Developing A Successful Classroom Inclusive Environment Is...

Another factor that incorporates in having a successful classroom inclusive environment is the quality of teaching. Alton-Lee (2003) argues that quality teaching has been identified as an important practice of positive outcomes for diverse students. Forlin (2012) discusses, but with more details than in Alton-Lee (2003) saying that quality teaching for students with diverse abilities has got various characteristics. For example, it has to focus on student’s achievement, to make clear links between the curriculum and the student’s culture, and to respond the learning processes. Foreman (2014) adds that quality teaching is also related to providing a feedback that helps with the students’ self-regulation and scaffolds their learning. Moreover, it is acting like a bridge of interactive communication between the students and their teacher. The Australian Curriculum â€Å"makes it clear to teachers what has to be taught and to students what they should learn and what achievements are expected of them†¦ Classroom teachers are the people who decide how best to organize learning for students. They will make decisions about their pedagogical approach that will give the best learning outcomes.† (National Curriculum board, 2009, p.8). In addition, teacher’s learning resources (including ICT) are opening new learning opportunities to diverse abilities that enrich the quality of teaching. The rapid increase in available technologies (both assistive and instructive) has provided teachers withShow MoreRelatedInclusive Curriculum : Education And Inclusive Education769 Words   |  4 PagesInclusive Curriculum In the 19th century, special needs learners, particularly students with disability have to be segregated in the special schools. However, over the past decades, humanity’s progress has occurred in acknowledging that students with special needs enjoy the same education rights as their peers. Nowadays, this group of student cohort has access to mainstreaming schools and inclusive education. In Australia, today’s classrooms are becoming increasingly diverse. According to AustralianRead MoreTeaching Students With Special Needs1740 Words   |  7 Pagesworkplace, but also school. Students with special needs have always been separated from a regular classroom. By including special needs children, this will help the student not only thrive in academics but also in life by gaining social and technical skills. Students will feel like they are part of a regular classroom and are not excluded because of their disability. By students having a regular learning environment they can start to master particular content and skills. Parents are scared because they haveRead MorePrinciples, Policies Frameworks of Inclusive Schooling Essay1176 Words   |  5 PagesBriefly discuss how you believe policies and legislation related to Inclusive Education could influence attitudes towards the way society accepts difference. In recent times I believe there has been a heightened awareness regarding the necessity to develop Inclusive Classrooms that celebrate difference and cater for a diverse range of learning styles and needs. My belief is reflected in the increasing amount of policies and legislation being developed at both state and Commonwealth levels. TheseRead MoreInclusive Education For Children With Disabilities1631 Words   |  7 PagesAbstract Inclusive education is where children with disabilities receive special education services in the general education setting. Many factors can make inclusion difficult or complex. Accommodating instruction to meet the educational needs of all students is one of the most fundamental problems in education. Many argue that inclusive practices benefit all students. While others argue that inclusive education is inadequately designed to meet the needs of exceptional students. Benefits of inclusiveRead MoreWhat about Dougs Rights?924 Words   |  4 Pagesever-changing environment in relation to education becoming more complex and dynamic. Teachers can expect to have a diverse range of students in their classes reflecting on the Australian society becoming a more diverse Country in terms of cultural, social and family backgrounds, ethnic origins and levels of ability. According to Forman (2011) teachers are likely to educate at least one or more students with a diagnosed intellectual, phys ical,sensory or learning disability within their teaching career.Read More2.2.2.4. Main Domains Of School Improvement Program. The1443 Words   |  6 Pages According to the guide line, there are 4 Domains and 12 Elements in the SIP Framework. Under the 12 Elements there are 24 Standards (MOE, 2010:12-17). Domain 1: Teaching and Learning Under this domain there are three elements namely teaching, learning and evaluation and curriculum; and also there are five standards. Under teaching learning domain there should be points to be considered. Regarding to teachers: continuous professional development delivered to the teachers. Professional developmentRead MoreMy Professional Responsibility Of Being A Teacher1445 Words   |  6 PagesIn my eyes, teaching is one of the most significant careers throughout the world. As a teacher, I will be a positive factor for change and instil a love of learning into all of my students. I will endeavour to constantly be committed to my professional responsibility of being a teacher, combining my knowledge, skills and passion to create lifelong learners and impact positively on students’ lives. As a teacher, I aim to ensure I teach inclusively, believe in my students’ ability to learn and ensureRead MoreImproving Student Participation Is A Matter Of Importance1543 Words   |  7 PagesIntroduction: In a classroom we come across student diversity in terms of ability, ethnicity and learning needs. Ensuring student participation is a matter of importance, since children are at times deprived of equal right to use inclusive education from early childhood through to adulthood. Inclusive education means eliminating the distinction between special and regular education and giving equal opportunities despite their level of disability. It implies that providing educational facilitiesRead MoreWhats Your Excuse?1765 Words   |  8 Pagesdisabilities in normal classrooms, happens to be a widely debated topic; whilst there are valid arguments on both sides and benefits for both inclusion and segregation, inclusion has become law (Holdheide Reschly, 2008). Inclusion requires a great deal of work in and out of the classroom setting. One of the most prominent barriers is that of communication; with lack of time, funding and negative attitudes of not only parents, but the student body and tea chers bringing up the rear (Teaching children withRead MoreMultiple Roles Of X Secondary School883 Words   |  4 Pagessetting, apart from providing support in planning and implementing the learning and teaching adaptations. Case Manager A learning support teacher may be a case manager who runs a learning support program or unit. A case manager’s primarily responsible is to promote and facilitate inclusion within the school. Case managers should be responsible for managing verification processes of students with special needs and developing and reviewing EAP (Educationally Adjusted Profiles). They need to collect and

