous credit terms in an effort to boost end of year or quarterly sales is a short-term answer at best. Looking at the purchase history of customers and integrating theses sales number into future budgets should help alleviate the need to resort to last minute scrambling to make budget targets.

Chemistry Essays Essential Fatty Acids

Chemistry Essays Essential Fatty Acids A discussion on the role of essential fatty acids in human health. Introduction: Fatty acids are important components of lipids (fat-soluble components of living cells) in plants, animals, and microorganisms.   Generally, a fatty acid consists of a straight hydrocarbon chain and a terminal carboxyl (-COOH) group.   It is the carboxyl group that makes it an acid.   If the carbon-to-carbon bonds are all single, the acid is saturated; if any of the bonds is double or triple, the acid is unsaturated and is more reactive.   The physical properties of fatty acids are determined by chain length, degree of unsaturation, and chain branching. This essay focuses on the role of essential fatty acids, i.e. fatty acids that must normally be present in the diet of certain animals including man.   These acids occur in body structures, especially the different membranes inside and around cells, and cannot be synthesised in the body from other fats.   Essential fatty acids all possess double bonds at the same two positions along their hydrocarbon chain and so can act as precursors of prostaglandins, thromboxanes and leukotrines.   Deficiency of essential fatty acids can cause dermatosis, weight loss, irregular oestrus etc.   Table 1 shows the most important natural fatty acids. Acid Number of Carbon Atoms Number of Double Bonds Saturated acids Butyric 4 0 Caproic 6 0 Caprylic 8 0 Capric 10 0 Lauric 12 0 Myristic 14 0 Palmitic 16 0 Stearic 18 0 Arachidic 20 0 Behenic 22 0 Monounsaturated acids Palmitoleic 16 1 Oleic 18 1 Erucic 22 1 Polyunsaturated acids Linoleic (w6) 18 2 a-Linolenic (w3) 18 3 g-Linolenic (w6) 18 3 Arachidonic (w6) 20 4 Eicosapentaenoic (w3) 20 5 Docosahexaenoic (w3) 22 6 Table 1: The most important natural fatty acids. Omega-3 (w3) Omega-6 (w6) fatty acids: The Western Diet There is an absolute requirement for a dietary intake of w3 and w6 polyunsaturated fatty acids (PUFA), because of their role in constructing cell membranes, and also as precursors for the prostaglandins and other eicosanoids.   In fact, w3 fatty acids are particularly prevalent in the brain, retina, and spermatozoa, in which docosahexanoic acid (see table 1) constitutes approximately 36.4% of total fatty acids.   The two parent compounds, which are considered to be dietary essentials, are linoleic acid (w6) and a-linolenic acid (w3).   These two can undergo chain elongation and further desaturation to yield arachidonic acid (w6) and docosahexaenoic acid (w3) respectively, which are both precursors to two families of prostaglandins.   There is no requirement for a dietary source of the longer chain PUFA, but they are potentially desirable in the diet, since their formation from linoleic or linolenic acids is a rate-limiting step.   So, what is the desirable level of w3 and w6 fatty acid intake and does the western diet meet this level?   Ideally, the body requires a near balanced intake of both w3 and w6 fatty acids since the eicosanoids derived from w3 fatty acids have opposing metabolic properties to those derived from w6 fatty acids.   Omega-3 fatty acids, on the one hand, have anti-inflammatory, antithrombotic, antiarrhythmic, hypolipidemic, and vasodilatory properties.   For example, they have the ability to make blood thinner by reducing platelet aggregation (this is particularly beneficial in reducing blood clots and stroke).   They also play an important role in the modulation and prevention of human diseases, particularly coronary heart disease, type 2 diabetes, and renal disease, and there is strong evidence that w3 fatty acids are essential for human development from infancy onwards.   