Unit II Journal InstructionsYou have been a successful divisio.docx

Unit II Journal
Instructions
You have been a successful division manager in a company with
subsidiaries in several countries in Europe and Southeast Asia.
Your boss wants to help your career growth and offers you
opportunity for an expatriate assignment in Saudi Arabia
knowing a success there will open the door to a directorate role
upon your return. As a female and knowing that this subsidiary
has all males in every leadership position, you have some
concerns of discrimination and unfair treatment that will make
the assignment difficult. Would you accept the position? Why?
How would you prepare to face the challenges to gain the
respect and trust of the males who will be important to your
success or failure?
Your journal entry must be at least 200 words in length. No
references or citations are necessary.
Unit II Scholarly Activity
Instructions
For this assignment, you will again be writing about the
fictitious company that you created in Unit I. In a minimum of
two pages, discuss the following items that address the human
resource (HR) implications for your company as it goes
international as well as your role in HR in this growth. These
will also help you to prepare for your PowerPoint briefing to the
CEO that will be submitted in Unit VII:
1. Discuss current HRM practices that will need to be modified
as the organization goes abroad.
2. Discuss the three different types of HR structural forms
(centralized, decentralized, and transition) and select the one
this organization should adopt and explain why.
3. Explain the control mechanisms to put into place to ensure
the organization’s culture is congruent across international
borders.

4. Address factors driving standardization.
5. Discuss factors driving internationalization growth and the
spread of internationalization.
6. Discuss the IHRM professional’s role and challenges in a
typical merger and acquisition.
7. Discuss international joint venture challenges.
8. Discuss the term SME as it applies to IHRM.
The paper should be APA-formatted using at least two peer-
reviewed articles and the textbook as supporting documentation.
You should also have a title page and a reference page, which
do not count as part of the two-page minimum requirement.
Textbook:
Dowling, P. J., Festing, M., & Engle, A. D., Sr. (2017).
International human resource management (7th ed.). Hampshire,
United Kingdom, : Cengage Learning.
Turner, Chakaela | Fort Valley State University| BIOL 4254K |
November 28, 2017
Autism
THE TRUE CAUSE OF AUTISM
Autism
Turner

Introduction
Vaccines have been a controversial topic on social media and in
the headlines in the past
year. The purpose of a vaccine is to guard individuals to work
with the immune system to
avoid disease. A vaccine is an item that produces resistance
from an ailment and can be
administered through shots, orally, or by airborne.
Many people are now turning to natural approaches to heal the
body rather than using
medications and vaccines. Top-rated causes of Autism Spectrum
Disorder (ASD) were
genetics, brain structure, will of God, toxins in vaccines, and
environmental pollutions
(Goin-Kochel, Mire, & Dempsey, 2014). However, in the result
of receiving vaccines,
many parents believe that their children were showing signs of
autism due to toxins in the
vaccines. In the summer of 2017, doctors diagnosed my
youngest nephew Dylan with
high-functioning autism, ADHD, and hypotonia. Autism is one
of three disorders part of

the Autism Spectrum Disorder (ASD); it is a range of states
portrayed through social
skills, tedium behaviors, speech, and nonverbal correspondence
(Autism Speaks, 2017).
Children who possess autism have restricted interests or
repetitive behaviors with
difficult transitions. Paul Eugen Bleuler coined the term autism
in 1912. Its origin derived
from the Greek word autos, meaning "self" (Blake, Hoyme, &
Crotwell, 2013).
"Spectrum" refers to the variation in challenges and strengths
possessed by each person
with autism (Autism Speaks, 2017). The subgroups recognized
within ASD include
autistic disorder, Asperger syndrome and pervasive
developmental disorder not otherwise
classified. (Blake, Hoyme, & Crotwell, 2013). Moreover, there
are two types of
symptom onsets of ASD: regressive onset and early onset.
Children with a regressive
autism demonstrate a loss of previously established skills in the
first 24 months of life.
Early onset displays ASD symptoms in the first year of life, but
no forfeiture of skills