U.s. Government s Impact On The United States - 877 Words

The U.S. has suffered from many Natural Disasters from Hurricane Katrina to wildfires in California. When it comes too natural disasters Hurricanes are by far one of the most devastating. The results can be catastrophic, possibly leaving the death tolls in thousands and leaving millions homeless. Even though the U.S. has responded to and recovered from Hurricanes, Meteorologists are presently not able to predict them early enough, and the U.S. government is unprepared financially, and responsively. Being well prepared for a hurricane is critical to saving peoples lives and their well-being. The government needs to do more not for just hurricanes but any disaster. When it comes to predicting a Hurricane obviously the earlier it’s predicted the better the outcome will be, it will give the government and citizens more time to prepare and evacuate city’s or even a state if necessary. â€Å"Once a hurricane has formed, it can be tracked. Scientists can usually predict its path for 3-5 days in advance† (Samsot). Giving a city to a state possibly only 3 days to evacuate is not long enough for everyone to pack up as many belongings as they can and leave the area. If meteorologists are able to predict when a hurricane is going to form and project the path the time to prepare will increase significantly. What the McDonald 2 government needs to do is help Meteorologists be able to predict Hurricanes earlier by helping them get more resources and giving them a good fund to help themShow MoreRelatedU.s. Government s Impact On The United States2065 Words   |  9 PagesThe U.S. made many daring decisions at the end of the 19th century. These gambles the U.S. made helped to guide the country to the path of greatness. At that time, the U.S. was looking to expand economically and improve its grip on the world. The U.S. government knew making some good choices would be critical to set the U.S. on the path to success in the following decades. The purchase of Alaska in 1867 and the annexation of Hawaii in 1898 were two of the crucial decisions. The outcomes of theseRead MoreThe Role of Government in Business Essay1425 Words   |  6 Pagessince the colonial times businesses in the United States of America faced business regulations. During the 19th century, when the American economy became more indu strialized, and grew to a world power, the federal government passed business laws, that favored social reforms over the interests of big business. In the 20th century government involvement in business continued to expand. So made Roosevelt’s â€Å"New Deal† legislation effectively the federal government the countries largest regulator of businessRead MoreFunctions Of Currency And Currency1355 Words   |  6 PagesThere are multiple functions to U.S currency and currency in general. One of the functions is that it is a medium of exchange. U.S currency can be used for the buying and selling of goods and services. This means that a person with money can exchange their money in order to get something of equal value. What determines the value of goods and services are called market forces. Another function of money is to store value. Money is not the only thing that is used to store value but it is the most commonRead MoreThe American National Government Is A Influential Political System1622 Words   |  7 PagesWilliams POL 201 – American National Government Jamie Weitl June 6, 2016 â€Æ' America’s Democracy The American national government is a influential political system. There are many different entities that come together to make the system work as a whole. These include the key structures, systems, roles, and processes that embody our national government. Many can point of n the strengths and weaknesses, advantages and disadvantages, and positive and negative impacts of these aspects of our democracy.Read MoreFiscal Policy1119 Words   |  5 PagesFiscal Policy The United States impacts various policies not only at home but abroad. It has been a powerhouse for many years, and its strengths and weaknesses impact other countries. The deficit, surplus, and debt are three major areas influencing these policies. These three factors have a huge impact on many areas we will discuss. These include taxpayers, the future of Social Security and Medicare users, the unemployed, a University of Phoenix student, the United States’ financial reputationRead MoreDrug Wars : The United States1643 Words   |  7 Pagesthe Drugs and Violence flowing through into the United States, is all Mexico’s fault, that Mexico is the cause of so many deaths and a War that the United States thinks it’s â€Å"Winning†, but they are not even making a little dent. Interestingly enough, Mexico is not the only cause of this War going on around the Border, The United States plays a big role around the Drug Wars as well. THE TIES THE U.S. HAS WITH MEXICAN DRUG CARTELS The United States has been having ties with some of the MexicanRead MoreImmigration On The United States1302 Words   |  6 PagesImmigration Rights in the U.S. Immigration has occurred in the U.S. for for many years. Some say it’s the foundation of our country. America is the country where people leave their own country to live. People would leave due to mistreatment, hunger issues or job opportunities. America is known for starting over or accomplishing dreams, so immigrants travel over to follow those dreams. People emigrate from one country to another for a variety of complex reasons. Some are forced to move, due to conflictRead MoreThe United States Immigration Policy1199 Words   |  5 Pages In the United States immigration has almost always been a controversial topic to discuss. James Madison wrote that Our kind reception of immigrants is very proper, but it is dictated more by benevolent [sic] than by interested consideration, though some of them seem to be very far from regarding the obligations as lying on their side(Madison, James) When Madison wrote this he had no clue of the problems that immigration could cause in the modern day United States in the last five to six decadesRead MoreHealthcare Between Canada And The United States1240 Words   |  5 Pageshealthcare status between Canada and the United States. Canada and the United States have a totally different healthcare system. Many people argued that the United States healthcare system needs some upgrading, while, some people admire Canada’s healthcare system due to the fact that Canada’s healthcare does more for less. Research has shown that Canada spends less of its’ GDP on it’s healthcare yet performs better than the United States. Canada and the United States have quite a few differences in theirRead MoreChin An Entrepreneur Economy With Tyrant Government1591 Words   |  7 PagesIndividuals are detained if dissented and who undermine security and there doesn t exist common freedoms, worker s organizations, and focuses of political force outside to comrade party. At the point when comes to financial matters among the world s countries there is no more in the middle of socialism and free enterprise. It s political. China is an entrepreneur economy with tyrant government. For a long time, suspicion made that free enterprise and majority rules system goes as one. The American arrangement

Justice & Change In A Global World of Accounting Firm †Free Samples

Question: Discuss about the Justice Change In A Global World. Answer: Accounting firms, at the present day, show a clear lack of adherence and realization towards the shared responsibility for the common good. There is a need on part of the accounting firms to adhere to the drafted standards and the laws in this regard, to the true letter and spirit (Klein, 2015). But, the growing corruption in this field has marred the path towards the adherence to such standards. Instead, the accounting firms help the business houses and conglomerates, in evading these standards by finding the loopholes, which beat the purpose of the drawn standards (Duska, Duska and Ragatz, 2011). In the following parts, a discussion is carried over the lack of accounting firms in working towards the common good. Moreover, the emphasis of this discussion is over highlighting the manner in which these challenges can be addressed. The non-adherence to the common good on part of accounting firms is further evidenced from the number of recent accounting standards which have left the investors and the workers to bear the devastating effects of these breaches. And even though criminality and corruption are to be blamed for such incidents, the unethical accountants who falsify the numbers for protecting the equally unethical clients also have to be blamed for. Another reason for the failure in the accounting firms working towards common good is the increased burden on the private and public accounting firms in succeeding towards the common good objectives. The pressure which the accountants have to face while creating the financial statements is immense. By using the creative accounting mechanisms, the unethical accountants have alerted the financial statements (Pratt, 2010). This is in addition to the out-dated technology being used by the accountants, which make it easy for the unethical accounting firms to alter the data. Along with this, the issue of failure on part of the accountants to act in a responsible manner towards the whistleblowers again beats the common good. The first manner in which this issue can be resolved is through community engagement. Through the process of community engagement, the workers, investors, organizations, community groups, along with the accountants and the accounting firms, can come together and mutually decide to work towards the common good (The State of Victoria, 2013). A key reason for the failure of the accounting firms to work towards a common good, and instead opting for corrupt ways, is the lack of proper leadership, in addition to the increased pressure and even lack of proper administrative capacity. These can be easily resolved through the use of community engagement. The objective of community engagement is to join hands with the communities in need of assistance, and based on the principle of preferential option for the poor, the commitments are made (Levy, 2014). Replacing the preferential option for the poor, in this case, the community engagement has to be adopted by the accountants towards adherence to the law, in spirit more importantly. And even if the concentration is upon the poor, the well off accounting firms, can help in the lower level accountants in removing the problems which they face in terms of poor or inadequate infrastructure, or merely making them aware of the possible manner, in which the same could be misused by anyone. Community engagement could also be used to safeguard the whistleblowers, by protecting and safeguarding the individuals who raise their voice against the corrupt accountants. Through the use of community engagement, the skilled accounting firms or accountants could be hired for helping the entire professional community of the accountants, in working in an ethical manner and helping in attaining the common goal. The ethical accounting firms need to provide the example of being an ethical firm, and the resulting benefits of it (McPhail and Diane, 2009). Another mode which can be taken help of for dealing with the failure of accounting firms is through teaching the significance of human dignity. Each and every individual, who has been born on this earth, has human dignity with them, at all times, and only proper perception is required to see the presence of human dignity. And just because one of the accounting firms has forgotten about this, does not imply that the others have too. With the proper motivation, the people can be made aware about the importance which the human dignity serves, especially to those, who ignore it and pay no regard to the human dignity (OMahony, 2012). In case the accounting firms are taught the significance of human dignity, they can be properly made aware about the need to not indulge in unethical practices, which results in the other humans being hurt. The accountants are required to keep in mind that others too have their interests in what they do, and the consequences have to be borne by the other people, due to the unethical actions of the accountants. By keeping their self-interests supreme, along with the ones who support them in such unethical behavior, they forget to respect the human dignity (Donaldson, 2015). Hence, there is a need for the accountants to be re-taught the basic principle like human dignity. This becomes crucial in the case where the whistleblowers are treated in the most dignified manner, which makes it difficult for them to even survive. The significance of human dignity gets amplified in such cases. There is a need for the accounting firms to be motivated towards understanding, as well as, spreading th e significance of human dignity (Wendel, 2014). Advocacy is the way through which community engagement can help in raising the issue of human dignity. Advocacy can be stated as such an act, which advocates, supports and promotes a particular cause through a personality with power in the world, to specially speak on behalf of those who do not hold such power. For instance, if the present head of International Monetary Fund (IMF), i.e., Christine Lagarde, advocates that there is a need to adhere to the standards drawn internationally for the accounting practices, in order to avoid the incidents which can be deemed as financial blunders, would help in raising awareness about the significance of adoption of ethical practices by the accounts and the accounting firms (BBC News, 2016). Or instead of the head of the IMF, the executive director of International Financial Reporting Standards Foundation, or IFRS Foundation, Yael Almog, could help in spreading awareness on these issues. Advocacy would help in making the accounting firms follo wing the examples of the advocates, i.e., Yael Almog or Christine Lagarde, to indulge in such practices, which respect the human dignity and working towards the common good (IFRS, 2012). Bringing back the ethical behavior amongst the accountants and the accounting firms, require the merger of the three, i.e., of advocacy, community engagement and human dignity. The leaders, apart from the two mentioned above, of this field, have to show the way to the others, that by adhering to ethical practices, not only is the common goal achieved, but it also helps in safe and tension free practices, which do not attract criminal or civil penalties, like the unethical practices do. To conclude this discussion, the unethical practices being adopted by the accounting firms and the accountants pose as a great threat to the common good, as instead of working in a manner where the responsibilities are shared, the personal inserts is kept supreme. To deal with these issues, there is a need to adopt the measures highlighted above. References BBC News. (2016) Profile: Christine Lagarde, 'rock star' head of the IMF. [Online] BBC News. Available from: https://www.bbc.com/news/business-13452436 [Accessed on: 15/05/17] Donaldson, T. (2015) Toward a theory of business. Research in Organizational Behavior, 35, p. 181207. Duska, R., Duska, B.S., and Ragatz, J.A. (2011) Accounting Ethics. New Jersey: John Wiley Sons. IFRS. (2012) Yael Almog appointed as Executive Director of the IFRS Foundation. [Online] IFRS. Available from: https://www.ifrs.org/Alerts/PressRelease/Pages/Yael-Almog-Jan-2012.aspx [Accessed on: 15/05/17] Klein, G. (2015) Ethics in Accounting: A Decision-Making Approach. New Jersey: John Wiley Sons. Levy, J. (2014) Community engagement is not about being nice; its fourth pillar of CSR. [Online] The Guardian. Available from: https://www.theguardian.com/sustainable-business/2014/sep/08/community-engagement-pillar-business-csr-sustainability [Accessed on: 15/05/17] McPhail, K., and Walters, D. (2009) Accounting and Business Ethics: An Introduction. Oxon: Routledge. OMahony, C. (2012) There is no such thing as a right to dignity. International Journal of Constitutional Law, 10(2). Pratt, J. (2010) Financial Accounting in an Economic Context. 8th ed. New Jersey: John Wiley Sons. The State of Victoria. (2013) What is Community Engagement?. [Online] The State of Victoria. Available from: https://www.dse.vic.gov.au/effective-engagement/introduction-to-engagement/what-is-community-engagement [Accessed on: 15/05/17] Wendel, W.B. (2014) Ethics and Law: An Introduction. Cambridge: Cambridge University Press.