On the other hand, w6 fatty acids promote platelet aggregation and vasoconstriction, as well as increasing blood viscosity and bleeding time. The western diet is far richer in w6 fatty acids than w3.   This is due to the increased intake of w6-rich foods such as cereals, fried foods, baked foods etc.   In fact, in today’s western diet, the ratio of w6 to w3 fatty acids ranges from @20-30:1 instead of the traditional, and optimum, range of 1-2:1.   This means that the eicosanoids produced from the metabolism of w6 fatty acids are formed in greater amounts than those derived from the w3 fatty acids, specifically eicosapentaenoic acid.   The result is an increase in allergies, inflammation, type 2 diabetes, and the formation of thrombi and atheromas.   This explains why cardiovascular diseases are far more prevalent in the west.   Consequently, people should be encouraged to eat more w3-rich foods (such as cold-water fish, flaxseed, rapeseed etc) in order to make the ratio more even.   Figure 1 shows the relationship between the ratio of w6 to w3 fatty acids in dietary lipids in the Indian diet and the prevalence of type 2 diabetes.   It is clear that, as the ratio of w6 PUFAs to w3 PUFAs increases, the prevalence of type 2 diabetes also increases. Figure 2: Data obtained from Raheja BS, Sadikot SM, Phatak RB, Rao MB. Significance of the n-6/n-3 ratio for insulin action in diabetes. Ann N Y Acad Sci 1993, 683, 258-7. As far as cardiovascular diseases are concerned, a more even w6 to w3 ratio (i.e. greater w3 fatty acid intake or decreased w6 intake) has been shown to contribute to keeping cholesterol low, stabilising arrhythmia, and keeping blood pressure low. Fatty Acids, Inflammation Autoimmune Diseases Omega-3 PUFAs, in particular eicosapentaenoic acid and docosahexaenoic acid, have been shown to have potent immunomodulatory effects.   Some of the effects of w3 PUFA are induced by modulation of the amount and types of eicosanoids made, and other effects are triggered by alternative mechanisms that do not involve eicosanoids, for example actions upon intracellular signalling pathways, transcription factor activity and gene expression. Eicosapentaenoic acid (w3) competes with arachidonic acid (w6) for the enzymatic metabolism (by cyclooxygenases) that results in prostaglandin formation.   The eicosanoid metabolites of eicosapentaenoic acid produce fewer inflammatory and chemotactic derivatives than the arachidonic acid metabolites.   Therefore, increasing the dietary intake of w3 fatty acids reduces the likelihood of inflammation. Omega-3 fatty acids have also been shown to slow down the production of interleukin 1 (IL-1b) by suppressing the IL-1b mRNA, as well as the Cox2 (cytooxygenase) mRNA that is induced by IL-1b.   Cox2 is overexpressed in colon cancer cells.   Furthermore, research also suggests that a high dose of a-linolenic acid can suppress the formation of Tumor Necrosis Factor (TNF), which is implicated in causing some of the pathological responses that occur in inflammatory conditions.   Hence, it appears that by improving diet management, and ingesting more w3 (as opposed to w6) fatty acids, we could significantly reduce inflammatory disorders and the 40% of cancers that are caused by diet alone.   Managing autoimmune and inflammatory conditions in this way is clearly beneficial since it eliminates many of the side effects associated with the available drug therapies. Fatty Acids and Mental Health Given the fact that around 60% of the brain is composed of fat, it is not surprising that the organ needs w3 fatty acids to function properly.   There is evidence that links mood disorders with low concentrations of w3 fatty acids in the body.   According to certain theories of depression, w3 fatty acids help to regulate mental health problems by improving the ability of the brain’s serotonin (5-HT) receptors to understand mood-related signals from other neurones.   These theories are being investigated further. Conclusion Essential fatty acids have justifiably been linked with a plethora of health issues affecting society at large today.   