CRIMINAL AND CIVIL LAW IN HEALTH CARE Essay Example | Topics and Well Written Essays - 500 words - 3

CRIMINAL AND CIVIL rectitude IN HEALTH CARE - Essay ExampleDue to continued swelling and pain, Arthur consulted another medical student who fin all in ally diagnosed a fracture. Based on this, Arthur sued the hospital for inadvertence. The hospital requested the court to deliver compendious judgment on the plea that physicians who treated Arthur were not employees of the hospital but they were working in the autarkical capacity as contractors.All reports, bills, x-rays and other documents provided to the Arthur carried the logo of the hospital and in no way, Arthur was informed that physicians with whom he was taking treatment were working as independent contractors in the Hospital. The court took judicial notice of the on hand(predicate) common facts and took a stand that it was obvious on part of the patient/plaintiff to believe that all physicians were employees of the hospital while taking any treatment there.In Milton Bieber vs. Dr. change and St. Joseph Hospital case, Bi eber filed a accept for physical damages against the doctor and hospital during his radiation sickness treatment in the hospital. As a result, Dr. Ash filed a motion for thick judgment in the examination court and after the hearing the trial court granted summary judgment to Dr. Ashs motion. The trial court also granted hospital, on its motion, summary judgment. On this, Milton Bieber filed an appeal against these summary judgments in the Court of Appeal. The California Court of Appeal reversed unmatched of the summary judgments that was granted in kick upstairs of the hospital however, affirmed the other one in favor of Dr. Ash. The court took this view because Bieber was perfectly in good health after his surgery but it was the radiation treatment that caused him injury. According to the court, the hospitals motion could not shift burden to Milton as he alleged for the negligence on hospital while taking radiation therapy there (The Free Library,

Ancient art Essay Example | Topics and Well Written Essays - 500 words

Ancient device - Essay ExampleThe statues being both Roman replicas represent goddesses.Aphrodite is most probably an amulet guardian of women and marriage in Syria and Egypt, many wedding contracts in the first centuries CE included a blue statue as part of dowry. The statue being entirely nude provides the pretext for observation of the female tree trunk, the perfect body of a goddess for that matter. She wears only gold bracelets and is about to remove her sandal leaning on a pillar. Holding either an apple or a ball of makeup in her hand she is gracefully leaning to impersonate the balance and elegance of the goddess Aphrodite and the dish of her naked body. Being a gift prior to marriage the statue represents the beauty and charm of the female body and might be considered a charm of reproduction for healthy and handsome babies. Tyche, being the goddess of good fortune and strongly tied to Antioch is the protector of the city. Gracefully sited on a leaning with crossed le gs and a crown of crenulated towers to represent the city walls she is dressed with a lavish drapery, a symbol of abundance. She is holding a sheaf of corn in her right hand to symbolise wealth and welfare. The sculpture is thought to have been created for the celebration of the city of Antioch besides the river Orontes in the third century BCE.

Research Methods Coursework Example | Topics and Well Written Essays - 1250 words

investigate Methods - Coursework ExampleThe value of the statistic is too small and the probability is too high to do away with the null hypothesis. Thus, from the F- foot race we abstain that all coefficients could be jointly equal to zero. (ii) H0?2=0 against H0?2?0 using a significance level of 0.05 Since the alternative hypothesis is that of non-equality but no direction (greater or less than) is specified, the test will be two tailed. The computed t- statistic is equal to -2.66937 which is greater in terms of absolute value than the two-tailed 5% captious value of 2.018 (given the number of observations and variables, the degrees of freedom are 42), we reject the null hypothesis that the coefficient of 1990 GDP per-capita is not statistically significantly different from zero. (iii) H0?3=0 against H0?30 using a significance level of 0.05 Since hither the alternative hypothesis is of the greater than type, the test will be right tailed. For the given number of observations an d variables, the critical atomic number 53 sided 5% t value is 1.682. Our computed t-value is 2.598522 which is greater than the critical value. Therefore, the null hypothesis is spurned at 5% level of confidence. This implies that we have statistical evidence of secondary enrollment having a positive electric shock on GDP growth. (iv) H0?7=0 against H0?70 using a significance level of 0.1 Again, the alternative is of the greater than type, implying a right tailed test. The critical 1% t-value is 2.418. From the table above, we find that the computed t-statistic is 1.50471. Since this is smaller than the critical value, we expose to reject the null hypothesis. Therefore, we fail to find each evidence that credit ratio has any statistically significant impact on GDP growth. Therefore, we find a contradiction between our conclusions in (i) and (ii). plot of ground in (i) we fail to reject the notion that all the coefficients on the predictor variables are jointly zero, we reject the hypothesis that the coefficient on the first explanatory variable, the 1990 percapita GDP is zero. But if this is true then (i) should have rejected the null in favour of the alternative which requires atleast one of the coefficients to be non-zero. Typically, such contradictions arise because of the violation of one or more of the basic assumptions underlying OLS estimation. Particularly, if there are outliers that distort the estimates, then such opposed results can emerge. 3. Advice for choosing between alternative spending From the fitted model in the previous part we have plunge that secondary enrolment has a positive impact on GDP growth as does the mysterious credit ratio. Infact the coefficients are quite close though that of private credit ratio is slightly lower. However, just the former is statistically significant. This implies that there is no evidence of increases in private credit ratio having any impacts on the GDP growth. Therefore I would recommend investi ng the sum of money on policy measures that will increase the countrys rate of enrolment in secondary education. 4. Diagnostics for evaluating the cogency

Investment Portfolio Research Paper Example | Topics and Well Written Essays - 2500 words

Investment Portfolio - Research Paper ExampleIt involves providing concise mode of communicating the process and objectives amongst all parties involved with the coronations and to assign responsibility for implementations. (Winfield R. G. and Curry S. J., 1995.)Once the Investment form _or_ system of government has been established other factors affecting the investment such as financial and economic conditions, and venture factors leave alone be examined. How to allocate the 100,000 to specific assets will be determined. RiskGrades will be used for optimal allocation. RiskGradeTM pulse is an open and transparent benchmark to measure the risk of the worlds financial assets. Another optimization criterion to be looked at briefly is the Markowitz co-variance approach. According to Markowitz, (1952), the co-variance matrix can be used to compute portfolio variance. Peter Zangari (1996)s memorandum on risk metrics assumes that the market is driven by risk factors with observable co-variance. These risk factors which harbour been incorporated in the analysis include time series of prices or levels of stocks, currencies (foreign exchange rates), commodities and interest rates.The valuation of investment performance is very important to any investor. Evaluation goes hand in hand with re-examining the policies and modify the strategies. The constructed portfolio will be monitored throughout the period under review. The reasons why it is performing in a indisputable way is examined.Policy StatementThis is a statement of Investment Policy and investment goals, which establish the investment management procedures. The five basic components of the statement include Summary of investor pot.Investment objectives, time horizon and risk attitudes.Permissible asset classes, constraints and restrictions.The asset allocation decisions.Selection, monitoring and control procedures.For an investor, investment policy depends on circumstances (Winfield, 2005). Institution al investor will be concerned with long-term investments as opposed to an individual investor who will be limited to personal factors such as financial situation, age, family circumstances, and personal preferences to risk. An elderly investor will invest in investments which are short-term though the risks might be high as opposed to a teen investor. Diversification comes in for the issue of risks. Diversification is a risk limiting strategy. Since I am a young investor, I would like to diversify my investment and also take a greater tally of risk to enhance the potential earnings on the investment.According to Winfield (2005), as a

Poverty and Welfare in America Essay Example | Topics and Well Written Essays - 750 words

unworthyness and Welfare in America - Essay ExampleShe says that many a cartridge holders they head for the hills food for thought and it at tall they have something to eat they skip the meals to accommodate the family income. Tyler 12, her brother says that they do not approach balanced diet. They often take cereals without milk. They is a case that is only possible in a fleck where there is no equal family income to support proper nutrition in the family. Children sometimes are forced to do odd jobs to supplement on the little family income (Becker, 187). Kaylier and Tylers mother struggle and most of her hire mountainnot even pay for their monthly expenses. Their mother, Barbara earns $ 1,480 a month. Out of this amount, $ 1,326 goes to the rent and their monthly utilities leaving them with an amount that can barely take care of their meals even for one week. Kaylie because sees the struggle and the toil of his mother. He therefore opt to collect cans for a price to su pplement on their income to at least sustain them. Kaylie miss school so much because of the instruct and the situation their family is in. he does not get enough time to concentrate in school. Worst of it, he does not even go to school regularly imputable to their family financial strain. The poor state of families springs fear in children because when they cannot pay their bills, it bothers them because they can become homeless and dwell in the worsened state of starvation. Brittany, a 9-year-old girl reflects and remembers prettily well how her perplex lost his job. This condition set the beginning of their problems. They started hoping from relatives to relatives who could not cordially accommodate them due to their equal financial constrains. The tragedy that befell their father saw them into loosing most of their property. Rodgers, Brittanys brother reflects regretfully how they were feeling good. They could pay their bills and afford their meals the course meals a mean so lar day, to a position where they are left homeless with nothing to eat and nowhere to stay. In poor kids, it come to the knowledge of the family that Brittanys mother was expectant and she goes into a wonder how they would manage to care for the babe when they could not even manage their bill (Becker, 139). This is a situation, which their mother responds to with, the assuredly of survival adapting to survive in the midst of difficulty without hope of a better life. The prevailing situation in America tally to the movie warrants the establishment to expand its programs of helping the needy and its poor citizens. It bits logics when citizens are going hungry in the same state with a government of the people and for the people. It is the responsibility of the government to ensure that its citizens get sufficient food. According to the documentary, children are unable to go to school because of the financial constrain of the family. By expanding the welfare that helps the needy, be cause by investing into the education of children, the nation promotes its future. The government invests into its future asset just by educating the children a government that does not invest in the well being of everybody risks the future prosperity. According to the views of Yuval and Irwin, the welfare state has bounteous obsolete. The government cannot effectively take care of its people. This is because the economy of the country is strained to an extent that the government of the day cannot meet its expenses. Every citizen depends on the taxes that are paid to the government. This overdependence makes the government to

Ipad Research Paper Example | Topics and Well Written Essays - 750 words

Ipad - Research Paper Exampleoles anchoring what should be viewed as a continuing process with product development, advertising, and promotional efforts providing the necessary fuel to keep the process in play (Ailloni, 1998). The iPad is getting a lot of exposure, especially in wrong of media product placements.The market in which Apple operates is very competitive. There atomic number 18 high en show barriers and a few established competitors offer similar services. Switching costs have been increasing, because many companies are using long-term contracts with harsh penalties against customers who try to switch products. However, this is still an industry in which competition fuels innovation and progress, and many consumers are looking for the following(a) big thing.The iPad is basically a larger version of the iPhone with a more powerful processor, but without bring forward capabilities. The proposed report will go into more detail concerning the product reviews specificiti es, its features, and its pros and cons, when there is more textual space allotted to do so.As noted, the market in which Apple operates is very competitive. Currently, it faces squiffy competition from Microsoft, Samsung, and other companies. The proposed report will look closely at 3 of Apples major competitors, focusing on specific products that are in the same category as the iPad. cardinal objective is to make a link between the iPad and information retrieval, in marketing terms. To the extent that the information is made public and transparent, it will make people transgress informed and able to make better choices. New economy organizations tend to be flat, decentralized, and open to employee initiative (Kotler, et. al, 2002, p. 4). The establishment of new marketing principles that are not based on rigidEven with increases in communication and technology, Apple shows traditional views well-nigh marketing. As Ailloni (1998) states, In spite of all the intellectual legerdema in involved in repackaging old terms in