Vietnam War Essays - Vietnam War, Presidency Of Lyndon B. Johnson

Vietnam War To many, the Vietnam War symbolizes controversy, myth and question in America. There are many events that made Americans wonder what reasons we had for putting our troops and families in Vietnam. Up till that point, many other Americans had never questioned the acts of the American government and armed forces. Issues dealt with in the Vietnam War showed great impact on the American people, particularly the students. American involvement started off very low key. Two marine battalions landed in Da Nang on March 8, 1965 (Doyle, Lipsman). They were not fighting a war yet, though a war was going on in the very country that they were in. Their job was to merely protect an air field in Da Nang, not look for trouble or initiate any kind of war tactics. But soon, holding off the enemy was not so easy for the American soldiers, and more troops were sent in. This continued on, and when May rolled around there were 46,000 American Troops in Vietnam (Doyle, Lipsman). It was at this time when American troops were then given the "permit to use more active defense," and soon after, the number soared to 82,000 American troops in Vietnam (Doyle, Lipsman). From there, the American defense quickly turned into an offense, and transportation flights turned in to rescue missions. This was about the time that Americans at home began to become worried that the war in Vietnam was getting out of hand. Small protests broke out amongst college students across America, but these began to become very serious. On April 17, 1965 The Students for a Democratic Society organized a national protest on the steps of the capitol in Washington D.C. (Doyle, Lipsman). Television coverage enraged people by misleading facts and disturbing war images of troops killing women and children. Frustration in America grew and riots and protests got out of hand as no questions seemed to be answered. Students protested and gathered, building rage against the war spurring events like the Kent State Massacre. The Kent State Massacre is named after a calm protest uprooted when guards killed and wounded students by opening fire on a mass of students as they gathered on the Kent State campus (Encarta). Events such as the Kent State Massacre enraged Americans more than ever causing violent riots and outbreaks. Meanwhile, America's position in Vietnam worsened. More and more were sent, and more and more troops were killed. America's great offense was tattering down and guerrilla warfare on unfamiliar terrain hampered soldier performance. The war then quickly switched over and put more weight on air attacks and bomb raids. Helicopters became America's best friend as they were a brand new invention that had not previously seen much use. The helicopter made landing and exiting in rough terrain easier than any other method seen before by the United States military. Other weaponry made its debut in the Vietnam War. Spurred from the second world war, where tanks were introduced, the anti-tank missile launcher was a key weapon for all countries to develop. The Vietnam War was the first war that the anti-tank missile launcher was effectively used. Standard guns also were changing; they become lighter in weight, more accurate, and able to function better with less maintenance and malfunction. All of these new, and newly perfected, weapons made the Vietnam War an unfamiliar territory for everybody as the death toll soared through the roof. More troops were sent, more black troops. Racism raced through the veins of many white Americans at this time, and blacks still felt discriminated against by the government and the people of America. All of this as more black troops were being put on the battle front to fight. Black gangs erupted and dodged the draft, became violent, and held to one another very closely. This was the first sign of gangs in America, as we see gangs today. Many black Americans did not understand why they were being force to fight and die for a country that hated them. They felt as if they were being sent in place of whites, but in fact only 12.5% of all troops in Vietnam were black, and it was merle stretched facts and media influence that caused the black eruptions in America (Westmoreland, VHFCN). As America boiled, the "photographers war" continued in Vietnam (Cohen). The Vietnam War has been said on countless occasions to be the most photographed war in history. The reason for this is the development and improvement of the camera. The camera had become small enough and

American Revolution Essays - British East India Company, Tea Act

American Revolution Essays - British East India Company, Tea Act American Revolution In this Essay I will point out the different causes that led up to the American Revolution. The main three reasons are Political, Economic and Social Causes. In my opinion of the American Revolution the Political reason was the most important, because for the most part the colonists did not agree that the Parliament had the right to make laws for American colonists and to tax them when the colonists had no elected representatives in the Parliament. The Economic causes of the Revolution are second most important. In the eyes of Great Britain the American colonists? primary job was to build a favorable balance of trade. With a favorable balance of trade a nation could be self-sufficient, become wealthy and build a powerful army and navy. However the British laws were to hard on the American colonists. The Sugar Act of 1764, placed taxes on molasses, sugar and other products imported from places outside the British empire. Most of the colonists openly broken the law by smuggling, Since no one obeyed the laws the British cut the tax to a sixth of what it was. later on the British tried to enforce the Sugar Act by inspecting ships and searching homes for smuggled goods. Even thought Britain cut the taxes on molasses, the Sugar Act still cut into the business of colonial merchants and shipowners, and rum distillers. Other events such as the Stamp Act, and the Tea Act were the beginning signs of the revolution, The Tea ! Act levied a tax on the tea imported from the East India Company. The colonists got mad and destroyed 342 chests of tea. The Political causes of the Revolution were the proclamation of 1763 which were plans to reduce conflicts with the colonists and the Indians. It stated that no one was permitted to cross the mountains without the consent of British officials. American fur traders who wanted to settle the western lands resented the Proclamation. The other cause of the Revolution was the Boston Massacre. Which took place on March 5, 1770. A large crowd gathered in Boston around soldiers of the 29th British Regiment, the crowd yelled insults and threw snowballs, matters got out of hand and as the mob got closer someone gave an order to fire. Three civilians were killed and two badly wounded. As the news spread Boston civilians got angered and demanded that all British troops we withdrawn from the city. I think that all these events had an equally important roll in the American Revolution, especially the so called Boston Massacre. It gave the most obvious reason for the American Revolution. The British soldiers and the policies were harmful to the development of the new nation.