What is most evident is that, in the western world, we are failing to ensure that we make optimum use of the benefits that w3 fatty acids have to offer.   In order to benefit more, we must take action to balance our intake of w3 and w6 fatty acids.   At present, the balance is tipped too greatly towards w6 fatty acids.   Consequently, heart disease, hypertension, type 2 diabetes, depression, inflammatory disorders, cancer etc are on the increase.   That is not to say that w6 fatty acids are totally bad for us: the body requires reasonable amounts for the purposes of vasoconstriction etc.   The ratio of w6/w3 essential fatty acids can be improved by reducing our intake of w6 fatty acids from vegetable oils and increasing our intake of w3 fatty acids from foods such as oily fish, leafy green vegetables, wild game etc. What is clear is that new benefits of w3 fatty acids are being discovered every day.   This is evident from the masses of literature on the subject.   But it is one thing to learn about the benefits of w3 fatty acids and a completely other to use this information effectively.   This is the area that needs to be addressed.  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   REFERENCES Journal Articles Referred to in the text: Neuringer M et al., Biochemical functional effects of prenatal and postnatal omega-3 fatty acid deficiency on retina and brain in rhesus monkeys, Proc Natl Acad USA 1986, 83, 4021-5 Connor W.E., Importance of n-3 fatty acids in health and disease, American Journal of Clinical Nutrition, 2000, 71(1), 171-5 Simopoulos A.P, Essential fatty acids in health and chronic disease, American Journal of Clinical Nutrition, 1999, 70(3), 560-569 Raheja BS, Sadikot SM, Phatak RB, Rao MB. Significance of the n-6/n-3 ratio for insulin action in diabetes. Ann N Y Acad Sci 1993, 683, 258-7 Harris WS et al., Effect of fish oil on VLDL triglyceride kinetics in man, J Lipid Res 1990, 31: 1549-58 McLennan PL, Relative effects of dietary saturated, monounsaturated, and polyunsaturated fatty acids on cardiac arrhythmias in rats, Am J Clin Nutr, 1993, 57, 207-12 Charnock, JS, Antiarrhythmic effects of fish oils, World Rev Nutr Diet, 1991, 66: 278-91 Berry EM, Hirsch J., Does dietary linolenic acid influence blood pressure? Am J Clin Nutr, 1986, 44: 336-40 Simopoulos, AP., Omega-3 Fatty acids in inflammation and autoimmune diseases, American Journal of Clinical Nutrition, 2002, vol 21(6), 495-505 Maes M et al., Fatty acid composition in major depression: decreased omega-3 fractions in cholesteryl esters†¦, J Affect Disord, 1996, 38, 35-46

Sexual Harassment at the Workplace Essay -- Sexual Harassment in the Wo

Harassment and Discrimination at the Work Place Three repair workers at the Facilities Management Division of the Lee County jail filed a series of harassment and discrimination claims after being repeatedly harassed and discriminated by nine co-workers for over three years. After an extensive investigation by the Equal Employment Opportunity Commission (EEOC), it was determined that there was sufficient evidence to file a claim in federal court. Now, the United States Justice Department has filed a claim against Lee County in Florida costing tax payers thousands if not, millions of dollars. This is an example of how thriving companies can suffer an unexpected harassment or discrimination lawsuit which can cost them thousands of dollars affecting their bottom line as well as their reputation. As an independent human resources consultant, Santiago-Santos will organize a local education campaign and provide employers with different trainings to educate them and their employees about harassment and discrimination. Educating business owners and their employees is key for reducing the number of claims being filed due to harassment and discrimination. Harassment and discrimination can affect a business in many ways. Having a history of harassment and discrimination claims can