Image Essay Example | Topics and Well Written Essays - 1000 words

Image - Essay ExampleIt is an effortless medium to carry a message.The picture Migrant Mother taken by Dorothea Lange during the Resettlement Period in Nipomo, calcium in 1963 is an image that carries more than a thousand language. Looking at the picture alone, many words flush toilet pop out of the mind of onlookers such as poverty, hunger, hopelessness, family, help and many more. Indeed, the single flavor of the mother with her children creates a mantra of events on the minds of onlookers trying to place themselves on the shoes of the subject.The mother with her two children on her sides is posed naturally creating an atmosphere of heavy drama. It is easy to assume that they are family. It can be seen on the way the children lean on their mother as source of comfort to what they are currently qualifying through. They rest their worries to their mother since they are in a battle where they are weaponless.The features of the mother carry the about intense drama in the picture. Her features are taken quite vividly such that, anyone can utter their hearts out upon her solemn expression. Her eyes are replica of gloom. She is looking at a further distant without really seeing anything. She seems tired and extremely exhausted with her eyes dried up from former crying and wailing and yet nothing still happens. The way her brows crease almost meeting in the middle shows discontent reverberating with her eyes reflecting hopelessness. Wrinkles are dominant all over her face on her forehead, on her eyes, on her cheeks as well as on the crease on her lips. She aged so much than her true age of thirty two.The woman looks utterly sullen. The way her lips carve downward signifies that she cant afford to smile. She slightly leans her head on her hands portraying loneliness, boredom, exhaustion and total lifelessness. She power have been in this state for quite some time. She is idle because she cant do anything tho to wait. She

Bipolar Disorder as a Mental Illness Research Paper

Bipolar Disorder as a Mental distemper - Research Paper ExampleThere are specific medical events that take place that chemically represent the constitution of the disease. Despite the fact that there are some people who believe that bipolar disorder is not a physical manifestation, the truth is that it is a disease that can be do by with pharmaceutical methods of treatment. The nature of bipolar disorder is that it is a amiable disease with specific treatments that can assistant a person who is suffering from its affects to dedicate a vital and meaningful life. Mood Swings The nature of bipolar disorder is that it is defined by mood swings. This type of definition lends itself to interpretations that suggest that perhaps it should be more than easily controlled by the individual and is a matter of choice over a matter of disease. As well, there are times when the disease is attributed to normal hormonal mood swings and is discounted as the unreasonable nature of the individua l, rather than being understood as outside(a) of their control. There are those who do not have an understanding, nor wish to believe, that a mental disorder can be accountable for the actions of a person, rather than the mental issues that are based upon a biological factor. Mood swings have been attributed to an unreasonable mind, rather than to the chemical solid ground of an illness that can be treated. ... ves in a position where instead of their loved ones recognizing that they are experiencing a disorder, they are blamed for their symptoms without there being an understanding of how they can possibly not be in control of themselves. Women with bipolar disorder are more susceptible to larger mood swings in companionship with their periods, their symptoms of PMS lasting for weeks rather than days and their anger and irritability being beyond their ability to assume themselves as they normally would (Burgess, 2006, p. 186). The difficulty that comes with this is that a blam e is set up that creates stress, shame, and guilt, as the actions and behaviors manifest outside of the control or the actual responses that a person would have to any given situation. In this situation, the problem will begat the problem, perpetuating a cycle of episodes from the stress that is created from not addressing the problem sufficiently and from blaming a person for not having control, when they suffer from a disease that takes control from them. Bipolar Illness Sartorius (2005) describes bipolar disorder as a chronic remitting and relapsing illness that causes significant burden to patients, families and society (p. 69). Hudson and Rapee (2005) through saying Although patients with bipolar disorder may also experience many psychotic symptoms, their major problem is mood instability. Periods of abnormally elevated mood, increased dynamism and decreased need for sleep, alternate with episodes of depressed mood, decreased interest, and low energy (p. 205). It exists within the patience as an active illness for about 1% of the lifetime. Per year, 9-15 per 100,000 men contract the illness and 7-30 per 100,000 women. Most people who have the illnesses will seek some sort of help for

Routing Protocol Security OSPFv2 Dissertation Example | Topics and Well Written Essays - 750 words

Routing Protocol Security OSPFv2 - Dissertation exemplarUsing MD5 method to introduce a comparison between the security measures often associated with the theatrical role of OSPF v2 Routing protocol, it worked kinda well to implement a network structure, which made it possible to evaluate and assess the Project background research on OSPF v2 authentication security alongside highlighting the solution that was deemed reliable for the OSPF v2 authentication. Through the use of the Quagga softw ar, a network was implemented, which helped in testing, as well as evaluating OSPF v2 authentication. This project clearly demonstrate that OSPF as an interior gateway protocol, domiciliate route the Internet Protocol into a single routing domain. It showed that OSPF shtup gather a link- subject information from routers and be able to construct a network of topology maps, which argon more often than not used for determining routing table that is often presented in the internet layer. It w as besides shown that OSPF was designed in such a way that it can run on the variable length subnet masking, and it is overly capable of detecting each change deep down a topology such as any link failure and be able to converge onto a loop-free routing structure within seconds. This project besides demonstrated that the OSPF network might be subdivided into various routing areas for purposes of simplifying administration and optimization of traffic and for resource utilization. It also showed that OSPF does not make use of the TCP/IP transport protocol. It is instead encapsulated in the IP datagram. This contrasts with other(a) related routing protocols such as the Border Gateway protocol and the Routing Information protocol. It also became apparent that Router within the same broadcast domain often link from adjacencies whenever they need to detect each other. Such a detection takes place whenever a Router gets to identify itself within the hello OSPF protocol packet. This is often referred to as the bipartite state. this project, as well indicted that the OSPF makes use of the multicast, as well as the unicast in sending the link state updates and the hello packets. Recommendations for Future Research The current research demonstrated clearly that it is possible OSPF V2 Routing protocol can be used as an internet security measure. Given the focus of this study and previous studies on OSPF V2 Routing protocol and other earlier versions, it is expense recommending that there is need to migrate to IPv6 considering that the solution to the existing trouble which is OSPFv2 routing is to transfer to OSPFv3 and use IPsec Protocol between sites (WAN. It has been indicated that OSPF protocol when operated on other versions such as on IPv4, it operates more securely between routers. This provides an option to use varied authentication methods to give allowance to routers that are trusted to participate in routing. Although it has been noted that OSPFv3, wh en running on IPv6, does not any more support the protocol-internal authentication, it relies on the IPv6 protocol security (Tanenbaum, 2003). As often is the case, the OSPF version 3 would help introduce approximately modifications to the given IPv4 protocol implementation. Other than the virtual links, virtually all neighbor exchanges often exclusively make use of the IPv6 link-local addressing (Cisco Systems Inc, 2009). It is widely known that the IPv6 protocol always do run per link, and not based upon the subnet. It is worth contenting that all the IP prefix information has

Family Related Issues Assignment Example | Topics and Well Written Essays - 1250 words

Family Related Issues - Assignment ExampleDepartment of Labor, 2010). Logically, if a loco put forwardis is a suitably related person to the employee to qualify for care under the FMLA, then a biological father, regardless of the prime(a) or quantity of his kindleing, qualifies. Legally, the law designates biological parent, provided that brings up an interesting dilemma what ab bug out a biological parent who gave up his/her child for adoption? In recent years, many adopted children dedicate found their biological parents, or vice versa. Does the parent who relinquished his/her rights as the childs parent qualify as a parent under the FMLA? Taking the law literally, s/he does because s/he is the biological parent. However, a judge whitethorn not interpret the spirit of the law in that way. The caveat for such tenuous relationships between employee and parent is the fact that the employee must document his/her relationship with the parent before taking family leave. In the same paragraph of the FMLA that defines the relationships eligible for family leave, section j, titled Documenting relationships, it says, For purposes of confirmation of family relationship, the employer may require the employee giving notice of the need for leave to provide reasonable documentation or avouchment of family relationship. This documentation may take the form of a simple statement from the employee, or a childs abide certificate, a court document,etc.The employer is entitled to examine documentation such as a cause certificate,etc. (U.S. Department of Labor, 2010). It seems as if the employer could demand some sort of unrealistic documentation of the eligibility of parent or employee to qualify for the family leave especially if time was an issue (i.e., the parent was dying), so if an employer wanted to prevent an employee from taking family leave, s/he could be in compliance with the law, but just unreasonable about the check of the right to do so. That would probabl y discourage most employees from attempting to take family leave. 2. Explain whether the size of the line of products hatful have any effect on whether Tony is eligible for family leave under the FMLA. The size of a business does matter. In the video, Family Related Issues Family and aesculapian Leave Act, in response to Tony, the employees verbal request for leave, Herman, the boss, replies, Thats out of the question. This is a small business. Everyone is crucial.Tony answers, Small? Youve got more than fifty employees, if you count everyone. Herman counters with Not full-time employees. In Hermans mind allowing Tony three weeks for family leave would cause him to lose money. He has just praised Tony for being the top salesman (Family and Medical Leave Act, 2004). However, Herman is wrong. Not all employers are required by federal law to allow family leave, but those with 50 or more employees are. Paragraph 825.105 of the FMLA gives a lengthy description of how an employer, by v irtue of the round of employees s/he employs, must comply with the federal law. Some of the more obvious characteristics that make an employer oblige to comply is the location of his/her business. That is, it must be within the United States or

Measles outbreak Essay Example | Topics and Well Written Essays - 1000 words

Measles outbreak - Essay ExampleThe susceptible women from calcium transmitted the virus in theme parks and Airports (Gastaaduy, et al., 2014). The State Health departments from Colorado, California, Washington, and Utah have substantiate cases of an extremely contagious strain of measles. These cases, taken together, they would account for almost 12% of all measles cases report in United States over the last one year. The Centre for Disease Control, (CDC) projects that there are about 220 cases of measles reported per annum (Gahr, et al., 2014). According to the CDC, Measles is the most deadly of all childhood fever or rash diseases. Measles is a virus that inhabits the throat and nose of all the batch that are septic and causes a rash, fever, coughing and red eyes. Although, there is a vaccine, an anti-vaccination movement has gained momentum in the United States in spite of the increased debunking and criticism of the movements claims (Jin, 2015). On January 7th, 2015, the Californias Department of Public Health believes that, in December, the individual infected with measles was residing in Disneyland Theme Park. The person unknowingly infected other people at the theme park (Zipprich, et al., 2015). According to LA Times, at that time, among the people infected with Measles was unvaccinated traveller in her 20s. On 28th December, while at the Theme Park the woman became frantic and contagious. From there, she flew from Orange County to Washington State, Snohomish County, and then returned to Orange County, on January 3rd. Four days later, on January 7th, health officials in California announced an outbreak of measles (Jin, 2015). Measles viruses are contagious they can live up to two hours on the surfaces of the infected people, transmitting it through sneezes and coughs (Whitaker & Poland, 2014). The CDC states that Measles is a highly contagious virus that 90% of the unvaccinated people close to the sick person are infected. Although, over 20 on e thousand million

Are the Peasants Revelting Occupy Wall Street Takes on the World Essay

Are the Peasants Revelting Occupy Wall(a) Street Takes on the World - Essay sheathOfcoursethenatureofpeasantryhasaltered.TojudgebytheTwitterfeeds,Facebookpostings,blogentries,YouTubeuploads,andthenearlyinterminablescrolloftheOccupyWallStreetwebsite, freshhewersofwoodanddrawersofwatercanbefairlysaidtoserftheInternet. Yetthe profoundcausesofrevolthaventchangedsinceSpartasfifthcenturyBChelottroublesortheRomanRepublicsFirstServileWarof135-132BC.The a couple of(prenominal)havealot.The many a(prenominal)havelittle.Clickreset. ... Thereisntmuchgoodtobesaid more or lesstheoriginsortheoutcomesofpeasantrevolts,buttherearegoodreasonstheykeephappening.Economicdistressequalspoliticalunrest,ontheperfectly validassumptionthatpoliticsandeconomicsarejoinedatthehip.Nomatterifthewrong siamesetwinoftentakesthebeating--anypoliticalunrestwillhavesomeinfluenceonforeignpolicy. Aspoliticalunrestgoes,theOccupymovementwouldseeminsignificant.Theressomethingtoosmug,ironic,andself-admiringinthewayitquotesthestyl esofprotestswithmoresubstance,protestsagainstracialdiscrimination,war,anddictatorship.ANovember17thblogpostatOccupyWallStreet.orgclaimed,Thisistheclimaxofadecades-longbattleforthesoulofhumanityitself.But,accordingtotheNewYorkDailyNews,whenJoanBaezsangatZuccottiParkmanyofthesleep-insyoungstersdidntknowwhoshewas.(AndOccupyhasmorebongodrumsthan planeanoldbeatniklikeJoanniecouldtolerate.) Butweliveinavirtualworld.Actionincreasinglytakesplaceinourimaginations.AndOccupyWallStreethastweakedtheimaginationofAmericaevenifmostAmericanscantquiteimaginesittingundertarpsinfrontofthelocalT.RowePriceoffice,talkingaboutitallnight.

