Ethics in Conducting Research Paper Example | Topics and Well Written Essays - 2000 words

Ethics in Conducting - Research Paper Example The term ethics simply referred to the behaviour and moral conducts of any person. Generally, when the people talk about ethics, everyone think that, differentiation between the right and wrong is called ethics. This definition is right up to some level, but it does not include other necessary elements those are necessary to fulfil the ethical requirements. If you are going to write any of the literature review or any other research paper, then there are many ethical requirements that should be considered for quality paper. For better understanding, some of the necessary elements for conducting ethical research are mentioned below separately. Originality of the material is the main element of any research paper. For this purpose, the main ethical requirement is that, your material should be original and based upon on your own research and work. You are not allowed to use the technique of plagiarism in your research work. The term plagiarism is generally referred to the situation of taking the credit of some other’s work. For example, you want to address the audience through your research paper, but you use the information that is based on some other’s work, then this act is treated unethical by every mean. You are not allowed to use the technique of copy and paste with your work. That does not mean that you cannot refer to someone else work. You can use other’s work to gain the ideas or improving your own work. In some research papers, you are also not allowed to copy the ideas of others, but it is only in some extreme cases. As it is mentioned above that the research papers are referred to valid source of information. So â€Å"honesty† is also treated as a major element of ethical factors. For example, you are going to make a research paper on some scientific research then you must ensure that you are honest gathering all scientific information

Eragon The Movie vs. Eragon The Novel Essay Example for Free

Eragon The Movie vs. Eragon The Novel Essay People have different views in life. Some would opt to wallow with the beauty of words and the power of the imagination, while others would opt for movies and witness the wonders of visual effects. Some of the stories made turn out to be inspirations for many, while others become a driving force for people to go on and continue with life. One of the most interesting stories in Literature is Eragon. Due to the story and the lessons that both children and adults would learn, the novel was adapted as a movie into the big screen. However, I believe that the novel version of Eragon is still better than the movie version. THE STORY The story revolves around a young boy, named Eragon, who grew up in a small farm in Carvahall together with his uncle and cousin. During one of his hunting trips in the mountains, he found a big blue stone. The stone attracted him greatly, and Eragon thought that if sold in the city, the stone would be enough to suffice for their winter needs. Unknown to Eragon, the blue stone was actually a dragon egg, ready to hatch. Since care for dragons was prohibited by the king, Eragon had no choice but to secretly raise the poor animal, naming her Saphira. Eventually, they were haunted down by the king’s men and had no choice but to flee the village. Eragon’s uncle, Garrow, died due to his injuries, making him furious and hungry for revenge. Eragon’s journey towards survival with Saphira led to more secrets. In the course of their adventures, Brom proposed that he would do whatever it takes to help Eragon. The symbol in Eragon’s hand shows that he is indeed one of the dragon riders, like how Brom used to be. Towards the course of the journey, he was transformed from an ordinary teenager to a sword-fighting rider knowledgeable in magic and the ways of Dragon Riders. Eragon meets more people and encounters more life-threatening situations towards the course of the journey, which allows him to learn more about himself. His quest for revenge allowed him to learn more about himself, and how his search for answers would lead him to protect a whole Empire. SIMILARITIES AND DIFFERENCES Books always have their own identity as compared to the film adaptations. This may be attributed to the fact that readers are given the opportunity to view the novel in their own way, and see things according to what their imagination has to offer. The book and film version of Eragon had the same dilemma. Both media had the opportunity to share with people the wonders that Eragon’s life had to offer, and at the same time bring them to a world unknown to many. However, the 2 media used also had their own differences. The film version was intricately made in such a way that the viewers would become curious of what the story has to offer. The special effects used in the film version would definitely come as an impressive work of art. The descriptions set in the book, such as Saphira’s appearance were perfectly executed in the film. One who has read the book with agree with me, especially in the details set for the other locations in the film. The language used in both versions were also similar with each other. The book on the other hand, made us of too many words. Some of the dialogues and scenes were cut in the film version, somehow giving the viewers a different impression of how the story would go. Take for example Eragon’s journey. Some of the places were deleted, and even Eragon’s reactions towards Katrina were deleted in the film version. In this manner, the plot of the story was somewhat changed deviating from the original context of the novel. PERSONAL ANALYSIS The film version of Eragon was something to be considered. Those who have read the novel would have different impressions about the adaptation, especially when some of the important scenes and dialogues have been deleted. Although the aim of the producers was to fit the whole book in one film, this should have been done using a different approach. In the same manner, I also admire how the visual effects were executed. Saphira was one of the wonders of the whole story, and this was very well presented in the film adaptation. Arya herself was a wonder to marvel at. As the book would have it, she was a beautiful elf, and was supposed to look mysterious at some point in the story. This was done perfectly, and I believe the actress who played her should also be given credit. Unfortunately, the film and the book had so many differences. The film version would look as if it was another story formed from the original novel, and not an adaptation. Although both had considered to keep the plot as the center of the film, the choice of words made the story difficult to absorb. Both readers and viewers would have difficulty in trying to keep in tune with the story because of the many names and places it included. For someone who has seen both media, disappointment would not come as a surprise. However, for those who have not read the book, the film adaptation is impressive, especially with how Saphira was manipulated. Works Cited Eragon. Dir. Stefan Fanmeier. Perf. Jeremy Irons, John Malkovich, Sienna Guillory, Edward Speleers, and Rachel Weisz. 20th Century Fox Home Entertainment, 20 March 2007. Paolini, Christopher. Eragon. Alfred A. Knopf Books for Young Readers, 2003. â€Å"Eragon. † 2006. Eragon the Movie. 22 January 2009 http://www. eragonmovie. com/main. html? cid=us. â€Å"Eragon. † The Internet Movie Database. 22 January 2009 http://www. imdb. com/title/tt0449010/. â€Å"Eragon. † Book Browse. 22 Janury 2009 http://www. bookbrowse. com/reviews/index. cfm? book_number=1284. â€Å"Eragon (Inheritance, Book I). † 2003. Kids Turn Central. 22 January 2009 http://www. kidsturncentral. com/topics/books/eragon. htm. â€Å"Eragon DVD Review. † 22 January 2009 http://www. shurtugal. com/news/comments. php? id=558anum=50.

The Marxist and Functionalist Perspectives on the Family Essay

The Marxist and Functionalist Perspectives on the Family For the purpose of this essay question I will discuss the Marxist and the Functionalist perspectives on the Family. I will compare and contrast them and give a critical analysis of each and place them in historical context as well as modern day. In Britain today there are many different types of families. A social unit living together defines what a family is. The family resembles the core feature of society. Both Marxist and Functionalist perspectives believe the family is what holds society together and helps socialise the future generations. There are three types of family existing in today’s society. The nuclear family resembles a family unit made up of no more than two generations, stereotyped as a mother, father and 2.4 children. The extended family refers to a family unit made of many three generations or more who live with each other or near by. This type is typical of pre-industrial or ‘primitive’ societies. The third type of family is the reconstituted. This type has become more apparent in modern day society. It refers to adults who have married before and have brought their children from the first marriage to the second, creating a new family unit. It is important to note that not every household includes a family – for example student flats. The functionalist perspective believe society is like a machine in that all its institutions sustain continuity and consensus and keep society running smoothly. Functionalists believe the family contributes to society’s basic needs and helps maintain social order. Functionalists have been criticised for placing too much ... ...e into existence with the invention of private property. Both Murdock and Parsons paint a very ‘rosy’ picture of family life. They fail to take in account the darker side of society and family issues such as domestic abuse etc. Parsons views on men and women in relationships are often out dated. A lot of women these days are the breadwinners in the family and therefore the husband and wife roles have been reversed. Functionalist do not recognise that women suffer from the sexual division of labour while Marxists highlight this is their theory. Marxists also come under scrutiny for exaggerating the importance of the family life as being a refuge from the capitalist society. Marxists also underestimate darker issues such as violence within the home etc. Zaretsky overemphasises the fact that family and work are separated.

Socrates as “Eros”