damage a business’ reputation and affect its bottom line. It can cost the business current and future clients as well as investors and employees. Depending on the gravity of the claim(s), the process of settling the claim(s) can take anywhere from months to years. Meanwhile, the cost of the settlement and other fees continue to add up. A business might have to compensate the affected parties besides paying court fees and lawyers. The Equal Employment Opportu... ...s, organizing a local campaign wish will provide training about harassment and discrimination for local business will help build a healthier community and possibly improve the local economy. References Clark, C. S. (1991, August 9). Sexual harassment. CQ Researcher, 1, 537-560. Retrieved from http://library.cqpress.com/cqresearcher Glazer, S. (1996, July 19). Crackdown on sexual harassment. CQ Researcher, 6, 625-648. Retrieved from http://library.cqpress.com/cqresearcher/ Kane-Urrabazo C. (2007). Sexual harassment in the workplace: it is your problem. Journal of Nursing Management, 15(6), 608-613. doi:10.1111/j.1365-2834.2007.00725.x U.S. justice department sues lee county over discrimination accusations. (2012, February 06). Naples Daily News. Retrieved from http://www.naplesnews.com/news/2012/feb/06/us-justice-department-sues-lee-county-over/

Evaluating National Environmental Health Association’s (NEHA) Performan

A mission statement is what defines an organization’s reason for existing and is the foundation for everything they do (Aguinis, 2009). Furthermore, the vision statement is where the organization desires to be in the future (Cady, Wheeler, DeWolf, & Brodke, 2011). Therefore, it is important to make sure that the organization has a good mission and vision statement that is clear and concise. According to Aguinis (2009), an ideal mission and vision statement booth have eight different characteristics. The mission statement must describe what they do, their market, their unique benefits, what technology they use, concern for their survival, managerial philosophy, what public image they want, and their self-concept of business (Aguinis, 2009). In contrast, the vision statement must be brief, verifiable, bound by a timeline, current, focused, understandable, inspiring, and not easily attainable (Aguinis, 2009). The National Environmental Health Association’s (NEHA) mission statement is â€Å"to advance the environmental health and protection professional for the purpose of providing a healthful environment for all† (NEHA, 2011,  ¶ 1). In addition, NEHA does not have a vision statement. Instead, they have a strategic direction that focuses on directions and not destinations. It is the organization’s belief that by focusing on directions, it will allow them to change course quickly should a change be appropriate. In addition, NEHA’s strategic direction includes training, education, credentialing, advocacy, and organizational capacity (NEHA, 2011). Therefore, based on Aguinis’s criteria, NEHA’s mission statement is missing seven of the eight elements and only really addresses who their customers are, the environmental health and ... ...ization is, where they are going, and how they plan to achieve it (Cady, Wheeler, DeWolf, & Brodke, 2011). Unfortunately, NEHA is lacking a real strategic direction since their mission statement is too vague and they have no vision for the future. While they have a strategic direction statement, it is not tied to a clear mission or vision so it is also not very useful in aligning the organization. For an organization to realize their full potential and to stay competitive, they must have a strong mission and vision statement. â€Å"A vision alone is only a dream. Coupled with a mission, the vision is a destination† (Dossenbach, 2001). NEHA must have a destination if they want to continue to be the association that the environmental health and protection specialist turns to for education, professional advancement, and knowledge of the environmental health field.