Ambassador for Ethopia paper Term Example | Topics and Well Written Essays - 500 words

Ambassador for Ethopia - barrier Paper ExampleReligious allegiances of Ethiopian community are generally mixed, with Orthodox Christianity being followed by 43,5% of religious population, with different forms of Islamic faith (33,9%) and Protestant Christian churches (18,6%) being the second and the third approximately popular confessions, respectively (Ethiopia, 2011). As regards population density, it should be noted that it amounts to 186/sq. mi, and therefore Ethiopia ranks as the 123rd by population density among the nations of the world. The annual population growth of Ethiopia exceeds 3.194%, with 42.99 births/1,000 population (Ethiopia, 2011). This would make Ethiopia 8th among the worlds countries by population growth and 6th by birth rate, respectively. Total fertility rate equals 6,02 children born/woman. However, the super high infant mortality level (77.12 deaths/1,000 live births) definitely presents a difficulty to further demographic development and stabilization of the country, while life expectancy at birth amounts to mere 56.19 years (Ethiopia, 2011).

Any current controversial issue Essay Example | Topics and Well Written Essays - 750 words

Any current controversial issue - Essay ExampleCriminals go forth think twice before adornting a crime if they know there are other mint in their midst with the same weapons as they have. Having a gun in the house reduces the come upings of insecurity. People feel a bit safe when they possess something to use whenever a mishap happens especially when they are alone. It is in addition effortless to flash out an intruder, when one has a weapon, intruders are kept at bay. In addition, those in self-will of a gun at home are less analogously to lose their home or get injured during a robbery ordeal. Guns and weapons, if given to the right people, that is, the law abiding citizens, butt be of great advantage to a country, but if they land in the wrong hands, it can be disastrous. Some people would argue that having a gun at home is like sitting on a time bomb. The liabilities that come with it are numerous. The owner has to take various measures to avoid hurting themselves and o thers. It is most-valuable to store the weapons in a safe side, probably locked or in a safe place to avoid them getting into unintended hands. Consciousness is a mans compass, and if one lacks it, they lack direction. such(prenominal) people, if, in possession of a weapon, one can be sure there have to be bloodshed. Unfortunately, it is not easy to identify them and hence may end up owning guns. An example of this is in the new-fashioned case at the Connecticut where a gun man mercilessly killed twenty school children for no apparent reason. The advocators of guns legalization should wake up and smell the coffee. Enough incidences have already happened for people to slake burry their heads in the sand as if nothing wrong is happening. It is ironical that the gun that is supposed to cling to the owner is the very one that kills him. There have been cases of suicide, whereby the owners of the weapons use the same weapons to end their lives. If weapons were not kept in the house, probably it would not be so simple for a few people to commit suicide. Nobody keeps a gun hoping that it will kill him one day. Everyone hopes to be protected by it if admit arises. Weapons at home have been turned against members of the family. Reportedly, licensed guns have been used in various incidences of domestic help violence. Instead of protecting loved ones, these weapons are harming them. various groups have argued that stricter measures should be adopted regarding gun will power and use, but even with the strict measures it is a no win situation unless, these guns are left in the hands of their rightful owners that is, the police and the military. Human rights activists have done a great job in educating people on the dangers of being in possession of weapons at home, but people have moreover decided to shoot the messenger. It is unfortunate that most of the times these weapons have ended up hurting impeccant people instead of the criminals. However, much people wan t to turn a blind eye to this situation. It is unambiguous the harm brought about by guns and weapons in the name of self defense outweighs the benefits. Rowdy youths in possession of guns have been seen to cause chaos and crimes in various cities. The possession of a weapon makes them feel like they are on top the world. It is unfortunate that the security officers, who are mandated and qualified to carry guns, have install themselves on the receiving end. The hunters have become the hunted. There have been various cases of police officers being

FINAL RESEARCH PAPER Example | Topics and Well Written Essays - 1000 words

lowest - Research Paper Exampledesignate the following steps in divisor therapy first, the partial remotion of a patients cells, second, the introduction of normal, functional copies of the gene via vectors to replace defective cells in the patient, and finally, the reintroduction of the modified cells into the patient in one case the genes have been fixed in their vectors (Bergeson). Treatment of diseases at the genetic level is a preferably beguiling prospect. Nevertheless, similar to any intervention in the human body, it can lead to completely unexpected results. everywhere half a century of development of this field of medicine scientists have received both exacting and negative experience in the use of gene therapy. For this reason, currently, the question of whether the further development and use of gene therapy should be allowed is particularly important in modern science. However, despite the various ethical objections to genetic engineering, this written report defe nds the idea of further development of this field, since the use of gene therapy is able to save a large modus operandi of human lives, as well as prevent the development of serious and dangerous diseases, which are rather difficult or even impossible to treat.As mentioned above, humanity suffers from a variety of serious diseases. Moreover, several(prenominal) of them have a transmissible nature that implies that they can pass from parents to their children. The problem is that many of these diseases are disgustful to treatment. This means that people who suffer from them are doomed to a painful life. Unlike other good people who enjoy life, these people are regular patients of hospitals and clinics, and their lives are always subject to continuous risk. In this regard, gene therapy is seen as a revolution in modern science, which is able to save mankind from a variety of serious and even untreatable diseases that are transmitted by heredity. Historically, gene therapy was aim ed at the treatment of hereditary genetic diseases, but later it has expanded its field of

Factors influencing participation in sport Essay Example for Free

Factors influencing participation in chromosomal mutation EssaySome people have in truth different views on calculateing and the factors that advert them to participate in sport. They have very different attitudes to neatening.Im doing clime affecting participation.Some people may want to go out in the rain and hold in as they may find this enjoyable, but a lot of other people may disfavour the cold and wet weather and stay at heart to participate in sport or notwithstanding sit about.Also the majority of people would rather be outside, but in the warmth, with the sun shining. The countrys clime is a big factor that affects the participation and subjectwrite of sport that they do, this excessively affects their attitudes towards training, for example, people in Australia testament play more outdoor sports such as windsurfing and skateboarding as their climate is ideal for this type of exercise.Kenya has produced a lot of world class athletes, this is due to their cli mate, calorifacient and dry all year. This encourages people to train a lot more and also outdoors.Kenya are world class at long outgo running as are morocco, this is mostly due to when they train, and what type of weather they train in. If the weather is hot all the time, athletes entrust train on a regular basis, but if the weather is cold and wet, the athletes result not be motivated enough to go out and train, they will either train indoors or simply just sit around and watch tv or play boardgames. This is the sentiment in Northern Ireland, and Sweden etc as these countries have unpredictable weather and climates so no one knows what type of day it is going to be. When the weather changes this suffer change most athletes attitude to training.The heat outside motivates athletes to train outdoors.Fumes from traffic and factories, over a long period of time will start to affect the community in which people live in, this will, in actual fact, bring you bad health. The fumes w ill bring harm to your lungs and make breathing difficult. This means your fitness level will suffer.The environment also affects your performance in a sport event for example, on a hot day you can overheat which makes you weak and dizzy. And think what a windy day can do to a tennis match, all these factors affect the performance and attitudes towards the training and participation in sport.At high altitudes air is hairlike than at sea level, so you mustiness breath harder in order to get the right make sense of oxygen to your lungs. To perform well in a sport at high altitude you must first need time to adapt to the climate and the type of environment you are playing the sport in.All types of weather affect the way in which we think about sport. Hot, cold, dry, wet.

Theory Essay Example for Free

Theory tasteExplain what you understand by theory. Would you reject a theory of accounting on the radix that a particular research use up found results that failed to support the theory? Explain your answer, with particular reference work to Watts and Zimmermans Positive accountancy Theory, including a discussion of wether any theory can be proved or rejected. The theory is a set of assumptions, propositions, or attempts to provide a plausible or quick-scented explanation of cause-and-effect relationships among a group of observed phenomenon. It is non helpful for improving the relationship between theorizing and qualitative empirical research in social science disciplines. It can be said that research study is established on the basic of theory. So the answer is No. According to Watts and Zimmermans Positive Accounting Theory, positive accounting is the branch of academic research in accounting that seeks to explain and predict existing accounting practices.It believes t hat it is just an object statement about what theory is and that contains no indication of approval or disapproval, instead of whether correct or wrong or being couched in terms of what should be or ought. Therefore, if the result of research failed to support its theory, it does not mean the theory and maybe the process is wrong. And I would not reject this theory. In addition, any others like PAT can also be proved such(prenominal) as agency theory and contracting theory. However, if it is a normative theory which against Watts and Zimmermans Theory, it should be rejected.

Ethics in Information Technology Essay Example for Free

Ethics in Information Technology sampleChad White (2009) discussed that by the end of 2008, retailers pitch been sending a record breaking number of promotional emails. The main question is, is this increase worth the price of all the negative consequences of such campaign? Cassar (2009) utter that people had less money to spend in 2008 and that they view the internet as a contain seeking venue but not actually purchase online. There are a circularise of costs associated with even simple system messages like, You have items left in your cart. Doubling the sending of these emails everywhere the holiday period faeces cause some serious irritation, likewise, as the accompany can comfortably be soiled as spam because of these emails that are creation sent at least doubly daily by some. Before actually spending out the money for these promotional mails, it might be better if the companies spend the extra cost in promotion by helping the customers save more, for instance, they can offer a promotional coupon or free shipping. Noguchi (2008) said that email has become too time-consuming for people that instead of aiding to get things accomplished, email has become a distraction from tend being done.In another article, Noguchi (2008) said that family can be reasons for email overload as some members of the family slam sending pictures, videos and all other stuff they can think of to every email address they have on file. These things can get really distracting especially at work. Suggestions to resolve this dilemma a someone can always limit messages in his mailbox, do not open personal emails at work, mark emails requiring action, use spam blockers, be alert on the proper subject headings (Asiado 2010). The key is being organized (Asiado 2010).Schaper (2009) said that one way to avoid email overload is taking a break from emails even once a week. In fact, his research showed one Chicago based company is implementing this exact uniform rule. They understand that email is important and necessary to business but it can just be toxic, thence this policy. Glenn (2008) said that there is practically no privacy at work. Everything done by an employee on a work computer can easily be seen by his employer as everything is saved in the companys hard drive. There is only one suggestion to resolve this avoid using work computer to do incriminating acts against your own person or another.References Asiado, T. (2010). Tips How to Reduce Email Overflow at Work. Suite101. Retrieved, 14 July 2010, from http//businessmanagement. suite101. com/article. cfm/tips-to-reduce-email-overflow-at-work Cassar, K. (2009). Little Holiday Cheer Ahead for Online Retail. neilsenwire. Retrieved, 14 July 2010, from http//blog. nielsen. com/nielsenwire/consumer/little-holiday-cheer-ahead-for-online-retail/ Glenn, H. (2008). E-mail at Work Tips to spare You out of Trouble. npr. org. Retrieved, 14 July 2010, from http//www. npr. org/templates/story/story. php ? storyId=91604666 Noguchi, Y. (2008). Help Family Spam is Crowding My Inboxnpr. org. Retrieved, 14 July 2010, from http//www. npr. org/templates/story/story. php? storyId=91402876 Noguchi, Y. (2008). Make it ruin Crushed by Too Many E-Mails. npr. org. Retrieved, 14 July 2010, from http//www. npr. org/templates/story/story. php? storyId=91366853 Schaper, D. (2009). An E-Mail Vacation Taking Fridays Off. npr. org. Retrieved, 14 July 2010, from http//www. npr. org/templates/story/story. php? storyId=91724075 White, C. (2009). Email Volume Sets New Records During Holidays. mediapost. com. Retrieved, 14 July 2010, from http//www. mediapost. com/publications/? fa=Articles. showArticleart_aid=98215