Difference Between Atomic Radius and Ionic Radius

Difference Between Atomic Radius and Ionic Radius You cant simply whip out a yardstick or ruler to measure the size of an  atom. These  building blocks  of all matter  are much too small, and, since  electrons  are always in motion, the diameter of an atom is a bit fuzzy. Two measures used to describe atomic size are  atomic radius and  ionic radius. The two are very similar- and in some cases, even the same- but there are minor and important differences between them. Read on to learn more about these two ways to measure an atom. Key Takeaways: Atomic vs Ionic Radius There are different ways to measure the size of the atom, including atomic radius, ionic radius, covalent radius, and van der Waals radius.The atomic radius is half the diameter of a neutral atom. In other words, it is half the diameter of an atom, measuring across the outer stable electrons.The ionic radius is half the distance between two gas atoms that are just touching each other. This value may be the same as the atomic radius, or it may be larger for anions and the same size of smaller for cations.Both atomic and ionic radius follow the same trend on the periodic table. Generally, radius decreases moving across a period (row) and increases moving down a group (column). Atomic Radius The atomic radius is the distance from the atomic nucleus to the outermost stable electron of a neutral atom. In practice, the value is obtained by measuring the diameter of an atom and dividing it in half. The radii of neutral atoms ranges from 30 to 300 pm or trillionths of a meter. The atomic radius is a term used to describe the size of the  atom, however, there is no standard definition for this value. Atomic radius may actually refer to the  ionic radius,  as well as the  covalent radius, metallic radius, or  van der Waals radius. Ionic Radius The ionic radius is half the distance between two gas atoms that are just touching each other. Values range from 30 pm to over 200 pm. In a neutral atom, the atomic and ionic radius are the same, but many elements exist as anions or cations. If the atom loses its outermost electron (positively charged or cation), the ionic radius is smaller than the atomic radius because the atom loses an electron energy shell. If the atom gains an electron (negatively charged or anion), usually the electron falls into an existing energy shell so the size of the ionic radius and atomic radius are comparable. The concept of ionic radius is further complicated by the shape of atoms and ions. While particles of matter are often depicted as spheres, they arent always round. Researchers have discovered chalcogen ions are actually ellipsoid in shape. Trends in the  Periodic Table Whichever method you use to describe atomic size, it displays a trend or periodicity in the periodic table. Periodicity refers to the recurring trends that are seen in the element properties.  These trends became apparent to  Demitri Mendeleev  when he arranged the elements in order of increasing mass. Based on the properties that were displayed  by the known elements, Mendeleev was able to predict where there were holes in his table, or elements yet to be discovered. The  modern periodic table  is very similar to Mendeleevs table but today, elements are ordered by increasing  atomic number, which reflects  the number of protons  in an atom. There arent any undiscovered elements,  although new elements  can be created that have even higher numbers of protons. Atomic and ionic radius increase as you move down a column (group) of the periodic table because an electron shell is added to the atoms. Atomic size decreases as you move across a row- or period- of the table because the increased number of protons exerts a stronger pull on the electrons. Noble gasses are the exception. Although the size of a noble gas atom does increase as you move down the column, these atoms are larger than the preceding atoms in a row. Sources Basdevant, J.-L.; Rich, J.; Spiro, M. Fundamentals in Nuclear Physics. Springer. 2005. ISBN 978-0-387-01672-6. Cotton, F. A.; Wilkinson, G. Advanced Inorganic Chemistry (5th ed., p.1385). Wiley. 1988. ISBN 978-0-471-84997-1.Pauling, L. The Nature of the Chemical Bond (3rd ed.). Ithaca, NY: Cornell University Press. 1960Wasastjerna, J. A. On the Radii of Ions.  Comm. Phys.-Math., Soc. Sci. Fenn.  1  (38): 1–25. 1923

Human Resource Management Strategies and Planning Essay

Human Resource Management Strategies and Planning - Essay Example Keeping all the diversity of present day organizational structure in view, it is evident that the human resource directed towards the achievement of the strategic goals has to be expertly handled to get full dividends. With the present fluid market and competitive environment, it is evident that should not arise a situation in which the organization achieves its strategic objective without incorporating the changes to improve or simply bringing in line with the fluctuating environment. This fact in itself amplifies the HRM concept’s importance. HRM in such case will not only be restricted to selection and realigning of the human resource available. It should have to be closely monitored and implemented with the required changes. If there is any change required in the organization there are some fundamentals which are to be followed. Among them, the most essential are accessibility to knowledge about change by all the effected knowledge of the need for the change, acceptability for the change, resources made available to implement it and discipline in the human resource to implement it. With such a challenging requirement, it is essential that HRM be made effective and prudent enough to address it. With â€Å"change management† in mind, the HRM has to make an effort for managing the human resource in a manner that not only it is competent and fit enough to achieve the objectives but also should be flexible enough to incorporate the changes required.

Yum brand expatriate management in Beijing, China Essay

Yum brand expatriate management in Beijing, China - Essay Example mpanies has indicated a significant increase among multi-national businesses ranging from manufacturing companies to food and hotel industries (rphrm.curtin.edu.au). The use of expatriates as a means of ensuring that businesses succeed in international markets has been associated with various benefits. Yum brand is an American Fast Food Company, with over 40,000 restaurants distributed in various parts of the World. Yum brand has implemented various operational strategies geared towards facilitating its success in the current highly competitive fast food industry. One of the operational strategies that has been applied by the company to facilitate its success in foreign markets i.e. China is the application of expatriates, who are sent to manage its branches in foreign markets. This discussion will focus on ways that may be used by the company to increase expatriate effectiveness i.e. how the company may select, prepare and train its employees for an expatriate assignment. Additionally, the discussion will focus on describing how the company may ensure appropriate repatriation of its employees i.e. safe return of the expatriates to the company in the United States. The discussion will also highlight and explicate characteristics of the Host Country, which is China, placing a particular emphasis on why Yum Brands sent its expatriates to the Chinese Market. The effective performance of an expatriate in any foreign country begins by the selection process. In the case of Yum Brand, the selection of a employees to undertake expatriate missions in China should be based on selection characteristics that consider; technical competencies of employees, family situation i.e. considering whether one is married or not, personality traits i.e. inter-personal skills or an employee’s interest in performing expatriate missions and environmental variables i.e. cultural dimensions of the host nation as well as the needs of a qualified expatriate (rphrm.curtin.edu.au). After

The Face of the Terrorist Essay Example for Free

The Face of the Terrorist Essay A faceless enemy. It has been eights years after the September 11 attack in the United States of America. Several people died and it was also the same time when the Unites States of America government contemplate on how the terrorists look like. Terrorists had been faceless for all we know and we do not even have any idea about them until Osama bin Laden was identified by Bush. The knowledge about terrorism and terrorists has been very limited but in some occasions and in present, the internet was able to give face to the faceless enemy and as soon as Bush gave bin Laden’s name, it was the start of identifying more faces of the enemy. In this paper, the author ought to explain terrorism and the face of terrorists wherein images from online sources and references are presented by the author to justify what she was pertaining to in line with terrorist’s face. Using Racialist, Sexism and Fascism ways, the author explained her argument and gave a face to the nameless enemy. At the same time, it was not the face of the enemies alone that was tackled in this paper but also the different faces of terror which was marked when Al Qaeda, the name given to Osama bin Laden’s organization as western and media name attacked United States of America. Considering the primitive years wherein pictures are not yet existing, identification of someone, probably a suspect or a colleague is hard to do and the mind was the only one who does the job of recognizing culprits and acquaintances. In present generation, mug shots are used to identify criminals and soon after to relate them with one another to solve a certain crime. Offerings several incidents and examples, the author named and identified when a terror becomes and terror and how those who were victims became the terrorists. As she presented two faces of people, the victim and the terrorist, it seems that these two can trade places and with sacrifice and revenge present, it is not impossible to have another kind of terror from a different kind of terrorists. Stereotyping was of course an unfair act and yet, we cannot help but guard ourselves from people who have turbans on their heads and all bearded like Santa Claus, only that they were not the good ones. America might be too cautious to a person who has a diaper on their head and a fan belt in it and decide to pull them off (Engle, 2009) but we can never blame them, after all, the leader of Al Qaeda looks like that and although there are heroes presented, they should also be cautious about what they were doing because defacement is much easier than being really the good ones. Critique Karen Engle’s analysis of the faces of terrors and the terrorists allow us to understand the distinction and the stereotypes made by the people, especially those in the government to identify them as crime promoters and culprits. An analysis that gives light to the unknowns in present and the many questions arising from the attacks, both previous and recent ones, this article was informational enough to be endorsed to people of any age, except to those who were still too young to understand that in this world, safe is not safe until we are sure of the people we are dealing with. While we can consider the victims as real victims, looking on the other side of the story, we will understand that they are not victims until the end. As long as there are revenge and sacrifice, it will be easy to understand that people, terrorist or not are capable of doing anything that can terrorize people around them. This paper had served as a lesson to be learned that allows the readers to be open minded and to stop stereotyping people. List of References Engle, Karen. The Face of a Terrorist. Sage Publications. Online Version from http://csc. sagepub. com/cgi/reprint/7/4/397