Esther Rodulfa PHL-1010H-LD01 09/18/12 Socrates as eros? Truly, love takes on many different forms. Love, for many centuries, has been given many different names. It also serves different functions. To distinguish a specific type of love, one of them is called eros. How love as eros can be defined is based upon the utilization of a specific writer’s perspective. Numerous published written works may account for the definition of eros. In this Essay, Plato’s perception of love as eros will be described. Furthermore, how and why Socrates, of â€Å"The Apology† by Plato, embodies Plato’s definition of eros will be shown.This embodiment will be based off Plato’s eros as poor being, eros as an intermediary between God and men, and eros as resemblance of the â€Å"god of Plenty†, eros’ father (Needleman 15 – 17). According to Plato’s â€Å"Symposium†, eros has always been in need or poor (Needleman 16). Socrates embodimen t of this description of eros can be seen in Plato’s â€Å"The Apology†, where Socrates â€Å"remain in infinite poverty† (Plato 509) as a result of his commitment to his god through convicting Athenians of the condition of their souls and lives.Most of his time, Socrates converses with people and asks them questions pertaining their lifestyle. Due to this he does not have enough time to make earnings for himself. In return, some of his listeners put in time to hear him out and take on his advices (Plato 509). This even more takes time off from Socrates. Although others perceive this as Socrates teaching the Athenians with a charge, not one witness testified of Socrates’ activity of charging fees from anyone (Plato 519), which proves his disinterest in obtaining monetary wealth that contributes to his impoverishment.It can be suggested that Socrates does not spend great deal of time in obtaining monetary wealth or pleasure (Plato 519) due to this commitme nt. He places more priority on his care for Athenians than tending for his own health. His full dedication and sacrifice for others’ good sake contribute to his condition of being poor. Other than this, after Socrates was charged guilty, he had to offer an alternative penalty for himself. However, he said â€Å"I have no money to pay† (Plato 526) if ever his alternative penalty was to pay a fine.It can be implied from this Socrates’ deep poverty condition due to his inability to pay his freedom from the unjust guilty charges pressed against him. Since the death punishment upon him is too great, Socrates would need so much money to annul this punishment; but as he said, he does not have any means of doing so due to his poverty. Another definition of eros, as Plato defines it, is an intermediary between God and men. By intermediary, it means that eros â€Å"interprets†¦between gods and men† (Needleman 15).He also delivers â€Å"to men the commands of the gods† (Needleman 15). Thus he brings connection between god and men. Socrates in â€Å"The Apology† embodies these characteristics in few ways. During Socrates trial, he admits that he has been â€Å"commanded by god† (Plato 521) to rebuke the Athenians of their foolish ways and reach an epiphany of their lives wasted on money and fulfilling selfish evil desires. He also says that he occasionally receives â€Å"signal from God† (Plato 529) whenever a wrong impulse is about move him.Since all he desires is fulfilling the right and just actions, he fully depends on the divine voice he claims to hear so the message of god will definitely reach the Athenians. In doing so, he will accomplish the god’s commanded upon him. However, it seems that the Athenians do not desire moral living as commanded by the god Socrates’ follows. Nevertheless, Socrates stays on his task and does not give into discouragement as he serves his intermediary role. More over, Socrates emphasizes to the Athenians that â€Å"I am really the one given to you by God† (Plato 519).How he affirmed this is through his denial of self; denial of own pleasures, denial of health, and denial of own interest throughout his life for the sake of the Athenians virtue. Doubtlessly, denying or depriving self of fulfilling own selfish desires is difficult as human live for own selfish ends. Also, these selfish desires seems built-in to humans. Humans have natural tendencies to act according to what he or she desires, in spite of it being selfish and sometimes evil.In the Athenian society, which Socrates describes as a â€Å"big thoroughbred horse† (Plato 518) due to its riches, wealth, and greatness, it can be inferred that some of its citizens posses this riches and wealth, and for those who do not may have great desires for earning such wealth and power to, again, meet own selfish ends. However, Socrates differs from this in this that he never craved f or wealth and richness, which makes him extraordinary and approve his claim as sent by the god to the Athenians.And, this confirms he embodies eros as the intermediary between god and men. Moreover, Plato also defines eros through eros’ inheritance of his father’s, god of plenty, characteristics (Needleman 16). These characteristics include eros being bold, being â€Å"terrible as an enchanter†, who interlace interest or curiosity, â€Å"keen in pursuit of wisdom†, and a â€Å"philosopher at all times† (Needleman 16). Socrates in â€Å"The Apology† displays these characteristics in many ways. Socrates’ boldness emanated from his audacious and specific address towards the Athenian citizens and officials.He sought out other well known citizens of great power and are known to have â€Å"highest reputation† (Plato 508) and cross-examined them to measure their wisdom. In particular, he approached poets and concluded that â€Å"no w isdom enabled them to compose† (Plato 508) and they resemble diviners and oracles by not â€Å"understanding anything of what they say† (Plato 508). As a poet whose passion is literature and is known for eloquence, creativity, and gift of poetic thoughts, for Socrates to make a claim of a poet’s void composition renders great offense on the poet’s part, and all the more proves Socrates’ boldness.Moreover, Socrates claims he cannot be damaged by either Meletos or Anytos’ proposed death punishment to Socrates for he thought â€Å"the eternal law forbids a better man to be hurt by worse† (Plato 518). By this, he referred the better man as himself and the worse as either Meletos or Anytos. Apparently, these men have some power as they represent those people who may have been offended by Socrates. Yet Socrates boldly acknowledges them as worse than himself. Other than this, Socrates honestly claims that he exposes and hinders â€Å"the man y unjust and illegal doings† (Plato 519) of the Athenian state.Certainly, the Athenians would totally dislike Socrates for admitting these deeds of his yet he carelessly and publicly declares this during the trial. Beside this, Socrates fully declares that the Athens’ lives are wrong (Plato 528) and ending his life would not stop any reproach to come upon them. His confidence on this matter can also stir up more irritation among the crowd but he still bravely announced this. From each examples Socrates gave during his trial, he was aware of the risks yet due to his audacity, he was able to get across his message to the Athenians.Other than his boldness, Socrates also embodies eros as someone who is â€Å"terrible as an enchanter† and who interlace the curiosity and interest of his audience (Needleman 16). He achieves this through his talent of clever wordings and phrases to connect to and capture attention of the Athenians. Socrates often used phrases such as â⠂¬Å"I beg and pray you most earnestly† (Plato 503), â€Å"I appeal to most of you to bear me out† (Plato 505), â€Å"don’t make an uproar, gentlemen, remain quiet as I begged you, hear me without uproar at what I have to say† (Plato 507) and many others.Through these, he can captivate their attention and hinder a possible uproar among them so he can clearly deliver his message to them. For a crowd of 501 people, it will be difficult to counteract uproar if it arises. But it turns out that Socrates had the situation under control while he delivered his speech on his trial day. This reflects his strong enchanting abilities, just like eros. Socrates also has a talent of stirring up interest of those that he speaks to.Although some citizens of Athens have been offended by Socrates’ conviction, some of them were actually â€Å"delighted to hear people being cross-examined† (Plato 509) and that some of them chose to imitate Socrates’ ways of making people, who thinks they have wisdom, realize that they have no wisdom at all. Furthermore, Socrates embodies eros through their resemblance in â€Å"keen pursuit of wisdom† and being a â€Å"philosopher at all times† (Needleman 16). As he was going about cross-examining people, he â€Å"approached the craftsmen† (Plato 508). He has no knowledge of being crafty.But since he loves gaining knowledge, whatever it may be, he continued his talk with them since he knew he would learn something that has â€Å"much of real value† (Plato 508). Going further his trial, Socrates assures the citizens that he will â€Å"never cease being a philosopher† (Plato 517) and that he will continue giving advice and cross-examining and testing those who think they possess wisdom. Even if this costs him his life on the line, Socrates will insist in doing these to anyone he comes across with. After the jury finally approves his death punishment, Socrates found the decision favorable because he will have the hance to cross-examine and investigate those who have deceased, including Troy, Odysseus, and Sisyphos, of whether they are wise or not (Plato 530). Socrates perceives this as his â€Å"infinity of happiness† (Plato 530) if he does meet these great men and other numerous men and women because in the second life, he believes he will gain immortality, and he can infinitely live as a philosopher there. Surely, Socrates has strong desires for gaining knowledge and for living all his life as a philosopher. In conclusion, although there are many ways in which love can be defined, Plato’s definition of eros has been utilized.The definition for this eros love refers to eros being a poor being, eros being the mediator between god and men, and eros being a resemblance of the god of Plenty’s characteristics. In analyzing Socrates of â€Å"The Apology†, we can see how he embodies Plato’s definition of eros and the re asons for this embodiment in many ways. Definitely, Socrates’ personify eros of Plato. Works Cited Page Needleman, Jacob. The Heart of Philosophy. 1st ed. New York: Tarcher/Penguin, 2003. 15-17. Print. Plato, . â€Å"The Apology. † Trans. W. H. D. Rouse  Great Dialogues Of Plato. New York: Signet Classics, 2008. 502-531. Print.