Determining Databases and Data Communications Essay Example for Free

Determining Databases and Data Communications EssayIn this paper the writer will seek to respond to the questions designated for both scenarios. This paper will list typical fields for some(prenominal)ly type of data. Provide an example of two relationships that you need to track. This paper will also answer the questions of Do you need a database system? If not, wad go past handle the data and the output? What argon the advantages and disadvantages? Would you utilisation a personal database or an enterprise database? Explain your answer. Would a decision backup system (DSS) be helpful? Explain your answer. When directing companies who work diligently with computer applied science, it be succeeds increasingly imperative to have an adequate knowledge of the technology that is obtainable. This will allow those who have to manage reading to hold back the most in force(p) choice concerning what technology should be enforced for the company. In the two scenarios, do the best choices in technology allows the manager to best confer time and energy with superficially formidable responsibilities. For instance, in the first scenario, an market assistant of a consumer electronics company is asked to not only maintain the booths for various trade shows from beginning to end, hardly is also asked to ensure that in that location any issues that arise during the delivery of the products are resolved. First, it is important to realize what reading should be maintained in straddle to best ensure that the tools that are used during the trade shows. In cases like these, it would be important to have a list that details what displays, equipment and booths are needed for proper(postnominal) trade shows, as well as when the displays, equipment, and booths should be shipped to the area and substantiate. For example, if a trade show set(p) in Tulsa, OK only needed integrity booth with one display in order to accommodate the space, it would be the job of the marketing assistant to ensure that the various parts made it to Tulsa, as well as ensure that the booth and display made it back to the position for rising use it would be necessary to know when it would be sent, as well as when it will be delivered back (which could be maintained with the knowledge of the delivering postal tracking number). In order to keep track of what is necessary for apiece trade show, there are several technological tools that would be instrumental in maintaining the education that will be transmitted.While one could use an Excel to begin the process of tracking the information that is needed, it would not be the best method of collecting that type of information, and it could be overwhelming over time. A database, on the other hand, could handle the information that is contained, and would allow the marketing assistant to create reports later on that can be used to analyze what changes could be made in the future whether it is making in front shipments in order to ensure that it reaches an area on time, etc. (Middleton, 2009). Since there would only be one person keeping track of the information, it would not be necessary to create an enterprise database, which would have the capabilities of cosmos made available to other departments within the company (Web Definition, 2012). This would allow one person to maintain the apt(p) information that other departments may need without having too many people managing information, which could lead to confusion regarding where equipment is or what is needed for certain trade shows. Also, in order to maintain the large amount of information that would come from managing various trade shows, it would be necessary for the marketing assistant to have a decision stake system, which is a computer system that is designed to provide assistance in determining and evaluating alternative courses of natural action by acquiring data from the mass of transactions of a firm, by analyzing it with advanc ed statistical techniques to buy food meaningful information, and by narrowing down the range of choices by applying rules based on decision viableness (Web Definition, 2012). This will allow the marketing assistant to gain better knowledge of what could be improved upon for future trade shows. In the second scenario, technology has to be used in order to manage a consulting team of seven, some of whom work in an office and others who work from home. In this case, ensuring that there is equal approachability to each employee is paramount to maintaining the business. A wide area network, or WAN, would help to accommodate the needs of employees who are working in the office as well as those who work from home. The WAN would create several LAN connections that would allow workers to the same portal to important information regardless of where they are (John, 2009). Also, for projectsthat more than in all probability will be time-sensitive, employees within the consulting team wil l have access to the printers and other equipments that is a part of the network, so that tasks are completed in a timely manner (John, 2009). While there are certain security risks with using WAN that includes the potential infiltration from people other than employees and the possible placement of viruses that would threaten the maintenance of information that is stored, the use of anti-virus programs and other programs would help to protect the computers and information that they have, and the eudaimonia far outweigh the potential risks. Also, a wireless access would better assist the team in completing tasks in different areas.Like WAN, wireless access would assist employees in gaining pertinent access to the information may normally be stored in in the office. For a consulting team who works in different areas, privacy and computer protection become a relevant problem that can be addressed with creating a virtual private network, or VPN. A VPN would ensure that the information that is held at the office for the team remains on a network that would only be accessible by the team, and it would interrupt others who are not a part of the team from placing viruses on the computers or accessing the information, which could greatly hinder the utmost of tasks and the accessibility of information. When considering what wireless networks should be used, cost as well as features must be considered. Excel documents often help to organize this information in order to assist leaders in making decisions regarding the best wireless network to purchase. For instance, if a wireless network is priced low but does not leave the speeds or other features necessary to operate for a company, the network would not be good to swing money on. However, it could be equally dangerous to expend a lot of money on a wireless network that has a lot of features that may or may not be used. As a result, this requires that a company list the various features that would be necessary for the functioning of the company. The company can then review the list of features that are included for wireless networks that they are considering, listing the price of each network. This allows them to find the wireless network that best meets their companys needs without paying a lot of money for it. In conclusion, having a working understanding of the technology that is available to a company can help managers make wise and efficient choices regarding what tools should be used. In the first scenario, using databases in comparison to excel documents allows the marketing assistant to properly track equipment that is used on a daily basis, as well as track where it is being shipped to. In the second scenario, using WAN or wireless networks allow a team to maintain access to pertinent information that could help employees complete tasks in a timely manner regardless of their location. In these ways, technology assists companies in maintaining their business.ReferencesDecision Support System. (2012). Decision support system. Retrieved from http//www.decisionsupportsystem.info/Middleton H. (2009). Maintaining a relational vs. flat file marketing database. Retrieved from http//www.dbmarketing.com/articles/Art223.htmCharlene N. (2010). Benefits of developing maintaining a database. Retrieved from http//www.reviveprojects.com.au/blogs//2010/10/06/benefits-of-developingmaintaining-a-customer-database-Web Definition. (2012). go-ahead data. Retrieved from www.dataclaritycorp.com/cognos-glossary.html

Judging Words Not Fidgets Essay Example for Free

assessment Words Not Fidgets EssayJudging satin flower by Words, Not Fidgets is a short analyze written by Benedict C bey. It explores how in police interrogations, interviewers behind use words to decide if people are lying more than looking at their physical movements. Traditionally, police provoke used lie detector tests and underhanded techniques to force suspects and witnesses to give confessions. This author cites seek and experiments to show that analyzing how a witness communicates preserve be indicative of his/her honesty.This essay explains how different, less aggressive interrogating techniques, can be more helpful than forceful types of questioning. It points out that some clock times suspects can learn to cheat on a polygraph and that liars may not have different body language than those that are being truthful. This essay has many strengths. One is the authors use of entertaining phrases and questions at the beginning, which helps to engage the referee. A nybody that has watched Law and rove or CSI has seen the type of interrogation where the police lie to the suspects to get them to confess.The opening makes a connection with the reader in an entertaining way and that is a strength of this essay. There are also many examples of interrogation that have been used to tell if people are lying this indicates that the writer is informed and makes him credible. The reader has assertion in the authors information. This essay is short and easy to read, which is a huge positive. When essays are long, they operate to take the reader out of the mindset needed to maintain interest.The author points out how police are altering their techniques to make use of this research, so the application aspect of this research is interesting. While there are many strengths to this essay, there are a few weaknesses as well. The biggest weakness is in the amount of time spent reading names of psychologists and researchers that have studied body language, i nterview techniques, and lying. While it is understood that it is a requirement that researchers names be cited, it takes away from the entertainment value and becomes more like reading a research paper and can be boring in those sections.Another minor weakness is the find of the TV show Columbo at the end of the essay. While the character in that show may have used some of the techniques from the research, many contemporary readers may not be familiar with him. Judging Honesty by Words, Not Fidgets is a short, easy read. It is also actually interesting since most readers have seen police interviews on TV and in the movies and are familiar with some of the techniques fictitious officers use.Also, with all of the mankind shows on TV today, many readers may have seen real interviews taking place. With readers having some knowledge of the topic, it is very interesting. While there are a few minor weaknesses of this essay, overall, it is entertaining and engages the audience. Works C ited Carey, Benedict. Judging Honesty by Words, Not Fidgets. 2009. The McGraw-Hill Reader Issues across the Disciplines. Ed. Gilbert H. Mueller. 11th ed. New York McGraw-Hill, 2010. 9-12. Print.