characterizes symptom onset (Goin-Kochel, Mire, & Dempsey,
2014).
There are several types of vaccinations. Those include: live,
attenuated vaccines;
inactivated vaccines; subunit vaccines; toxoid vaccines;
conjugate vaccines; DNA
vaccines; and recombinant vector vaccines. Moreover,
vaccinations such as Thimerosal-
containing vaccine and the measles, mumps, and rubella (MMR)
vaccine are two
vaccines that have caused the most controversy in whether they
result in autism. MMR is
a live attenuated vaccine; in other words, the microbe is
weakened in the lab to prevent
disease and is the closest thing to a natural infection. They
elicit strong cellular and
antibody responses and often confer lifelong immunity with
only one or two doses.
Individuals with weakened immune systems cannot be
administered live vaccines
(National Institute of Health, 2012).
Thimerosal, however, contains ethylmercury; ethylmercury
prevents the growth of
bacteria in vaccines. Once thimerosal enters the body, the body

can break it down to
ethylmercury and thiosalicylate, which are eliminated without
trouble (Centers for
Autism
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PAGE 2
Disease Control and Prevention, 2015). Thimerosal was once
used in some childhood
vaccines, but in 2001 thimerosal was removed from vaccines.
Today thimerosal only
exists in flu vaccines packaged in multidose vials. Thimerosal-
free alternatives are also
available for flu vaccines (Centers for Disease Control and
Prevention, 2015). Thimerosal
had never been utilized within MMR since antimicrobial agents
are not utilized within
live vaccines (The College of Physicians of Philadelphia, 2017).
Since the 1990s, a
various amount of studies have been done that indicate a
thimerosal-containing vaccine, a
thimerosal-free vaccine, and an MMR vaccine does not cause
autism. However, many

tests are still being done by researchers to determine if this still
stands true for any
vaccine, including flu vaccines or if genetics plays a role.
Methodology/Description/Genetics
Various studies were done over the decades to determine
whether the MMR vaccine, a
thimerosal-containing vaccine, or genetics played a role in an
individual being diagnosed
with autism. The myth that vaccines caused autism started an
anti-vaccine movement; it
was the result of a TV documentary titled DTP: Vaccine
Roulette shown on WRC-TV, an
NBC affiliate in Washington D.C., on April 19, 1982, linking
pertussis (whooping cough)
vaccine to severe reactions in children (Blake, Hoyme, &
Crotwell, 2013). Three studies
are referred to below:
METHOD
MMR vaccine
All children born on January 1, 2001, to December 31, 2007,
were included in the
database. These children were registered in a health care plan

from birth to at least five
years of age and who also had an older sibling enrolled in a
health care plan for at least
six months between the beginning and end of the study period.
Siblings had to be at least
between 6 months and 17 years older than the index child to be
included in the study.
ASD in index children and older siblings was determined using
a claims-based algorithm
with a positive predictive value of 87% that required two or
more claims on separate
dates of service with an International Classification of Diseases,
Ninth Revision, Clinical
Modification diagnosis code in any position for autistic
disorder, other specified
pervasive developmental disorder including Asperger syndrome,
or unspecified Pervasive
developmental disorder.
Relative risks included children receiving one dose of MMR at
ages 2, 3, 4, and 5 years
and two doses at age five years vs. those who were unvaccinated
at those ages. Separate
relative risks were estimated for children with older siblings
with and without ASD. Age

since birth was utilized as a time scale and included MMR
receipt as a time-varying
Autism
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PAGE 3
covariate assigning follow-up time to either the unvaccinated
group, the 1-dose group, or
the 2-dose group, depending on immunization standing at any
given age.
Fixed covariates included in the models were gender of the
index child, parents’ age at
index child’s birth, geographic position defined by the four U.S.
Census regions, mental
health assistance, index childbirth year, occurrence of seizures,
presence of vaccination-
associated allergies, preterm birth, modified Childhood Chronic
Conditions score (CCC)
parents’ educational level, household income, and
race/ethnicity.
Statistical significance testing of unadjusted rate proportions
was conducted utilizing the