Health Law and Regulations Essay

In understanding regulatory agencies the differences between regulation and legislation needs defining. Legislation is the law that has been passed by a voting process and regulation is the responsibility of the regulatory board appointed to enforce laws once the law is passed; it sets forth rules on how the laws are to be implemented and to what degree. In health care the Department of Health and Human Services (HHS) has the predominant responsibility to enforce legislation that impacts the health and well-being of Americans. Under the umbrella of HHS there are 13 regulatory agencies tasked with setting rules on the enforcement of the legislation passed by lawmakers. Regulatory Agencies Two of the most influential regulatory agencies within HHS are the United States Food and Drug Administration (FDA) and the Center for Medicare and Medicaid Services (CMS), these two agencies have substantial influence on every aspect of health care delivery. The FDA is responsible for protecting and promoting public health through the regulation and supervision of food safety, medical devices, drugs, vaccines, blood products and biologics. In addition, they monitor medical errors and adverse reactions and reporting such to providers, (U.S. Department of Health and Human Services, 2011). CMS controls the Medicare program and works in collaboration with state governments to oversee Medicaid, and the State Children’s Health Insurance Program (SCHIP). In addition to these responsibilities, CMS dispenses criteria from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), surveys and certifies quality standards in long-term care facilities, and clinical laboratories, (Centers for Medicare and Medicaid Services). The proportion of national health spending sponsored by both federal, state, and local governments was 45% in 2010, a significant source of revenue depended on by providers of health care, (Centers for Medicare and Medicaid Services, 2011). Current FDA Regulations The Patient Protection and Affordable Care Act (PPAC Act), amended the Public Health Service Act (PHS Act) to create a shortened authorization route for medications found to be â€Å"highly similar† or â€Å"interchangeable† with an FDA-approved medication, (U.S. Department of Health and Human Services, 2011). The goal is similar to the Drug Price Competition and Patent Term Restoration Act of 1984 (â€Å"Hatch-Waxman Act†), which produced condensed methods for the approval of drug products under Federal Food, Drug, and Cosmetic Act (FFD&C Act). The outcome is aimed at the FDA’s instituted policy of allowing confidence on what is already known about a drug, thus protecting time and resources, (U.S. Department of Health and Human Services, 2011). To help increase access to affordable prescription medications, the FDA implemented measures to expedite the development and approval of generic drugs. Generic drugs cost 50 to 70% less than their brand-name counterparts equating to a savings of eight to ten billion dollars a year at retail pharmacies, (Crawford, June). These savings do not include the use of generic drugs in an institutional setting. PPAC expands on the practice of generic drugs and incorporates using medications that have the same efficacy as another more expensive medication leading to more options in the prescribing of medications. The practice of using generic drugs is not without concern. As evidenced by the case Pliva v. Mensing where the question was; the safety standards for brand-name drug labeling also apply to generic-drug manufacturers. The patients in the case took the generic drug metoclopramide and developed tardive dyskinesia, which was listed on the label. The patients argued the warning was not adequate and the manufacturer argued the â€Å"changes being effected† process was not available to generic-drug manufacturers because the FDA requires labels for generic versions of drugs to be identical to those of the brand-name drugs, (Glantz & Annas, 2011). The FDA upheld the manufacturer’s claim although the FDA added the manufacturer had a responsibility to request a label change if the manufacturer knew a stronger warning was needed to market the drug safely. The court found in favor of the manufacturer stating â€Å"federal law still preempted injured patients from bringing lawsuits in state courts, because the state laws in question require a safer label, not communicating with the FDA about the possibility of creating a safer label,† (Glantz & Annas, 2011, p. 682). Despite this regulatory standing, a controversial issue may entail for the FDA in the allowance of medications to be â€Å"interchanged† to promote an additional avenue for savings in prescription medications. Much foresight needs to be included to protect the safety and well-being of patients. Current CMS Regulations The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009 (ARRA), is legislation aimed at the adoption and â€Å"meaningful use† of health information technology. CMS was authorized to establish incentive programs for eligible Medicare and Medicaid providers who adopt, implement, upgrade, or â€Å"meaningfully use† certified electronic health records (EHR). The term â€Å"meaningful use† is an acknowledgement that improved health care is not the product of technology but a method to exchange and use health information to support clinical decisions at the point of care. To qualify for CMS’ incentive program the provider must obtain certified electronic health record technology. An incentive of $44 thousand can be achieved by an eligible professional who shows â€Å"meaningful use† over a five year period. Hospitals implementing a certified EHR system can qualify for a t wo million dollar base payment. In 2015 Medicare will implement a reduction in payment to those not displaying â€Å"meaningful use†. The decrease in payment begins at one percent and rises each year that hospitals and providers receiving Medicare payments do not make evident â€Å"meaningful use,† to a maximum reduction of five percent, (Centers for Medicare and Medicaid Services, 2011). The use of EHRs is encouraged by touting improved efficiency, cost-effectiveness, quality, and safety of health care delivery. A study on the use of EHR in 2952 hospitals in the United States revealed 12% of hospitals had instituted electronic physicians’ notes across all clinical units and 17% had instituted computerized provider-order entry for medications in all clinical units, (Jha, et al., 2009). The cited barriers to implementation of EHR were inadequate capital (74%), maintenance costs (44%), resistance of physicians (36%), unclear return on investment (32%), and lack of available staff with expertise i n information technology (30%), (Jha, et al., 2009). Ironically, the hospitals who had implemented the use of EHRs cited financial reasons such as additional compensation for electronic health record use (82%) and financial enticements for implementation (75%), (Jha, et al., 2009). The estimated cost of purchasing, installing, and implementing an EHR system in a provider’s office is approximately $40,000 and this figure does not reflect the cost of maintenance, (Blumentha, 2009). A survey by the American Hospital Association revealed â€Å"the median annual capital investment on information technology was over $700,000 and represented 15% of all capital expenses. Operating expenses were much higher at $1.7 million, or 2 percent of all operating expenses,† (National Institutes of Health, 2006, p. 18). Although there are indisputable reasons for implementing an EHR system, CMS’ incentive program is merely a pittance compared to the ongoing costs of operational expenses. The concept of all health care providers possessing an EHR system is ideal. As with any form of electronic technology comes the prospect of personal information being violated. The Health Insurance Portability and Accountability Act (HIPAA) does provide for penalties from $100 to $1.5 million, depending on the violation and whether it was done unknowingly or willfully and can include imprisonment up to 10 years. HIPAA protects the health information of individuals; â€Å"it does not create a private cause of action for those aggrieved,† (The General Counsel Department of Health and Human Services, 2005). Conclusion Federal regulatory agencies are a necessity to interpret and assist in the implementation of legislation. Without federal regulatory agencies the United States would have over 50 different interpretations on one piece of legislation. The FDA and CMS play a significant role in the ever changing health care arena. The FDA is based on scientific integrity evidenced by the recent publication of defined key principles of scientific integrity. Through this commitment to scientific integrity and quality the FDA provides medical safety to the American people. Through research and establishing guidelines the FDA has been instrumental in making generic drugs available to the public, saving them more than eight billion dollars annually. The PPAC tasked the FDA has been tasked with expanding on the generic drug practice by discovering medications that have the same efficacy as another medications leading to more cost saving options in the prescribing of medications. CMS has been tasked with implementing HITECH that has the promise of decreasing costs and errors in health care delivery. This is a lofty goal with over 80 percent of the United States hospitals without any type of electronic health record in place. The financial incentive provided by the federal government through CMS does not seem to be enough of a motivator to encourage the financial commitment of an EHR. Although, after 2015 when hospitals and providers have not demonstrated â€Å"meaningful use† these providers of Medicare services may be more inclined when losing one percent of their Medicare payments. These regulatory agencies and the legislation cited in this paper are a minute representation of the responsibility and obligation the federal agencies have to protect the well-being of the American people. The cited legislation delegated to these regulatory agencies is not only focused on health but financial constraint and safety of the American people. References Blumentha, D. (2009, April 9). Stimulating the Adoption of Health Information Technology. Retrieved from The New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMp0901592 Centers for Medicare and Medicaid Services. (2011, October 17). Medicare and Medicaid EHR Incentive Program Basics. Retrieved from CMS.gov: https://www.cms.gov/EHRIncentivePrograms/35_Basics.asp Centers for Medicare and Medicaid Services. (2011, September). National Health Expenditures 2010: Sponsor Highlights. Retrieved from CMS.gov: https://www.cms.gov/NationalHealthExpendData/downloads/sponsors.pdf Centers for Medicare and Medicaid Services. (n.d.). About us. Retrieved from CMS.gov: http://www.cms.gov/home/aboutcms.asp Crawford, L. (June, 23 2004). The Law of Biologic Medicine. Retrieved from FDA: http://www.fda.gov/NewsEvents/Testimony/ucm113745.htm Glantz, L., & Annas, G. (2011, August 25). Impossible? Outlawing State Safety Laws for Generic Drugs. Retrieved from The New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMp1107832 Jha, A., DesRoches, C., Campbell, E. G., Donelan, K., Rao, S., Ferris, T., . . . Blumenthal, D. (2009, April 16). Use of Electronic Health Records in U.S. Hospitals. Retrieved from The New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMsa0900592#t=articleBackground National Institutes of Health. (2006, April). Electronic Health Records Overview. Retrieved from National Institutes of Health: http://www.ncrr.nih.gov/publications/informatics/EHR.pdf The General Counsel Departmentof Health and Human Services. (2005, June 1). SCOPE OF CRIMINAL ENFORCEMENT UNDER 42 U.S.C.  § 1320d-6. Retrieved from The United States Department of Justice: http://www.justice.gov/olc/hipaa_final.htm U.S. Department of Health and Human Services. (2011, November 16). FDA Fundamentals. Retrieved from About FDA: http://www.fda.gov/AboutFDA/Transparency/Basics/ucm192695.htm U.S. Department of Health and Human Services. (2011, March 10). Implementation of the Biologics Price Competition and Innovation Act of 2009. Retrieved from U.S. Food and Drug Administration: http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/ucm215089.htm

Aaa Sex Story Essays - Free Essays, Term Papers, Research Papers

Aaa Sex Story Essays - Free Essays, Term Papers, Research Papers Aaa Sex Story I'd always thought of her as a fairly shy girl, so I was totally unprepared for what happened next. As soon as we sat down on the sofa in the living room, she leaned over and kissed me. Not a little peck, but a full-blown french kiss. It must have lasted for ages as she pushed me down onto my back, pressing her firm breasts against my chest. When she broke the kiss, she looked into my eyes and said I've liked you for so long, but I never had the nerve to do anything about it. I want you. Before I could say anything else, she kissed me again. This time, though, she slid one of her hands down into my jeans to find my penis, which by this time was fully erect and longing for some action. Encouraged by this finding, she undid my jeans and pushed them and my underwear as far down my legs as she could until finally she had to break the kiss. She wasted no time in moving down to my cock and licking its head. She took me in her mouth, but not very deeply. I grabbed her head and gently pushed down, but she resisted. She came up off my *censored* and said Uh ... this is my first time; I hope I'm not too bad at it, then surrounded my cock with her lips once again. She took me a little deeper each time, with a little more suction, a little more tongue action. I didn't tell her, but it was my first time, too, and I'd never felt anything like this before. I lay my head back against the chair arm, closed my eyes, and the feeling swept me away. No wonder guys always talk about getting head, I thought to myself. She was evidently a quick learner, for she soon had me about to cum. I moaned Ohh .... ooohhhh ... I'm ... I'm about to ... , but I didn't get a chance to finish the thought. As every muscle in my body tensed up, I looked at her head bobbing up and down and I shot my semen into a woman for the first time. I guess she didn't quite know what to expect, as she coughed a little before managing to swallow a couple of times. She gave my cock one last suck and lifted her head, smiling. I grabbed her by the shoulders and pulled her head up to meet mine. I kissed her, passionately jousting with her tongue. I was surprised at the taste of my semen; I'd always thought it would be gross, but it actually wasn't so bad. When we broke the kiss, she looked me in the eye and said Did I do OK? The only answer I could think of was another kiss, as my hands went down to her skirt. I fondled her ass a bit while I removed the skirt and her panties. I broke the kiss and told her Now it's your turn. We exchanged positions and I moved down to her *censored*, kissing her breasts through the sweater on the way and wondering if I'd be anywhere near as good for her as she was for me. I gave her outer lips a little kiss, prodding between them with my tongue. Heidi shuddered and spread her legs some more, so I figured I was starting out OK. I spread her lips with my hands and found her clit with my tongue. Her response was a little moan. As I licked her clit, she grabbed my rig ht hand and pushed it towards her breasts, under her sweater. She was wearing a front-closing bra; I wonder if she had anything in mind when she put it on today? It was quite a challenge undoing her bra without my tongue losing track of what it was doing, particularly with only one hand free to work on her bra, but I finally managed to get one of her magnificent breasts in my hand. I was running my fingers around her nipple, pinching it, pressing on it, squeezing her breasts; meanwhile, I was probing into her cunt with my

