Alcoholism and Public Health Law Essay

Alcohol consumption poses a threat for many public health harms. Impaired driving is one of the largest contributors to motor vehicle crashes (Burris, Grunwald, Anderson, &ump; Filippoli, 2011). In the United States each year roughly 13,400 people die and an additional 255,500 are injured in motor vehicle crashes involving an alcohol-impaired driver according to Burris et al., 2011. In 2006, these crashes accounted for almost a third of all U.S. traffic-related deaths (Burris et al., 2011). Alcohol is the most commonly abused substance in the United States according to Pandrea, Happel, Amedee, Bagby, &ump; Nelson, 2010, and studies show that reducing alcohol consumption can lead to public health improvements such as decreased incidence of â€Å"liver cirrhosis, delirium tremens, male suicide, criminality, hospitalizations, alcohol-related disease mortality, workplace injuries, STDs, IPV, rape, robbery, and severe violence towards children† (Jernigan). Public heath deals with m any other issues that cause burdens to individuals and society alike such as obesity and gun use. Over the past several months, headlines in the news have been echoing â€Å"Chocolate Milk Removed from School Lunches,† and â€Å"Senate Considers Federal Tax on Soda.† While the removal of chocolate milk from school menus has actually happened in certain school districts across the country, federal tax on sodas has only been a proposal at this point. However, both echoes resounding through the news originated from escalating research that America’s twin epidemics of diabetes and obesity are due to diets high in sugar. The end result is that the actions taken to fight obesity have not been classified as either effective, uncertain, or harmful consistently through studies and research because there are too many variables like genetics, other sugar-loaded beverages and foods on the shelf, lack of exercise, abundance of video games, and the lifestyle one is accustomed that contribute to obesity as well. But even with the slightest inclination eliminating chocolate milk or federal tax on soda will eliminate sugar from obese population’s diet and thereby reduce weight, support groups and supporting research seem to load up the band wagons. Alcohol abuse is certainly an epidemic, and the domino effect of negativity it can cause in one’s life and surroundings creates a dismal forecast into the future of American public health somewhat similar to the obesity epidemic. Obesity and alcohol consumption act as a comparison between two similar, yet contradictory issues, much like public health and  public health law. High-risk drinking results in many consequences for public health and unlike obesity and soda tax, a multitude of systematic literature reviews conducted by highly-regarded scholars and published by credible organizations or peer-reviewed journals prove taxes that increase the price of alcohol effectively reduce overall alcohol consumption. Although ways to reduce alcohol consumption are not made glamorous in the news like many other trending public health epidemics, alcohol abuse is one of the few conflicts public health epidemiologists and economists have derived a bullet proof plan of action to effecti vely reduce its harmful effects. This manuscript serves as an evidence brief summarizing the problem, the law, the evidence, and the bottom line pertaining to the effect of increasing tax levels on alcohol use, and to prove why understanding public health law and policy is essential in bridging the gap between proven studies performed by public health professionals and the legislators and lobbyists who can implement the findings. Using the current state of obesity as an example was merely to cast light on the standstill alcohol abuse is undergoing, which ultimately resides in the poor connection between public health research and public health law. However, it is worth noting that other strategies exist to control alcohol abuse besides trying to impose what some may call a â€Å"sin tax,† such as comprehensive prevention programs: 1) Offer and promote social, recreational, extracurricular, and public service alcohol-free options; 2) Create a social, academic, and residential environment that supports health-p romoting norms; 3) Limit alcohol availability both on and off campus; 4) Restrict marketing and promotion of alcoholic beverages both on and off campus; and 5) Develop and enforce policies and laws at the campus, local, state and federal levels (The Demand for Alcohol: The Differential Response to Price, 2005). The elements of a comprehensive prevention program limit some of the damage caused by alcohol abuse but the epidemic flows forward. Numerous epidemiological studies have demonstrated that alcohol use disorders (AUDs) such as alcohol abuse and alcohol dependence are widespread in the general population of the United States, with approximately 8.5 percent of adults having had an AUD in 2007 (Falk, Yi, &ump; Hiller-Sturmhofel, 2008). Moreover, many people suffering from AUDs also suffer from one or more other psychiatric disorders, including other drug use disorders (DUDs), mood  disorders like major depression, anxiety disorders, or personality disorders like antisocial personality disorder (Falk et al., 2008). Falk et al., 2008, also reported the prevalence of alcohol use and AUDs is much higher among people with drug use and DUDs, respectively, than vice versa. This reflects the fact that alcohol is much more widely used than other drugs may be a gateway to the use of illegal or mo re potent drugs (Falk et al., 2008). Falk et al., 2008, reported that their results showed a dose-response relationship between the two classes of substances, with rates of drug use, weekly drug use, and DUDs increasing â€Å"monotonically with increasing levels of alcohol consumption and the presence of AUDs.† The descriptive study by Falk et al., 2008, not only portrays the grim effects of alcohol abuse but is also just one of the many credible reviews providing prevalence estimates providing health care policymakers and treatment planners with a â€Å"comprehensive assessment of the state of the use, co-use, and co-morbidity of alcohol and other drugs in the United States.† The flow of abuse and effects unfortunately does not have a dam, and floods further along into public health. Justice, Lynn, &ump; Fiellin, 2010, have shown that past and present alcohol consumption directly influences HIV progression and survival by altering timing of, adherence, and response to medication designed to minimize levels of HIV in the body like antiretroviral treatment (ART). Alcohol use also influences patient outcomes by increasing the risk for HIV and antiretroviral associated co morbidities, including liver disease, cardiovascular and cerebral vascular disease, pulmonary disease, bone disease, and cancer (Justice et al., 2010). Those with HIV have a lower tolerance for alcohol, according to Justice et al., 2010, yet preserve intense levels of consumption as they age and the growing effects of past and current alcohol consumption is likely to increase because patients with HIV infection are expected to live 20 to 30 years with ART. Lamentably, alcohol is a terror that looms around society and affects the weak and strong alike. Strong populations mostly include college and university students, who likely do not have HIV or AUDs or DUDs while pursuing a higher education. However, 25 percent of students report academic problems caused by alcohol use according to The Demand for Alcohol: The Differential Response to Price, 2005. Students who practice high-risk drinking are at risk for a host of problems, including: 1) A decline in academic performance  due to poor grades, missed classes, and falling behind that may lead to academic probation or dropping out of school; 2) Engaging in unprotected sex; 3) Increased risk of perpetrating or being a victim of violence, including sexual assault, hazing, vandalism, and fights; 4) Health problems related to alcohol use; and 5) Injury, arrest or death due to drinking and driving, or other alcohol-related causes (The Demand for Alcohol: The Differential Response to Price, 2005). Much like concrete cracking and eventually more and more cracks ensuing, are the secondary effects alcohol abuse has on campuses. Firstly, drinking undermines the goal institutions of higher education set forth, since heavy drinking leads to a decline in academic performance. Furthermore, heavy drinking can affect the campus as a whole through reducing retention rates, increasing expenses due to damage from vandalism, and branding the institution as a party school. The â€Å"party school† image may attract students who choose to be in high-risk settings, increasing the likelihood of alcohol-related incidents on campus (The Demand for Alcohol: The Differential Response to Price, 2005). Students who do not drink may also experience negative consequences of alcohol use by their peers according to The Demand for Alcohol: The Differential Response to Price, 2005. Effects may include study or sleep interruption, taking care of a drunken friend, having an unwanted sexual advance, hav ing property damaged, and being a victim of violence including physical or sexual assault. Over three-quarters of students living on campus have experienced at least one of the negative secondary effects of alcohol use at their school (The Demand for Alcohol: The Differential Response to Price, 2005). Perhaps a creative genius health professional strategizes a prevention program that eliminates alcohol consumption, only a short duration of time will pass and the marketing departments of major breweries will promote their brand in a way to pull the public right back into the flow of intake. Or maybe no successful prevention program forms, but raising the excise taxes on alcohol is being accelerated by legislature efforts in order to reduce alcohol consumption and abuse. In this case, consistent industry political donations and lobbying aimed at keeping alcohol excise taxes from increasing are in place for these companies profiting from their unhealthy product. The primary problem this brief sought out to analyze is alcohol abuse and the extensive list of problems discussed in detail above it  causes. The problem paves the way to the law. And given the circumstances that stricter law enforcement and prevention strategies have only resolved a minute fraction of the problem, the law is the answer as it offers a glass ceiling. No federal tax increases have been implemented since 1991 and many states, although legislative efforts have been accelerating across the country, have failed to increase the tax. However, tax law in the epidemic of alcohol abuse, is the solution with most opportunity for proving effective. Burris et al., 2011, define tax law as a mechanism for reducing consumption of unhealthy products. The same news that reported the removal of chocolate milk from selected school districts has reported increased taxes on cigarettes, so it is simple to understand that both the federal government and the states have used taxes as a means of increasing the cost of products associated with health risks in the past. Taxes can be levied upon the production and or sale of alcohol and are often described as excise taxes Burris et al., 2011, have reported. According to the Federation of Tax Administrators, almost every state taxes the sale or production of beer, liquor and wine (Burris et al., 2011). Nevertheless, increasing alcohol tax is not as straightforward and effortless as simply applying the definiton of tax law to the problem and stepping away. State readiness to act on alco hol tax research findings marks the beginning of constructing the bridge that will essentially connect public health to public health law. Many key factors are subject to broad consensus among members of the Coordinating panel and other participating experts (Tremper &ump; Mosher, 2005). Components that are most important are the budget deficit or other substantial need for the state to raise taxes, the strength of the advocates/coalition that would introduce research findings, and the availability of funds that can be used for legislative advocacy. Items of decreasing importance are existence and efficacy of a lobbyist for the issue, well-positioned champion in both houses of the legislature, and the political strength of the alcohol industry and its allies. Other factors include support of the governor, permissibility of earmarking, high proportion of nondrinkers, high proportion of evangelicals and/or fundamentalists, and support of major media (Tremper &ump; Mosher, 2005). Discussion of the former findings serve as a starting point for analyzing the conclusions of specific literature reviews that increasing alcohol taxes  improves public health and that various factors affect the likelihood that research findings will influence alcohol tax policy. After the preliminary analysis, possibly the most important finding to extract is the consent among alcohol tax advocates, legislative process experts, advocates who have successfully used research findings to influence tobacco tax policy, and other interested parties in regard to state tax policy, and whether a state needs to raise taxes for financial reasons. Tremper &ump; Mosher, 2005, have stated that in practical terms reflecting political realities, if a state is not facing a budget deficit, raising alcohol taxes to achieve public health benefits is highly unlikely. Continuing strain on state budgets has a high likelihood of continuing; therefore, raising taxes is going to be on most states’ legislative agenda for the projected future. Another important finding that bodes well for alcohol tax to appear on legislative agendas is that alcohol taxes are low by several measures and in some states have not been raised for decades, which means that inflation has reduced them t o a fraction of their previous level (Tremper &ump; Mosher, 2005). For example, had the beer tax merely kept up with inflation, it would be more than three times today’s rate of $18 per barrel; the liquor tax would be more than five times its current rate of $13.50 per proof gallon (Alcohol Taxes on the Federal Front, 2005). As prices rise, the relative importance of the taxes falls, unless Congress raises them according to the website Alcohol Taxes on the Federal Front. The website further foes on to state statistics indicating beer and wine taxes have been raised only once in the past 55 years, liquor taxes only twice and as a result, tax revenues that accounted for 12 percent of the sales of alcohol in 1980 now amount to only 7 percent of total sales. The result is a de facto subsidy on drinking and extra profits for alcohol manufacturers at the expense of taxpayers (Alcohol Taxes on the Federal Front, 2005). CONCLUSION: The beer industry has long opposed raising taxes on its products, even maintaining that they should be lowered. However, lower beer taxes would only add to the deficit, cater to a prosperous industry, reward and encourage heavy drinking, and attract more young drinkers, fueling increased alcohol problems and increasing public costs. The best interests of consumers, young people, the U.S. Treasury, and the public health and safety  of America would be better served by raising, not lowering beer taxes. (Alcohol Taxes on the Federal Front, 2005)