evilhod Uncovering Evil in Joseph Conrads Heart of Darkness Essay exa

Uncovering Evil in Heart of Darkness In Heart of Darkness, a novel written by Joseph Conrad, the literary characters are forced into a web of darkness and evil as they enter the heart of the African Congo. However, the Congo itself is not the true evil, but the darkness instead lies within the dimming hearts of mankind. Conrad uses the literal darkness of the African jungle as a contrast to societies "supposed" enlightenment to show how the morals of civilized man are broken down when exposed to what they claim to be "savagery." This contrast is most evident in the different settings, the changes in civilized individuals as they venture deeper into Africa, and the final collapse of white man under the darkness of the innermost Congo. The setting of Heart of Darkness has a profound role in depicting the evil that radiates from the African Congo. Marlow, the protagonist and assumed narrator, presents his story on a boat in the dark of night, as if attempting to create a sense of internal darkness or evil from the black night. This setting serves to foreshadow eve... evilhod Uncovering Evil in Joseph Conrad's Heart of Darkness Essay exa Uncovering Evil in Heart of Darkness In Heart of Darkness, a novel written by Joseph Conrad, the literary characters are forced into a web of darkness and evil as they enter the heart of the African Congo. However, the Congo itself is not the true evil, but the darkness instead lies within the dimming hearts of mankind. Conrad uses the literal darkness of the African jungle as a contrast to societies "supposed" enlightenment to show how the morals of civilized man are broken down when exposed to what they claim to be "savagery." This contrast is most evident in the different settings, the changes in civilized individuals as they venture deeper into Africa, and the final collapse of white man under the darkness of the innermost Congo. The setting of Heart of Darkness has a profound role in depicting the evil that radiates from the African Congo. Marlow, the protagonist and assumed narrator, presents his story on a boat in the dark of night, as if attempting to create a sense of internal darkness or evil from the black night. This setting serves to foreshadow eve...

Leased Line

Leased Line:- A leased line is a private high-performance circuit leased by a common carrier between a customer and a service provider’s network. It is rented on an annual basis and usually carries voice and data or both. Leased lines are mostly used for either internet access (Internet Leased Line) or used privately between two customer sites (Point to Point Leased Line). Unlike a dial-up connection, a leased line is always active. Similarly unlike broadband, a leased line is not contended or shared and delivers dedicated guaranteed bandwidth straight to the internet backbone.Customers pay a premium for a leased line and it is supported by a comprehensive Service-Level Agreement (SLA) with a guaranteed fix time and a compensation clause. Otherwise referred to as a point to point, private circuit, private line or dedicated access. Leased Line History: Leased lines services (or private line services) became digital in the 1970s with the conversion of the Bell backbone network f rom analog to digital circuits.This conversion allowed AT&T to offer Dataphone Digital Services (later re-branded digital data services) that started the deployment of ISDN and T1 lines to customer premises to connect. With the extension of digital services in the 1980s leased lines were used to connect customer premises to Frame Relay or ATM networks. Access data rates increased from the original T1 option up to T3 circuits. Access data rates also evolved dramatically to speeds of up to 10Gbit/s in the early 21st century with the Internet boom and increased offering in long-haul optical networks or Metropolitan Area Networks.

Fast Food Essay

Introduction In this modern era where the flows of customers are increasing towards fast food restaurants, it is more challenging to offer good customers service. It is also imperative that you maintain a high degree of consistency in your offerings, which prevents you from alienating your customers. The Philippine Star (1997) described the Filipinos are fast food lovers. They enjoy tasty meals. They go to restaurants serving smorgasbords in a luncheon or supper buffet offerings a variety of foods and dishes. These restaurants, most especially attract students. They are the group of people that regularly patronize fast food restaurants, which accounts for the sudden boom in the fast food industry. To become successful in the industry the company must knows the preference of their consumer towards fast foods restaurant. Fast food restaurants are a breakthrough from traditional catering methods and standards. They have resulted in more sophisticated operations and styles for services. They have provided flexibility and comfort with reasonable prices. Their services are within the level of that can satisfy customers with various tastes, drives, and upbringing. Customer satisfaction has been one of the measurable objectives of other service-oriented establishments. It is to the satisfaction of the customer’s needs that the business strives. Research Objective In this research, aims to determine the preferences of the customer towards fast food restaurant. And specifically it aims to answer the ff. questions: 1. What is the consumer demographic profile most likely to purchase our product? 2. What is the frequency, and kinds of foods they most likely to purchase in a fast food restaurant? 3. Do our customers purchase based on price? The Methodology Research Approach A research problem might state the need to identify or determine the consumer preferences towards fast foods restaurants. The proposed methodology is a descriptive research because it is the best method to collect data get the proper information and confirm the findings. Research Proposal (Fast Food Industry) To study the attitude towards consumption of healthy food within the fast food industry. Background We are a marketing research team of a fast food chain store. With increasing awareness about healthy food among the masses and with consumer preferences changing towards healthy food, we intend to launch a health food segment to cater to this need of the customers. We are also concerned about the pricing of the product that whether it should be priced same as that of normal fast food or the customers would be willing to pay a premium for healthy food. But before launching that product we want to know that â€Å"Is it worth it to our fast food restaurant to market healthy food†. To answer this management decision problem, we intend to conduct a marketing research within the region of West Delhi. Introduction * What is fast food? Definition1. Fast food have been defined by Bender and Bender (1995) as a â€Å"general term used for a limited menu of foods that lend themselves to production-line techniques; suppliers tend to specialize in products such as hamburgers, pizzas, chicken, or sandwiches†. Definition2. In Data Monitor’s (2005) survey the fast food market is defined as the sale of food and drinks for immediate consumption either on the premises or in designated eating areas shared with other foodservice operators, or for consumption elsewhere. Definition3. As per â€Å"the free dictionary† fast food is â€Å"inexpensive food, such as hamburgers and fried chicken, prepared and served quickly†. Definition4.According to Merriam-Webster online dictionary fast food is â€Å"designed for ready availability, use, or consumption and with little consideration given to quality or significance * Why fast food? * Brief history of fast food industry in India * Fast food industry trend, facts and figures, key players in India * According to a study by the Tata Strategic Management Group, the size of the  Indian health-and-wellness food†¦ Research Objectives To examine the most popular fast food among UMP students. To identify the effect of fast food consumption to the UMP students’ life. To investigate the awareness level of the effect of fast food consumption among UMP student. What is the most popular fast food among UMP? What is the effect of fast food consumption to the UMP students’ life? What is the awareness level of the effect of fast food consumption among UMP students? participant UMP Students Faculty of Technology 60 respondents 30 males and 30 females