Japanese Funerals essays

Japanese Funerals essays In Japan, funeral procedures adhere strictly to traditional beliefs and customs, unlike Japanese weddings, which have been strongly affected over the years by Western influence. The beliefs and etiquette surrounding the funerary procedure is a splicing of Shinto, Buddhist, and Confucian beliefs. Most Japanese consider themselves as Shinto, Buddhist, or Shinto-Buddhist, yet it is important to the Japanese that the funeral ceremony is approached in the Buddhist practice. The traditional notions of death in Japan are also involved in the funeral process. Traditional Japanese beliefs on death and funeral ceremony: The Japanese people understand that the natural process of death is the final event of life, due to their relationship as a race with Buddhist and Shinto beliefs. According to Kimura, Zen Buddhist phrases such as accept death as it is and Life-death as one phenomenon are key motifs integrated into Japanese culture (1996, 374). True to Buddhist precepts, the Japanese also believe in re-incarnation, or the coming of a next life after one has ended. A Japanese funeral thus marks the end of a human life on earth. Traditionally, the Japanese funeral is a very important ritual practice in Japanese society. The Japanese believe that the spirits of the dead are revived during a funeral. The ceremony itself thus does not focus on the bereavement of the surviving friends and family, but on the spiritual journey of the deceased person. Keeping the Japanese funeral tradition is important to the Japanese, who believe that retaining funerary custom shows respect for the deceased and their ancestors. The Japanese believe that their ancestors are always with them, watching, protecting, and guiding them, so respect for their dead through ritual is important. Funeral ceremony, and associated customs: In the hour after a person has died, the lips of the deceased are moistened, and the body is washed a...

Regla de presencia de infantes para solicitar pasaporte

Regla de presencia de infantes para solicitar pasaporte Si usted es el padre o la madre de un infante que es menor de edad y es ciudadano americano, puede que tenga dudas sobre si es necesario llevarlo a la oficina donde se solicita el pasaporte, particularmente cuando se trata de un bebà © o tiene muy pocos aà ±os. En este artà ­culo se resolver esa duda claramente y tambià ©n se brindar informacià ³n esencial sobre los pasaportes americanos de los nià ±os. Regla sobre presencia de los nià ±os para solicitar el pasaporte americano Cuando se solicita por primera vez o la renovacià ³n un pasaporte para un estadounidense menor de 16 aà ±os, el nià ±o debe estar presente siempre, incluso aunque sea un recià ©n nacido. No hay excepciones a esta regla. Por el contrario, si ya ha cumplido los 16 y se trata de una renovacià ³n, se puede hacer todo el trmite por correo, sin necesidad de presentarse en ninguna oficina. Sin embargo, si se trata de una solicitud por primera vez, sà ­ que deber acudir en persona. Si se est en Estados Unidos, hay que llevar al nià ±o a la Oficina de Recepcià ³n de Solicitudes de Pasaportes o en la Agencia de Pasaportes. Si se est en otro paà ­s, deber cerrarse una cita y presentarse en la Embajada americana o consulado que corresponda al lugar donde se encuentra en ese momento el solicitante.  ¿Deben el padre y la madre estar los dos presentes cuando se solicita el pasaporte para un nià ±o? La respuesta es sà ­, si bien se admiten  tres excepciones a la presencia conjunta del pap y de la mam  cuando no es posible. El objetivo de todas estas reglas es evitar que nadie pueda sacar a un nià ±o americano de su lugar de residencia habitual  sin el consentimiento de los dos padres. Esto aplica incluso cuando un progenitor se enfada con el otro y se quiere llevar al menor a otro paà ­s. Si se cree que el hijo corre este riesgo, esto es lo que se puede hacer para evitar lo que se llama un  secuestro internacional de nià ±os. Quà © documentos son necesarios para solicitar el pasaporte americano para un nià ±o Adems de llenar la planilla de solicitud y aportar fotos tipo pasaporte, el documento ms importante es el que acredita la nacionalidad estadounidense. Si el nià ±o ha nacido en los Estados Unidos hay que presentar copia del certificado de nacimiento.   Si ha nacido en el extranjero pero adquirià ³ la nacionalidad por uno de los padres o la adquirià ³ posteriormente la ley seà ±ala cules son los documentos son vlidos para acreditar la ciudadanà ­a estadounidense. Por cunto tiempo es vlido el pasaporte de un nià ±o Los pasaportes de los nià ±os expiran a los cinco aà ±os de haber sido expedidos.    ¿Es siempre necesario el pasaporte para viajar internacionalmente? El pasaporte es siempre el mejor documento, pero se admiten excepciones, como una tarjeta de pasaporte. Adems, en el caso se nià ±os pequeà ±os que son ciudadanos caben otras posibilidades para  ingresar a los Estados Unidos por tierra procedente de Canad o Mà ©xico. El pasaporte no llega,  ¿quà © hacer? Si se solicità ³ el pasaporte y no se recibe, puede que se trate de una demora normal.  Si se desea acelar el trmite se tiene la opcià ³n de pagar para que se realice con carcter urgente. Pero tambià ©n es posible que se extraviara en el correo. Si sospecha que eso es lo que ha ocurrido entonces se debe solicitar la anulacià ³n de ese pasaporte y pedir otro sin ningà ºn costo aà ±adido. De interà ©s: doble nacionalidad, conservar ciudadanà ­a y derechos padres Es comà ºn que nià ±os estadounidenses residan en otro paà ­s. Estas son las reglas sobre la conservacià ³n de la nacionalidad y sobre la obligacià ³n de inscribirse al Servicio Selectivo en el caso de los varones. Adems, tener en cuenta que un nià ±o estadounidense puede tener el pasaporte de otro paà ­s, por ejemplo, el de los padres, ya que Estados Unidos aplica unas leyes liberales en asuntos de doble nacionalidad. Por otra parte, tambià ©n es frecuente que un infante estadounidense tenga paps que tienen otra nacionalidad.  Estos son los derechos de los padres de los nià ±os ciudadanos.  Es muy importante entender quà © derechos se pudieran derivar de esa situacià ³n, cul es el requisito de edad de los hijos y cundo, a pesar de tener hijos ciudadanos, no se puede sacar ningà ºn derecho. Y es que en este punto hay mucha informacià ³n equivocada. Consejo y curiosidad Ya que este artà ­culo trata de pasaporte para nià ±os viene al caso recomendar esta informacià ³n sobre cà ³mo entender fcilmente el sistema educativo de los Estados Unidos. Hay varias opciones para que los infantes estudien y todos ellos merecen las mejores oportunidades. Por à ºltimo, una curiosidad. Y es que los latinos somos la minorà ­a ms grande en Estados Unidos, lo cual se refleja en el censo. Dos apellidos hispanos estn entre los 10 ms comunes del paà ­s y 19 en el top 100,  Ã‚ ¿sientes curiosidad por saber si est el tuyo? Este artà ­culo es meramente informativo. No es asesorà ­a legal para ningà ºn caso concreto.

Operation Plan Essay Example | Topics and Well Written Essays - 2250 words

Operation Plan - Essay Example Operations plan should also put into consideration economic constraints. Poor financial governance in a new operation plan may be hindrance to its success. Strategy Before expanding its business to serving breakfast, the organization should completely stabilize its former operations. This is because the initial operations form the identity of the business. In an argument by Grant (2005) the identity of a business venture is the most important thing in a business even in the consideration of increasing its operations venture. In case of any incidence of risk, the former operations will be used as a mitigations tool. According to Schermerhorn (2009) once an organization is identified with a particular business operation, it is more likely to prosper in it than when venturing in other operations. However, in this case the operations are similar and involve similar operations. The staff in the restaurant should be tuned so that they accommodate breakfast schedules their activities. Diffe rent from serving other meals, breakfast served to walk in consumers requires appropriate time management. Time barrier may hinder the restaurant from offering reliable breakfast services. The restaurant transition from serving breakfast to serving other meals should also be well structured (Ferrell & Hartline, 2010). Considering it as a new activity the restaurant should adapt indulging into two shifts of serving meal. In making the new operations the organizations efficient, the management should consider training of the staff. Training of the staff will increase their efficiency in serving a new set of meal. In this serving also includes packaging of contents in breakfast. As new venture the restaurant needs new staff training procedures which would incorporate new activities in the venture. For instance, the restaurant will have to add trained chefs who are experienced in the preparation of breakfast meals. Apart from employment of new cooking staff the restaurant should conside r training the already existing staff. These will the cut the cost on the implementation of the new operation plan. The restaurant should also consider implementation of a good marketing plan. In the consumer population the restaurant is famous only for other meals rather than breakfast meals. To increase their significance in the market, the restaurant should employ very informative marketing strategies. The marketing strategy should be in consideration of other competitors SWOT analysis (Johnson, Scholes & Whittington, 2008). Processes The process of a business transformation is generally referred to as a project. In this case, the restaurant should view this operational change as a project. To make the project successful the restaurant need to separate the operations of serving breakfast from the rest of the restaurant setting. In this way the breakfast operations will be handled as lone projects. According to Strategic Direction (2007) in this way the project will have enough at tention and attention to launch to full operation. Launching a new line of operation in an existing business should be free from influence from an already existing company. If the two lines of operations are different it becomes more than impossible to launch a successive new line of operations. For instance, a breakfast line in a fast food setting requires a well structured new management an operational strategy. The designing of the project should not