Share Holder Value Essay Example for Free

Sh are Holder Value EssayPublic and private companies are under a great deal of pressure to create and sustain partingowner cherish by change magnitude both harvestings on nifty and increase paces and comp whatevers stock expenditure or equity treasure. persona bearers would like to associate with a tighten whose stock prices are non depressed. Who is a partingholder? A share holder can be defined as the proprietor of one or more shares of stock in a corpo proportionalityn, commonly also called a stockholder.The benefits of cosmos a shareholder include receiving dividends for each share as determined by the Board of Directors, the expert to vote (except for certain preferred shares) for members of the tabular array of directors, to bring a derivative action (lawsuit) if the corporation is unwell managed, and to participate in the division of repute of assets upon dissolution and winding up of the corporation, if on that point is any assess. A shareholder s hould induce his/her name registered with the corporation, but may hold a stock certificate which has been gestural everyw here(predicate) to him/her.Before registration the new shareholder may not be able to invest votes represented by the shares. (Enhancing share holder honour, Dr William . e. Broxterman Chairman/CEO Chemquest Group,unc). Shareholder take to be is a short letter term, which implies that the ultimate appreciate of a come withs success is to enrich shareholders. It became popular during the 1980s, and is particularly associated with former CEO of global Electric, Jack Welch. ( In March 2009), Welch openly turned his back on the fancy, calling shareholder tax the dumbest idea in the world.The term used in several ways To refer to the market crackingization of a beau monde (rarely used) * To refer to the concept that the primary goal for a company is to increase the wealthiness of its shareholders (owners) by paying dividends and/or causing the stock pr ice to increase * To refer to the more circumstantial concept that proposened actions by counseling and the returns to shareholders should outperform certain bench-marks such as the cost of capital concept. In essence, the idea that shareholders silver should be used to earn higher returns than they could earn themselves by investing in other assets having the same amount of run a risk.The term in this sense was introduced by Dr Alfred Rappaport in 1986. ) In (1981, Jack Welch made a speech in Hotel Pierre, New York City called) Growing fast in a slow-growth economy (8. 12. 1981) this is often acknowledged as the dawn of the obsession with shareholder value. Welchs stated vex was to be the biggest or second biggest market player, and to return maximum value to stockholders. Strategic planning In todays fast-changing, often business environment, formal systems for strategic planning have become one of top managements principal tools for evaluating and coping with uncertainty. One of the key roles of Board of directors is to authorize and withdraw the strategic and annual business plans, the setting of objectives and review of key risk and performance areas. Corporate board members are also showing change magnitude interest in ensuring that the company has adequate strategies and that these are tried and true against actual results. While the organizational dynamics and the sophistication of the strategic planning process vary astray among companies, the process almost invariably culminates in get offed (commonly five-year) financial statements.This enables top managers and the board to review and approve strategic plans in the same terms that the company reports its performance to shareholders and the financial community. Under current figure the envisioned financial statements, particularly projected earnings per share performance, commonly serve as the stem for judging the attractiveness of the strategic or long-term corporate plan. The conven tional accounting-oriented approach for evaluating the strategic plan does not, however, provide reliable answers to such basic questions as Will the corporate plan create value for shareholders?If so, how much? Which business units are creating value and which are not? How would alternative strategic plans affect shareholder value? Managing shareholder value This management principle, also known under value based management, states that management should first and foremost consider the interests of shareholders in its business decisions. As shareholder value is difficult to deviate directly by any manager, it is usually broken down in components, so called value drivers. A widely used model comprises 7 drivers of shareholder value, giving some guidance to manage.These drivers are, * Revenue, the amount of money that is brought into a company by its business activities. In the case of government, revenue is the money received from taxation, fees, fines, inter-governmental grants or transfers, securities sales, mineral rightfulnesss and resource rights, as well as any sales that are made. * Operating Margin, the ratio used to measure a companys pricing strategy and operating efficiency, if a companys margin is increasing, it is earning more per dollar bill of sales.The higher the margin, the better. Can be calculated as Operating margin=Operating Income/Net Sales. * interchange Tax Rate, the cash a company pays to governments as a percentage, while looking at an unlevered company. * incremental Capital Expenditure, additional cash invested by a firm in its long term assets in piece to generate a dollar of new sales. * Investment in Working Capital, a measure of both a companys efficiency and its short-term financial health.The work capital ratio is calculated as, working apital=current assets-current liabilities * Cost of Capital, equity and debt capital and the related discount rate. * Competitive Advantage Period, advantage over competitors by offeri ng consumers better value either through greater benefits or lower prices. Share holder value, and the Economic value concept The value that a shareholder is able to obtain from his/her investment in a company ,is made up of capital gains, dividend payments, and proceeds from buy back programs and any other payouts that a firm might make to a shareholder.In other words share holder returns exceed the required return to equity, and the company is deemed to have exceeded the required expectation. Share holder value in recent long time is being measured using the Economic Value Added Concept (EVA), a measure of a companys financial performance based on the residual wealth calculated by deducting cost of capital from its operating profit (adjusted for taxes on a cash basis). Share holder value, and the WACC conceptInvestors use WACC as a tool to decide whether to invest. The WACC represents the minimum rate of return at which a company produces value for its investors. Lets say a compan y produces a return of 20% and has a WACC of 11%. That means that for every dollar the company invests into capital, the company is creating nine cents of value. By contrast, if the companys return is little than WACC, the company is shedding value, which indicates that investors should put their money elsewhere.It measures a trend of improving or declining share holder value and it helps managers to focus on projects, businesses, product lines and activities yielding more than a firms weighted average cost of capital WACC (The return that both debt holders and equity holders expect, WACC, in other words, represents the investors opportunity cost of taking on the risk of putting money into a company. Investors use WACC as a tool to decide whether to invest. The WACC represents the minimum rate of return at which a company produces value for its investors.Lets say a company produces a return of 20% and has a WACC of 11%. That means that for every dollar the company invests into cap ital, the company is creating nine cents of value. rate of flow value of a business is fairly expressed by the share price, there fore increasing EVA should move prices upwards. This means an earning return greater than its cost of capital. Value creation for shareholders through strategic acquirement Acquisitions have known to create value for share holders, however this has to be done strategically, for ideal in the study of industry acquisitions in 1998(1999 The Chemquest Group.Inc) describing the adhesives industry, such acquisitions have integrated a number of companies in to a single unit with a positive EVA have added significant value and enhanced shareholder value of the company. In order for an acquisition to create share holder value it must generate a positive NPV. In other words it behaves the same as a capital investment. By carrying assets that maximize long term value of the firm for example outsourcing activities such as manufacturing.Dell investments are complic ated extensively in marketing but out sources distribution, inventory and manufacturing. Also hiring of employees should be strategic. Share holder value and capital structure design Share holders wealth can be improved with increasing leverage by using more debt in place of equity and or dealing judiciously with debt and equity, designing a capital structure that will reduce WACC and increase the value of the firm. This is based on the fact that the composite cost of debt lies between the least expensive debt and the more expensive equity.This approach enables the maximization of corporate profits and shareholders equity. By keeping an eye on the capital market for the firm, the Financial private instructor should keep an eye on capital markets for the firm, substituting methods for more effective ones which can improve the firms value and so the shareholder value. Areas such as interest on loans and normal dividend rates as driven by the market should be examined for decisions. Share holder value and expansion and diversificationA company can increase shareholders wealth by diversifying for example addition of a new product line. When BOC gases wanted to expand its business there was consideration by the board for an acquisition of a business in a similar industry, Carbacid. Although this did not succeed, the focus to grow through this product is still on and there is a plan to buy a carbon dioxide mining well. Nakumat seeks sh 1 billion for expansion and is talking with commercial banks for a syndicated loan.The loan is a long term five year loan to be used for stocking new branches recently opened in Rwanda Kigali( avocation Daily pg 23). Share holder value and replacement and modernization Finlay Kenya in kericho the tea producing company has replaced a large number of manual intentness, with machinery for plucking tea leaves in a bid to modernize the labor market, to improve on productivity and to reduce labor costs and there fore shareholder valu e. Boc gases is evaluating an investment for an additional air separation in order to improve performance of machinery (Annual Report 2007).As a firm continues to grow, it may consider improving its sell centers, availing information to customers , displaying sales ware while encouraging caller customers to come and buy the goods in the retail shop. Investors Africa transformation fund, are trying out new methods to tap Africa Agriculture aimed at double dactyl returns with programmes to boost food production. ( Top News Business Daily pg 3 Dec 6 2010). Share holder value and investment decision ruleThrough sound capital budgeting techniques, a firm may come up with appraisal techniques to measure economic worth of an investment project for example, advent up with an unambiguous way of separating good projects from bad projects, ranking projects according to profitability, and choosing amongst a number of projects, the project that maximizes wealth. Investment decision can be divi ded into long-term and short-term decisions and techniques. Capital investment decisions are long-term choices about which projects receive investment, whether to finance that investment with equity or debt, and when or whether to pay dividends to shareholders.On the other hand, short term decisions deal with the short-term balance of current asses and current liabilities the focus here is on managing cash, inventories, and short-term borrowing and lending (such as the terms on credit extended to customers), for example treasury has signed up for a new World Bank fronted bonds trading plan, which should help the commutation bank in diversifying its forex reserve mix and cushion the shilling against wild swings(professor Njuguna Central Bank of Kenya Governor, Business Daily Dec 6).Share holder value and discounted/non discounted cash flow methods By recognizing that bigger and earlyish cash flows are preferred, the shareholders value can be improved. Using discounted cash flow meth ods such as NPV and PI. When NPV is +ve, the project should be accepted and when it is ve it should be rejected. In the decision rule for profitability where PI is less than 1, then the project should be rejected while where PI is greater than 1 then the project should be accepted.In the non-discounted cash flow method, projects with higher ARR are preferable. In order to make the right investment decision, it is important that the project is thoroughly analyzed using available tools, remembering that the resources are nominal and can not be wasted. Increasing or liquidating part of shareholding This can be achieved by shareholders taking up shares and so increasing their investment in the business, or selling their rights and liquidate part of their investment.In theory, share splits have a positive effect on the shareholders wealth because they encourage beneficial price movements. This should be in line with the dividend policy. Cash cycle and cash management Firms should ensure that there is a match between accounts payable and accounts receivables and that payment to creditors is delayed while receivables are collected earlier. These may appear like daily chores but can cost the shareholder dearly if poorly managed.Many firms have closed down because of not managing accounts receivables appropriately. Summary In summary Strategies selected in creating share holder value should be strategic in the real sense. Strategies selected will usually cover three to five years and will incorporate the big picture. Strategies of substance that have been tested will ensure that the right programs for growth of the firms share value are selected and implemented.

International Students in America Essay Example for Free

Inter populational Students in America EssayDid you know that there were oer six hundred and twenty special K international students in the get together States of Americas universities and colleges for the academic year 2007/08? This according to the lax Doors report by the lay down of International Education was a 7 pct increase. tally to the Mr. Goli Ameri, the Assistant Secretary of State for Educational and Cultural Affairs, the increase in adjustment was an indication that ground forces is still the premier destination for foreign students.U.S. higher education is unparalleled in its vitality, quality, and diversity. The U.S. regimen joins the U.S. higher education community in a commitment to wel engender international students to the linked States (Gardner and Witherell, par. 1)He stated that he had graduated in the United States as an international student and thence was in a better position to testify that Americas universities not only deport and welcome inter national students warmly, but transform their lives (Gardner and Witherell par. 1). The United States department of state has expanded escort to advice on US education by setting up centers around the humans in order to back up students gain rag to American education.The itemize of the international students in the United States is double that of the United ground (the second host). It was reported in the year 2007 that the international students in the States contributed about thirteen trillion US dollars to the its economy through their living expenses and tuition charges (Ford p. 1) This research paper seeks to show the reasons why the United States of America is the most preferred destination for the international students.Statistics of the international students in USAAccording to the Open Doors 2008 report, India is the leading country that sends students to the United States with the figure increasing to ninety quad molar concentration, five hundred and lux third. Th e second sender was listed as China with cardinaly wiz molar concentration, whizz hundred and twenty unmatched students in US. Those from South Korea took the third spot with threescore nine thousand, one hundred and twenty four students (which was an eleven percent increase).Though it showed a four percent slight drop, Japan was fought with thirty three thousand, nine hundred and seventy four students in US. Canada took the fifth spot with twenty nine thousand and fifty one students. Other countries with students in the United States be as follows Taiwan 29,001 and Mexico, 14,837 (this was a seven percent increase).Saudi Arabian students in the United Stated increased to nine thousand eight hundred and seventy three, this being attributed to the scholarships that are being offered by their government in a schedule that was launched in 2005. The greatest increase (45%) was by students from Vietnamese students with eight thousand seven hundred and sixty nine students. Other international students in the United States universities and colleges came from Indonesia, 7692 Nigeria, 6,222 and Kenya with 5,838 students (which was an eight percent drop) (Gardner and Witherell par. 1-10).From the statistics above, it is clear that Asia accounted for the sixty one percent of all international students. Philippines recorded a twelve percent increase Singapore, seven percent Mongolia, thirteen percent Hong Kong, seven percent. However the following Asian nations recorded a decline in the number of students they sent to US Pakistan, one percent and Bangladesh, four percent. Others with the same trends include Israel, Palestinian Authority, Yemen and Lebanon (Gardner and Witherell par. 1-10).According to the same report, US Universities that had the highest number of international students, University of Southern California lead the pack with seven thousand one hundred and eighty nine of students. Other leading Universities included New York University, 6404 Columb ia University, 6297 University of Illinois, 5933 Purdue University (main campus), 5772 University of Michigan, 5748 University of Texas, 5550 Harvard University, 4948 and capital of Massachusetts University with 4789 international students in US (Gardner and Witherell).Reasons why USA is a preferred destination for International Students star may be keen to ask the question of why the nation has led opposite nations of the population such as Britain, Germany and France in enrolling international students. The United States has been reported to piss a great wealthiness of initiatives and policies meant to lure international students into its educational system such as policies that include specific visa and add requirements.This is despite the drop in enrolment that was caused by the September 11 terrorist bombings of the United States. This is in phone line to the small number of students that the nation sends to the other nations. According to the statistics, only about forty five thousand American students study abroad, majority of them being in the United Kingdom and Canada (Cremonini et al, par.1).To maintain the lead in maintaining the number of foreign students who study in USA, the government and the higher education state of affairs has intensified its promotional efforts. They have done this by opening several centers in different countries that serve different regions of the world and reducing the Visa regulatory rules for the students (Cremonini ET all, par.Cremonini refers to the United States as the academic powerhouse meaning that it is academically absorbive. He states that the charity can be associated with civilization attraction which is a social contract pattern or a flow of people a situation that explains why researchers and students tend to travel to countries and centers that are acknowledge and attractive.A zone civilization attraction is neartimes referred to as a zone of prestige. Academic attraction is also related to other concepts used to study higher education mobility. The concepts posit that many of the educational possibilities are in specific places of the world and that become the most popular destinations for international students (Cremonini ET all, par. 6).Ann White, the director of China-Hong for the Institute of International Education stated that the United States is the preferred destination for the Hong Kong students because they associate US degrees with quality and prestige. She added that students from Hong Kong are drawn to lifelong rewards and values of study in the United States of America (Institute of International Education p.2).The other reason why for those students to prefer the US Universities and colleges is because they are in a better position to access information about higher education that is accurate and comprehensive as compared to other countries. There is an EducationUSA office in Hong Kong providing the needed information in addition to the increased level of ac tivities by Universities and colleges from the USA to attract these students.The IIE often organize the annual US Higher Education Fair in Hong Kong and it was reported that in the year 2008, it attracted twenty five percent more attendees when compared with the previous year (Institute of International Education p. 2).The government has established a website with extensive databases of grants, scholarships and fellowships that are organized by Institute of International Education. The president and headway Executive officer of IIE stated that the increased number of the international students in the US is as a result of the actions that are taken by the US government plus the Colleges and Universities to make sure that those students reckon that they are welcome and that that their contribution to cultural and the environment is highly appreciated (Institute of International Education p. 2).The USA Department of State online newsletter has in it the reasons as to why US education is preferred. One is that U.S. colleges and universities are known to have resources, faculty and facilities of high quality. To maintain the standards on these institutions, accreditation systems are used. Secondly, the education system in US features several types of academic and social environments, institutions, degree programs, entry requirements, and subjects from where students can specialize.Thirdly, degrees in US have a wide range of tuition fees and living costs, in addition to the financial help that some colleges offer, this resulting into affordable education for many students. Finally, the Universities and colleges in the United States are flexible in offering courses that one can even study in one college for two years and then move to some other for the next two years (Bureau of Educational and Cultural Affairs).Several Universities in US have come up with academic and social programs for the international students. The support program may be based on identifying t he students at risk, analyzing their languages and cross- cultural needs, research their academic performance, assist in finding accommodation, monitoring their income and providing the exit support so that the students can be prepared to enter global labour markets. This is helpful as USA continues to compete for international students with other nations (Clendenin, par. 2-5).ConclusionFrom the research, it is clear that the United States of America is the largest destination for the international Students. However, this has not been achieved easily but through policies and activities by the government to attract many students to the nation. However, it is also clear that the nation is facing stiff competition from other nations such as Britain and Germany. With such programs that have been initiated to maintain the number of students, US will continue leading in this area.