20 Descriptive Essay Topics on Life in Kenya Based on #8220;A Primate#8217;s Memoir#8221;

20 Descriptive Essay Topics on Life in Kenya Based on #8220;A Primate#8217;s Memoir#8221; When you are tasked with writing a descriptive essay on life in Kenya based on a book, you have to be selective about the topic you choose. It should be something the author wrote about, something that you can take as a single moment, a single activity, or a single day, and convey in vivid detail to the reader utilizing all of the five senses. Below you will find a list of 20 topics for a descriptive essay on life in Kenya: Concepts about Baboon Society that Overturn Common Misconceptions about Their Social Life. Correlation between Each Stage of Development Ascendancies of an Alpha Male in the Tribe Significant Impact of the Masai Effects of Chronic Stress on the Human and Animal Brain How Social Behavior is Related to Stress Diseases How Emotional Life is Related to Stress Diseases How Social Rank is Related to Stress Diseases Euphoria from Shooting a Baboon with an Anaesthetizing Dart Recognition of Common Scams by the Poor-Ridden Africans upon American Visitors Kindness and the Deceits of the Masai Role Played by the Hypothalamus in the Brain Short Term vs Long Term Stress of Living with an Alpha Male Short Term vs Long Term Stress of Adolescents Short Term vs Long Term Stress of Living with and Communicating with People You Don’t Know Short Term vs Long Term Stress of Trying to Complete Studies without Close Friends or Family Describe the Physiological Impact that Cortisol Has When You Are out Observing a Fight. Pilgrimage to the Ruwenzoris Mountains of the Moon or Mount Karisimbi Odd Behavior Seen among Humans Compared to Baboons These topics are all quite cool, aren’t they? Of course it is still helpful sometimes to have more than just a topic to guide you in your writing quest. In most cases students will find that they are more comfortable starting out on their writing endeavor if they know what specifically is expected of them. And here we also have what to suggest 12 facts about life in Kenya based on Primates Memoir. That is why having a sample can help teach the structure, organization, and use of evidence or descriptions necessary for any writing piece. Below you will find an essay sample on one of the topics above: An Extract from a Descriptive Essay on Life in Kenya based on A Primates Memoir The wind shifted. With it came a fresh gust of red dirt blown up around my feet in swirling patterns devoid of life, and up my nostrils where the associated river stench from the village accosted me. But with the shift in the wind came new sounds. My head cocked so my left ear might gain better audio, the sound of a scream. Then another. Suddenly the lone female scream which tore at my ears like nails on a chalkboard was supported by a cacophony of male voices, each declaring that the elephants had come back. They ate our tents. They stood above them as a starved man waits above a buffet table gorging himself. Then there was only red dirt again. They removed our shields, our protection from the blazing heat that sears to the bone and from the wild animals that prey. It would be time to rebuild later. Right now the perception of the threat triggered the stress response. I looked for the baby, held it close and whispered murmurs of assurance as I felt all non-essential body functions stop and all energy diverted to the brain and the muscles. My heart was beating faster. Blood was flowing to every tingling end of my body. The adrenal glands released adrenaline. The sugar in my body increased with the heart rate. I could feel my heart beating through my chest and held the baby close in an attempt to prevent it from escaping. With raised levels of cortisol I was ready to dash out of the way of the herd, my decision making skills seemingly the only mental function working as of late. My eye sight became razor sharp, cognizant of ever flutter or moving leaf. The wind which was previously tangy in scent but light in waves and pressure became a deep howl whose echo could be used to trace the movements. The ground vibrating beneath my feet indicated the strength with which the herd moved, the swiftness, and the force. The thumps grew in size, the vibrations swelled. My eyes caught sight of peripheral movement and I dove behind a tree as the group came rushing through the lands. Then it was over. Calm was restored around the aftermath of the herd trampling through the land. The wind calmed in tune with my heart. The baby was looking at me with eyes bewildered, confused, and all at once accepting of and reflecting my face. My brow was furrowed; I noticed when I consciously smiled at the infant and felt it unfurrow. My lips were pressed firmly, the dry African heat parching them beyond recognition, and they cracked in release when I smiled at the baby. The child was incredibly sensitive to emotional expression and this sensitivity must be a crucial component for the development of stress and how the brain handles stress. My emotionally expressive influence taught in that moment, how the children should encode emotions. References: Baker, Jack, Allen Brizee, and Elizabeth Angeli. Essay writing.  Retrieved April  25 (2013): 2014. Crossley, Scott A., Laura K. Allen, and Danielle S. McNamara. A Multi-Dimensional analysis of essay writing.  Multi-Dimensional Analysis, 25 years on: A tribute to Douglas Biber  60 (2014): 197. McEwen, B. S. (2011, September). Effects of stress on the developing brain. In Cerebrum: the Dana forum on brain science  (Vol. 2011). Dana Foundation. Pennisi, Elizabeth. Baboon watch.  Science  346.6207 (2014): 292-295. Redman, Peter, and Wendy Maples.  Good essay writing: a social sciences guide. Sage Publications, 2011. Sapolsky, Robert M.  A primates memoir: a neuroscientists unconventional life among the baboons. Simon and Schuster, 2007. Szalay, Frederick S., and Eric Delson.  Evolutionary history of the primates. Academic Press, 2013.

All About the Animals Belonging to Class Asteroidea

All About the Animals Belonging to Class Asteroidea While the classification name, Asteroidea, may not be familiar, the organisms it contains probably are. Asteroidea includes the sea stars, commonly called starfish. With about 1,800 known species, sea stars are a variety of sizes, colors and are a wide-ranging marine invertebrate. Description Organisms in the Class Asteroidea have several arms (usually between 5 and 40) arranged around a central disk. Asteroideas Water Vascular System The central disk contains the madreporite, an opening that lets water into the asteroids water vascular system. Having a water vascular system means that sea stars have no blood, but bring water in through their madreporite and move it through a series of canals, where it is then used to propel their tube feet. Classification Kingdom: AnimaliaPhylum: EchinodermataClass: Asteroidea The Asteroidea are known as the true stars, and are in a separate class from the brittle stars, which have a more defined separation between their arms and their central disk. Habitat and Distribution Asteroidea can be found in oceans around the world, inhabiting a wide range of water depths, from the intertidal zone to the deep sea. Feeding Asteroids feed on other, usually sessile organisms such as barnacles and mussels. The crown-of-thorns starfish, however, is causing extensive damage by predation on coral reefs. The mouth of an asteroid is located on its underside. Many asteroids feed by expelling their stomach and digesting their prey outside their body. Reproduction Asteroids may reproduce sexually or asexually. There are male and female sea stars, but they are indistinguishable from one another. These animals reproduce sexually by releasing sperm or eggs into the water, which, once fertilized, become free-swimming larvae that later settle to the ocean bottom. Asteroids reproduce asexually by regeneration. It is possible for a sea star to not only regenerate an arm but also nearly its entire body if at least a portion of the sea stars central disc remains.

Abacus in the world Research Paper Example | Topics and Well Written Essays - 500 words

Abacus in the world - Research Paper Example mechanical frame containing several rods on which are mounted wooden beads which can be slid manually into different positions and combinations to represent numbers† (188). Materials used to make early abacuses in different regions varied. For example, among the Maya and Aztec people of Mesoamerica, maize kernels threaded on strings were used instead of beads, while the Inca people who lived in Peru centuries ago had an abacus that was made up of a â€Å"tray with compartments that were arranged in rows in which counters were moved in order to make calculations† (Keoke and Porterfield 1). The abacus originated from the Middle East thousands of years ago. Jain asserts that its evolution took place in 3000 B.C. (7). Darling points out that â€Å"the word appears to come from the Hebrew á ºÅ¡bá ºÅ¡q (dust) or the Phoenician abak (sand) via the Greek abax, which refers to a small tray covered with sand to hold the pebbles steady† (3). Over the centuries, there have been different types of abacuses. The first type was called suanpan and was used in China in 1300 (Barnes-Svarney and Svarney 349). There is no agreement regarding who invented this type of abacus but it is that believed it was the Chinese, Japanese or Koreans. Barnes-Svarney and Svarney affirm that â€Å"although merchants used this type of abacus for standard addition and subtraction operations, it could also be used to determine square and cube roots of numbers† (349). The other type of abacus was the soroban or the Japanese abacus. Apart from the fact that it lacked a bead in the upper and lower deck of every column, it was very similar to the Chinese abacus. The Roman abacus also had one bead lacking from the upper and lower deck of every column making it very similar to the Japanese abacus. According to Barnes-Svarney and Svarney, â€Å"the Russians also have their own version of an abacus; it uses ten beads on each wire, and a single deck† (349). To separate the two wires, a wire with fewer beads is

The art of the impressionists Essay Example | Topics and Well Written Essays - 500 words

The art of the impressionists - Essay Example The light and color effects can also be noticed in Camille Pissarro's works wherein the lights and colors vary depending on the specific time of the day. In "The Stage Coach at Louveciennes," the artist painted the scene in dark lighting conditions possessing complementary colors of reds and greens generously used by the artist while in "Le verger (The Orchard)," the noticeable brightness of the day light and the complementing colors of violet with shades of yellow and the blue sky in contrast to the hint of orange shade of the soil. In the "Village Path," the red lighting of the painting can be clearly seen which in turn complements the dominantly green color of the scenery. In addition to the attribute of light and color effects of the impressionist style, impressionistic paintings are also characterized by concentration on the general impression produced by a scene or object and the use of unmixed primary colors, as explained with the examples previously mentioned, and small strokes to simulate actual reflected light (Pioch).