Personal and professional development plan Assignment

Personal and professional development plan - Assignment Example I am a Bachelor’s Degree Holder (Mathematics & Economics) having graduated from National University of Odeassa I.I Mechnikov in Ukraine. I am also continuing in my second Degree in International Business, as a Third Year student at London School of Business and Finance in United Kingdom. Away from this pack of knowledge, my competence in MS Word, MS Excel, MS Power Point, and Internet have ignited my reliability to undertake any initiative accorded to me in any field of work. My oratory skills are a match of class for my excellent communication and interpersonal skills for working in a multicultural group for I am conversant and proficient in English, Ukrainian, and Russian languages (Beers, S. 2007:78). This empowers my ability to lead successfully a team of competent people to accomplish objectives and the commitment to deliver the results and achieving the goals within stipulated deadlines. My scaling initiatives have earned my trust from colleagues, superiors, and customer s due to positive attitude, integrity, politeness, and compatibility. In these avenues, I have extended an outstanding decision -making skills to solve any emergency problem in a diplomatic manner and in the interest of the entire organization. Key lessons learned from education and training (last 2 years) My education and training have not come with futility as my work experiences have earned me a lesson. For example, as a sales Executive in a show room in Ukraine, these skills were instrumental in achieving higher sales for the showroom due to superior presentation and customer relations skills. The virtue of responsibility has also helped a lot for I performed the assigned duties, such as maintaining inventory, loading and unloading of merchandise, and ensuring customer satisfaction, which assisted in the development of organizational and time management skills. I belief my versatility, not only in holding a valid Driver’s License, my dancing skills of five years have gain ed my far reaching accolades and appreciation. It is this appreciation and ability to have the niche and affinity for clients that drew admiration from my former manager for boosting sales during special occasions. Having people friendly attitude has really defined my professionalism and remains as a virtue to hold for long. Current situation My public relations and business acumen strengthened by my ongoing and never-ending attitude I have for serving, makes me proud and can declare that I have personal and professional strengths. However, as much as I would want to walk the tightrope of professionalism head on, I am aware of the hurdles I would face and the challenges. Overcoming all these situations successfully as they unfold is what shall define me as a valuable resource. To be a well-baked individual in my current situation, I have learnt that the faster I would learn to embrace consistency, practice, patience, tolerance, and professional assets the best would work out for me. I also have to a bolster up my personal and professional strengths and weaknesses to help me eventually develop an action plan for continuing personal and professional development. As a Cabin Crew Member, I know I am a mandate to be at my best if this chance swings to my side. Personal and profes

Mercedes-Benz Essay Example | Topics and Well Written Essays - 500 words - 1

Mercedes-Benz - Essay Example Later on, Emil Jellenik made a deal with the Daimler manufacturers in Germany, to sell him the cars and then he honored his daughter by naming the fleeting of the bought cars after her-Mercedes. The reason which made the Mercedes cars to stand out is the high performance engines which had a relatively higher horse power than any other vehicle at that time. Secondly, the Mercedes Benz had custom made leather seats which introduced comfort of another level. This was particularly prominent in the US where the customers had a taste of class and luxury or ostentation. Over the years, the brand of Mercedez Benz has grown to be known as a car of luxury and ostentation (Jenkins, 2010). This is to imply that the price was relatively higher to denote the class that Mercedes Benz was postulated to be in. Thus, the people who drove or bought Mercedes Benz were assumed to belong to a certain class, like in Singapore, where few elites could afford it. In the same line of thought and respect, the technical and technological ability of Mercedes Benz was more agile and superior giving the owner or drive some natural technical abilities to maneuver the car as compared to other models of cars . The production center in China ensured that the Mercedes brand was technically alright to as to appeal to the mechanically savvy population of China. It is important to note that the vehicles were designed with proper engines which were powerful and superior in terms of engine use and fuel consumption. Thus, if person bought the Mercedes Benz, he or she would be assured of spending lesser in terms of gas and fuel consumption (Sandalow, 2006). Culturally, it is important to note and mention that the people who drove the Mercedes Benz were considered to be of a superior cultural dispensation or class. The performance of the Mercedes Benz as a company relied on business environment that would be

Potent and specific genetic interference by double-stranded RNA in Essay

Potent and specific genetic interference by double-stranded RNA in Caenorhabditis elegans - Essay Example Notably, this reflects limited interference activity. To achieve a commendable effect, there should be a high dose of the injected RNA. In an endogenous activity, an antisense-sense mixture has the capacity to produce interference that is very effective. In the development of a dsRNA (double-stranded RNA), the evident feature is the potency of the antisense-sense mixture in the interfering activity. Placing the double-stranded structure in cis has no effect on the potent activity of the interference. That is, double-strand sequences that are positioned on level 3 or 5 of a single-strand segment are not able to trigger interference. Using unc-54, fem-1 and hlh-1 to assess the target uniqueness of the effects of dsRNA, the results include (1) progeny broods with a null-mutant phenotype are produced and (2) the single RNA threads with no important interference. At cellular levels, the effects of interference of dsRNA can also be examined. Fractions of the Derived fluorescent protein (GFP) decrease when they are injected with dsRNA and the same is explained by in the figure above and

Business writing Essay Example | Topics and Well Written Essays - 750 words - 1

Business writing - Essay Example In contrast, external communication refers to the spread of information outside a particular organization (Courtland 4-7). Especially in a personal interview process, verbal and non-verbal communication techniques are extensively used. Verbal or spoken communication technique cannot be fully isolated from other interpersonal skills such as listening. On the other hand, non- verbal communication relies mainly upon eye contact between a sender and a receiver, facial expression, posture along with gesture, personal appearance, time and space (Loewy and Guffey 12-14). THESIS STATEMENT This essay intends to conduct a self-critique writing based upon an interview. In this regard, several aspects such as analyzing the facets of delivery along with speech composition, distinguishing between weak and strong support, diagnosing interviewing problems and depicting proposed remedies will be discussed. CRITICAL ANALYSIS OF SPEECH COMPOSTION AND DELIVERY In relation to the mock interview conducted , it can be analyzed that during the interview process, my speech composition was not up to the mark. This can be justified that when the interviewer asked me to tell about myself, I was not very much confident to give her a specific answer. Consequently, as I was not much confident, my eye contact missed a lot. Moreover, during the time of delivering a speech, at certain times, I felt much hesitated to give her with appropriate response. When the interviewer took a time to ask me the next question, in between that time, I looked around here and there, which eventually revealed a negative impression towards the interviewer. When the interviewer asked me the reason for working in her company, I told her that it is my personal interest of doing the job rather than professional interest. DISTINGUISH BETWEEN WEAK AND STRONG SUPPORT One of my strong supports in relation to the mock interview was my polite behavior while communicating with the interviewer. I presented myself quite joyfull y and friendly with the interviewer. Moreover, in relation to the strong support, it can be affirmed that when the interviewer asked me about my strengths along with weaknesses, I was able to provide these information much confidently. On the other hand, relating to the mock interview, my weak support was that I was not properly dressed, which might created a negative impression in front of the interviewer. It can also be viewed from the interview that I was not much confident enough as I looked here and there while asked the questions by the interviewer to me. IDENTIFY UNCLEAR RESPONSES AND IDENTIFY POSSIBLE SOLUTIONS In relation to the conduct of the mock interview, an unclear response can be identified at the time when I asked the interviewer about the future planning of the company. In this regard, one of the possible solutions concerning this unclear response could be asking the interviewer about various job related aspects such as job timing, salary structure and other associa ted questions. DIAGNOSE INTERVIEWING PROBLEMS AND PROPOSE REMEDIES From the mock interview conducted, certain interviewing problems can be apparently observed. In this similar concern, one of the problems was that I was not much confident enough to answer the questions asked by the interviewer. Moreover, the other interviewing problems were identified to be less eye to eye contact and the tone of voice is also quite low. Apart from

Business financial management Essay Example | Topics and Well Written Essays - 2000 words

Business financial management - Essay Example In the year 2004, this amount increased by about 9%, while in 2005 it fell by 19%. This suggests that this amount responded as the sum of long-term debt fluctuated. Also, the company's gearing policy, as suggested by above ratio is to maintain a mixed structure of capital and rely on equity funds more than the borrowed capital, because debt demands fixed payment of interest to the lenders whereas dividends are decided by the management according to their future plans. The gearing ratio of Baa plc reveals that the company's debt at market value is about 95% of the total funds invested by the shareholders. It also means that the company has kept the level of debt slightly below the equity capital so as to avoid interest payments. Koch and Shenoy (1999, p18) posit that, "an increase in leverage due to a debt offering will initially provide more cash for possible over investment, but over time the higher interest expense will decrease the cash available for over investment". Hence, the company might have adopted this strategy to keep the interest payment at a minimum level. The gearing policy of the company as illustrated in part A also reflects that the company has opted to continually decreas... In the year 2004, this amount increased by about 9%, while in 2005 it fell by 19%. This suggests that this amount responded as the sum of long-term debt fluctuated. The amount of long-term debt was 49% of the total capital invested in the company for the year 2003, which rose to 53% in 2004 and declined to 52% in 2005. This suggests that about half the company's total capital comes from external sources i.e., lenders and other outsiders. This in turn also reflects the gearing policy of the company to keep the level of long-term debt in the company at a balanced level Also, the company's gearing policy, as suggested by above ratio is to maintain a mixed structure of capital and rely on equity funds more than the borrowed capital, because debt demands fixed payment of interest to the lenders whereas dividends are decided by the management according to their future plans. Part B: Gearing Ratio Baa Plc 2005 Market Value Debt 4,150 = 95% Total Shareholders' Equity 4,374 The gearing ratio of Baa plc reveals that the company's debt at market value is about 95% of the total funds invested by the shareholders. It also means that the company has kept the level of debt slightly below the equity capital so as to avoid interest payments. Koch and Shenoy (1999, p18) posit that, "an increase in leverage due to a debt offering will initially provide more cash for possible over investment, but over time the higher interest expense will decrease the cash available for over investment". Hence, the company might have adopted this strategy to keep the interest payment at a minimum level. The gearing policy of the company as illustrated in part A also reflects that the company has opted to continually decrease the percentage of long-term debt in the total