Sally Jameson

To: Prof. Chalmers From: Travis Ramme and Meghan Smith Date: April 26th, 2007 Re: Ms. Chalmers’ Compensation Choices 1. Ignoring taxation and other constraints, Ms. Jameson is better off taking the options. The stock currently trading at $18. 75 and the exercise price is $35. This may seem drastically far away. However, 5 year T-Bill rates are currently at 6. 02%. Combined with a current stock volatility of approximately 42%, this allows each option to be valued at approximately $4. 93. At this amount, Ms. Jameson’s options would be presently worth $14,790 were she to sell them. Where she to hold them instead, Ms. Jameson’s potential upside is limitless. Her possible gains would be equal to her number of options multiplied by the difference between the stock price and her exercise price of $35, assuming that the stock price is higher than $35. There is risk involved, however. If Ms. Jameson decides to hold onto the options and not sell them, it would be possible for her to earn nothing. If the stocks price where to stay below $35 dollars, Ms. Jameson’s options would be worth nothing. Comparatively, the $5000 cash bonus, where it to be invested over the 5 years at the risk free rate of 6. 02%, would yield only $6697. 44. 2. If Ms. Jameson was not allowed to sell her options before the allotted 5 years, the choice to take the options would have much more inherent risk. The current value of the options is derived from their market value. This market value means nothing if Ms. Jameson cannot sell the options. If this where the case, Ms. Jameson’s potential profits would be created solely by the Telstar stock rising to a price that was greater than $35 by the end of 5 years. In fact, to equal the $6697. 44 value of the bonus she could have chosen instead, the stock would have to reach a price of at least $37. 23. This value would allow the 3000 options to be exercised for a profit of $6697. 44. This, however, is ignoring the fact that Ms. Jameson would have to pay taxes and transaction fees. If Ms. Jameson was not allowed to sell her options, she should choose the $5000 up front bonus. It represents a less risky asset. 3. Companies are often inclined to use stock options to compensate employees rather than exhausting cash flow. It does not directly cost a company anything in terms of â€Å"accounting costs. † There is, however, an implied economic cost equal to that of outside investors’ costs. The cost of a stock option is more or less a perceived cost, as the true value is not concrete and is virtually unknown at the time of issuance. This is due to the length of the option and specified strike price being of possible value at expiration date. The current value of an option is dependent on the performance of the company and its stock price, that is, in the future. Executive stock options help align an executive employee’s monetary compensation with both individual performance and the overall performance of the firm. In this sense, an executive is encouraged to act in the best interests of the firm and to also to take some risks to grow the company in which they work for and thus, increase the company’s stock prices. Stock options are an effective way to correlate performance and compensation, but mainly only for employees that are in positions that can have an affect on the company’s performance. Employees in executive, decision-making positions have the ability to impact the profitability and growth of the organization, whereas administrative assistant positions would not be as likely to improve performance due to being compensated with stock options. Companies could better individualize compensation packages for different positions. Executive positions fit the stock options benefit plan while administrative assistants may prefer stock purchasing rights rather than options. Other employees that fall somewhere in the middle would be better suited for a combination of monetary compensation, stock options and stock in the firm. In addition, stock options with a lessened length of time to the expiration date may prove to drive option-holding employees to set short-term, achievable goals. Employees would be given successive stock options to promote their care for the company without feeling as though they are being forced to stay with the organization. This set up of granting stock options would also help to encourage performance of employees to lead to both the short and long term success of the firm. . If Ms. Jameson decided that the option was a better deal, but was concerned with being too committed and reliant on the fortunes of Telstar, she could modify her compensation package to better suit her individual needs. Ms. Jameson would be taking considerable risk by keeping all of her bonus in Telstar for stock options with such a lengthy expiration date a nd also due to the historical data of Telstar showing that only stock prices reached $35 (the exercise price) only once. Instead of holding on to all 3,000 issued stock options, Ms. Jameson could keep a portion of the stock options and trade some in the market. Keeping some Telstar stock options would help keep her tied to the company without making her feel that she is bound to the company for the next five years or that she is facing enormous risk of losing her bonus altogether. By doing this, Ms. Jameson would provide herself with the opportunity to make investments outside of Telstar, and thus, better diversify her investments.

Character Analysis “I Stand Here ironing”

What society doesn't grasp is the difficulties it is to maintain this character in the struggles of balancing work, parenting, and everyday life to the underprivileged though the narrator did what she could as a parent even with facing all the difficulties and dilemma she came across. The Narrator in â€Å"l Stand Here Ironing† holds a heavy heart of guilt for her lack of involvement for her daughter and the way she turned out, but at the same time she knows she can't hold all the blame. L Stand here Ironing† opens with the narrator being asked to come in and speak about her daughter. We are never told who is asking this, but whoever is seeking Information from the narrator believed that her daughter Emily â€Å"needs alp†. The narrator expresses that Emily is the first of five children. She goes into deeply explaining Emily as â€Å"The first and only one of our five that was beautiful at birth. † (402) our narrator proceeds to tell us that Emily father le ft them therefore languid 2 old.Due to the situation at hand our narrator had to send Emily away to her father's family at a young age. The reasoning was so that she could make enough money to live a somewhat stable life and also have the proper care for her daughter as she worked. Unfortunately the proper care situation wasn't as simple as one loud think. When our narrator placed Emily in a nursery school she expresses to us how unfriendly the location was, but â€Å"It was the only way we could be together, the only way I could hold a Job. (404) Right here is one point where we can see things aren't the mothers fault. She wants to be with her daughter and the same time she has to work to provide for her so she has no choice but to take the opportunities that are available to her; even if these opportunities are not what she prefers. When our narrator goes into having her second child Susan we learn that Emily has become delirious with the fever that comes before red measles .. . â€Å"(405). Emily was home alone for the week her mother was in the hospital after giving birth to Susan.When our narrator is home again she expresses that Emily did not start to get much better she explains her as â€Å". . Skeleton thin, not wanting to eat, and night after night she had nightmares. † (405) we learn that Emily calls for her mother when she has these nightmares but from being over and to go back to bed. Finally later as she said is â€Å"too late† she begins to start languid 3 hacking on Emily she hears her cried but Emily doesn't need or I guess you could say want the affection at this point.Later we learn that a clinic talk our narrator into sending Emily away to â€Å"Convalescent home† (405). The clinic basically tell our narrator that she can't give Emily the proper care she need and by doing this she can focus on her new baby. When Emily is sent away they are unable to visit her for the first six weeks because the institute decides when they are able to. Once they start visiting we are taught that this place is not of the homiest places, Emily does not enjoy her ATA, and they kind of treat her as a prisoner.When Emily returns home she refuses food and affection from her mother. Emily over the years has had much neglecting which our narrator does understand, but at the same time she had little options, and was also instructed that being sent away was the best for her daughter. To wrap things up we can see pretty clearly that our Narrator did in fact love her daughter. Our narrator never intended to neglect Emily from the love and affection she deserved, but she didn't have many options to choose from.

Mastering Time Management Essay Example | Topics and Well Written Essays - 750 words - 1

Mastering Time Management - Essay Example How an individual allocates time for different activities depends upon his level of education and understanding of life. As a manager one must first know how to manage oneself and only then can one manage an organization or a subordinate. One has to identify what is important in life and spend more time on that. If one knows of the hectic week ahead, decisions and planning in advance helps (Green & Skinner, 2005). Prioritizing work reveals that some work could be delegated or were not really important. It can help to avoid stress that reduces efficiency. Stress also leads to high absenteeism and labor turnover, all of which can be measured in terms of money. Time management can help to avoid missing deadlines which hampers customer relations, affects the image and competitiveness of the firm. it helps to develop cognitive skills. It enables a person to be more organized, assertive, he is able to prioritize work and achieve targets. The whole environment is less stressful and results in better health conditions of the employees. In the field of nursing time was a condition that structured the planning, accomplishment and result of nurses’ work (Bowers, Lauring & Jacobson, 2000). Their main source of job dissatisfaction was too little time. Limited time makes it difficult to complete the required work and it is difficult to spend time with residents. Timing is important even in political campaigns and decisions. It can mar the campaigns if some events in the nations erupt just during that period. Timing makes or breaks the situation; timing influences the victory or loss as in the case of Rudy Giulani who faced bad news from the drug indictment of his South Carolina chairman to criticism for skipping meetings of the Iraq Study Group (MSNBC, 2007). The timing could not have been worse as the string of events came just as national polls showed him ahead of his rivals. People want to ‘manage stress’. Managing

Manifest destiny and the forcible removal of american indians Research Paper

Manifest destiny and the forcible removal of american indians - Research Paper Example The term Manifest Destiny integrated the nationalist concepts of Anglo-Saxon superiority with capitalist expansion of territory, â€Å"ideas which had deep roots in American political culture† (Nevins 2002: 17). On the other hand, Caldwell (2006) identifies the roots of manifest destiny in religion, the providentially sanctioned Christian destiny territorial conquest going back as far as the Crusades, and â€Å"a God-given right to any land occupied by non-Christian peoples† (p.84). The extensive American efforts at expansion included in addition to the Louisiana Purchase and the acquisition of the lands of the Mexican cession, internal expansion as American settlers moved westward during the California gold rush (Joy, 2003) Thesis Statement: The purpose of this paper is to investigate the concept of Manifest Destiny in 19th century American history, and its role in America’s rise from a colony to a super power. Further, the extent to which manifest destiny was r eflected in domestic policy by the country’s government will be identified. The forcible removal of American Indians, attempts to civilize them, and Americans’ seizing of Mexican land, and waging war on Mexico will be discussed. The underlying roots of European racism and imperialism fuelling manifest destiny will be examined. Manifest Destiny and Westward Expansion in America From the 14th century to as late as the 1840s, Europeans fled to the New World of America in search of religious freedom and a new life. There was westward expansion in the 19th century because the population density in the industrial towns in the east was increasing tremendously by growing numbers of Europeans who entered America at the eastern seaboard. Moreover, the gold rush in the western region particularly in California, as well as news of fertile soil and plentiful opportunities were powerful motivators to move westwards. Consequently, the Americans found it necessary to spread westward i n search of new land to cultivate, to build on, and new livelihood to undertake. This westward expansion was termed as manifest destiny by Anglos were the whites arriving in California from the eastern towns in the 19th century. Through close association and marriage allegiance with the California elite the white settlers acquired great wealth and political power (Mountjoy 2009). Notions of national superiority form a significant reason for the concept of Manifest Destiny to take shape and to promote westward expansion towards new opportunities. According to Caldwell (2006) the reasons for America’s notions of superiority include myths of the unique regenerative power of the new land of America that the Europeans made their home; from Americans’ self developed visions of being the people chosen by God to utilize the abundance of natural resources; of being given the mission to spread civilization in underdeveloped areas, and of being granted the high destiny of spreadi ng westward for achieving profit and prosperity. Americans’ sense of supremacy is also rooted in their ability to succeed as immigrants through self-sufficiency, confidence, self-reliance; their realization of the abundance of natural wealth in the land; and their view of the universality of American ideology. Expansionist Theory, Racism and Imperialism in Manifest Destiny American Indians who were the original natives of the land were marginalized and every