Analyzing Macbeths Weak Charachter in Shakespeares Macbeth Essay

Shakespeare's Macbeth is about the change in Macbeth's character and his inner motives and feelings. Throughout the play the audience bears witness to Macbeth's thoughts and feelings in his soliloquies, speech, and asides. One often wonders whether it is fate, the witches, or the people around him that compel him to think in certain ways and influence his decisions. It is only his own character from the beginning, however, that allows him to make some of the choices that he does and commit horrific deed during the play. Macbeth is a weak, selfish, traitor, as shown through his submission to Lady Macbeth's demands, his betrayal of Duncan and Banquo, and his inability to admit wrongdoing or accept the consequences of his actions. Macbeth demonstrates weakness when he gives in to Lady Macbeth?s will and follows through with her crazed schemes. Lady Macbeth is a greedy person with grand desires, but one who finds it hard to follow through with the nefarious deeds that are associated with accomplishing her goals. She often wishes to be more of a man, calling upon the devil to help her ignore her conscious and give her cold blood. She uses Macbeth as a tool to accomplish doing these things she cannot without having to do them on her own. However, Macbeth is also reluctant and Lady Macbeth has to influence him to kill Duncan. When learning of Lady Macbeth?s plot to take Duncan?s crown, Macbeth contemplates all the reasons it should not be done. He admits it would be suicide, and that he has no reason to do it. Macbeth decides he will let luck and fate decide whether he will be crowned. ?I have no spur/ To prick the sides of my intent,? (I, ii, 26-27) says Macbeth. But soon afterwards he is coerced by Lady Macbeth ?s taunts and critici... ...ing himself up honorably. Through these statements and Macbeth?s fight until his death, he has demonstrated a lack of regret for the things he has done and the inability to repent for his actions. Shown by his mental insecurity and weakness, treachery against god and country, and reluctance to confess fault, Macbeth has proved a pathetic and selfish person who ultimately gets what he deserves. Macbeth?s character demonstrates all the qualities of a criminal mind. People often find themselves fighting against problems they have created for themselves through their own unwise actions, and losing in the end like Macbeth does because they cannot not change their ways soon enough or aren?t willing to. If one chooses to be selfish, greedy, and overconfident and betrays the ones surrounding him without regret, then he will find himself fighting alone to the bitter end.

Evidence suggests a link between Late Onset

It is a primary degenerative disease of the cerebral cortex. It accounts for over 65% of all dementia cases, commonest cause of dementia. First described by Alzheimer in 1907 and named after him by Kraeplin. It is a progressive brain damage. It destroys brain cells, causing problems with memory, thinking and behavior. The incidence is about 2 – 7 % at ages above 65yrs. This doubles after every additional 5yrs to 8-10% at 80yrs and 30-40% at 90yrs. Rare below 50yrs. This progressive increase in incidence with age has caused significant medical, social and economic concerns in nations with growing number of elderly people.It is the 6th leading cause of death in the United States. It does not have any current cure; treatment available is targeted at presenting symptoms. Pathology Aetiology: The cause is unknown. However there is increased incidence in Down’s syndrome. The risk is also higher with increased free radical formation and failure of antioxidant defenses which ma y contribute to the degeneration [SOD is reduced by 25% in the frontal cortex and hippocampus]. It is occasionally familial. Besides, genetic studies show linkage between Familial AD and loci on chromosomes 1, 14 & 21.Late onset AD is a heterogenous disorder. Evidence suggests a link between Late Onset AD and atherosclerosis, inflammation and cholesterol. Linkage has also been found to a gene locus on chromosome 19q. There is also a strong association between Alzheimer disease and amyloid proteins. In this disease condition, there is a breakdown in some of the synapses that serve the function of information storage, processing and memory; this spreads to other cells and over time, these cells die. Such affected cells are surrounded by plaques and contain characteristic tangles.Macroscopy: Macroscopic examination of the brain shows a variable degree of cortical atrophy with widened sulci. These changes are pronounced in the frontal, temporal and parietal lobes. Hydrocephalus ex vacuo -compensatory ventricular enlargement occurs due to parenchyma loss. Microscopy: Microscopic examination shows senile plaques, neurofibrillary tangles and amyloid angiopathy. All these changes are also found in the brains of elderly because they are features of aging. The pathologic changes seen in this disease begin first in the entorhinal cortex, spread to the hippocampus and isocortex and eventually