Yates χ2 test; statistical significance testing of hazard ratios
was conducted using Wald
χ2 statistics. All analyses were two-sided and were performed
using SAS statistical
software (Jain et al., 2015).
Thimerosal-containing vaccine
From 1970 on, the only thimerosal-containing vaccine in the
program was the whole-cell
pertussis vaccine. The same vaccine was reformulated without
thimerosal and used
January 1, 1997, when it was replaced with an acellular
pertussis vaccine. The whole cell
vaccine was administered at five weeks, nine weeks, and ten
months from 1970 and until
it was replaced. The thimerosal formula comprised 50 µg of
thimerosal (~25 µg of
ethylmercury) in the first dose and 100 µg (~50 µg of
ethylmercury) in each of the
following two doses.
Since April 1968, all citizens of Denmark were given a unique
identification number. The
scientists constructed a cohort consisting of all children born in
Denmark in the period

from January 1, 1990, to December 31, 1996. The identification
numbers were used to
link information on vaccinations, diagnoses of autism,
diagnoses of other ASDs, other
relevant diagnoses, and potential confounders to the children in
the cohort. Doses
administered before June 1, 1992, were considered to contain
thimerosal, and doses
administered after June 1, 1992, were deemed thimerosal-free.
Data were obtained on possible confounding factors from the
Danish Civil Registration
System and the Danish Medical Birth Registry. Factors are as
follow: child's gender,
child's birth-place, weight at birth, 5-minute Apgar score, how
far along the pregnancy is,
mother's age at birth of the child, and mother's country of birth.
Children within the cohort contributed time to follow-up from
one year of age or January
1, 1991, whichever occurred last, until ASD, 11 years of age, or
until December 31, 2000,
whichever occurred first. Follow-ups were done at one year of
age due to evaluations for
ASD done after one year of age. Vaccination history was
considered a time-varying

variable. Rate ratios were adjusted for age and calendar period.
Autism
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PAGE 4
Brain Study
Colombia University researcher Guomei Tang analyzed brain
tissue from 26 children and
young adults affected by autism. 13 of the children were
between the ages of 2 and 9
when they died. 13 were between ages 13 and 20. For
comparison, she also examined
donated postmortem tissue from 22 children and teens who did
not have autism. Tang
measured the abundance of synapses in a small section of the
cortical tissue from each
brain (Autism Speaks, 2014).
DESCRIPTION
MMR Vaccine

In 1998, Wakefield and associates published a study in The
Lancet claiming that the
MMR vaccine was linked to autism even though they could not
demonstrate a
relationship between MMR and autism. His paper was retracted
in February 2010.
However, years after the study many other research experiments
were carried out.
A reflective cohort study was directed utilizing a managerial
claims database associated
with a significant U.S. health plan (the Optum Research
Database). The database
included more than 34 million individuals each year, containing
both commercially
insured individuals and Medicare managed care enrollees.
The MMR vaccine should be administered twice: once at age 12
to 15 months and once
and the age 4 to 6 years. Decreased vaccination rates could
threaten public health and
reduce both individual and community protection. The belief
that MMR is linked to
ASD, in collection with knowing that younger siblings of
children with ASD are already
at higher genetic risk for ASD, may alert parents to avoid

vaccinating their younger
children. According to the survey, out of the 486 parents of
children with ASD,
approximately 20% had declined or deferred MMR
immunization in the younger siblings
(Jain et al., 2015).
Mercuric compounds are nephrotoxic (toxic to the kidneys) and
neurotoxic (toxic to the
nervous system) at high doses. Thimerosal, a preservative,
contains ethylmercury. Many
believe that the vaccine is related to autism. 467450 children
born in Denmark from
January 1, 1990, until December 31, 1996, were used in the
study, comparing children
treated with a thimerosal-containing vaccine with children
treated with a thimerosal-free
formulation of the same vaccine (Hviid, Stellfeld, Wohlfahrt, &
Melbye, 2003).
Brain Study
A recent brain-tissue study proposes that children affected by
autism have an excess
number of synapses or connections between neurons. The

surplus is due to the decreased
Autism
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PAGE 5
amount of regular pruning that occurs during brain growth. The
scientist found that in
mice, the medication rapamycin not only aided in normal
synaptic pruning but also
reduced autism-like behaviors. Their goal is to eventually use
the medication to treat
autism in humans (Autism Speaks, 2014).
During regular brain development, an eruption of synapse
formation arises in infancy.
The formation is noticeable in the cortex, which is essential to
thought and processing
information from the senses. But by late adolescence, pruning
eradicates about half of
these synapses. Also, many genes linked to autism are known to
affect the development
or function of brain synapses (Autism Speaks, 2014).
GENETICS