Symbolism or Theme of the Story of Peter Pan Research Paper

Symbolism or Theme of the Story of Peter Pan - Research Paper Example The essay hereby aims to discuss the various symbolisms used in the story: ranging from the shadow, the manifestation of illusion, the kiss, acorn, crocodile, ticking clock and childhood. There are diverse forms of symbolism in the story. There is initially the shadow – the cause of Peter Pan’s sadness in trying to catch it and to have it reunited to himself. The shadow has been known to symbolize mystery and it cannot be seen without a form of illumination. It could also be interpreted as an alter ego: something integral to oneself that could exemplify characteristics and traits that parallel exactly one’s identity; but when viewed more closely, from an illumined wall or blank space, it could reflect an exact opposite of oneself. For Peter Pan, the shadow could symbolize escaping from fantasy into reality: from a magical world at Neverland, to the real world where children grow old. As such, Peter Pan’s sadness of losing it and trying to catch it manifest s his desire to remain eternally young and to live forever in a land of adventure and magic. By Wendy’s being able to catch it and tie it to Peter Pan by sewing the shadow to him, Wendy established a strong bond of attachment which assisted in regaining Peter Pan’s embodiment of freedom, youth, vitality, and carefreeness. Another symbolism was Peter Pan’s indication that he should not be touched. It indicates that Peter Pan was elusive and seems like just an illusion to many. As emphasized by Bjornsdottir, â€Å"not being able to touch him is a confirmation that he is an idea or concept and does not really exist† (12). This symbolism was also stressed in the message that indicates adults could not see him, as cited: â€Å"In his author’s comments he writes: â€Å"You can’t see Peter if you are old. They think he is a draught at the corner† (5.2 151). The comment refers to the people in the street who are too old to see Peter as he ho vers above it at Wendy’s window† (Bjornsdottir 14). The symbol of illusion persisted throughout the story as indicative of Peter Pan’s supposed magical persona which the author could have intended to remain the ultimate mystery in the main character’s identity: fleeting, elusive, dreamlike. Furthermore, there is symbolism in the kiss that was supposedly given to Wendy. According to Linwood, â€Å"the kiss represents not only Wendy's affection for Peter and her maturity beyond his, but also her compassion towards Peter in his moment of weakness. In exchange, Peter gives her an acorn† (par. 4). The acorn again is another symbol for strength and a token of appreciation for Wendy’s assisting him in catching his shadow. As a result, it was instrumental in saving Wendy’s life when it was disclosed that â€Å"the acorn on the chain around her neck, stops the arrow which Tootles fired at her on Tinkerbell’s command† (Linwood par. 5). Through the kiss which symbolized their affection for each other, it was revealed in further stories about Wendy when she eventually became old that despite aging, she could still apparently see him as he tries to visit Wendy’s grandchildren. In another scene, there is also symbolism in the crocodile that apparently ate Hook’s arm when Peter Pan supposedly cut it off in one of their previous encounters. The crocodile symbolizes death. It was reported to be following Hook ever since his arm was eaten by this

Intelligence Research Methods Essay Example | Topics and Well Written Essays - 250 words - 1

Intelligence Research Methods - Essay Example The most in-depth paper that I had to write was a research paper on the class international relations of in the middle-east for the topic; Islam and politics. Although the terminology might not be the same, I am sure with my analytical skills; I can do great and well detailed papers as these are invaluable skill sets. Though the technology has pretty much reduced the need for analytics as there are now softwares that analyze data, these cannot be done away with as they are the ones checking the validity and fundamental worth of data. Although both scholarly and intelligent research methods might seek to determine whether data is reliable and authoritative, the scholarly researchers have not embraced the notion of going out and searching for data sources as the intelligence community does with security in mind. This is very true as in the world of a scholar; there are much analysis and data validation techniques that are applied as the skills are there but not geared towards solving security puzzles. There needs to be integration of the scholarly and intelligence community research methods and processes to shape up great data analysts. Catholic University of America, School of Library and Information Science â€Å"Library Science and Intelligence Analysis: Converging Educational Paths†. You Tube. Flash Video File. https://www.youtube.com/watch?v=wSbfUZ2bg_Y (Accessed April 9, 2014)

Standardized Testing Essay Example | Topics and Well Written Essays - 1250 words

Standardized Testing - Essay Example A non-standardized test, on the other hand, is the opposite of a standardized test. This type of testing gives notably different tests to diverse test takers, or administers the same test under extensively different conditions. For instance, a non-standardized test might occur when one group is offered far less time to tackle the test than another group. It might also occur when one group evaluates a test differently than another group for instance when the same answer is regarded right for one scholar, but incorrect for another scholar. Standardized tests are considered as being fairer when compared to non-standardized tests (Butler & Stevens, 2009). The steadiness also permits more reliable contrast of outcomes across every test taker. Standardized tests, due to their fairness, should be regarded as the best way of testing English Language Learners. This paper will, hence, seek to support the argument that standardized tests are the best way of testing English Language Learners. Wh en it comes to English Language Learners, standardized testing should be considered as the best way of assessing their understanding (Coltrane, 2009). This is due to a lot of reasons that will be explained later in this paper. It is essential to discuss the pros and cons of standardized testing in order to understand the significance of standardized testing to English Language Learners. Standardized testing holds educators, schools, as well as their ELLs, accountable. Perhaps the best benefit of standardized testing is that educators and their respective schools are responsible for training their English Language Learners what they are needed to be familiar with for these standardized tests. This is mainly because these scores turn into public record and educators, as well as their respective schools, who do not perform as expected can come under severe scrutiny. This scrutiny might lead to losing of jobs and in some situations a school might be shut or run by the state (Coltrane, 2 009). Standardized testing also allows English Language Learners or ordinary students located in different districts, schools, or even states to be compared. If it were not for standardized testing, this contrast would not be possible. Students from public schools in Texas are all needed to do standardized tests at the same time, whether an ELL or not. This implies that a learner in Amarillo may be compared to a learner in Dallas. Being capable of accurately comparing data is priceless, and this is why that the Common Core Standards for each state have been developed. These will grant a more precise comparison between every state (Flores & Trumbull, 2002). Another advantage of using standardized testing with regards to English Language Learners is that standardized testing is naturally accompanied by a set of well-known standards or instructional framework that provide educators with help for when and what needs to be taught. Without this arrangement, a third grade tutor and a sixth grade educator could be teaching a similar content to their English Language Learners (Menken, 2008). Having this curriculum also keeps ELLs who shift from one district school to another from being far ahead or behind their new institution. Standardized tests are also objective in reality (Flores & Trumbull, 2002). Classroom grades set by a tutor are at the very least simply subjective in reality. Standardized tes

Country Analysis (Libya) for international business class Essay

Country Analysis (Libya) for international business class - Essay Example In addition to the normal requirements for a contract to be valid and implementable, sharia has strict guidelines on other religious requirements for contracts. These requirements put into account all recommendations and prohibitions of the Muslim law. However, this would be appealing to investors if applied to the letter. Other factors that influence the running of businesses in Libya include but not limited to corruption and discrimination. Legal protection of property The reign of Gaddafi has not given citizens the right to own property. All property in Libya is everyone’s property in accordance to the principle of socialism. The only property that a family can own in Libya is their residential home. This was a good idea that could have worked if used legitimately instead of the way Gadhafi, his family and circle of friends used public property for personal gain (Heritage 2010). Even after change of regime, Gaddafi still wields power as the de facto leader of the oil rich N orth African nation. The transition government that has taken over leadership of Libya after Gadhafi’s ouster has a great deal to do to put in place mechanisms for an independent legal system. In addition, it has to deal with the ills of the Gadhafi regime that have wrecked the governance system. In addition, the constitution must be changed to allow profitable property ownership as the power to privatize or nationalize property still freely solely with the government (Dep. of State, 2010). There has been no move in the right direction to change the laws on intellectual property rights since the government abolished them in 1978. The Libyan government has signed treaties on intellectual property rights but the implementation of the contents in Libya is wanting. Libya ranked 113 out of 125 countries in the 2010 Intellectual Property Rights Index, having one of the most widespread trademark violations in the world (Heritage 2010). Country’s trade policy There is no levy for goods produced in Libya but all imports attract a 4% service tax. This attempt to make local goods more affordable fails majorly because of other factors that increase the cost of trade and the cost of final products. Some of these factors include government interference like price controls, practices in oil products trade, bans and restrictions, subsidies, competition from state owned corporations, sanctions and arbitrary and other unexplained charges. Corruption plays a major role in order for private organizations to obtain trade licenses and to secure contracts and tenders. Since 2007 to 2009, inflation was moderated at 4.9% by the central government mostly by price controls through state-owned firms and via government utilities (Heritage 2010). Country’s laws regarding ownership (FDI) In most cases, foreign companies do not own land in Libya. This means that if one considers investing in Libya they have to put into account the cost of rent that is determined by the g overnment and whose amount might be unfair for the investor. This is however expected to change if the Libyan transitional government delivers a new, more democratic constitution. The worst part for foreign companies comes in when their ownership is considered. 35% of stake in foreign companies is reserved for natives. Even though legislation was passed in 2005 that allows foreign banks to operate in Libya, the high cost of credit, competition with state-owned banks and unavailability of funding are the major obstacles to investing in the