Corn coffee Essay Example for Free

Corn java EssayMajority of Filipinos atomic number 18 cocoa drinkers. The growing number of java shops in almost either lemoner of the metro has become the most evident indication that the coffee industry is a well-to-do business. Whether its a form of social activity or simply a favorite pastime, tipsiness coffee has become an inevitable trend. With the popularity of coffee as a beverage comes the cautious effort to fall the caffeine intake especially among health conscious consumers. Hence, introducing ersatz drinks that will let people love drinking coffee without worrying too much caffeine intake. Corn coffee looks and tastes like your strong ol caffeinated coffee, but it is healthier to drink. Perhaps a distinction comes with the aroma since give coffee comes from ground, roasted corn, explained Mr. Chito Rodriguez of the convey of Plant Breeding-University of the Philippines Los Banos (IPB-UPLB) in a seminar talk organized by the Bureau of Agricultural Research (BAR). In the presentation titled, Corn Coffee Health and Economic Benefits, Rodriguez underscored the dark side of caffeine one familiar of which are threat attacks.Caffeine intake triggers the fight-or-flight mechanism in our bodies. When the fight attack mode wears off, panic attack starts. We add nervous, jittery, sweaty, and shaky. Caffeine is also addictive so once we get into the habit of acquire our caffeine fix, our tree trunk begins to crave the boost that we get from it. If we fail to get the dose of caffeine that our body has adapted to, we become irritable, tired, and even depressed, Rodriguez explained. Given the side effects of caffeine, he advised trying coffee corn instead. The healthful benefit.Essentially, the healthful benefits came from corn which is packed with vital nutrients that provide energy, growth and development, and regulate embodied functions. Although some of these may have been reduced after(prenominal) roasting and grinding the corn, the ess ential nutrients are slake there. Every 100 gram of corn coffee contains carbohydrates, fiber, ash, protein, and antioxidants, explained Rodriguez. In a taste test conducted after the seminar, Mr. Patrick Lesaca, one of the participants and a coffee enthusiast, revealed that, corn coffee does look like your regular cup of coffee, besides that it smells roasted corn. Clearly, a great distinction comes with the health value of corn coffee. The dark liquid you are drinking is caffeine free and is healthier, Rodriguez added. Aside from the nutritive value, Rodriguez enumerated some of the healthful benefits one can get from drinking corn coffee. It can control diabetes, prevent cardiovascular disease, lower hypertension, reduce cholesterol level, sully risk of colon cancer, and prevent neural-tube defects in infants, he reported. The economic benefit Corn coffee is non new.In fact, people in the province have been boiling their roasted, ground corn as alternative to coffee. Currentl y, with the advent of new technologies and the need for healthy alternative, corn coffee has already reached the mainstream market. It is being commercially interchange and is available in the supermarket, one of which is the famous Sumilao Corn Coffee. But if you want to produce your testify coffee, its easy. Ground corn is roasted until the color turns to dark brown. The resulting coffee powder is boiled for 10-15 minutes.You alone allow the sediments to settle and then get the black liquid and then your hot corn coffee is ready to serve. Sugar and cream can also be added to enhance the taste, explained Rodriguez. The production cost of corn coffee is cheap. One kilo of corn when processed can produce an approximately one kilogram of coffee, he said. When packaged, the production cost is about Php120 per kilogram. Corn coffee is currently being sold in the market from Php 350 Php 500 for every kilogram. This means at least Php230 profit for every kilo of corn coffee sold.

The drugging of our children Essay Example for Free

The drugging of our children EssayAre young children archeozoic on exposed to psychotropic medications due to lack of checkup attention? Do millions of children in these countries in reality catch institute or minimal brain dysfunction? These questions arise all over North America, Great Britain, and Australia. medicate of children at young ages is the result of self-diagnoses, teacher diagnoses, and lack of medical cargon and treatment for children with the disease of tending Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder ( attention deficit hyperactivity disorder).In the documentary The Drugging of our Children, Gary Null, Forever subsisting Products, 2005, DVD Web, brings ab reveal the argument. Back in the 1980s and 1990s children began to be put on umpteen different drugs for their behavior in schooling, the main drug being Ritalin. In the documentary, Null speaks out to parents of children that are on medication by interviewing many differen t parents, physicians, and education committees about the use of Ritalin and opposite psychotropic medications in young children.All of these things that are being evaluated of the childs behavior is at school, and is compared to the expected behavior of that particular teachers classroom. The conduct goes on explain how teachers diagnose those more than challenging students with either ADD or ADHD and have them forced to put their kid on a medication to cure their so called disease. After showing each case and their stories, the film excessively reflects the long circumstance effects of the medications also. The process of diagnosing a child with ADD or ADHD starts in the school environment.Teachers early on look for flaws in students in regards to classroom disruption. There is a list of nine elements including cant sit in seat, fid cleaves, jumping out of chair, doesnt seem his turn, blurts out answer before question is finished being asked, careless mistakes in schoolwork etc. If the teacher can identify at least six out of the nine characteristics, then she has the laterality to tell the parent that their child will be sent to a special submits school program. They will also tell parents that their child needs to be medicated for this disease.Dr. James Schaller of the Medical College of Pennsylvania (Life handwriting James Louis Schaller, MD) believes that one must rule everything out first and then see the actual fuss before considering medication. It is common in this day and age for people to accuse the hyperactive child of their parents non knowing how to raise or control them. Dr. Michael D. Fraser states that parenting style is not a nonplus of ADD and ADHD but that its hereditary and can even have to do with things like low kindred weight, diet, and allergies.Needleman stated that, It has also been claimed that exposure to lead can cause delinquent behavior in children. The payoff one symptom of ADD or ADHD is Often fidgets with hand s or feet or squirms in seat, stated by Peter Breggin, MD. Null only gets facts and stories from people that have been negatively affected by the use of psychotropic medications and doctors that are against the use of them. The interview is only open to wrap the perspicacity around tragic situations thatll lead to agreement with the argument presented. It was observed that as children got older, school shootings became more common.The cause of this was claimed to be that children now days had easier access to guns in the home. Researchers looked further into this answering their own questions like Werent guns easy to access in the 1950s and 1960s? In fact, yes, it was just as easy, if not easier for children to get their hands on guns then also. Physicians looked further into the children committing these acts. Miguel Humara, Ph. D states that, The most effective form of treatment for ADD and ADHD are cognitive behavioral therapy, and psychotropic medication.All of the children featured in the film had a history of being on some sort of psychotropic medication, the most common being Ritalin. These drugs are most commonly meant for people ages eighteen years or older, but doctors were being inert and just prescribing these drugs to small children also. Comparing an eighteen year old on Ritalin to a seven-spot year old on it, they had different side effects. While the eighteen year old was experiencing business and vomiting, the seven year old was hallucinating and unconsciously doing violent acts.Obvious to viewers that these had long term consequences to younger aged children. This information makes sense and is valid from people with first-hand experience, but what about the people with no horrendous side effects? What about the doctors that do rule out everything before trying out medicine? These things should have also been addressed throughout the film for accurate accusation. The argument is strong and makes the audience forecast about medicating young children and is definitely persuasive in making them agree.This argument makes the audience think more in depth of the side effects of medication on young children in some(prenominal) their short term and long term effects. Null, throughout the entire film, speaks to the audience through the credibility of doctors, educators, and parents that have lived through experiences. This is an effective way to grab the attention of the audience with real life stories of victims. It makes the audience receive as if they know the victim and can have sympathy for their experience and on that pointfore be able to agree with the argument, making the argument effective.In reality, young children are going to be a potato chip hyper and squirmy in their childhood and shouldnt be look at as diseased or troubled. They need time to grow up and understand acceptable behavior. Though teachers and parents quickly make the assumption that there is something wrong, doctors need to be the ones to m ake the ultimate decision. Therefore, drugging of young children is the result of self-diagnoses, teacher diagnoses, and lack of medical attention and care for those with ADD and ADHD.

How Students and Teachers Can Avoid and Prevent Plagiarism Essay Example for Free

How Students and Teachers Can Avoid and Prevent Plagiarism strainPlagiarism has been any and every spell outrs concern, both in the scholarly and non scholarly sense. It is the dreaded term which implies various complications from those who choose to plagiarize, those plagiarized by accident, and those authors who are mere victims of such unfair treatment. From the students standpoint, neat and keen consideration must be done in the process of how they choose to construct their ideas and write about a required topic.With the lenient accessibility of information within a clicks reach, buccaneering even gets more tempting. The Michigan Library Association (MLA) Forum (2008) adds With the Internet offering students such a wealth of information at their fingertips, it is no surprise that one of the main reasons that they commit acts of plagiarism is simply due to how easy and convenient it has become (n. p. ). Hence, students must understand the definitions and details of what plagiarism is and what to do and what not to do as a plagiaristic situation arises. Students always use plagiarism insure free.Students must maintain their academic responsibility as they fulfill the scholastic obligations. Students should be responsible in understanding and realizing other tools available to them as they fulfill certain literary requirements. The use of methods like puritanical paraphrasing, formal, and correct citing of references, being consistent to the requirements of a specific referencing style plagiarism may be avoided given that all must be understood and well executed by the student.From the teachers standpoint, there are a series of issues which must be explained to the student. The clear discussion of what plagiarism is and the consequences it brings must be well and exhaustively comprehended by the students. Teachers should emphasis the valuable use and wideness of the use of bibliography. As the Plagiarism. org (2008) writes Emphasize that the p romissory note has to be in their own voice and words, and should specifically discuss the relevance of the source to their research (n. . ).Teachers should describe themselves clear and specific in what they demand of their students. They should help exercise further the skills of their students such as by assigning the students to make a presentation which would enhance their research and idea conceptualization. It is also of beneficial importance for teachers to be creative in building their students skills in writing formal academic works.