Autism is fundamentally a genetic disease. A study done by
scientists at Cold Spring
Harbor Laboratory in New York suggests that autism traces to
one of 200 gene-disabling
mutations found in the child but neither parent. These mutations
completely disable genes
that are crucial to early brain development. Also, they appear to
be more common among
people who are severely disabled by autism versus those who
are only mildly affected.
De novo, or new mutations first occur in the mother's egg, the
father's sperm or early in
embryonic development. These variations also contain
disruptive variants, which have
biased transmission: they are more often transmitted from
mother to child affected with
ASD. Biased transmission is seen more frequently in affected
children of lower IQ.
(Iossifov, et al., 2015).
These mutations are seen in higher rates of autism among
children of older parents.
Mutations, however, are also based on environmental exposures
(Iossifov et al., 2015).

These mutations can include deletions or duplications, also
known as copy number
variations. To look at the changes in DNA between parent and
child, another group of
scientists at Stanford School of Medicine used a CGH array to
look for significant DNA
changes in a person's DNA all at once (Stanford School of
Medicine Department of
Genetics, 2013). Of the discovered genes, 49 play a role in
chromatin remodeling, RNA
processing or building connections between neurons (Gholipour,
2017).
Results/Research Data
MMR vaccine
Out of 95727 children in the study, 1929 (2.02%) had an older
sibling with ASD. Overall,
994 (1.04%) children in the cohort had ASD diagnosed during
follow-up. Among the
individuals who had an older sibling with ASD, 134 (6.9%)
were diagnosed with ASD,
compared with 860 (0.9%) diagnosed with ASD among those
with siblings without ASD
(P < .001). The MMR vaccination rate (at least one dose) for the
children with unaffected

Autism
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PAGE 6
siblings was 84% (n = 78549) at two years of age and 92% (n =
86063) at age five years
of age. On the contrary, the MMR vaccination rates for children
who had siblings with
ASD were lower (73% at age two years of age [n = 1409] and
86% [n = 1660] at age five
years of age) (Jain et al., 2015).
Autism
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PAGE 7
Out of 2,986,654 individuals, there were 440 identifiable autism
cases and 787 cases of

other autistic-spectrum disorders. The average age for diagnosis
of autism was
approximately four-and-a-half years and six years for other
autistic-spectrum disorders.
In the cohort, only 20755 (4.4%) of children did not receive any
whole-cell pertussis
vaccine, 446695 (95.6%) were vaccinated at least once, 416081
(89%) were vaccinated
twice, and 293186 (62.7%) received three doses of whole-cell
pertussis vaccine. In those
receiving at least one dose of whole-cell pertussis vaccine, there
were 407 cases of autism
and 751 cases of other autistic-spectrum disorders (303
receiving thimerosal-free and 321
receiving the thimerosal-containing vaccine). Furthermore,
there was no evidence of a
dose-response association between the dose of ethylmercury
received and ASD.
The danger of autism and other autistic-spectrum disorders did
not vary significantly
between children vaccinated with thimerosal-containing vaccine
and children treated with
the thimerosal-free vaccine (RR, 0.85 [95% confidence interval

{CI}, 0.60-1.20] for
autism; RR, 1.12 [95% CI, 0.88-1.43] for other autistic-
spectrum disorders). Moreover,
Autism
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PAGE 8
no evidence was found of a dose-response association (increase
in RR per 25 µg of
ethylmercury, 0.98 [95% CI, 0.90-1.06] for autism and 1.03
[95% CI, 0.98-1.09] for other
autistic-spectrum disorders) (Hviid, Stellfeld, Wohlfahrt, &
Melbye, 2003).
Brain Study
After measuring the abundance of synapses, by late childhood,
the density had decreased
50% in the brain tissue unaffected by autism. By contrast, the
density had reduced by
16% in the brain from individuals who had autism. Likewise,
evidence was found as to
what may have caused the lack of pruning. The neurons from
the individuals with autism