Issues of Equality and Diversity Essay Example for Free

Issues of Equality and Diversity Essay Equality is about learners’ rights to attend and participate, regardless of their gender, race, ethnic origin, religion, disability, sexual orientation and age. Therefore it is extremely important to identify any barriers to learning that may arise. To promote inclusion, at the point of initial assessment, the learner needs to disclose any disabilities that may make it difficult for them to access the course. Once these needs have been identified, the teacher needs to consider effective strategies or identify appropriate resources which would support the student, for example, a visually impaired student may need worksheets written in Braille, a hearing impaired student may need the use of a hearing loop. The teacher too must ensure that their own attitudes and beliefs do not discriminate in any way and so understand, as Gavells states,P18 â€Å"All learners are entitled to be treated with respect and dignity. Everyone is an individual, with different experiences, abilities and needs. As a teacher, you need to take this into account when teaching and ensure you give equal support to all your learners without favouritism.† The teacher needs to establish good rapport and equal opportunities by showing respect. Diversity is about valuing the differences in people. To ensure that all different students feel secure in their learning environment, it is important that at the start of the course the teacher establishes ground rules which explicitly state that all students will respect the points of view of others thus ensuring all students are valued. The teacher also needs to enforce these rules consistently. Inclusion may also be promoted by an understanding of different learning styles –visual, aural and kinaesthetic (Fleming 1987). The teacher may identify that different students prefer to learn in a particular way, for example a kinaesthetic learner likes physical activities but may not like reading, therefore the teacher can personalise the teaching to incorporate more physical activities to ensure that the learner is fully engaged and included in the lessons. This may need the teacher to adapt activities within the Scheme of Work to ensure that a range of activities meet the learning styles within the group of students. Geoff Petty P.560 lists further strategies which can promote inclusive learning which include motivating individual students with tasks they value, using inclusive questioning methods such as assertive questioning, ensuring feedback is constructive and set challenging tasks. Finally, all learners are individuals and for effective inclusion the teacher needs to listen to his students and reflect on their experiences. At the end of the course the students may complete evaluation sheets and these will allow the teacher to reflect on the learners experiences and identify strengths of the course and areas which need to be modified to improve the learning for future students. Bibliography Petty, G.(2009) Teaching Today 4th Edition Nelson Thornes Gravells,A. (2008) Preparing to Teach in the Lifelong Learning Sector 3rd Edition Learning matters

The Scope Of Materials Management Construction Essay

The Scope Of Materials Management Construction Essay Site material management is a scientific technique. Materials Management is the process of planning, implementation and control of field and office activities in construction. The materials management goal is to ensure that building materials in their perspective when you need to.Materials management system attempts to ensure that the correct quality and quantity of material is appropriate, purchase, delivery and on-site processing in a timely manner and at a reasonable cost.Materials management system attempts to ensure that the correct quality and quantity of material is appropriate select , purchase, delivery and on-site processing in a timely manner and at a reasonable cost.So Materials management is an important element of project management. The material shows a major cost in the construction, thus reducing procurement costs to improve the opportunity to reduce the cost of the entire project. Construction projects, building materials fees accounted for 60 to 70% of the project cost. A reasonably organized planning, supply and use of building materials, construction materials from the production companies enter a construction according to the variety, quantity, quality, duration, reducing the transfer of part ofprevent the backlog of waste, shorten the construction period, accelerate the construction speed, reduce the cost of the project is important. 2.1 Scope of Materials Management It was referring to the various functions of materials management of the materials management coordination of various departments of manufacturing enterprises. Once the material procurement and brought by the organization, its value continues to increase other costs of materials required for the sorting, carrying materials in inventory, maintenance and management costs must be allocated to the cost of materials before entering into a product or converted to other form. In order to save the cost of all the materials management company has taken a clear method to determine the amount of material is ordered, the number is stored as inventory and in-process inventory. In order to reduce the cost of materials and other costs, there must be effective and efficient management of materials technology, it must be dynamically adjusted with changes in demand and production. Materials management efforts to ensure that the material cost component of the total product cost is the least. To achieve this goal, the control is in the exercise of the following fields. 1. Materials Planning. 2. Purchasing. 3. Store Keeping. 4. Inventory Control. 5. Receiving, Inspection and Despatching. 6. Value Analysis, Standardization and Variety Reduction. 7. Materials Handling Traffic. 8. Disposal of Scrap and Surplus, Material Preservation. The function of the planning department of the material for future plans to purchase the required materials according to the production plan. In materials planning, budget allocation will also be critical to the materials research progress, for better control. Materials planning, procurement must be done. Purchasing department to purchase materials based on purchase requisitions from user departments and store departments and production plan for the year. There are four basic procurement activities. a) Selecting suppliers, negotiating, and the issue of the purchase order. b) to hasten the delivery of the goods from the supplier. c) as a liaison between the suppliers and other companies. d) looking for new products, materials, and suppliers can help company objectivity. At the time of purchase, the right quantity and quality of the materials must be purchased on time, the lowest price and choose effective procurement system, and draw maximum benefits. The procurement is based on the make or buy decision, and also using PERT / CPM effectively. When the project is the purchase of goods, must provide adequate storage facilities, so the waste is minimized. Sometimes, to be doubly careful in order to protect the quality during storage. Of these tariffs inventory control department to decide on the type of sorting system, to solve the safety stock limit fixing up the reorder levels and maximum / minimum inventory levels. Responsible for receiving, inspection and shipping department receives material suppliers delivered. In receipt of it, the quantity and quality must be checked. Production of parts and materials specification blueprints and inspection. Non-production items were reviewed. Once it is given according to the specification, the goods will be accepted. Value analysis and standardized to provide maximum range, reducing the cost of materials. It also reduces the range of varieties, but also to help find alternatives to lower-cost materials. Material handling part responsible for the transport of materials in different departments. There are four basic transport activities. Choose the ordinary or chartered carriers and routings to send / shipment requirements Tracing in-bound shipments of material in short supply as requested by production control or purchasing, To assist customers in tracking outbound shipments when asked. audit invoices refund excess charges from operators and application needed for damaged shipments. Development of technology to reduce transportation costs. This may include negotiating with competition the shipper, special study, the position of the dominant plants of the latest products, analysis of the tariff, and negotiations of any number of special arrangements to deal with specific traffic. activities including trading of finished packaging, labeling, and loading the final product. Finally, the processing of waste and surplus must be done to release the capital locked in those projects on a regular basis. 2.2 Objectives and Functions of Materials Management Primary objectives Which can be classified as: (i) Efficient materials planning (ii) Buying or Purchasing (iii) Procuring and receiving (iv) Storing and inventory control (v) Supply and distribution of materials (vi) Quality assurance Secondary objectives there can be several secondary objectives of materials management. Some of them are given below: (i) Efficient production scheduling (ii) To take make or buy decisions (iii) Prepare specifications and standization of materials (iv) To assist in product design and development (v) Forecasting demand and quantity of materials requirements (vi) Quality control of materials purchased (vii) Material handling (viii) Use of value analysis and value engineering (ix) Developing skills of workers in materials management (x) Smooth flow of materials in and out of the organization Achieve all these goals, it is necessary to establish harmony and good coordination between all employees of the materials management department. 2.3 Components of material management 2.3.1 Material supply and management Through market research, and look for the qualified materials The scope of inspections, investigations should first production and management vendors. One is the audit inspection material production and operation of the main body of all kinds of production and operation procedure is a complete range; The second is on-the-spot investigation enterprise production scale, management concept, sales and after-sales service, etc; The third is mainly studies the enterprise of quality control system, whether it has national and industry product quality authentication, material quality in the similar products is to belong to the general, intermediate or high-grade, etc. Another study visits range is building industry. Through the understanding of the building industry, information obtained a more accurate, more careful, more comprehensive. Generally speaking, really good quality materials will get architectural recognition, inferior quality of materials will be people spit on. By understanding building industry, can be more accurately master the material manufacturer enterprise reputation, product quality, price condition, the post-sale service, etc. The material the approach test Acceptance warehousing must ask the supplier of building materials security record to prove. The material inspection units must have the appropriate testing facilities and capabilities. Materials management in the construction process The central task is to check the use of the materials management process to ensure the quality of the material entering the construction safekeeping of materials approach, strict, reasonable use of a variety of materials, reduce consumption, to ensure the realization of the management objectives. 2.3.2The price of materials management 1. Control of the market, reduce the price of materials Control of the market, the market price is the extensive collection of materials. Material price information-gathering process, price information collection is in the building materials market, the material origin, the course of the investigation. The acquisition price information must be appropriate to the actual situation of the market to reflect the general level of prices of materials. Investigation and collection of price information for engineering materials, covers a wide range, heavy workload, is a complex information system. 2.Make full use of the market, reasonable arrangements for transportation Freight expenditures are important factors that constitute material procurement costs, save on shipping costs, reduce material procurement costs. Therefore, to consider the following aspects should consider the problems of the transport distance transportation cost savings: material when ordering. In the case of material quality, performance can meet the material procurement program, and almost equal to the price of materials, it should go to the nearest location away from the construction site procurement; material as a transport in place, to reduce secondary unlucky and handling costs. Take reasonable mode of procurement Doing so supply, storage, integration, reducing both parties arguing back and forth; owner can reduce material prices, reduce the project cost; course reasonable supply mode according to specific circumstances. 2.3.3 Material storage issue management Specifically the Treasury, proper storage. Identified clearly, classified storage In addition to the release of the material, whether by the Ministry branch or the issuance of project department warehouse supplies, should implement the principle of first-in, first-out project materials consumed should be read in conjunction with the segment and sub-project accounting, strict implementation of quota / fixed picking system must be opened by the project construction personnel before construction sign limits pick lists limit pick lists must fill part requirements essential items. Valuables and a larger amount of items, multiple payment based on usage, with picking small ticket points. Easily damaged goods, the material need for more detailed experience exchange members issued by the recipients of the two sides to sign off on the certificate. Material need generated from site Material ordered in the store Indents is generated Check availability in the store Check for the balance items Vendor selection from the approved list of vendors from the client Material inspection from the received stock Rejection of the unacceptable stock Issue of material to the concerned department Fig.1 process of material management Sources: National Conference on Recent Trends in Engineering Technology 2.4 Benefit of Materials Management Materials management to create a niche in many organizations, which have achieved a comprehensive materials management. These organizations often enjoy the following advantages: The better accountability part of the material, as well as other departments and no one can blame others. As materials management by a single authority, which can lead to better coordination, because it became the central point of any substance-related problems. Materials management departments to ensure a better quality materials provide a request in a timely fashion department. This can lead to a better performance of the organization. A materials management system is usually controlled through a system, therefore, can help decision-making related to the material in the organization. An indirect use of materials management is the development of good quality material, ethical and moral standards in an organization. Comment and evaluate the existing site layout relation to the positioning of the material on the construction site and identify possibles Construction site materials should be placed according to the requirements of safe and civilized construction program to be trimmed and decorated. Temporary construction water, electricity, roads, completed construction requirements of the standard. For field use reasonable construction plane layout should be structured to minimize occupied by construction land, the layout is compact and reasonable, and at the same time do field capacity neat and clean, the roads are wider, in line with the requirements of fire safety and civilized construction. The construction process to avoid multiple trades in the same venue, the same area for construction and mutual restraint, mutual interference. à ¢- ª Keep work areas free from rubbish and obstructions à ¢- ª Maintain all floor surfaces safe, suitable and free from slip or trip hazards à ¢- ª Ensure floor openings covered or otherwise fenced off à ¢- ªMaterials are properly stacked and stored safely Keep all passageways in good conditions à ¢- ª Unobstructed and clearly defined à ¢- ª Provide adequate lighting à ¢- ª Ensure clear sightline at breaks and corners Stacking of all materials: à ¢- ª Ensure the proper heights and correct stacking à ¢- ª Allow sufficient space for moving stock à ¢- ª Store materials in racks/bins à ¢- ª Keep shelves free of rubbish à ¢- ª Keep floors around stacks and racks clear à ¢- ª Check drums and ensure pallets in good repair à ¢- ª Heavier items stored low and without danger of falling objects à ¢- ª Avoid sharp edges and provide safe means of accessing high shelves Site manager may face the following problems: Construction site temporary building (office) located in work area and near the waste materials faced with many unsafe factors and noise pollution. The area of construction waste, stored waste can not be transported out of the site.such as all solvent waste, oily rags, and flammable liquids,Scrap wood or chips, saw dust waste, and paper bags or cartons. If you accidentally cause a fire, then there will be heavy casualties. Most construction workers are exposed to excessive construction noise. One can get tinnitus, a ringing sound in the ears, or a temporary loss of hearing. Exposure to longer period can cause tiredness and nervousness. Concrete batching plant away from the material stores. It should be set in a near vertical transport machinery, as much as possible to reduce the concrete, mortar horizontal transport distance. Reduce transportation costs and save time. Store setting Concrete store should choose the higher ground, drainage, close to the batching plant. Inflammable and explosive materials shall not be mixed with other material. Inflammable and explosive materials warehouse layout should comply with the fire and explosion safety distance requirements. Proposed new site layout to improve the existing site layout mess hall temporary building (office) Workers Dormitory toilet Water Supply Site Entrance Double storey terrace Semi-detached houses Power supply Site exit Timber store Reinforcement Steel store Scaffold store Cement store Concrete batching plant Material store Waste material Suggestion/recommendation that will give strong impact on the material management process in the future based on the case study Responsibilities: Provide guidance, interpretation and direction to Major Projects staff regarding the Major Projects Procurement material standards and procedures. Assist in Procurement orientations and on-boarding of Major Projects staff. Review and provide improvement recommendations for Project Procurement Strategies and Plans. Lead the development, implementation and management of policies, procedures and templates supporting the continuous improvement of material management within Major Projects. Collaborate with Business Unit Procurement, Project Controls, Accounting, Construction, Engineering and Project Execution personnel to accurately understand capabilities in terms of systems and processes. Outline material management procedures through the development of process flow maps. Prepare draft and final assessment reports of material management findings. First, the general requirements 1. Stacking of construction material should be based on the amount of size, duration, supply and transportation determine dosage, use a long time, supply transportation is convenient, it should be phased in. approach to reduce the yard and warehouse space; 2. Construction site of a variety of tools, components, materials piling must be placed in accordance with the provisions of the position of the planar four Figure; 3. Position should select appropriate, easy to transport and handling, minimize secondary transportation; 4. Higher ground, solid, flat, backfill compaction in layers, have drainage measures to comply with the requirements of safety, fire; 5. Should be stacked according to the varieties, specifications, and set up the obvious signs to indicate the name, specification and origin; 6. Various material items must be stacked neatly.   Second, the main material semi stacked 1. Large tools, should one side alignment put; 2. Reinforced should be neatly stacked, square wooden paving should not be placed in a wet and exposed to rain shower; 3. Brick should be small code into the stack, are not allowed to ultra-high from trench not less than 0.5m, to prevent collapse; 4. The sand piled cube, stones should be different diameter sizes are stacked into a cube; 5. Various templates should be stacked neatly classified according to specifications, the ground should be flat solid, stack height generally should not be the ultra-high 1.6m; the large template stored specifically designed to save shelf should be placed two large template should be used for face-to-face storage when stored floor construction, shall meet the homeostatic angle and reliable anti-dumping measures; 6. Concrete component stacking space should be solid, smooth, specifications, models stacked skids position to be correct, to be up and down to align the the multilayer components of skids, the pile position are not allowed to ultra-high; the concrete blocking plate should be established insertion of frame interpolation put frame to be welded or lashing firmly to prevent collapse. Conclusion Construction site materials management is one of the important link. To strengthen the management of the site layout, according to the different construction stages, materials and supplies changes, design changes, and adjust the position of the stockyard site in a timely manner, and keep the roads open, reducing the second out of luck. Strict accordance with the arrangement of stacked material with a flat-screen piles into the line, always clean up debris and garbage, and maintain the site, roads, tools and containers clean. The construction site must be carried out by the allied materials on-site materials management, material must pass the examination certificates; member of the staff of the material running configuration to enable the production and management of working prevail. Materials management for the enterprise has an extremely important significance.In a certain period of time, material resources and funds are always wired, good materials science management can promote cost reduction.Which time the minimum material consumption, to the maximum economic benefits.