Case Study Of Unstable Angina

Case Study Of tottering AnginaThe tolerant in mount is a 61 year old male, Mr. X, admitted to hospital in the late evening for a persona of insecure angina. Presenting complaints include left-sided bosom aggravator which was slight severe than that of his previous admission and localized agony during rest. Absent symptoms argon prof utilise sweating as well as na uptakea and vomiting, orthopnea and paroxysmal nocturnal dypsnoea, cough and fever. tolerants past medical history includes diabetes mellitus and hypertension diagnosed 6 years ago, ischaemic nitty-gritty malady (IHD) since 3 years ago, for which the virtu onlyy hospital admission was 11 months ago. In the previous admission for IHD, Mr. X also suffered from pneumonia and ventricular failure, his electrocardiogram (ECG) indicated right bundle branch pulley-block, his blood serum troponin I levels were 0.3 ng/mL ( principle levels 0-0.1 ng/mL), and his creatinine levels were 5.0 mg/dL (normal for males 0.2-0. 6 mg/dL). Mr. X is also afflicted with inveterate kidney disease, for which his base crease creatinine during his last admission was 208 mol//L. Mr. X has retired from the military and is living with his wife, who monitors his medications and compliance. He used to be a degenerative smoker but has stopped smoking 15 years ago. His previous medication history is as be junior-gradeDrug and FormStrengthFrequencyFurosemide tabs40 mgBDOmeprazole tabs20 mgPRNAmlodipine tabs10 mgODSimvastatin tabs20 mgONPerindopril tabs4 mgOD put off 1 Table demo past medications of Mr. X.Mr. X takes no non-prescription medications and has no known drug completelyergies.On examination he appears to be alert and comfortable on his pinched ignorenula for delivery of oxygen 3L/min. His blood pressure is 134/81 mmHg, pulse rate is 76 bpm, body temperature 37oC, SpO2 of 99%, abdomen feels soft and non-tender, and no pedal oedema was observed. A blood glucose strip test reveals that Mr. Xs glucose levels w ere 10.3 mmol/L. sine qua non ECG shows right bundle branch block and no ischaemic changes. The tentative diagnosis was top-heavy angina and further tests were scheduled, including a full blood count (FBC), renal profile (RP), liver employment test (LFT), troponin and creatinine (CKMB) investigations, as well as a urine full examination and microscopy (UFEME). The immediate device was to give Mr. X subcutaneous enoxaparin 60 mg stat and twice daily thereafter, acetylsalicylic acid 75 mg tablets once daily, lovastatin 20 mg tablets once daily, sublingual glyceryl trinitrate when required, and to continue the 3L/min oxygen disregardnula.clinical Progress solar day 1Morning enduring was well, free from thorax pain, tolerating orally and scurvy from no nausea or vomiting. He had minimal shortness of breath (SOB). Troponin I levels were at 0.15 ng/mL and ECG showed no smashing or evolving changes. Fasting plasma glucose was at 4.8 mmol/L (within normal range). second-string deh ydration was observed using the skin pinch test, so patient was started on intravenous normal saline drip (3 x 500 mL bag per 24 hours). Patient was found to be anaemic due to pre-existing chronic renal failure.EveningPatient report mild chest pain and SOB. His troponin I levels were 0.15 ng/mL and some other springys were normal. His creatinine levels were 423 mol/L.Day 2Patient felt comfortable and his vitals were normal. His creatinine levels hangd to 345 mol/L.Day 3Patients flesh was well, no chest pain was reported but he was still experiencing some SOB in the morning, which subsided in the afternoon. Patient was put on continuous peritoneal dialysis in the late morning. Patients vitals were normal, and he was taken gain enoxaparin in the evening.Day 4Patient complained of chest pain in the morning, with minimal SOB. His vitals were normal. hypodermic enoxaparin 60 mg was given and the IV saline was continued.Lab FindingsUrine Biochemical Analysis (Day 1)investigation va lues typical valuesProtein++100 mg/dLGlucose forbidnegativeBloodnegativeLeucocytes+-10 WBC/LKetonenegativenegativeBilenegativenegativeUrobillinogennormalSpecific gloominess1.0251.003 1.040pH5.54.6 8.0NitritenegativenegativeTable 2 Results of urine biochemical analysis on Day 1Lipid Panel Fasting Serum Lipid plasma supply cholesterol / mmol/L4.5Desirable Borderline 5.17-6.19 last gamble 6.20Plasma triglyceride / mmol/L1.27 Desirable Borderline 1.7-5.64High happen 5.65Plasma LDL-cholesterol / mmol/L2.91 Desirable Borderline 3.36-4.12High attempt 4.13Plasma HDL-cholesterol / mmol/L1.01 Desirable 1.03High risk Total cholesterol / HDL-cholesterol4.5Desirable Borderline 3.8-5.8High risk 5.9Table 3 Results of lipoid panel (fasting serum lipid levels).Renal ProfileElectrolytesMeasured levels on Day 1-1.14amMeasured levels on Day 1-12.54amMeasured levels on Day 2-10.47amNormal rangeUrea / mmol/L22.822.421.12.8-7.2Sodium / mmol/L129128129136-146Potassium / mmol/L5.34.84.73.5-5.1Chlor ide / mmol/L989410198-107Creatinine / mol/L42339834558-96Table 4 Renal profile of Mr. X showing levels of electrolytes and creatinine.Plasma troponin I 0.15 ng/mLLiver lam TestMeasured levelNormal rangePlasma total protein81 g/L66-83 g/LPlasma albumin34 g/L35-52 g/LPlasma globulin47g/L25-44 g/LA/G ratio0.70.9-1.8Plasma alkaline phosphatase119 u/L30-120 u/LPlasma aspartate transaminase19 u/LPlasma alanine transaminase43 u/L Plasma total bilirubin6 mol/L5-21 mol/LESR47mm/hour 0-20 mm/hourTable 5 Results of liver function test showing protein and liver enzyme levels in plasma.Full Blood Count (FBC) (Beckman Coulter)Cell typeMeasured levelNormal rangeWBC9.9109/L4-10109/LRBC3.341012/L3.8-4.81012/LHaemoglobin95g/L120-150g/LHaematocrit0.273L/L0.36-0.46L/LMean cell volume81.8fl.83-101fl.Mean cell haemoglobin28.4pg.27-32pgMCH niggardliness347g/L315-345g/LPlatelets353109/L150-400109/LRDW19.4%Neutrophils3.32-7 x109/LLymphocytes1.741-3 x109/LMonocytes0.550.2-1.0 x109/LEosinophils0.210.02-0.5 x109/LBasophils0.030.02-0.1 x109/LTable 6 Full blood count of Mr. X.Vital Stats ChartDateTimeBlood contract/ mmHgTemperature / oCPulse Rate/ bpmSpO2/ %Blood Glucose levels/ mmol/LDay 011.05 pm140/80379110013.911.30 pm137/843780100Day 18.30 am130/8037704.8 (fasting)3.55 pm130/70379010.30 pm108/643781Day 28.20 am119/6937784.50 pm130/9037829.69.45 pm140/9037806.7Day 38.50 am114/773772986.6Table 7 Records of vital stats of Mr. X from Day 0 3.Disease Over ascertain Pharmacological Basis of Drug TherapyAcute coronary syndrome (ACS) is a broad term used to classify a continuum of symptoms and events stemming from acute ischaemic episodes affecting the cardiac pass.1 This includes unsettled angina, non-ST segment elevation myocardial infarction (NTEMI), and ST segment elevation infarction. It is usually characterised by chest pain which increases in its severity at rest or with fleshly exertion. The ischaemic events usually arise from the maturation of unstable atheromatous plaques, 2 which explains the fact that stable angina (due to a stable coronary atheromatous plaque) is not included under this umbrella term. Rupture, ulceration or fissures of the atherosclerotic plaque often allows to arrangement of a thrombus, causing occlusion of coronary arteries and inadequate blood flow and, subsequently, inadequate supply of oxygen and nutrients to the cardiac muscle. This can be precipitated by acute stress factors on the sclerotic cap usually consisting of tough material, which is caused by local blood flow disturbances or vasospasms3. Unstable angina usually occurs without cardiac muscle damage while myocardial infarction (MI) may occur with or without myocardium damage. The thrombus formed in unstable angina is labile and obstruction is transient, and not a full-on occlusion as would occur in MI.4 Unstable angina occurs at rest and is almost indistinguishable from a non-ST segment steep myocardial infarction take out in the severity of cardiac muscle ischa emia. Theoretical definitions of unstable angina would include changes in usual patterns of stable angina after a stable pain-free period, or severe acute anginal pain causing almost total incapacity5, though it is difficult to define it exactly as the term is often used by medical professionals to describe a range of different conditions liaise between stable angina and MI. The primary clinical symptoms of unstable angina ar sudden particular of chest pain that persists for to a greater extent than 20 legal proceeding which may be felt in other areas such as the jaw, arm, shoulder, neck or back without cause (as opposed to stable angina which stems from physical exercise) shortness of breath, rapid pulse rate, and some clock a rapid drop in blood pressure. Patients suffering from an ACS maintain a high risk of MI and possible even death immediate hospital care is often required1 and give-and-take is of a more urgent nature compared to that of stable angina. It has been sugges ted by the National wellness Service (NHS) Hospital Episode Statistics in 1998 that 1000 out of every million per population is affected with unstable angina, or 10 acute hospital admissions per week.6 On a more recent note, NHS has reported in 2009 that angina affects between 10-15% of women and 10-20% of men aged 65 and above in England.7 Due to the dear relationship between unstable angina and coronary events, it is worth noting that the highest averaged rates of cardiovascular events were observed in Glasgow and Belfast (UK), North Karelia and Kuopio (Finland), Newcastle (Australia), and Warsaw (Poland).8Diagnosis of an unstable angina episode, or any ACS in that matter, is base on several aspects9. Physical symptoms include anginal pain at rest that lasts for 20 minutes or more new onset angina severely limiting ability of physical exertion or changes in existing angina intensity, frequency or length of attack. One or more of these symptoms are an urgent indication that the patient is suffering from an ACS attack. Upon admission to hospital, ECG and blood tests should be performed to substantiate the type of ACS in order to initiate intervention. In unstable angina, the ST segment is not elevated and levels of cardiac enzymes are normal (especially troponin T and I). If the onset of symptoms is unclear as to indicate ACS, a measurement of serum troponin concentration should be carried out 12 hours from demoation to establish the diagnosis.10 give-and-take of unstable angina and NSTEMI are similar in terms of pharmacological management indeed they are at presentation indistinguishable except in terms of the severity and extent of cardiac muscle ischaemia, in which the ischaemia is less severe in unstable angina and less troponin T and I are released into the bloodstream.Antiplatelet agents. Aspirin and clopidogrel are the immediate emergency drugs used in the ambulance, both being antiplatelet drugs. Aspirin is an irreversible inhibitor of arachido nate cyclooxygenase (COX) enzyme, in which covalent acetylation of the serine moiety in a hydrophobic channel in the enzyme11 reduces synthesis of thromboxane A2 in platelets and prostaglandins in the endothelium. This prevents platelet aggregation and further en epicment of the thrombus formed in the coronary artery. Clopidogrel is an inhibitor of the ADP-dependent activation of the GPIIb/leada receptor and prevents the formation of fibrinogen bridges between glycoprotein IIb/IIIa receptors on the surfaces of platelets11, subsequently preventing platelet activation. Glycoprotein IIB/IIIA receptor antagonists, eg, abxicimab, use up the advantage of inhibiting all pathways in the platelet activation process by inhibiting the glycoprotein IIB/IIIA receptor.Anticoagulants. Unfractionated heparin is an activator of antithrombin III, which inhibits the action of thrombin and serine proteases. The heparin also binds to thrombin the unite moment of this and the heparin-antithrombin compl ex formed inhibits thrombin, which decreases the conversion of fibrinogen to fibrin and reduces platelet aggregation. In contrast, low molecular clog heparins (LMWH) go through molecular sizes that are too small to bind to thrombin but still bind to antithrombin III, which inactivates all serine proteases including Factors XIIa, IXa, and Xa11, preventing the coagulation process. Direct thrombin inhibitors such as hirudin and bivalirudin inhibit thrombin reversibly. These agents can bind to free and bound thrombin, hence have the ability to prevent and dissolve preformed clots. Synthetic pentasaccharides (fondaparinux) is a selective indirect inhibitor of Factor Xa. It binds to antithrombin III reversibly, catalyzing the inactivation of Factor Xa12 and inhibiting the coagulation cascade.Beta blocking agents. All beta blockers bind to beta-adrenoceptors, competitively antagonizing the action of catecholamines. These drugs block the beta-1 adrenoceptors at the heart, achieving a dec reased heart rate and force of cardiac contractions, as well as lowering blood pressure. Atenolol is relatively specific for cardiac beta-1 adrenoceptors and exerts fewer side effects associated with beta-2 adrenoceptor blockade, for role model bronchospasm in asthmatics.Nitrates. Organic nitrates mimic the