to the neocortex.Senile plaques: are spherical collections of dilate neuritic processes which surround a central amyloid core. The neuritic processes are also called dystrophic neuritis; are silver-staining and contain paired helical filaments, abnormal mitochondria and synaptic vesicles. The periphery is occupied by microglial cells and astrocytes. The amyloid core is stained by Congo red stain; it contains abnormal proteins predominantly amyloid proteins. There are also diffuse plaques in those with Down syndrome; these lack the neuritic processes seen in senile plaques.Neurofibril lary tangles: bundles of filaments in the cytoplasm of the neurons encircling the nucleus. They are vivid as fibrillary structures with silver staining although they are also basophilic with Hematoxylin and Eosin stain. These structures contain paired helical and straight filaments; the former contain protein tau, Microtubule-associated protein [MAP2] and ubiquitin. The quantities of these tangles correspond to the degree of dementia. Another pathologic feature is Amyloid angiopathy which is an invariable finding in Alzheimer disease associated with amyloid protein.Besides, there is also accumulation of intraneuronal vacuoles in the cytoplasm. Amyloid angiopathy, hirano bodies are mostly within the frontal, parietal and temporal cortex, hippocampus and substantia inominata. There is also marked reduction in Ach, NE, 5-HT. Diagnosis Alzheimer disease usually becomes clinically apparent as insidious impairment of higher mental functions with changes in mood and behaviour. Later progre ssive impairment in orientation, memory, attention and concentration worsens.Eventually patient becomes mute, immobile and severely disturbed. The diagnosis of Alzheimer disease is based on a combination of clinical and pathologic presentations. There are impaired cognitive functions, Psychotic features such as delusion and hallucinations, and depression. The course is relentlessly progressive. Survival rate varies between 8 & 10yrs Management includes Good history, mental state and thorough physical examination. Every patient must be thoroughly evaluated to determine the extent and severity of the disease.Psychometric testing – for confirmation, Mini Mental State Examination ,7-min screening, mental test score, clinical dementia rating, Wechsler adult intelligence scale [WAIS: current IQ to previous I Q] Investigation: these physical investigations are useful to access the physical status of the patient; identify any physical illness and determine co-morbidities. Blood test : full haemogram, Erythrocyte Sedimentation Rate, C-Reactive Protein, urea and electrolyte, Fasting and random blood sugar, liver function test, Ca, Vitamin B12, Folate assay, Thyroid function test.Imaging: Chest X-Ray, cranial CT scan, MRI, PET, SPECT, angiography Others: Lumbar Puncture and CSF analysis, brain biopsy for histology Treatment Generally, goal of treatment is to maintain remaining ability as far as possible to preserve dignity, relieve distressing symptoms, slow disease progression & provide care for as long as possible in the familiar home environment. Patients should be made aware of their condition if possible. Inform patient the nature of the disease so that they can adapt favorably to existing conditions.Family support is an important part of the treatment plan: Counseling of the relatives & careers, family support and medical problems of the careers also deserve particular attention. The emphasis here is to encourage family members to show understanding for pati ent’s condition and help them live well with the condition. Behavioral methods that have been suggested include re- enforcement, shaping, desensitization, prompts & other practical aids to cope with forgetfulness. Drug treatment: there is not cure for Alzheimer disease but some drugs have proven useful in patients.These drugs are used based on their mechanism of action and the pathogenesis of the disease. These include: Antioxidants: these are useful to reduce free radicals implicated as etiologic agents for AD. Anticholinesterases, such as neostigmine, physostigmine increase, Ach levels. Antipsychotics are indicated to control paranoid delusions while antidepressants may be indicated when depressive symptoms are prominent. Prevention: recent evidence suggests that participation in cognitively demanding activities in later life can be preventive. Prognosis The changes in Alzheimer disease are irreversible.The disease is terribly progressive and the biological history can rare ly be altered. This makes the prognosis unfavorable. However, palliative measures can be adopted to alleviate the deficit and preserve remaining functions. References Cummings J, Cole G: Alzheimer Disease, JAMA 287:2335, 2002 Braak H, Braak E: Frequency of Stages of Alzheimer-related lesions in different age categories. Neurobiol Aging 18:351; 1997 Braak H, Braak E: Neuropahtological staging of Alzheimer-related changes. Acta Neuropathol [Berl] 82:239; 1991 Mirra SM, Hart MN, Terry RD: Making the diagnosis of Alzheimer’s disease. Arch Pathol Lab Med 117:131, 1993