Comparing Two Poems about Prejudice Essay -- Wole Soyinka U.A. Fanthor

Comparing Two Poems about Prejudice The poems "Telephone Conversation", by Wole Soyinka and "You Will Be Hearing From Us Shortly", by U A Fanthorpe are both about prejudice. The former poem is to do with racial prejudice and the latter is to do with social prejudice. The two poems are different in many ways. The first poem is an application for accommodation and the second poem is a job interview. Soyinka's poem is a Dialogue within a monologue where as Fanthorpe's poem is just a monologue. Also the tones are different the former poem has a shocking tone to start with but a mocking tone towards the end, while the other poem is extremely rude. The characters in the former poem are a white landlady and a black man and the characters in the latter poem are an interviewer and a possible interviewee the genders are unknown which helps highlight the fact that this can happen to anyone. The language in both poems is easy to understand neither have many difficult words and only Soyinka's poem uses metaphors and similes. The poems use questions for emphasis as well as for ...

Impacts Upon Skinclads Business in the Next Five Years Essay -- Busin

Impacts Upon Skinclad's Business in the Next Five Years In order to analyse the operating environment of Skinclad, an audit of the performance of the organisation was executed. This took the form of an environmental scan which assessed the internal and external environment of the company. The findings of this scan will provide an understanding and appreciation of the many factors impacting directly or indirectly upon the company’s operations. The report explores the macro and micro environmental factors which are likely to impact upon Skinclad’s business over the next five years, reviews the internal factors, existing marketing mix and highlights possible problems areas. The Swot analysis lists the main strength of the business, its weakness and likely threats and opportunities the company may face in the future. Finally, the report identifies recommendations and possible options for improving production and the financial viability of Skinclad. MACRO ENVIRONMENTAL FACTORS PEST ANALYSIS A1 A PEST analysis is an environmental scan of the macro economic factors impacting on the operations of an organisation. It analyses the following factors and its relation to the UK Textile industry: * Political * Economical * Social * Technological The relevance of this analysis is significant in gauging world trends and its consequent role in influencing social, cultural, technological, demographical and economical factors. The analysis notes with interest the current state of the UK Textile industry which has experienced a slump since the late 1990 (Figure 1). The figure shows that total output had declined significantly over the period and production has collapsed by 30%. This may be attributed to the effect of globalisation and a shift to importing clothing from cheaper Asian markets such as Philippines, Indonesia and Bangladesh. Many local manufacturers were affected by this move. A case in point was Marks and Spencer who were committed to local producers until the early 2000 when they were forced to source garments from cheaper suppliers outside of the UK to compete with the influx of European retailers. The establishment of the European Union and institution of the Euro dollar has further exacerbated the situation for local producers as a strong UK currency ( £) has made exports more costly to other regions in the Eur... ...shion Shared Values Ø This is not applicable to the case Sustainable Competitive Advantage Ø Has been in existence for over twenty two year Ø Developed an establish network that includes, suppliers, retailers Appendix 4 ========== 8 P’s Product * Jackets and full-length coats in twenty different styles Place * Old dilapidated building in the old textile industry main district Price * Basic assumption that product is high priced since product is high quality Promotion ========= * This information was not provided in the case. However, the need for promotion may be limited as there is a direct link to a retailer who purchase the majority of the product Profit * Profit has been eroded over the years with a net value of  £1 on certain product Physical * Old rented premises in what used to be the hub of the UK textile industry Process * This information was not available from the case People - Not accessible from case Appendix 5 ---------- Ansoff Matrix existing products new products Existing Markets Market Penetration Product Development New Markets Market Development Diversification

The African Queen Essay -- essays research papers

THE AFRICAN QUEEN Short Summary: "The African Queen" is the tale of two companions with different personalities who develop an untrustworthy love affair as they travel together downriver in Africa around the start of World War I. They struggle against the climate, the river, the bugs, the Germans and, most of all, against each other. In the course of much misery, they develop love and respect for each other. Detailed Summary: In September 1914, the German occupying forces hold East Africa. The story starts in a small village that is overlorded by a stuffy British missionary, Reverent Samuel Sayer and his spinster, prudish sister Rose Sayer, who is utterly devoted to her brother. Rose is also very naive and pious. She thinks, God would not permit a war between England and Germany or the whole world.. Some day, German troops marches into that village. Merciless, without any warning, these troops invade the village, they burn down the huts and the church. Livestock, poultry, pots and pans and foodstuffs even the portable chapel had been taken by the German soldiers. Only the mission bungalow was spared. Samuel goes on praying the awful calamity of war which has descended upon the world would soon pass away, so that slaughter and destruction would cease and that when they had regained their sanity men would turn from war to universal peace. Because of this war they were cut off from all communications and the rest of the world. Samuel thinks the Germans responsible for the outbreak of the war and all the sufferings. Rose is helpless as her brother suffers a nervous breakdown. He realises that his life's work has been destroyed and instantly loses his mind. He dies very soon after that, while Rose weeps at his bedside. One day later the sharp sound of a steamboat whistle could be heard in the village. A gin-drinking, cigar-smoking man, called Charlie Allnutt, arrives. He is the owner of this old, 30-foot ramshackle steamer named "The African Queen". He supplies the village with mails and news. Charlie offers Rose both to rescue her and escape from here and bury her brother's corpse. They have to use the old, ramshackle African Queen, since he has blasting gelatine, cylinders of oxygen and hydrogen as new cargo. They have a dangerous and difficult escape route: They have to pass the large Central Africa lake at the end of the dang... ...erested in. Actually he is married, but this was a long time ago and so he don't care about it. But he is also an realist and he thinks about his actions. The marriage with Rose is not only a love-marriage, he realises that he has no job no money and no future without Rose.   Cecile Scott Forester - curriculum vitae - C.S. Forester was born in Cairo in 1899. His father was stationed there as a government official. He studied medicine at Guy's Hospital but he left Gey's without getting doctor's degree. From that moment he began to start he writing career. His first important success was the novel "Payment Deferred". In 1932 Forester was offered a Hollywood contract. Until 1939 he spent a lot of time in America. During the war he entered the Ministry of Information and later he went to the Royal Navy to collect materials for his book "The Ship". Then he made a voyage to the Bering Sea to gather material for a similar book on the United States Navy. During this trip he was stricken with Arteriosclerosis, a disease with left him crippled. But he continued to write and created his book "Captain Hornblower". He died in 1966. The African Queen Essay -- essays research papers THE AFRICAN QUEEN Short Summary: "The African Queen" is the tale of two companions with different personalities who develop an untrustworthy love affair as they travel together downriver in Africa around the start of World War I. They struggle against the climate, the river, the bugs, the Germans and, most of all, against each other. In the course of much misery, they develop love and respect for each other. Detailed Summary: In September 1914, the German occupying forces hold East Africa. The story starts in a small village that is overlorded by a stuffy British missionary, Reverent Samuel Sayer and his spinster, prudish sister Rose Sayer, who is utterly devoted to her brother. Rose is also very naive and pious. She thinks, God would not permit a war between England and Germany or the whole world.. Some day, German troops marches into that village. Merciless, without any warning, these troops invade the village, they burn down the huts and the church. Livestock, poultry, pots and pans and foodstuffs even the portable chapel had been taken by the German soldiers. Only the mission bungalow was spared. Samuel goes on praying the awful calamity of war which has descended upon the world would soon pass away, so that slaughter and destruction would cease and that when they had regained their sanity men would turn from war to universal peace. Because of this war they were cut off from all communications and the rest of the world. Samuel thinks the Germans responsible for the outbreak of the war and all the sufferings. Rose is helpless as her brother suffers a nervous breakdown. He realises that his life's work has been destroyed and instantly loses his mind. He dies very soon after that, while Rose weeps at his bedside. One day later the sharp sound of a steamboat whistle could be heard in the village. A gin-drinking, cigar-smoking man, called Charlie Allnutt, arrives. He is the owner of this old, 30-foot ramshackle steamer named "The African Queen". He supplies the village with mails and news. Charlie offers Rose both to rescue her and escape from here and bury her brother's corpse. They have to use the old, ramshackle African Queen, since he has blasting gelatine, cylinders of oxygen and hydrogen as new cargo. They have a dangerous and difficult escape route: They have to pass the large Central Africa lake at the end of the dang... ...erested in. Actually he is married, but this was a long time ago and so he don't care about it. But he is also an realist and he thinks about his actions. The marriage with Rose is not only a love-marriage, he realises that he has no job no money and no future without Rose.   Cecile Scott Forester - curriculum vitae - C.S. Forester was born in Cairo in 1899. His father was stationed there as a government official. He studied medicine at Guy's Hospital but he left Gey's without getting doctor's degree. From that moment he began to start he writing career. His first important success was the novel "Payment Deferred". In 1932 Forester was offered a Hollywood contract. Until 1939 he spent a lot of time in America. During the war he entered the Ministry of Information and later he went to the Royal Navy to collect materials for his book "The Ship". Then he made a voyage to the Bering Sea to gather material for a similar book on the United States Navy. During this trip he was stricken with Arteriosclerosis, a disease with left him crippled. But he continued to write and created his book "Captain Hornblower". He died in 1966.