Business writing Essay Example | Topics and Well Written Essays - 750 words - 1

Business writing - Essay Example In contrast, external communication refers to the spread of information outside a particular organization (Courtland 4-7). Especially in a personal interview process, verbal and non-verbal communication techniques are extensively used. Verbal or spoken communication technique cannot be fully isolated from other interpersonal skills such as listening. On the other hand, non- verbal communication relies mainly upon eye contact between a sender and a receiver, facial expression, posture along with gesture, personal appearance, time and space (Loewy and Guffey 12-14). THESIS STATEMENT This essay intends to conduct a self-critique writing based upon an interview. In this regard, several aspects such as analyzing the facets of delivery along with speech composition, distinguishing between weak and strong support, diagnosing interviewing problems and depicting proposed remedies will be discussed. CRITICAL ANALYSIS OF SPEECH COMPOSTION AND DELIVERY In relation to the mock interview conducted , it can be analyzed that during the interview process, my speech composition was not up to the mark. This can be justified that when the interviewer asked me to tell about myself, I was not very much confident to give her a specific answer. Consequently, as I was not much confident, my eye contact missed a lot. Moreover, during the time of delivering a speech, at certain times, I felt much hesitated to give her with appropriate response. When the interviewer took a time to ask me the next question, in between that time, I looked around here and there, which eventually revealed a negative impression towards the interviewer. When the interviewer asked me the reason for working in her company, I told her that it is my personal interest of doing the job rather than professional interest. DISTINGUISH BETWEEN WEAK AND STRONG SUPPORT One of my strong supports in relation to the mock interview was my polite behavior while communicating with the interviewer. I presented myself quite joyfull y and friendly with the interviewer. Moreover, in relation to the strong support, it can be affirmed that when the interviewer asked me about my strengths along with weaknesses, I was able to provide these information much confidently. On the other hand, relating to the mock interview, my weak support was that I was not properly dressed, which might created a negative impression in front of the interviewer. It can also be viewed from the interview that I was not much confident enough as I looked here and there while asked the questions by the interviewer to me. IDENTIFY UNCLEAR RESPONSES AND IDENTIFY POSSIBLE SOLUTIONS In relation to the conduct of the mock interview, an unclear response can be identified at the time when I asked the interviewer about the future planning of the company. In this regard, one of the possible solutions concerning this unclear response could be asking the interviewer about various job related aspects such as job timing, salary structure and other associa ted questions. DIAGNOSE INTERVIEWING PROBLEMS AND PROPOSE REMEDIES From the mock interview conducted, certain interviewing problems can be apparently observed. In this similar concern, one of the problems was that I was not much confident enough to answer the questions asked by the interviewer. Moreover, the other interviewing problems were identified to be less eye to eye contact and the tone of voice is also quite low. Apart from

Microbiology tecniques Research Paper Example | Topics and Well Written Essays - 1250 words

Microbiology tecniques - Research Paper Example Through this technique, the many instances of typhoid related deaths can be effectively minimized if not fully extinguished. Also, it can be projected that this method, being cheap, will minimize instances of mis- diagnosis and wrong drug use, a prospect that has often led to many deaths in Sub- Saharan Africa. For quite a long time, typhoid fever has been a great problem in the developing states of Africa, Asia and Latin America. Notably though, the number of deaths related to typhoid are minimal in developed states. According to reports by the CDC, typhoid fever has so far led to over 200,000 fatalities, with over two million people having been infected with the bacterium. Critical reviews have shown that the prevalence of Salmonella typhi is common in congested localities where there are instances of poor hygiene and sanitation. Therefore, there is need to develop ideal strategies to detect the bacterium in the blood of the victims, and to consequently mount quick response to prevent progression of the infection to full- blown states. The other problem experienced within these localities is the presence of the carriers for the Salmonella bacteria. Such cases of carriers allow the bacterial populations to exponentially multiply. Thereafter, the bacteria can be easily passed over to new p opulations thus further spreading the infection. Therefore, it is necessary to create proper strategies to manage the spread of the infection through critical analysis of the population of Salmonella typhi in people, especially careers to alleviate further spread of the disease. This study is aimed at developing ideal strategies to detect populations of Salmonella typhi in populations. Through such detection of host bacterial counts, it is possible to develop proper strategies to prevent further spread of the bacteria to other people. This, consequently, helps to curb the spread of the typhoid fever to new hosts and hence significantly helps to reduce

The western end of the Kennet and Avon canal since the early 19th century Essay Example for Free

The western end of the Kennet and Avon canal since the early 19th century Essay 1790 Prospectus: The 1790 prospectus was created to show the importance of the canal and its mandatory construction. The prospectus basically said that the journey from Bristol to London was slow and tedious and often required the same amount of time as a trip to the West Indies. There were also problems with the new French leader; Napoleon, who was using privateers in the channel to make sure that his continental system deprived Britain of trade and resources, by intercepting the British ships in hope of republicanism spreading to this part of Europe. The canal would therefore solve the problem of the long and dangerous journey. The authors of the prospectus produced it to show the importance of the canal and all of the problems that it would solve (i.e. advertising the canal). It was, maybe a chance to exaggerate the benefits of the canal and get different groups of people on their side. There were a few major groups that the prospectus was aimed at to convince and persuade them and was the main reason that the prospectus was drawn up. They said that it would speed up trade and make it quicker and cheaper to transport goods such as coal from the Somerset Coalfields, slate, corn and American goods e.g. tobacco, rum and cotton. These attractions would bring in traders and thus more trade for the canal and more money from toll payments for cargo. They used the prospectus to persuade shareholders to invest in it and use it as a business. Shareholders were enticed by the prospect of a revolutionary new idea that could give them a large dividend. This invested money would make sure that there was enough capital to build the canal and aid with other financial expenses such as labour (wages). This money would also ensure that parliament gave permission for the construction of the canal and this was important because many MPs were rich land owners at that time and the canal planners needed their permission so that the canal was able to pass through their land. Widcombe Flight: There is not a lot of evidence to support the justification for the canal as put forward in the prospectus at Wicombe Flight. In general there is more evidence to suggest trade within Britain being a major reason for the canals construction i.e. Bristol to London (Tilbury) rather than trade from America to London via Bristol e.g. barley from Bradford-on-Avon, used in the malt house on the side of the canal. The only evidence that suggests this American trade link is the Sydney Wharf warehouses which may have been used to store some American goods e.g. sugar cane and cotton, in transit to London. Its difficult to find any more good evidence because warehouses have been converted and used for different purposes such as residential homes. The atmosphere has also changed with much less trade going on and more tourists on a quiet holiday, making it harder to imagine the trade that went on in the 19th century. The canals uses have changed dramatically since the early 1800s mainly due to the introduction of new types of transport such as rail. Narrow boats are being used now for holidays and people are walking dogs along the tow-path suggesting that the canal is used less for trade and more for tourism. I saw evidence of horses being used to pull boats in the 1800s such as the tow-path, change line bridges and stables. These stables are now an architects house and show how horses are no longer Guillaume Wright 10C2 GCSE History Around Us Coursework C/W 12/5/01 used to pull boats and how businesses have profited from the spare, cheap land on the bank of the canal. The other architects house above Top lock had a large chimney and suggested that it used to be a maltsters and shows that agricultural (barley) and industrial (malt breweries) uses have declined. Warehouses have been converted into restaurants and houses showing the change from trade to leisure and residential uses. There were people fishing on the banks which suggested the canal is also directly involved with leisure and is used for tourism. This site was useful to a certain extent in understanding the 19th century canal uses because it gives evidence of old-fashioned trade and ways e.g. barley and the use of horses. It also has limitations as to its usefulness because the area gas changed so much. The whole atmosphere has changed and buildings have altered their uses. Thimble Mill is now a restaurant and wine bar and the Hilton Hotel used to be a pump house powered by steam, used to pump the 100,000 gallons of lost water flowing downhill at the locks. Its very hard to imagine all of this happening now. Sydney Gardens Print The Sydney Gardens print was made in 1812, only two years after the canal was built, and depicts a beautiful sunny day at the section of the canal that passes through Sydney Gardens in Bath. In the print, Cleveland House is not shown either because the owners of Sydney Gardens thought it degenerated the areas appeal, or because it was not relevant to the canal at the time, as it did not become the canals headquarters until 1825. There is an attractive oriental summer house included in this version, that is not there any more, so the area could gain credibility and attract the wealthier people to somewhere where they could sit in the shade so as to keep their skin white (the fashion and a necessity for people in a high-class society). A small decorative pleasure boat which would have been very rare in those days, is travelling along the canal whereas you were more likely to see coal-barges and narrow boats due to the trade industrys heavy use of the canal. There are also other small differences like the tow-path that ends at the bridge and wealthy stylish people walking along the tow-path instead of horses (to tow the boats) so as to attract people to Sydney Gardens and use the canal leisure activities. Other changes include subtle alterations in the decoration of the bridge, less foliage around the canal to give a more open atmosphere and the fact that its a sunny day to give the overall effect of a perfect venue for a visit or day-out. The print is probably bot very accurate as it changes and alters some of the main features and distorts reality for the Sydney Gardens owners profit and gain. This is and artistic impression of the area and so is only the artists portrayal of it so details may have been altered, maybe so that the artist could impress the Sydney Gardens owners and earn more money and respect. Overall, you cannot trust rely on a picture that has been changed so much and had a motive to be changed. This interpretation was probably produced because it was specially commissioned by the owners of Sydney Gardens to increase profit from tourism because Sydney Gardens was privately run and needed to make a healthy profit to keep people such as the shareholders contented. Because of this and as they didnt want the canal to be seen as an eyesore they applied conditions for the canal builders such as four ornamental bridge (costing 2,200 pounds) and the canal to be sunken down into a ditch and these features are predominant in the print so as to advertise the best parts of the canal. It was produced to show a picturesque scene, set on a calm, sunny day with a beautiful canal which was a comparison to other fashionable cities such as Venice, which improved the areas credibility, especially for the more wealthy as these would bring more money to the area. In the 1700s Bath had built up a reputation of a beautiful Georgian town for the wealthy and offered luxurious attractions such as the Guillaume Wright 10C2 GCSE History Around Us Coursework C/W 12/5/01 Roman Baths, and so Sydney Gardens wanted to attract these wealthier people to their park for a larger profit and an excellent and maintained reputation. Dundas Aqueduct The Dundas Aqueduct funded by Charles Dundas, was one of John Rennies greatest architectural achievements when he built the canal. There was a crane and a few warehouses along the canal which suggests the lifting and storing of goods such as cotton and rum from Britains West Indian trade, rather than coal because this was often transported loosely. There is very little other evidence to suggest trade from the West Indies apart from these warehouses (storing goods in transit to London) to Britain and Dundas Aqueduct mainly consists of evidence of home-based trade such as the bulge (Dundas Marina) in the canal which shows the anticipated build up of traffic along the canal as though they were expecting a lot of trade from around the area. The major piece of evidence is the entrance to the Somerset Coal canal at Dundas, which suggests that trade and goods were regularly coming in from the coalfields and transported to other areas such as London (home trade). The Kennet and Avon canal is wider than the coal canal which suggests that they expected a lot more coal and other goods from other areas to be transported along the canal as well as the Somerset coalfields produce. This 1864 print of the Dundas Aqueduct was produced from the Illustrated London News, and was probably made to show London the thriving business and beauty of the area and to impress wealthy Londoners, who provided trade for this part of the canal with trade from the West Indies (Stonegate at Dundas shows that there were toll collections for cargo). It was also to show off John Rennies architecture, maybe for his personal career in the opportunistic city of London or maybe just to impress people. It showed off its leisure qualities (fishermen), despite a the heavy industry and gave the impression that its a pleasant place to visit and so would be good for the areas economy. It may also have been to impress venture capitalists in London who might invest much-needed money into the canal for repairs and maintenance. There are reasons to believe the pictures accuracy because nothing seems to have been left out, added in or changed dramatically (unlike the Sydney Gardens print) and unattractive features such as the railway and the railway arch are included as well as industrial features such as coal barges and horses. There is a boat going into the coal canal which suggests that it was still involved in business and trade and this is accurate as the canal made a profit until 1890 (print made in 1864). There also seems to be no major motive for any deviations from reality (unlike Sydney Gardens print) and features such as the stone work, decorations and style are very much the same as they are today. Having said this, there are still doubts as to its accuracy such as the exaggeration of the beauty of the area with the impressive cliffs and forests in the background. There is a cobbled bridge (entrance to Somerset coal canal) which has now been replaced by a metal swing bridge, and it is a matter of opinion whether the cobbled bridge ever existed. It is most likely to be very accurate as the cobbles are accurate when cross-checked with other tow paths in Bath for horses that look similar. Taking into account all of these factors, in my opinion, the photograph is accurate. Devizes Museum The Devizes museum holds artefacts and displays from the working days of the Kennet and Avon canal, and it is important for historians to check the authenticity of the artefacts so that the museum can paint a realistic picture of canal life in the 19th century. Cross referencing can be useful for checking artefacts, as dates and material use can be verified with any dates on the artefact e.g. the loading gauge rods may have a date imprinted on the artefact that can be checked with the dates of when they were used and when the technology was available. Horse equipment could be checked with similar equipment from the time to check for any obvious differences or fake parts. The material that the artefact is made from could be scientifically tested and dated using a method such as carbon dating on objects such as the narrow boat rudder, although this is not a particularly accurate method. Letters and prints can be checked (e.g. photos showing scenes from the late 19th century) by verifying the scene where the photo was alleged to have been taken. They could also check the type of photograph and whether the technology existed at that time. For items such as the mock up of the canal cabin or the model of the crane, there is the possibility of verification with people who have used and experienced these artefacts or cross-check with diaries or letters from canal workers or Victorian travellers. This is the most accurate method, as long as the source is reliable. Finally, they could check the mechanics of something like the pulley to see if it works like it should do (taking into consideration the possible damage and weakening of the artefact). There are limitations to these artefacts usefulness in determining what it was like in the 19th century. For useful objects such as the narrow boat rudder and the pulley, there is likely to be a fair amount of damage, or it will be repaired or altered in order to put it on display in the museum and so its hard to imagine how it worked. Because culture and technology has changed so much, its difficult to imagine how objects such as the crane and the pulley would have been used, as the canals uses have changed so dramatically from the 19th century. Again, there are limitations for the model of the cabin as, although it shows the visual side it gives no sense of the noises, smells, cramped conditions, and the general atmosphere of trade and travel. It is also hard to obtain realism in the working models (e.g. crane and pulley) as they are likely to work too smoothly and its hard to imagine the scale and size of it. With letters such as the one from John Ward, warning about navvies, its left up to the imagination as to what it was like and sections may be exaggerated leading to a misrepresentation of the area in the 19th century. Conclusion Hypothesis: The Kennet and Avon canal was only built in order to benefit the Somerset Coal canal. For the purpose of contradicting this statement, I can say that, no where in the prospectus is the Somerset Coal canal mentioned and it suggests that the main purpose of the canal was to create an inland navigation system from Bristol to London to benefit trade from the West Indies as well as home trade, by by-passing the long, tedious and dangerous journey across the channel. In fact the prospectus was drawn up in 1790; before the Somerset Coal canal was even built (1804-5), suggesting that the Somerset Coal canal just wanted to benefit from the Kennet and Avon canal rather than the Kennet and Avon being built purposefully for the coal canal. There is no specific mention of coal among the home trade section of the prospectus and there is also the fact that we saw evidence of other types of home trade around the canal such as Hugh Bairds maltsters who used barley from places such as Bradford on Avon to make alcohol. There was also plenty of information at the Devizes museum explaining the canals use as a method of transit for West Indian goods. There are no reasons that can support this statement fully, but there is evidence of coal being transported along the canal such as the warehouses at Dundas and Sydney Gardens. This isnt true but a major result of the construction of the Kennet and Avon canal was that it was beneficial to the Somerset Coal canal, shown by the entrance at Dundas which links the canals together. Again coal is mentioned as information in the Devizes museum as a good associated with the Kennet and Avon. Overall, I think each site we visited was good at helping us understand the old uses of the Kennet and Avon canal.