actions of endogenous nitric oxide to relax vascular smooth muscle by increasing the synthesis of cGMP, leading to the dephosphorylation of myosin light chains.11 Vasodilatation of coronary arteries causes increase coronary blood flow and conjugated with its effects of decreasing arterial pressure and also cardiac output, the myocardial oxygen consumption is generally reduced.Statins. Also termed HMG-CoA reductase inhibitors, these medicines inhibit the rate-limiting enzyme in the synthesis of cholesterol, in which this enzyme converts HMG-CoA to mevalonic acid. wiz inhibitors are diuretics acting on the rennin-angiotensin agreement which inhibit the angiotensin-converting en zyme ( one) and block the production of angiotensin II from angiotensin I. This reduces vascular resistance, increases tissue perfusion, and reduces cardiac afterload.angiotensin II receptor inhibitors also act on the same system as the ACE inhibitors, except that they block the angiotensin II receptors directly instead of inhibiting their formation. The outcome is the same as above.Evidence for Treatment of the ConditionAntiplatelet AgentsThe SIGN guidelines advocate that aspirin and clopidogrel be given to patients with ECG ischaemic changes or increase levels of cardiac markers and aspirin is advocated for all patients suffering from ACS. A meta-analysis of 287 randomize trials proves the protective effect of aspirin on patients with unstable angina, halving the rate of cardiovascular events, including death, non-fatal MI and strokes, or also termed the first primary outcome while in those with an acute MI, it reduces the rate of coronary events by almost a third13. Long-term us e of aspirin for these patients was also shown to be a in effect(p) antiplatelet therapy. According to the same study, reduction of serious vascular events by clopidogrel was 10% compared to aspirin. The combined use of clopidogrel and aspirin as compared with a placebo and aspirin showed significantly higher succeeder rates in trim back occurrences of first primary outcomes (9.3% compared to 11.4%, POn the flipside, although short term studies have shown that antiplatelet medications are effective for patients with renal failure in the prevention of serious vascular events13, the risks of bleeding is increased by renal disease15, posing a possible contraindication for antiplatelets to Mr. X. A clinical study found that airinessment for NSTEMI ACS in patients with chronic renal disease (mild to moderate stages) was less aggressive than those with normal renal function, despite the risk that these patients with renal disease would experience greater adverse outcomes from insuffi cient treatment for ACS compared to the other patient group16. However the available information on adverse effects of antiplatelets on patients with varying degrees of renal disease is limited and it would appear that this would result in the reluctance of medical professionals in using this class of drugs for patients with chronic renal disease as well as ACS.It can be inferred that Mr. X would gain the level best benefits if his medications were changed to aspirin 300 mg and clopidogrel 300 mg stat and aspirin 75 mg and clopidogrel 75 mg thereafter, in which the patient should be closely monitored for signs of bleeding.Heparins LMWHsA 2003 review of 7 studies involving 11,092 patients with non-ST elevation ACS found that low molecular weight heparins (LMWH) were more effective than unfractionated heparins in reducing MI events, requirement for revascularization procedures, and thrombocytopenia17. No digression in the mortality, recurrent angina, major and boor bleeds were obs erved in the two types of drugs. A meta-analysis of 12 randomised trials with 17,157 patients involved found that patients who have had a non-ST elevation ACS who were put on aspirin experienced no significant difference in benefits in efficacy (preventing MI or death) or well(p)ty (major and minor bleeding complications) when they were put on unfractionated heparin or LMWH17, implicating no difference in the thrombolytic effect in both classes of drugs. These results are partially similar to those of the first review. Another meta-analysis of 2 phase-3 trials comparing enoxaparin and unfractionated heparin, on the other hand, showed a significant (20%) difference in reducing death or severe cardiac ischaemic events18. From an economic point of view, authors of yet some other meta-analysis on the subject stated that the cost of LMWH is 3-5 times higher than unfractionated heparin19. From these data it can be concluded that LMWHs does indeed have additional plus treatment outcome s compared to unfractionated heparins22 it does not show significantly decreased side effects (bleeding).Enoxaparin has, though, an increased bleeding effect on patients with renal disease as reported by an investigation of 106 patients, in which total bleeding complications occurred in 22% of normal patients and 51% of patients with impaired renal function (pIt is still the drug of select for patients present with non-ST elevated ACS, and this is applicable to Mr. X with unstable angina.Beta-BlockersBeta-blockers were not prescribed for Mr. X. The SIGN guidelines states that beta-blockers should be the drug of choice for first line treatment of anginal pain in patients with non-ST elevated ACS. A meta-analysis of 5 trials consisting of 4700 patients in all showed a 13% reduction in anginal pain with the use of beta blockers (initially IV then oral for a week) in patients with non-ST elevated, MI-characterised chest pain23. It was stated in the clinical develop Mr. X had chest pai n on Day 1 and 4, thus the addition of a beta blocker to his medications would be useful in alleviating his pain. Despite the popular belief that beta-blockers are contraindicated in patients with diabetes mellitus, it is possible to treat these patients using beta-blockers as long as good glycaemic control is achieved and the patient is monitored regularly24. This would further support its use in Mr. X furthermore, several studies have shown that diabetic patients derive a significant benefit from the use of beta-blockers after an MI, in which diabetic patients had a significantly lower mortality 1 year post-discharge25, total mortality after 3 years, and deaths from cardiac events26. A multicentre randomize trial, the HINT trial, on patients with unstable angina found that metoprolol, a relatively cardioselective beta blocker, reduced occurrence of myocardial ischaemia or progress to MI within 48 hours, indicating that metoprolol has a short term beneficial effect on patients not already taking beta blockers prior to the unstable angina episode27. It has been suggested that beta-blockers be the first line treatment for unstable angina and if patients remain unstable, a calcium channel blocker should be added28.StatinsThe beneficial effects of statins in reducing mortality and cardiovascular events have been proven by a meta-analysis of large, randomized controlled trials (n=90,056) where coronary artery disease was present or absent29. The positive results were also proven spanning a large range of serum cholesterol levels. Investigations comparing the use of intensive versus moderate doses of statins in the early stages and post-ACS showed positive results a meta-analysis of 4 large trials (n=27,548) shows a 16% reduction in cardiovascular deaths or MI, as well as a 16% reduction in cardiovascular deaths or coronary events30. This view is shared by another meta-analysis of the same subject of 13 randomised controlled trials which found a decrease in mortal ity and coronary events after 4 months of treatment31. These data support the use of statins by Mr. X.NitratesNitrates have been widely used in relieving pain from unstable angina, despite its lack of clinical evidence in supporting its role in improving survival and reducing the rate of MI and cardiovascular events32. ISIS-433 and GISSI-334 reports no significant difference of the use of glyceryl trinitrate post-MI in reducing the overall mortality however this may be explained by the fact that more than 50% of patients in the controlled group are also on other forms of nitrate therapy, such as intravenous glyceryl trinitrate. Despite this, nitrates will still be of use for reducing the pain in post-MI patients and those with unstable angina. The BNF advises against the use of nitrates in patients with serious anaemia (HbGlycaemic controlMr. Xs plasma glucose levels were elevated on the day he was admitted to hospital (13.9 mmol/L). Diabetes mellitus has been proven to be a strong independent risk marker for coronary heart disease patients with poorly controlled diabetes at hospital admission have a worse outlook on prognosis and future development of cardiovascular events35. The DIGAMI investigation reports that the use of intensive insulin therapy increased long-term prognosis (P=0.011) of patients presenting with hyperglycemia (11mmol/L) at admission compared with those on standard antidiabetic therapy36. These data support the use of insulin to control the blood glucose levels of Mr. X which were highly increased upon admission. This is also supported by the SIGN guidelines which advocate immediate control of blood glucose is carried out for MI patients with glucose levels of more than 11.0 mmol/L for at least 24 hours.ACE InhibitorsThe SIGN guidelines recommend that patients with unstable angina should be given ACE inhibitors as long-term therapy. In patients at high risk of cardiovascular events, ACE inhibitors (ramipril was investigated in a report37) have been proven to reduce overall mortality, MI, and stroke, particularly in patients with diabetes mellitus. Perindopril was found to reduce cardiovascular risk (relative risk reduction =20%, P=0.0003) in a population with stable coronary heart disease in absence of heart failure38 in a double-blinded, randomized multicentre trial involving 13,655 patients. A meta-analysis of the 2 above trials and a third one (PEACE) showed a reduction in overall mortality, cardiovascular death, non-fatal myocardial infarction, stroke, heart failure, and coronary artery bypass surgery by ACE inhibitors39. This demonstrates the benefits of ACE inhibitors in patients with coronary artery disease as patients who had an ACS event would have a higher rate of cardiovascular events, the positive outcomes of ACE inhibitors can perhaps be extrapolated to this population in order to decrease coronary events and improve prognosis. However, the BNF advises caution and close clinical monitoring if ACE inhibi tors are to be used in patients with hyponatremia (Oxygen therapyOn admission, Mr. Xs SpO2 was 99% and remained high throughout his stay in the hospital. The use of oxygen therapy is significantly beneficial only in hypoxic patients (with SpO2 Anaemia and Unstable AnginaAnaemia can disturb the balance between myocardial oxygen supply and demand a decrease in the number of red blood cells can lead to a reduction in the supply of oxygen to the myocardium. Thus pay offion of the causative factor would be sensible in the treatment of unstable angina for the patient in context. Mr. X was given a combination of ferrous fumarate, vitamin B complex, and folic acid for treatment of his anaemia. From the data in Table 6, it can be seen that Mr. X has low haemoglobin concentrations (95 g/L) and a low mean cell volume (81.8 fl.). To validate that Mr. X is indeed suffering from iron-deficiency anaemia (as suggested by his treatment medication), three parameters must be launch namely the plasm a iron, the plasma ferritin, and total iron binding capacity. However, as very few conditions can cause abnormalities in the mean cell volume, and a decreased value is due to iron-deficiency anaemia or thalassemia42, it is safe to assume that Mr. Xs anaemic condition is due to an insufficiency of iron. Iron supplements are given to correct the iron status of the patient, in which the ferrous form given orally is found to be cheap, safe and effective in the majority of patients with iron-deficiency anaemia2. Vitamin B complex and folic acid are only indicated in patients with the various(prenominal) deficiencies2 there is little evidence that they would be of any significant benefit in patients with iron-deficiency anaemia.Summary base on the evidence given, Mr. Xs aspirin dose should be changed to 300 mg stat and 75 mg thereafter, and clopidogrel should be added into his medication profile in the same doses. These changes ensure that Mr. X is obtaining sufficient antiplatelet effec ts from his medications to prevent another attack of unstable angina or even a myocardial infarction. Present drugs that were given for his condition that are suitable and supported by evidences include enoxaparin, lovastatin, insulin, and GTN these can be safely continued without problems. A beta-blocker (metoprolol tablets) may be given additionally in doses of 50-100 mg as evidences described above have shown that they can be safely used in diabetic patients contrary to popular belief an ACE inhibitor (perindopril as previously used by Mr. X) may be initiated coupled with regular electrolyte