were filled with damaged parts, and deficient in signs of a
normal breakdown pathway
called autophagy.
Scientists traced the pruning defect to a protein called mTOR
(mammalian Target of
Rapamycin). When mTOR is overactive, the brain cells lose
much of their self-pruning
ability. Thus, the brain cells show an overabundance of
synapses. The researchers
restored normal autophagy and synaptic pruning in the mice by
administering rapamycin
– a drug that inhibits mTOR. Treatment eliminated the mice’s
autism-like behaviors. The
treatment remained effective even when given to older mice.
Further evidence showed
that large amounts of overactive mTOR were found in the
postmortem brain tissue of
individuals with autism. Countless genes have been linked to
autism, but a portion of
them affect the mTOR/autophagy pathway (Autism Speaks,
2014).

Autism
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PAGE 9
Discussion
MMR vaccine
The data and results were depended on privately insured
children with an extended period
of continuous enrollment in a single health plan. Observations
concluded that there was
no association between the MMR vaccination and increased
ASD risk among privately
insured children. No evidence was found regarding either one or
two doses of the MMR
vaccination was associated with an increased risk of ASD
among children who had older
siblings with ASD.
As the occurrence of diagnosed ASD rises so does the number
of children who have
siblings diagnosed with ASD. Even though there were no
statistically substantial rate
ratio estimates indicating increased ASD risk at any age in

those whose older siblings had
or did not have ASD, the statistically significant interactions in
the final model suggested
differences in the rate ratio by both age and older sibling ASD
status.
This study used a large administrative claims dataset spreading
a recent 11-year period to
observe the relationship between MMR immunization status and
ASD risk in the United
States. The administrative claims database permitted the
estimation of associations free
from potential recall bias. The directorial claims, however, do
demonstrate some
significant research boundaries. The MMR immunization rates
were 4% to 14% lower
than rates stated in the National Immunization Survey.
Therefore, children in the study
who were considered unvaccinated may have received vaccines
in public health clinics or
schools in which claims were not submitted. Many children with
ASD did not receive
care during the study time frame. However, a quantitative bias
analysis was done to
evaluate the potential impact of these measurement errors; these

errors did not strongly
influence the findings of the study (Jain et al., 2015).
There is no proof of a relationship between thimerosal-
containing vaccine and autism in
children who received the thimerosal-containing vaccine vs.
children who received the
thimerosal-free vaccine. Ethylmercury, on the other hand, is
believed to have a shorter
lifespan in the body than methylmercury; no controlled research
of low-dose
ethylmercury toxicity has yet been conducted in the human
body. The concentration of
mercury in the stool, urine, and blood of infants who were
administered the vaccine was
measured; the vaccine did not raise the blood concentration of
mercury above safe limits,
and ethylmercury was eliminated rapidly via the stools (Hviid,
Stellfeld, Wohlfahrt, &
Melbye, 2003).

Autism
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PAGE 10
Brain Study
Rapamycin is an FDA-approved antibiotic and
immunosuppressant. This drug inhibits
the activity of mTOR, which in turn inhibits the process called
autophagy. Autophagy
allows a cell to break down its molecules and other components
that are no longer
needed. In other words, rapamycin inhibits mTOR and promotes
autophagy. Rapamycin
also helps nerve cells break down, hence why pruning is
important (Liou, 2010).
Conclusion
Vaccines are safe and effective. They work with the immune
system to prevent disease
and protect individuals and the community (U.S. Department of
Health and Human
Services, 2011); they reduce the risk of infection by working
with the body's natural
defenses to help safely develop immunity to diseases. Vaccines