Tim Horton’s Website Analysis

On October 25, 2010, I examined the website of Tim Hortons Company. I did this as part of my assignment for Business Communication course in University of Toronto Scarborough. The assignment requires students to compose a website analysis report of a business. And I chose Tim Hortons because it has always been one of my favorite coffee shops. This report describes the strengths and weaknesses of Tim Hortons’ website. And at the end of the report, you will find my personal recommendations on the points that could be improved. The report’s purpose is to help Tim Hortons establish a more customer-friendly website. I will explain more on the word â€Å"customer-friendly† through the following parts of the report. Strengths of the Website I am quite impressed by the design of Tim Hortons’ website. By simply looking at the theme colors when I first entered in, I am able to recognize the brand. These brown and red colors are what we commonly see in a local Tim Hortons store. The use of the colors makes the store and website an integral whole. Another thing that attracts me is the flashing banner. Those well-designed advertisement videos give customers a quick view of what is new at the store. They also lead to a better trade promotion. I compared the webpage of Tim Hortons with Starbucks and Second Cup’s. And I discovered that Tim Hortons has some competitive advantages over the other two famous coffee shops. Here are four most prominent ones: * An Offer of Healthier Products Options. Many customers today are not in favor of eating traditional donuts that contained large amount of fat and sugar. In order not to lose those customers, more healthier food options are offered on the website. In the online menu, customers can find one category named â€Å"Healthier Options†. By applying those options, customers may add milk instead of cream to their coffee. They may also choose bagels that are high in fiber instead of donuts. People who enjoy a healthy lifestyle will find Tim Hortons’ products appealing to them. Moreover, for customers’ convenience, there is a link to the â€Å"Nutrition Calculator† beside each category of food. By clicking the link, customers can quickly obtain further information on the products. * Clear Classification of the Products. The catalog appeared in the menu helps to arrange all productions into detailed classes. The arrangement makes the menu more organized and clearer to look at. Customers who want to look for a certain type of products will quickly find their targets. This is a demonstration of â€Å"customer-friendly† webpage. * The Idea of Weather Forecast. On the front page of the website, I discovered a window shown the weather forecast and the best product option to choose under this weather. I found this idea very attractive. The weather forecast transfers a message that Tim Hortons is very concerned about it’s customers. It deserves a brand loyalty. Besides, customers who are aware of this information may come to the website everyday to check the weather. This will result in a higher click rate to the website and more exposure to the advertisements. * Online Shopping Option. A link to the online shopping website is attached to the front page. Not only can customers find cans of grind coffee there, but they can also find gift baskets and other accessories available. This online shopping option will contribute to a larger sale of Tim Hortons coffee. Weaknesses of the Website On the other hand, I discovered some weaknesses of Tim Hortons’ website after compared with other coffee shops’. Speaking critically, there are certain places that could be made better. To demonstrate my findings, I listed four problems below: * Catalog is Not Clearly Indentified. Most customers come to Tim Hortons website to search for information on coffee and baked goods. However, the catalog shown on top of the front page does not include these two items. It takes some time for customers to find their desired information. Besides, all the menus and nutrition information are under the category of â€Å"In Our Store †. I personally think this title is inappropriate. Because â€Å"In Our Store† can mislead people to think about locations, staffs and other unrelated information. * Nutrition calculator is difficult to use. The idea of making a calculator to track calories is very creative. However, the calculator did not function well when I was using it, especially on a Mac computer. The button for â€Å"Detailed Information† is often hidden behind the product category list. This makes the button difficult to click on. Fonts are Too Small to Read. Except for the headlines, the font sizes for most of the written materials are too small. This will result in unwillingness for customers to go further reading. Though the storyboard tells a thrilling adventure, customers may have no interest to look at. * No Sounds for the Banner. Research shows that people’s retention becomes stronger when they can be provided with both visual images and sounds. Having a banner is absolutely a good promotion choice, but without any audio inputs, the advertisements are a bit lack of excitement and harder for customers to remember. Conclusions A website can be said to be â€Å"customer-friendly† if it is able to offer the most to its customers. For the design, the website should be attractive and fun to look at. And for the function, the company ought to focus on an idea of clarity, convenience and simplicity. Compared with the webpage of other famous coffee shops, Tim Hortons is good at making convenience accesses for its customers and delivering sales messages. This is demonstrated by its strengths of clear classification, option of online shopping and an offer of eather forecast and healthier options. Nevertheless, Tim Hortons is a bit weak at providing clear information. Because some titles of the catalog fail to transfer definite information and the fonts of the words are too small to read. Things can be improved also include the nutrition calculator and the sounds of the banner. Recommendations Competition between coffeehouses is quite fierce these days. Though Tim Hortons are most well known in Canada. It does not have such popularity in other countries, even in the United States. One of the accesses for people to gather information of Tim Hortons is through the Internet. Therefore, it is of top primarity for Tim Hortons to establish a more customer-friendly website. Here I provide four recommendations that will contribute to its success: * Change the Titles of the Catalog Categories. Make Category titles clearer to indentify. For example, name â€Å"Coffee† or â€Å"Menu† instead of â€Å"In Our Store†. Also, put the items customers most interested to prominent places. For example, modify the â€Å"Menu† button as the first icon appeared in the catalog at the front page. Improve the Nutrition calculator. If the technical problems cannot be solved, simply add a list of nutrition information containing all products to the website. It is also a good idea to provide a search engine for that information. * Make the Fonts Larger. Make the size of the fonts larger so that customers can easily read the information they are looking for. * Make Banner’s Alive. Deliver music commercials. Add more fun and excitement to the website. This will catch customers’ attention and result in a higher click rate of the website.