Pathophysiology of Meningitis and Encephalitis Essay -- Biology Medica

Pathophysiology of Meningitis and Encephalitis Meningitis and encephalitis are two similar infections of the central nervous system that often lead to fatality of the host organism. Both diseases occur when pathogens enter the blood stream and gain access into the central nervous system. Stimulating inflammation within the cranial cavity, the pathogens continue to multiply and take harmful effects on the host. Inflammation, the body’s response to infection, ultimately causes all of the symptoms and complications of meningitis and encephalitis. The pathophysiology of meningitis and encephalitis aids in the explanation and understanding of the symptoms, effects, and underlying agendas of the two infections. Meningitis is the inflammation of the meninges, membranes that encase the brain and spinal cord. Although meningitis can result from protozoal or fungal infections, bacteria and viruses typically cause the often fatal disease. Known for its sudden onset of flu-like symptoms, the infection rapidly progresses into an agonizing cascade of high fever, chills, nausea, vomiting, light sensitivity, purpura (dark discolorations of the skin caused by bleeding beneath the skin), and possibly seizures. In severe cases of meningitis, limbs or extremities must be amputated due to the appearance of purpura. Viral meningitis, the most common form of the disease, often resolves itself without treatment within a few days. However, bacterial meningitis, somewhat rare in the United States but rampant in West Africa, requires immediate attention in order to prevent fatality. The bacteria that cause meningitis include Streptococcus pneumoniae, Neisseria meningitidis, Streptococcus agalactiae, and Listeria monocytogenes. The severity of the body’... ...ia Britannica Online. 20 July 2006 . â€Å"Meningitis.† Wikipedia The Free Encyclopedia. 20 July 2006. MediaWiki. 21 July 2006 . Patel, Mahesh R. â€Å"Herpes Encephalitis.† E Medicine. 2006. Health on the Net Foundation. 24 July 2006 . Phillips, Elizabeth J. and Andrew E. Simor. â€Å"Bacterial Meningitis in Children and Adults.† Postgraduate Medicine Online. 1998. 23 July 2006 . â€Å"Photobia.† Wikipedia The Free Encyclopedia. 20 July 2006. MediaWiki. 21 July 2006 . Sande, Merle A., Arnold L. Smith, and Richard K. Root. Bacterial Meningitis. New York: Churchill Livingstone, 1985. 6 â€Å"Viral Encephalitis.† Better Health Channel. 2005. State Government Victoria. 23 July 2006 . 7

Conservative Legislation and Trade Union Power Essay -- Essays Papers

Conservative Legislation (during the 1980s and early 1990’s) and Trade Union Power Trade Unions can be defined as: ‘ Organisations of workers set up to improve the status, pay and conditions of employment of its members’. Salaman, ‘Industrial Relations’, P77 From the end of the second world war, and up until the 1970’s trade unionism was continually growing. By 1979, 57.3% of all people employed were members of trade unions. Annual abstract Statistics, 1990, ‘Industrial relations’, M.P. Jackson, 1991, P57 ‘Trade unionism may be seen as a social response to industrialisation and capitalism’ Salaman, Industrial relations, P79 In the early days of trade unionism, there was a direct need for workers to be represented, in areas such as manufacturing, there were little channels of communication and as a result of this workers had little or no representation. The collective bargaining approach, is a system used by trade unions to regulate industrial conflict. If conflict arises, the collective bargaining approach allows the trade unions to come together in a public forum to discuss any conflicting issues. The collective barganing approach in Trade Unionism assumes that the Trade Union is bargaining for the collective group rather than individuals. The collective bargaining group is given the opportunity to resolve any conflicting issues and in some cases but not all can prevent disputes from occurring. Harbison concludes that collective bargaining ‘Provides a drainage channel for worker dis satisfaction’ Harbison in Industrial Relations, M.P.Jackson In 1970, Britain saw the return of the Conservative government under the power of Edward Heath. After the minors strike, the Conservative government lost power and Britain reverted back to a Labour government. After the ‘winter of discontent’ in 1979, Britain once again saw the return of the Conservative government, however this time it was under the power of Margaret Thatcher. Previous to Margaret Thatcher, the government had always seen their main focus to be the achievement of ‘full employment’, a solution which in times of 1979 could prove somewhat impossible. The new Conservative government saw their future, as one of creating more jobs and encouraging greater success in competitive product markets, this was in an attempt to achieve full employment. The main priority of the new Conservati... ...strial Relations in Britain Edited by: Geoge Sayers Bain Published : 1983 Basil Blackwell Publisher Ltd, Oxford 2. The Origins of British Industrial Relations By: Keith Burgess Published: 1979 Croom Helm Ltd, London 3. The Free Economy and the Strong State- The Politics of Thatcher, second edition By: Andrew Gamble Published: 1994 MacMillan Press Ltd, Hampshire 4. Contemporary British Industrial Relations By: S Kessler & F Bayliss Published: 1988 MacMillan Press Ltd, London 5. Human Resource Maanagement Rhetorics and Realities By: Karen Legge Published: 1995 MacMillan Press Ltd, Hampshire 6. Workplace Industrial Relations in Transition By: Millard et al. Published: 1997 Dartmouth Publishing Co., Aldershot 7. Industrial Relations in the Future By: Poole et al. Published: 1984 Routledge & Kegon Paul Plc, London 8. Human Resource Management: A Strategic Introduction, second edition By: G Salaman & C Maby Published: 1988 Blackwell, Oxford 9. Industrial Relations: Theory & Practice By: Micheal Salaman Published: Prentise & Hall, Hemel Hamstead