The Influence of Words During Times of War Essay

The Influence of Words During Times of War - Essay Example The Power of Words in Wartime by Robin Lakoff (2005) is an article describing just how powerful words can be a weapon. The article centers around the history of words used in wartime, focusing on the descriptive words that are typically used to describe 'the enemy'; barbarians, infidels, Japs, Yankees, Frogs. The article suggests that these words help to bring one side closer together by grouping the enemy as something negative, something outside of themselves. It gives a sense of supremacy to one side, often focusing on physical or cultural differences between the enemy and the home side. Killing another person is murder, but killing a 'target' or a 'Hun' in the event of war is something different, and just shows how powerful words can be in changing the normal morals of an individual. Churchill's Powerful Words. As previously mentioned, Churchill and his powerful speeches have been considered one of the most important elements in the Allied win of the Second World War (Brekle, 1989 ). "Give us the tools and we will finish the job† (Churchill, 2003) are the famous words of Churchill to Franklin D. Roosevelt, allowing the nation to see the confidence of Churchill, bringing faith, courage and hope to the nation. It suggests that Churchill himself had a great amount of faith in the Allied forces, and it is sometimes this type of faith that is needed to give confidence to an army, confidence being something that is perhaps more important than technology in winning a war (Oliver, 1987).... Churchill's Powerful Words As previously mentioned, Churchill and his powerful speeches have been considered one of the most important elements in the Allied win of the Second World War (Brekle, 1989). "Give us the tools and we will finish the job† (Churchill, 2003) are the famous words of Churchill to Franklin D. Roosevelt, allowing the nation to see the confidence of Churchill, bringing faith, courage and hope to the nation. It suggests that Churchill himself had a great amount of faith in the Allied forces, and it is sometimes this type of faith that is needed to give confidence to an army, confidence being something that is perhaps more important than technology in winning a war (Oliver, 1987). Churcill is also famous for saying "Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning† (Churchill, 2003). This again was a powerful quote at the time, stirring the forces and the nation into believing that there is so me hope that the tragedies of war would begin to end. In this quote, Churchill acknowledges the past, present and future struggles of the war, but does so in such a confident manner. There are numerous more quotes that can be used to show Churchill's rhetoric and how instrumental it was in instilling hope, but these serve to give evidence of his skill and its power during wartime. The Rhetoric of Roosevelt Roosevelt was also known for his skill in rhetoric. Whilst Churchill seemed more focused on giving the forces confidence on the battlefield, Roosevelt is possibly more associated with letting the nation know that the cause they were fighting for was the right cause. This is an important tool in persuading soldiers to sign up to fight; no-one wants to fight for