help build resistance by
imitating infection, but it does not cause infection. When
someone in a community has
been vaccinated, the spread of a virus/disease decreases.
Vaccination does not eliminate
an unvaccinated person from getting infected, but it does lower
the risk.
There is no evidence to prove that the measles-mumps-rubella
vaccine and a thimerosal-
containing vaccine cause autism. While vaccines have been
proven not to cause autism,
studies show that autism is genetic due to mutations in the
child. Genetics plays a major
role in autism, specifically as a mutation. Other causes of
autism include excess
cerebrospinal fluid and infections in mothers during pregnancy
but little evidence has
been found.
Autism
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References
Anjali Jain, Jaclyn Marshall, Ami Buikema, Tim Bancroft,
Jonathan P. Kelly, Craig J. Newschaffer.
Autism Occurrence by MMR Vaccine Status Among US
Children With Older Siblings With
and Without Autism. JAMA.2015;313(15):1534–1540.
doi:10.1001/jama.2015.3077
Autism Speaks . (2017). What causes autism? Retrieved from
Autism Speaks:
https://www.autismspeaks.org/what-autism/learn-more-
autism/what-causes-autism
Autism Speaks. (2014, August 21). Brain Study Finds Evidence
that Autism Involves Too Many
Synapses . Retrieved from Autism Speaks:
https://www.autismspeaks.org/science/science-
news/brain-study-finds-evidence-autism-involves-too-many-
synapses
Blake, J., Hoyme, H. E., & Crotwell, P. L. (2013). A brief
history of autism, the autism/vaccine
hypothesis and a review of the genetic basis of autism spectrum
disorders. South Dakota
Medicine: The Journal Of The South Dakota Medical
Association, 58-65.

Centers for Disease Control and Prevention. (2015, October 27
). Thimerosal in Vaccines. Retrieved
from CDC:
https://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.ht
ml
Centers for Disease Control and Prevention. (2015, November
23). Vaccine Safety. Retrieved from
CDC: https://www.cdc.gov/vaccinesafety/concerns/autism.html
Centers for Disease Control and Prevention. (2017, September
27). For Parents: Vaccines for Your
Children. Retrieved from CDC:
https://www.cdc.gov/vaccines/parents/vaccine-
decision/index.html
Gholipour, B. (2017, March 7). Discovery of 18 New Autism-
Linked Genes May Pint to New
Treatments. Spectrum . Retrieved from Scientific American :
https://www.scientificamerican.com/article/discovery-of-18-
new-autism-linked-genes-
may-point-to-new-treatments/
Glickman, G., Harrison, E., & Dobkins, K. (2017). Vaccination
Rates among Younger Siblings of
Children with Autism . The New England Journal of Medicine ,
1099-1101.

Goin-Kochel, R. P., Mire, S. S., & Dempsey, A. G. (2014).
Emergence of Autism Spectrum Disorder in
Children from Simplex Families: Relations to Parental
Perceptions of Etiology. Pub Med,
1451-1463.
Hviid, A., Stellfeld, M., Wohlfahrt, J., & Melbye, M. (2003,
October 1). Association Between
Thimerosal-Containing Vaccine and Autism . JAMA , pp. 1763-
1766.
Iossifov, I., Levy, D., Allen, J., Ye, K., Ronemus, M., Lee, Y.-
h., . . . Wigler, M. (2015). Low load for
disruptive mutations in autism genes and their biased
transmission . Proceedings of the
National Academy of Sciences of the United States of America ,
E5600-E5607 .
Liou, S. (2010, June 29). Rapamycin. Retrieved from Stanford :
http://web.stanford.edu/group/hopes/cgi-
bin/hopes_test/rapamycin/
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PAGE 12

National Institute of Health. (2012, April 3). Vaccine Types.
Retrieved from NIAID :
https://www.niaid.nih.gov/research/vaccine-types
Rutter, M. L. (2011). Progress in Understanding Autism: 2007-
2010. Pub Med , 395-405.
Stanford School of Medicine Department of Genetics . (2013).
Autism and genetics . Retrieved from
The Tech Museum of Innovation :
http://genetics.thetech.org/original_news/news49
The College of Physicians of Philadelphia. (2017, April 5). Do
Vaccines Cause Autism? Retrieved
from The History of Vaccines :
https://www.historyofvaccines.org/content/articles/do-
vaccines-cause-autism
U.S. Department of Health and Human Services . (2011).
Basics. Retrieved from Vaccines:
https://www.vaccines.gov/basics/index.html
References

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