Reasons for the Spratly Island Disputes Essay

The main reason for the conflict within the Spratly islands lies in the territorial disputes and quarrels among the different countries. Natural resources include fish, guano, undetermined oil and natural gas potential. There are mainly 2 reasons for disputes to occur in these islands mainly 1. The potential oil and natural gas reserves that lies dormant under the Spratly Islands. 2. Construction of the Busiest port Asia’s had been experiencing a rapid economic boom with giants such as China emerging as the next economic superpower. However, its economic advancement requires a large amount of energy and to claim the Spratly Islands would be useful for the countries’ future economic advancement. The 6 countries involve in the conflict is mainly Brunei, Malaysia, Philippines, China, Taiwan and Vietnam. Each of these countries requires the oil and natural resources within the sea bed of the Spratly islands to serve for these economic needs. Many of the emerging Asian countries require oil from the Middle East and Africa, these resources would have to pass through the Strait of Malacca into the South China Sea. The Spratly Islands lies on the strategic lines of the South China Sea therefore means that all 6 countries hope to have their hands on the Spratly islands to set up a sea port along the South China Seas. Over half of the world’s merchant fleet sails through the South China Sea every year. Therefore setting up a sea port at the Spratly Islands would therefore create one of the busiest ports in the world. This port will create numerous job opportunities and revenues for emerging countries. This had therefore sparked a part of the conflict as due to countries desire for the strategic location to belong to them, they would quarrel and fight over the claims of these islands to support their economic needs. However, the main reason for the conflict for the Spratly Islands would still be the scarce oil and natural resources found in the Spratly Islands. The future world is a world of a competition of economic development and economic gains and to obtain a substantial amount of oil and natural gas is the ability to create energy. The more energy a country has, the faster it can develop, the faster its economy can grow and become robust. Indeed, the strategic location of the Spratly Islands is also a cause for the conflict among the 6 countries. However, there is already a shortage of oil and natural gas in the world but there is not yet a shortage of strategic location in the South China Sea. The oil and natural resource is the main reason for the Asian countries to fight over these areas and it being a strategic location is merely an addition to their claim over these islands.

Drug Related Problems

Drug related problem Drug related problems (DRPs) are prevalent and causing considerable patient morbidity and mortality. Many of these DRPs are preventable through following the guidelines and rational drug used. There are many factors controlling the DRP occurrence such as patient age, disease status, drug characteristics, etc. High risk factors 1. Elderly (> 65 years); due to age related changes in pharmacodynamic and pharmacokinetics 2. Acute diseases such as acute renal failure, sepsis, etc†¦ 3.Patients with many chronic diseases; diabetes, hypertension, heart disease, liver problem, AIDS, etc†¦ 4. Patients with renal impairment or haemodialysis 5. Patients in special situations; pregnancy, lactation, 6. Certain diseases and their medications: cancer, diabetes, heart failure. 7. Polypharmacy (taken many drugs > 5 drugs) 8. Drug; certain drug classes are commonly involved e. g. Warfarin, insulin, digoxin, TCAs, etc†¦ Classification of drug-related problems 1. Inappropriate drug choice: Unjustified deviation from management guidelines consensus therapeutic can worsen the condition.Deviations that are based on the patient’s individual treatment goal and risk factors are not considered to be DRPs (e. g. Antibiotic used for viral infection. Furosemide prescribed for patient with hypokalemia). 2. Lack of necessary drug: Either one or more drugs are missing according to established guidelines or a medical problem is being treated with too little of the appropriate drug (under-prescribed) or appropriate drugs may be not used for maximum effectiveness. Moreover, duration of treatment may be too short which can lead to incomplete treatment.Deviations from guidelines that are based on the patient’s individual treatment goals and risk factors are not considered to be DRPs (e. g. B-blockers in heart failure or post-MI, stop diuretic before edema treated or loop diuretic used only for resistant edema). 3. Unnecessary drug and Duplicati on: A drug is unnecessary if the indication is no longer present, with continuation/prolonged use or double prescription of two or more drugs from the same therapeutic group or gives the same result. This intensifies their therapeutic effect and side effects.Duplication also can occur when more than one physician prescribes medications to a single patient or when a patient takes over-the-counter drugs with the same active ingredient (e. g. Long-term antibiotic prescribed for simple infection. Used of Ibuprofen and diclofenac concomitantly. 4. Incomplete medication history taking: Inappropriate integration of patient’s medical history can lead to many interactions due to lack of patient’s information such as hypersensitivity â€Å"medication allergy†, other diseases, OTC or herbal and medication used (e. g.Patient has allergy to penicillin). 5. Inappropriate dose or regimen: Dosing too high (overdose) or too low dose. Suboptimal dosing (including dosing time and formulation) according to established national/international guidelines, including frequency of dosing or duration of therapy. Deviations that are based on the patient’s individual treatment goal and risk factors are not considered to be DRPs (e. g. too high ACE inhibitor dose prescribed in relation to kidney function. Too low paracetamol dose use in relation to symptom-giving arthritis). . Adverse drug reaction (ADR): Any noxious, unintended, and undesired effect of a drug, which occurs at doses in humans for prophylaxis, diagnosis, or therapy (e. g. orthostatic hypotension happens with blood pressure lowering drug or intolerance dry cough due to ACE inhibitor). 7. Interaction: Drug–drug interaction, drug-food interaction, drug-disease interaction, drug-herbal, etc†¦ An interaction is occurring when the effect of a drug is changed by the presence of another drug, food, drink, herbal or some environmental chemical agent.Drug combinations with intended overall effe ct are not considered to be DRP (e. g. Drug–drug interaction; Furosemide and digitalis (increased effect/toxicity of digitalis with hypokalemia). Drug-food interaction; Amiodarone and Grapefruit, Grapefruit and Simvastatin (increase drug serum concentrations), or Tetracycline and calcium. Drug-disease interaction; used NSAIDs in chronic renal impairment). 8. Discontinuation of needed medication: Some times discontinuation of medication without reasonable medical indication can lead to therapeutic failure or a problem in treatment plan.In addition, stop some medications before controlling the disease or have good monitoring method can lead to failure in treatment plan (e. g. discontinue antibiotic before finishing its therapeutic course or stop Heparin injection before or just on start of Warfarin). 9. Contraindication: the used of some drugs are prohibited for some patients because to harmful risks of using these drugs are exceeding the benefits of their effect (e. g. ACE inh ibitor uses in treating high blood pressure in a pregnant lady or using sulfa-drug in G6PD deficiency patients). 10.Abrupt stoppage medication: for certain medications, abrupt stopping can exacerbate the problem or lead to complications related to drug. The stopping process should be gradually (e. g. abruptly stopping B-blocker in MI patients or stopping Corticosteroid suddenly). 11. Untreated medical conditions: can lead to worsening of the disease or may lead to more serious problems (e. g. untreated dyslipidemia in patients with other risk factors). 12. Lack of necessary monitoring: Monitoring with respect to effects and toxicity of drugs is not done or does not adhere to guidelines (e. . INR for Warfarin. Thyroid function tests in patients taking levothyroxine 13. Others: In general, DRPs that do not belong to aforementioned categories. References 1. Bemt P and Egberts A (2007) Drug-related problems: definitions and classification. Journal of European Association of hospital Pha rmacists (EAHP), 13, pp 62-64. 1. Lee S, Schwemm A, Reist J, Cantrell M, Andreski M, Doucette W, Chrischilles E and Farris K (2009) Pharmacists’ and pharmacy students’ ability to identify drug-related problems using TIMER (tool to improve medications in the elderly via review).American Journal of Pharmaceutical Education, 73, 3, pp 52-62 2. PCNE Classification for drug related problems (2006) Pharmaceutical Care Network Europe Foundation. Available from World Wide Web: http://www. pcne. org/dokumenter/DRP/PCNE %20classification%20V5. 01. pdf 2. Ruscin M (2009) Drug-Related Problems in the Elderly. Merck, Available from World Wide Web: http://www. merck. com/mmpe/sec23/ch341/ch341e. html 3. Ruths S, Viktil KK, Blix HS. Classification of drug-related problems. Tidsskr Nor Leageforen 2007; 127: 3073–6 Prescription Auditing SheetPatients Name Age: years Drug related problem: |Inappropriate drug choice |Lack of necessary drug | |Unnecessary drug and Duplication |Inco mplete medication history taking | |5. Inappropriate dose or regimen |6. Adverse drug reaction | |7. Interaction |8.Discontinuation of needed medication | |9. Contraindication |10. Abrupt stoppage medication | |11. Untreated medical condition |12. Lack of necessary monitoring | |13. Others | | Specification of the problem (and intervention if any): )†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. ( )†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã ¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. ( )†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. ( )†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚ ¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. ( )†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. Patient Resume Age: Sex: Drug Allergies: Medical History – – – – – – – Medication History – – – – – Laboratory Data base