Project Guidelines

APPENDIX A: FILM REVIEW PROJECT GUIDELINES (General) I. Select an Appropriate Topic A. Relevant and Appropriate: Check the following websites for ideas: 1. http://www. sampsoncc. edu/staff/pwolf 2. http://www. apa. org/monitor B. Be Specific: Narrow general topics down! C. Researchable: Search http://www. nclive. org for â€Å"hits† II. Title page A. Title of Project B. Date C. Student’s Name D. Course Number E. Abstract (1-paragraph summary) III. Text or Body A. Five (5) Full Pages, typed (double-spaced, 12 point Times New Roman Font) B. APA Text Note Documentation Required! (Get help on my website! C. Review the Film: Informatively describe the disorder/issue â€Å"raised† in the film. D. Apply appropriate Psychological 1. Theories (Psychodynamic, Behavioral, etc. ) 2. Studies (case/experimental/correlational, etc. ) IV. Bibliography A. MINIMUM 5References 1. May use an encyclopedia a. Use only a specialized encyclopedia (i. e. psychiatry, psychology, etc. ) b. Avoid general ones (i. e. Wikipedia, World Book, Britannica, etc. ) 2. May use a textbook a. Abnormal Psychology b. Psychiatric Nursing 3. USE at least two or three of the following: a.Magazine, journal and/or newspaper articles b. Interviews c. Valid Internet sources, i. e. http://www. nclive. org http://www. ask. com B. List Sources in Alphabetical Order, by author’s last name (APA Style) C. Include Complete Bibliographic Information SPECIAL NOTES: . * Late projects will be subject to a 10 point per day penalty! * Late projects must be HAND DELIVERED to Mr. Wolf in his office, by the student. *Search for APA Text Note and Reference Page examples on my website: http://www. sampsoncc. edu/staff/wolf *Additional assistance available through SCC Student Support Services (Turoring)Appendix B: Detailed Project Guidelines: Abnormal Psychology Film Review [pic] In addition to their sheer entertainment value, popular movies often depict psychological disorders. There is certainly n o shortage of â€Å"Abnormal Psychology movies† available for viewing; however, many provide inaccurate portrayals of psychological behaviors, traits and disorders. This often leads to the public at large having a distorted view of what Psychopathology is or how Clinical Psychologists work. Remember from General Psychology, a major part of becoming a â€Å"critical thinker† is becoming a critical consumer of popular information.Your mission in this assignment is to choose a film with an abnormal psychological theme or issue, research the theme or issue portrayed in the film, and then carefully analyze how well or accurately you believe the movie presented the theme to the viewing audience. Instructions: 1. Choose a movie from the attached list. I have indicated which are available from the SCC Library. The remainder may be rented from Netflix, a local video store or perhaps borrowed from a friend or family member. 2. View the movie at least once). Even if you have seen the movie previously, watch it again. You will need to pay very close attention to hat is being portrayed and you should probably take some notes. They will come in handy later, as you write your paper. 3. Write a reaction/research paper using the following guidelines: a. In an opening paragraph (or two), summarize the plot of the movie. Remember, this is a summation; I don’t need a description of every scene. b. Find three to five internet articles that deal with the specific type of psychological disorder/issue portrayed in the movie (Obsessive-Compulsive Disorder, Aversive Therapy, Insanity Defense, etc. ) and then write at least three pages on what you have learned from your internet research.You may also use your textbook as one of your sources, if you wish. Make sure to cite your sources in APA style, in the body of your paper and on your reference page. (See my website for examples) c. In the final portion of your paper, you will analyze (based upon your www. nclive. org internet research) how well you think the movie portrayed its abnormal psychological theme. You will do this by addressing the following questions: How did the depiction of __________ in the film compare to what you learned in doing your research? Do you believe the film to be of educational value to the general public regarding its psychological content?Was the subject matter treated in a humorous manner? If so, do you think this took away from the seriousness of the psychological disorder being depicted in the film (or did it help by making a serious point without â€Å"blowing the audience away†)? Which specific scenes (if any) in the film provided particular insight into the psychological disorder/issue being portrayed? Did you learn anything of value from viewing the film? (If so, what? ) Was the film entertaining to watch? Would you recommend the film to others? Why or why not? 4. Papers will be submitted, in class, on the assigned date.There will be a ten-point per day late penalty for papers turned in after that date. Papers are to be submitted in a two pocket report folder. In the left side pocket, place the internet articles used in your research. In the right side pocket, place your paper, which will include a title page, abstract page, text or body of report (5p), and reference page. 5. Papers should be word-processed in MS Word, double-spaced, using a 12-point Times New Roman font and should be at least eight (8) total pages in length if the directions, indicated above, are followed completely.The first section (see 3-a above) and last section (see 3-c above) of your paper will be your own words/opinion and will require no reference citations. HOWEVER, YOU WILL NEED TO CITE YOUR REFERENCES, APA STYLE, IN THE THREE PAGES OF RESEARCH (see 3-b above) WRITTEN FROM YOUR INTERNET SOURCES. NOT DOING SO WILL BE CONSIDERED PLAGIARISM AND WILL SUBSTANTIALLY REDUCE YOUR PAPER’S GRADE!! 6. Papers will be graded based upon the following rubri c: * Following directions (length, font, double-spacing, etc. ) 5pts. * Cover Sheet 5pts. * Abstract 5pts. * Film summation 10pts. * Research portion 50pts. Analysis of film 20pts. * Reference page 5pts. Total:100 7. Guidelines for APA-style (citations, abstract, reference page, etc. ) are attached. Further examples can be found on my website: http://www. sampsoncc. edu/staff/wolf 8. Films not included on the attached list may be used, BUT ONLY WITH PRIOR APPROVAL OF THE INSTRUCTOR. In preparing a paper in APA style, the following general guidelines should be followed. †¢ Font Selection Font size should be 12 points, with Times Roman being preferred. †¢ Line Spacing Double-space everything: title page, abstract, paper, and reference list. Margins and Indentations Leave one-inch margins at the left, right, top, and bottom of each page. Indent paragraphs five spaces using the â€Å"Tab† feature. †¢ Page Header The page header consists of a brief version of the pa per’s title (usually 2 or 3 words), followed by five spaces and then a page number. Starting with the title page, it appears in the upper-right corner of each page of your paper, including the reference page. Use the â€Å"Header† feature of your word-processing program to insert the header information. I. Title Page (or Cover sheet) (page 1) Name Title of ProjectPSY 281-0A Date II. Abstract Page The abstract follows the title page/cover sheet (it is page 2 of your paper) and is a one- paragraph summary of the content of your paper. The abstract should be no longer than 120 words. Because it is a summary of your project, it should be written after your paper is complete. Guidelines: Two lines below the page header, type the word, Abstract, and center it. Two lines below that, begin the paragraph, which should be unindented and double-spaced. III. Text (or Body) of Paper The text of your paper begins on page 3.The page header appears on the top line. Two spaces below th at, center the title. Two spaces below the title, the paper begins. Five pages, minimum, with text notes when citing research. IV. Reference Page The list of references used comes at the end of your paper and begins on a new page, continuing the numbers from the text of your paper. Two spaces below the page header, center the word, References. Two spaces below that, begin the first reference entry. The entries should be entered alphabetically by the author’s last name.If the author’s name is not given, alphabetize by the first major word of the title of the source, omitting A, An, or The. Each entry should start at the left margin; additional lines for that entry should be indented 5 spaces from the left margin. The reference page should be double- spaced. There are NUMEROUS sources on the internet for APA-style papers (besides my web site). One very good one is: http://owl. english. purdue. edu/handouts/research/r_apa. html Parenthetical Citation The APA system of cit ing sources indicates the author's last name and the date, in parentheses, within the text of your paper.A. A typical citation consists of the author's name and the year of publication. Example: Charlotte and Emily Bronte were polar opposites, not only in their personalities but in their sources of inspiration for writing (Taylor, 1990). Use the last name only in both first and subsequent citations, except when there is more than one author with the same last name. In that case, use the last name and the first initial. B. If the author is named in the text of your paper, only the year is cited. Example: According to Irene Taylor (1990), the personalities of Charlotte and Emily. . C. If both the name of the author and the date are used in the text, parenthetical reference is not necessary. Example: In a 1989 article, Gould explains Darwin's most successful. . . D. When the reference is to a work by two authors, cite both names each time the reference appears. Example: This theory oft en has been used to explore patters of various insect mating (Alcock & Thornhill, 1983). –OR- Alcock and Thornhill (1983) also demonstrate †¦ E. When the reference is to a work by three to five authors, cite all the authors the first time the reference appears.After that, use the first author's last name followed by et al. (Which means â€Å"and others†). Example: This pattern has long plagued the internal politics of college administration in Texas (Douglas et al. , 1997). F. When the reference is to a film, begin with the director’s name followed by the year of the film’s release. Example: (Speilberg, 1989) G. When the reference is to a work by a corporate author, use the name of the organization as the author. Example: Retired officers retain access to all of the university's educational and recreational facilities (Columbia University, 1987).

Intramedullary Spinal Cord Tumors Health And Social Care Essay

In this essay I will discourse a patient who had been enduring from Amyotrophic Lateral induration a signifier of Motor Neurone Disease which is a progressive, chronic and debilitating disease. I will discourse the consequence this disease has on the organic structure, look at differential diagnosing, the cardinal status impacting the organic structure by this disease, epidemiology, aetiology, pathophysiology and the associated pharmacological medicine that are all prevalent with Amyotrophic Lateral Sclerosis. Motor Neurone Disease is a general term for a few differential discrepancies of the diseases which are combined under the one umbrella ( see appendix A ) the specific disease I will discourse is Amyotrophic Lateral Sclerosis ( ALS ) . From this point Motor Neurone Disease will be known as MND and Amyotrophic Lateral Sclerosis known as ALS. The patient I attended was a 53 twelvemonth old who had been enduring from ALS. The patient when we arrived had died but had been in the terminal phases of the disease. In speaking with the household and acquiring a good societal and household history it became evident that this patient had led an active life style until she was diagnosed with ALS. In the early phases this patient managed herself but rapidly became unable to pull off her daily attention and required aid, due to the ALS the patient was known to us but I had ne'er attended to them before. In treatment with paramedic who I was on with they gave me a brief history of the patient so I was prepared when I went in. ALS comes under the umbrella of MND which affects the nervous system ( see Appendix B ) and can be divided into two countries the lower taking to muscle weakness/wasting ( wasting ) and the upper taking to stiffness, abnormally active physiological reactions by and large nonvoluntary and each impacting different countries of the organic structure in changing grades. The forecast for ALS is Death, as it affects the upper and lower nervous system ( see Appendix B1 ) . MND It is a chronic progressive neurodegenerative disease, nevertheless depending on countries affected it may take a few old ages or it can take longer. There is no remedy for MND and the pharmacological medicine is restricted. The pharmacological medicine for the patient was Riluzule in the early phases can decelerate down the devastation of the motor nerve cells as it is a neuroprotector, Baclofen is prescribed as a musculus relaxer which is used to handle the cramps and stiffness caused by the musculuss, Dantrolene is prescribed to handle long term musculus cramps and stiffness though it can besides do liver harm, Diazepam ( diazepam ) is prescribed for its ataractic consequence and helps command the musculus cramp and stiffness these along with other general medicines and with the aid of psychological and emotional support signifier household, friends and other bureaus all assisted the patient with get bying with their ALS. This patient was in ventilatory failure which is the terminal phase of the disease. On Arrival the patient was still on the ventilator and the Patients ‘ household were around her they stated that she had been experiencing ailing different signifier the disease itself and that she had non been herself, the patient was still able to pass on utilizing her eyes although this was going a strain on her and was now passing greater lengths of clip asleep. The patient had retained her sense of temper throughout the disease. The household managed all the daily patient attention themselves as they stated that they knew her best and as the disease progressed and the patient was unable to vocalize any longer they were still able to understand what was wanted. On Examination the patient had no bosom beat and remained in cardiac arrest, patient students were fixed, all marks of life were negative apart from the ventilator. The household knew that the patient had died but we had to repeat that and do certain as they had requested us to go forth ventilator switched on at that clip which meant that there were breath sounds although false reading as it was mechanical aided airing and there was no existent external respiration attempt from the patient it was explained to the patients sister and hubby that although the ventilator is still on it may be confounding for any of the other relations that were coming to understand and particularly for the patients kids as there were no marks of life but the noise of the ventilator might intend they got confused. Dr was called one time we had arrived and we explained what was go oning and as it was the GP that usually attended to the patients ongoing attention we requested that they attend the house. Dr pronounced the patients ‘ decease and was able to exchange off the ventilator as this was what the household wished, during this clip asperity had begun. The household and Dr stated that the patient was cognizant of the result of the disease and that the patient had a DNAR in topographic point which the Dr brought with them as it was a new issue and the one the household had was out of day of the month. I realised through speech production with the household that the symptoms of this disease were similar to other nervous system diseases and that I knew really small about this I decided I would read up on the disease and larn how these types of neurological diseases affect people. Differential Diagnosis: In order to derive the right diagnosing of any disease you must first regulation out several other different diseases that affect the organic structure in a similar manner. In making so you are able to name and handle the disease efficaciously utilizing the right pharmacological medicine, psychological science, or external aid. This is sometimes hard as they frequently present in this instance with muscular blowing particularly of the upper limbs which is the initial presentation in MND and ALS. Some of the differential diagnosing for ALS and MND are: Intramedullary tumour – See Appendix B. Cervical spondylosis – Cervical myelopathy – see Appendix B Peroneal muscular atrophy- see Appendix B Chronic polymyositis- see Appendix B Cervical rib- see Appendix B Peripheral nervus lesions- See Appendix B ( General Practice Notebook, 2012 ) Once all the differential diagnosing information has been correlated and ruled out it is so clip to look at the factors of MND and it variants that prevarication within the MND umbrella. There are assorted types of MND with ALS being the most outstanding and besides the 1 that appears to be speedy in oncoming therefore a rapid diagnosing eases the patients anxiousness and will besides give the patient the right pharmacological medicine and psychological science with support groups and healers to understand the forecast and the disease and its effects on the organic structure although everyone can bring forth different symptoms and no one individual has the same patterned advance through the disease it is in a sense individualised. MND has changing types under its umbrella some affect specific site and others whole countries of the nervousnesss. Amyotrophic Lateral Sclerosis ( ALS ) , both upper and lower motor neurone harm. Primary Lateral Sclerosis ( PLS ) , upper motor neurone harm entirely, Bulbar Palsy, the bulbar paralysiss Progressive Muscular Atrophy ( PMA ) , lower motor neurone harm entirely Epidemology of ALS ALS normally occurs between age 40 and 70, and 90 % of instances represent some signifier of MND disease. The incidence of the disease increases with each decennary, the mean age at oncoming is 63 old ages. The surveies of the addition of the disease are predominately due to one factor that we are all acquiring better wellness attention and that we are in the chief life thirster. Recent information has suggested that there may be some cultural variableness to the disease nevertheless there is still a lower incidence in non-whites or persons of assorted ethnicity. The male to female ratio is 1.3 in the ages between 40-70 but approaches equality at ages older than 70 old ages. ( Sharon M. Valente RN, 2007 ) ( Carmel Armon, n.d. ) The highest rate of ALS in the universe is Finland. There has been a recent survey in Finland to happen out why they have such high rates they found that a mutant in chromosome 9p21 as the major cause of familial ALS. Finland is non the lone state with a high rate Guam has a prevalence of 70 in every 100,00 this they believed was due to the toxins in the Cycad nut and the rhythm it went through to free it of the toxins. The nut was besides consumed by the Flying Fox ( a chiropteran ) which used to be portion of the diet. The toxins in the nut may hold been much more concentrated and as it was consumed it released the toxins. This statistic has been reduced as alterations in diet have occurred the people of Guam now have a prevalence of 7 in every 100,000. ( Sharon M. Valente RN, 2007 ) ( Carmel Armon, n.d. ) Aetiology of ALS: Between 5-10 % of instances are familial. 90-95 % of instances are sporadic. The mean oncoming for people with familial ALS is 10-20 old ages younger. The balance are sporadic. Diagnosis for this disease are blood trials, Electromyogram ( EMG ) , Magnetic Resonance Imaging ( MRI ) and one time every other neurological disease has been rejected so the diagnosing will be of MND so depending on clinical presentation a unequivocal diagnosing of what type of MND will go on next. Pathophysiology of Amyotrophic lateral sclerosiss: ALS is a disease of the Motor Neurones it is a chronic progressive neurodegenerative disease and it is fatal. There is no remedy for this disease and pharmacological medicine is limited to handling the symptoms as they occur. Famillia ALS is caused by a familial defect on chromosome 21 which is an enzyme ( an enzyme allows a cell to transport out chemical reactions really rapidly ) and helps destruct free groups ( Free groups take negatrons from the cells and do a batch of harm ) It is nevertheless non necessary to hold the faulty chromosome to develop ALS as non all bearers of the faulty chromesome contract the disease and people can contract the disease without a faulty chromesome. Sporadic ALS is mostly unknown in its cause nevertheless at that place have been links in the alterations to the organic structures nucleic acid through smoke have been shown to trip the disease oncoming. In ALS progressive musculus wasting predominately is found on the Lower motor neurones which reside in the anterior Grey horn of the spinal cord and in the encephalon root ( corticospinal ) . The upper Motor neurones predominately cause marking on the sidelong column of the spinal cord which may bring forth stiffness or abnormally active physiological reactions. There are instances although rare where the loss of prefrontal neurones may hold caused signifiers of cognitive damage. Although this is non typical in ALS as by and large there is no devolution of the five senses and these nervus cells remain integral. Nerve cell organic structures of the lower and upper motor neurone control the musculuss. The motor axons die by devolution and the larger motor neurones are affected to a higher extent than the smaller motor neurones. Equally long as the regeneration and devolution remains changeless so the nervus cell has the ability to maintain the motor neurones within normal bounds hence no symptoms will be evident, merely when the demand for regeneration of these cells can non fit the devolution it is so the first symptoms of ALS becomes apparent. The axon interruptions and the environing Schwann cells catabolise the axon ‘s medulla sheath and steep the axon interrupting it into fragments. The breakdown causes ovoids which are little compartments which contain the fragments of the axon the ovoids are so ingested and destroyed by the macrophages the hungry white blood cells who come en mass to clean up. This nevertheless leaves a grade on the country and if supply and demand for regeneration are non met this procedure so causes the wasting of the motor nervousnesss go forthing them denervated and unable to execute. There are as with all types of disease clinical manifestations in which we are able to name certain conditions non all of them present at one time and all varying in badness depending on the length of clip the patient has had the disease. Muscle failing is the primary mark of ALS with the musculus cramp and stiffness associated with musculus wast ing active nonvoluntary jerking a weakend clasp, slurred address, there is by and large no redness of the musculuss but the changeless vellication and contraction can do a batch of hurting. ALS begins in one limb before impacting the other limb. This disease can distribute through multiple sites on the organic structure and can impact the critical variety meats as they are made up of musculus tissue this is the terminal stages where the patient is unable to take a breath without the aid of a ventilator and as life anticipation for ALS is between 2-5 old ages it can be swift in oncoming. The pharmacological medicine for the patient was Riluzule in the early phases can decelerate down the devastation of the motor nerve cells as it is a neuroprotector, Baclofen is prescribed as a musculus relaxer which is used to handle the cramps and stiffness caused by the musculuss, Dantrolene is prescribed to handle long term musculus cramps and stiffness though it can besides do liver harm, Diazep am ( diazepam ) is prescribed for its ataractic consequence and helps command the musculus cramp and stiffness these along with other general medicines and with the aid of psychological, Physiotherapy, Occupational therapy and emotional support signifier household, friends and other bureaus all assist the patient with get bying with their ALS. As ambulance service there is small that can be done to assist the patient apart from doing them comfy. We can utilize Professional-Professional calls to the necessary adviser and inquire for advice as to the best attention for the patient and if we need to set up for the patient to be admitted into infirmary or whether organizing another carepathway would be suited. The carepathway could besides be used and was in this instance a call to the patients ‘ ain GP bespeaking them to see as this was the want of the patient and the household explicating what had happened. The usage of any analgetic drug for the hurting would hold to be discuss ed with the adviser as this may hold inauspicious effects on status or may hold contraindicators to drugs regime the patient was already on. Following the Care program that is in topographic point meant that although the patient had died we could still follow their wants. Pg1.APPENDIX A- The Nervous System The nervous system is the organic structure ‘s communicating web. It plays a critical function in keeping homeostasis and consists of a immense figure of cells called neurones. The nervous system can be split into two different divisions the Central Nervous System ( CNS ) which controls the encephalon and the spinal cord and the Peripheral Nervous System ( PNS ) which controls all the nervousnesss outside of the spinal cord and encephalon. The peripheral nervous system can be sub-divided into the motor or motorial tract and the sensory or afferent tract. The motor map is divided once more into- voluntary- controls motion of the musculuss and involuntary- which is portion of the autonomic nervous system that controls the cardiac musculus and its secretory organs, this system can be divided into two once more the sympathetic and parasympathetic. The nervous system is predominately made up of nervous tissue which consists of two types of cells- nervus cells or nerve cells and neuroglia, it besides includes the blood vass and the connective tissue. Nerve cells Nerve cells specialise in responding to physical or chemical stimulations from the alterations within their milieus. Nerve cells send and receive nervus urges. The construction of a nerve cell is like an arm with thenar and fingers. Dendrites are like your fingers projecting from the thenar of your manus they are little projections coming from the axon APPENDIX B INTRAMEDULLARY SPINAL CORD TUMORS Pain and failing are the most common presenting symptoms of intramedullary spinal cord tumours. Pain is frequently the earliest symptom, classically happening at dark when the patient is supine. The hurting is typically local over the degree of the tumour but may radiate.Progressive failing may happen in the weaponries ( cervical tumours ) or legs ( cervical, thoracic, conus tumours ) . Impaired intestine, vesica, or sexual map frequently occurs early. Patients may hold hapless balance. Rarely, symptoms of subarachnoid bleeding may be present. Examination may uncover a combination of upper and lower motor nerve cell marks. Lower motor marks may be at the degree of the lesion and may help in localisation. Other marks apparent upon physical scrutiny may include spine tenderness, stiffening of pace, trophic alterations of appendage, centripetal loss, hyperreflexia, clonus, and scoliosiscervical spondylosis – Cervical myelopathyCervical myelopathy occurs when terrible cervical spondylosis causes narrowing of the spinal canal ( besides known as stricture ) and compaction of t he spinal cord. When the spinal cord is compressed, it interferes with the signals that travel between your encephalon and the remainder of your organic structure. Symptoms can include: a deficiency of co-ordination, for illustration you may happen undertakings such as buttoning a shirt progressively hard, heaviness or failing in your weaponries or legs, jobs walking, less normally, intestine and urinary incontenance, centripetal loss is normally present but the upper limb failing and lower limb spasticity may be unusually similar to MND. MND has a more rapid myelopathy and cervical phonograph record bulge will be absent on X-ray. Occasionally, MND may co-exist with cervical spondylosis. cervical rib – fasciculation absent, hurting prominent, centripetal loss normally present, characteristic radiology peripheral nervus lesions – localised cachexia, normally accompanied by centripetal loss. peroneal muscular wasting – centripetal loss of the peripheral nervousnesss become damaged it can do the undermentioned symptoms: numbness and prickling in the pess and custodies a combustion, knifing or hiting hurting loss of co-ordination in the affected organic structure parts musculus failing chronic polymyositis – The history of patients with polymyositis or dermatomyositis typically includes the followers: Symmetrical, proximal musculus failing with insidious oncoming Muscles normally painless Myalgias occur in fewer than 30 % of patients. Dysphagia ( 30 % ) and aspiration, if pharyngeal and oesophageal musculuss are involved Arthralgias may be associated Trouble kneeling, mounting or falling stepss, stepping onto a kerb, raising weaponries, raising objects, combing hair, and originating from a seated place Weak cervix extensors cause trouble keeping the caput up Engagement of pelvic girdle normally greater than upper organic structure failing Cardiac engagement may do symptoms of pericarditis or myocardiopathy Characteristic roseola of face, bole, and custodies seen in dermatomyositis merely Patients with polymyositis normally present with symmetrical, proximal musculus failing in the upper and lower appendages. Weakness of cervix flexors besides occurs. Patients with polymyositis may describe musculus hurting and tenderness, which may be confused with symptoms of polymyalgia rheumatica. The disease may be for several months before the patient seeks medical advice, and all of the musculuss of the thighs, bole, shoulders, hips, and upper weaponries are normally involved. Muscle failing may fluctuate from hebdomad to hebdomad or from month to month. Fine motor motions that depend on the strength of distal musculuss, such as buttoning a shirt, run uping, knitting, or authorship, are affected merely tardily in the disease. Dysphagia secondary to oropharyngeal and oesophageal engagement occurs in approximately one tierce of patients with polymyositis and is a hapless predictive mark. Dysphonia is besides a hapless predictive mark but is much less common. Ocular musculuss are ne'er involved in generalised polymyositis. However, stray orbital myositis, an inflammatory upset affecting the extraocular musculuss, is good described. Facial and bulbar musculus failing is highly rare in persons with polymyositis. A household history of neuromuscular disease, endocrinopathy, or exposure to myotoxic drugs or toxins is absent. differentiate by electromyography and musculus biopsy myasthenia gravis – bulbar marks but seldom muscular cachexia ; responds quickly to anticholinesterase