Reflective Summary On Prescribing Practice Learning Nursing Essay

Reflective Summary On Prescribing Practice Learning Nursing Essay The author, a nurse practitioner based in an Emergency Department (ED), from here on in will be referred to as the practitioner. The practitioner is currently employed in a development role with the view, following training, of becoming an acute care practitioner. This will entail working autonomously: taking accurate clinical histories, physical examination, gain differential and working diagnosis and organise a plan of care. This plan of care could well include a number of prescribed medications. Hence it is in the practitioners job description (as it is increasingly in many specialist/autonomous nursing roles) to become a Nurse Independent and Supplementary Prescriber (NISP). The Cumberlege Report (1986) suggested that nurses should be able to prescribe independently and highlighted that patient care could be improved and resources used more effectively by doing so. It identified that nurses were wasting their time requesting prescriptions from Doctors. Since the publication of this seminal piece of work, non-medical prescribing has been analysed, reflected upon, researched at great lengths and changes in practice made (DoH 1989, 1999, 2006 2008; Luker et al 1994; Latter et al 2011) and is still under constant review. The aim of this portfolio is to: Reflect on practice as a means of on-going personal and professional development. Demonstrate a capability of integrating learning into practice. Submit a range of material mapped against the module learning outcomes, NMC 2006 prescribing standards, domains of practice and core competencies. Establish an evidence-based approach to practice competence as a safe independent supplementary prescriber. This prescribing practice portfolio will be a reflective portfolio using Rolfe et al (2001) model of reflection to aid learning from experience and close the gap between theory and practice. This model has been chosen as it is something the practitioner is familiar with and has used before. The portfolio will conclude with a reflective summary on prescribing practice learning which will draw together the evidence used to support achievement of the competences identified. After discussing with colleagues who have already completed the NISP course, the practitioner is aware of the complex nature and volume of work that is required over the duration of it. There is a feeling of nervousness due to this but also a feeling excitement over what will be learnt. If successful the practitioner believes her practice will be enhanced significantly as she will have the ability to give patients seamless care. References Department of Health. (1986) Neighbourhood Nursing: A Focus for Care. (Cumberlege Report). London: HMSO Department of Health. (1989) Report of the Advisory Group on Nurse Prescribing. The Crown Report). London: HMSO Department of Health. (1999) Review Of Prescribing, Supply And Administration Of Medicines. (The Crown Report Two) London: HMSO. Department of Health. (2006) Medicines Matters. London: HMSO Department of Health. (2008) Making Connections: Using Healthcare Professionals to Deliver Organisational Improvements. London: HMSO Latter, S. Blenkinsopp, A. Smith, A. Chapman, S. Tinelli, M. Gerard, K. Little, P. Celino, N. Granby, T. Nicholls, P. Dorer, G. (2011) Evaluation of nurse and pharmacist independent prescribing. Faculty of Health Sciences, University of Southampton; School of Pharmacy, Keele University on behalf of Department of Health [Online] Available at http://eprints.soton.ac.uk/184777/ [Accessed 15th Sept 2012] Luker, K. Austin, L. Hogg, C. Ferguson, B. Smith, K. (1998) Nurse-Patient Relationships: The context of Nurse Prescribing. Journal of Advanced Nursing. (28) 2: 235-242 Rolfe, G. Freshwater, D. Jasper, M. (2001) Critical Reflection in Nursing and the Helping Professions: a Users Guide. Basingstoke: Palgrave Macmillan. Consultation Holistic Assessment Case Study In this case study the consultation, diagnosis, prescribing options and decisions of a 35 year old female seen in the ED will be discussed. This case study will aim to improve the practitioners knowledge of conducting a consultation and its relationship with making a diagnosis and treatment options. To maintain confidentiality, in line with the code of professional conduct, the patient will be referred to as Mrs A (Nursing and Midwifery Council (NMC), 2008). Consultation Examining the holistic needs of the patient is the first of seven principles of good prescribing (National Prescribing Centre (NPC), 1999) and must be undertaken before making a decision to prescribe (NMC Practice Standard 3, 2006). Holistic assessment takes into consideration the mind, body and spirit of the patient (Jarvis, 2008). Traditionally consultation and making a diagnosis has been completed by Doctors. However, nurse diagnosis would appear to have been formally acknowledged since The Crown Two Report (DoH, 1999) as part of the independent prescriber role. Horrocks et al, (2002), found greater patient satisfaction with nurse consultations than with GP consultations. Jennings et al, (2009) and Wilson Shifaza, (2008) also found this to be true of nurse practitioners working in emergency departments. Importantly, they also found no significant variation in other health outcomes. Most of these studies found that consultations with nurses were to some extent longer, they offered more advice on self-care and self-management and that nurses gave more information to patients. Although there are various consultation models that have been described (Byrne Long, 1976; Pendleton et al, 1984; Neighbour, 2005; Kurtz et al, 2003; Stott Davis, 1979), these are based upon observation of doctor, not nurse consultations. Nevertheless, the consultation models and skills described in the medical literature are relevant to all practitioners (Baird, 2004). Consultation models help the practitioner centre the consultation around successful information exchange and try to provide a theoretical structure. Consultation models can also be used to help make maximum use of the time available at each consultation (Simon, 2009). Traditionally the medical model is used to assess patients however; it does not take into account the social, psychological, and other external factors of the patient. The model also overlooks that the diagnosis (that will affect treatment of the patient) is a result of negotiation between doctor and patient (Frankel et al, 2003) In this case study, the practitioner has used Roger Neighbours model of consultation. This was found by the practitioner to be simple and easy to remember, whilst covering all areas needed to make an effective consultation and assessment. He describes a 5 stage model which he refers to as a journey with checkpoints along the way: Connecting establishing a relationship and rapport with the patient. Summarising taking a history from the patient including their ideas, expectations, concerns and summarising back to the patient to ensure there are no misunderstandings. Handing over negotiating between the practitioners and patients agenda and agreeing on a management plan. Safety netting the consideration of what if? and what the practitioner might do in each case. Housekeeping reflecting on the consultation. (Neighbour, 2005) Connecting Mrs A was called through to the Rapid Assessment and Treatment area in the ED. It was apparent from Mrs As facial expression and limp that walking caused her pain. Silverman Kinnersley, (2010) state that non-verbal communication is extremely important and can often provide clues to underlying concerns or emotions. The practitioner had never met the patient before so had no previous relationship with her but was aware that she may have pre-conceived ideas about the ED which may have caused her anxiety. The practitioner introduced herself to Mrs A, explained her job role, the process that was about to be undertook and consent obtained. During this time eye contact was maintained and the practitioner also asked Mrs A how she would like to be addressed. This was done to try and build up a rapport with Mrs A, to help her feel at ease and reassure her. Simon, (2009) and Moulton, (2007) agree and state that rapport is essential to effective communication and consultation. Mrs A was also of fered a trolley to sit on to make herself comfortable and the curtains pulled around for privacy and dignity. On reflection the practitioner was aware that the environment was a busy and noisy assessment area and this can have a negative impact on the consultation (Silverman et al, 2005). Identifying this with Mrs A and apologising may have re-assured her further and gained trust and respect. Summarising The practitioner began with an open ended question and did not interrupt the patients response. Neighbour, (2005) and Moulton, (2007) advise this to open the consultation. Gask Usherwood, (2002) found that if a practitioner interrupts, patients then rarely disclose new information, which could lead to not finding out the real reason for the consultation. Mrs A revealed that she received an insect bite to her right lower leg 5 days ago, since then the surrounding skin had become swollen, increasingly red, painful and hot to touch. She explained that the redness was spreading up her leg and the pain was getting worse. Mrs A explained that she was concerned that it was not going to get better and was very worried that it had got worse during the last 3 days. Upon questioning Mrs A also complained of malaise and that she had been feeling very hot and cold and at times. She had been managing to eat and drink as normal. Mrs A lived with her husband, was a non smoker and drank alcohol occasionally. She had no past medical history and took no prescribed or over the counter (otc) medications. It was also elicited that she was allergic to Penicillin which she had an anaphylaxis reaction to. Taking a medical, social, medication and allergy history is important as it can be relevant to the presenting complaint, makes sure key information has not been overlooked and is essential in preventing prescribing errors (Bickley, 2008; Young et al, 2009). The practitioner actively listened to what Mrs A was saying by maintaining eye contact, using open questions and by summarising the history back to clarify points and to make sure nothing was missed. On reflection the practitioner feels this also gave the opportunity for Mrs A to add any further information not disclosed so far. Closed questions were then used to gain specific information related to the initial information given, this is advised by Young et al, (2009) and Moulton, (2007). Effective communication is important as Epstein et al, (2008) explains that a precise history can supply at least 80% of the information necessary for a diagnosis. Upon examination there was obvious erythema. Light palpation revealed that the area was very warm and tender. Neurovascular assessment was performed and was unremarkable. Mrs As chest was clear, heart sounds normal and her abdomen was soft, non tender. Physical examination is important as it is used to detect physical signs that the patient may not be aware of and can be used to confirm or disprove a possible diagnosis. It also suggests to the patient that their illness is being taken seriously. (Bickley, 2008, Charlton, 2006). Observations were taken including blood pressure, heart rate, temperature, respiratory rate and oxygen saturations. All were within normal parameters except her temperature which was 38.2 degrees Celsius. Venous blood was taken to check haematological, biochemical and coagulation status. Mrs A white cell count (WCC) and C-reactive protein (CRP) levels were raised, all other blood results were normal. Handing Over Before making a final diagnosis, it is important that differential diagnoses are excluded (Nazarko, 2012). The practitioners differential diagnoses were deep vein thrombosis (DVT) or venous eczema. However, Mrs A had a straightforward history (insect bite) that together with her observations (raised temperature), examination findings (redness, heat, swelling and pain) and blood results (raised WCC and CRP) indicated an alternative diagnosis, so DVT and venous eczema were ruled out. The practitioners working diagnosis was cellulitis. This was discussed with Mrs A and she appeared reassured that a diagnosis had been made. The practitioner explained that she would like to discuss this with a senior Doctor to help decide on a treatment plan. The practitioner presented the patient to an ED Registrar who agreed with the diagnosis. Diagnosis, treatment and prescribing options were then discussed to aid the practitioners learning. Cellulitis is a bacterial infection of the skin and subcutaneous tissue which is potentially serious (Epstein et al, 2008). It is caused by one or more types of bacteria, most commonly streptococci and staphylococcus aureus (Nazarko, 2012). Cellulitis usually occurs on the lower legs, arms and face but can arise anywhere on the body (Bickley, 2008). Patients with cellulitis present with signs of inflammation, distinctively heat, redness, swelling and pain (Nazarko, 2012). Inflammation is localised initially but increases as the infection progresses. Patients can be systemically unwell (pyrexial, tachycardic, hypotensive) and white cell count and C-reactive protein levels will be markedly raised (Beldon, 2011, Wingfield, 2009, Nazarko, 2012). It appears there is a general lack of evidence based literature surrounding the treatment of patients with cellulitis. The practitioner could only find one national guideline on the management of cellulitis in adults, which was published in 2005 by the Clinical Resource Efficiency Support Team (CREST, 2005). However, to the practitioners knowledge, these have not been validated by a clinical study. Morris, (2008) found in his systematic review that antibiotics cure 50-100% of cases of cellulitis but did not find out which antibiotic regime was most successful. Kilburn et al, (2010) also could not find any definitive conclusions in their Cochrane review on the optimal antibiotics, duration or route of administration. Eron, (2000) devised a classification system for cellulitis and its treatment which CREST used in their guidelines. This system divides people with cellulitis into four classes and can serve as a useful guide to admission and treatment decisions. However Koerner Johnson, (2011) found in their retrospective study, comparing the treatment received with the CREST guidelines, that patients at the mildest end of the spectrum were over treated and at the more severe end undertreated. They also found a significant variation in antibiotic regimes prescribed for patients with cellulitis. Marwick et al, (2011) questioned whether classes I and II could actually be merged to improve treatment. The practitioners trust has antibiotic guidelines (updated yearly) which also include a classification system. This aids the prescriber in choosing the correct antibiotic, dose, route and duration for certain conditions, cellulitis being one of them. After discussion with the Registrar it was determined that Mrs A was in Class I or non-severe which meant she could be managed with oral antibiotics on an outpatient basis. The practitioners trust and CREST, (2005) guidelines advise first line treatment for non-severe or class I cellulitis as oral Flucloxacillin 500mg, three times a day. Flucloxacillin is a moderately narrow-spectrum antibiotic licensed for the treatment of cellulitis. However, Flucloxacillin was contra-indicated for Mrs A as she had a severe penicillin allergy (British National Formulary, (BNF) 2012). Clarithromycin is a macrolide which has an antibacterial spectrum that is similar but not identical to that of penicillin; they are thus an alternative in penicillin-allergic patients (BNF, 2012). Clarithromycin is licensed and recommended by CREST, (2005), and by the practitioners trust, as an alternative to Flucloxacillin in cellulitis for patients with a Penicillin allergy. It is indicated in the BNF, (2012) for the treatment of mild to moderate skin and soft-tissue infections. It demonstrates suitable pharmacokinetics, with good distribution into skin and soft tissues, and is effective against the large majority of staphylococcal and streptococcal bacteria that cause cellulitis (Accord Healthcare Limited, 2012), (See drug monologue page 21-28). There were no contraindications in prescribing Clarithromycin for Mrs A. The option of not having any medication was discussed with Mrs A however, she wanted treatment so the benefits and side effects of Clarithromycin was explained, and consent obtained from Mrs A to prescribe the antibiotics and to be discharged, (NMC Practice Standard 5, 2006). Dose and duration were then also clarified and the importance of taking the antibiotics as prescribed and to complete the full course. On reflection, by discussing and deciding on the best treatment together this would hopefully promote concordance. Negotiating with patients and agreeing on a management plan is very important aspect of reaching patient centred care (Neighbour, 2005). Using an FP10 Clarithromycin tablets 500mg twice a day was prescribed by the Registrar (as the practitioner was not a licensed prescriber, NMC Practice Standard 1, 2006), as per trust guidelines, for 7 days. Paracetamol tablets 1g four times a day was also prescribed for its analgesic and anti-pyretic properties (BNF, 2012). A stat dose of both were prescribed and the practitioner asked the nurse to administer the first dose (NMC Practice Standard 9 14, 2006), and was aware that by delegating this task the prescriber remained accountable. The FP10 was given to the patient to take to the pharmacy of her choice for them to dispense (NMC Practice Standard 10, 2006), (See mock prescription page 29). The practitioner did not initially contemplate cost effectiveness but on reflection it has been recognised that this needs to be taken into consideration when prescribing (NPC, 1999). Intravenous antibiotics may have been prescribed, which may have meant an admission into hospital or administration by nurses on an outpatient basis; thus would have increased the cost of treatment significantly. Admission to hospital can also be overwhelming and can put the patient at risk of hospital acquired infections and increased risk of antibiotic resistance (Wingfield, 2008). Safety Netting The erythematous border was marked, with the patients consent, with permanent pen to monitor for any improvement or additional spread of infection (CREST, 2005, Beldon, 2011). The practitioner advised Mrs A that she should return or see her GP if she had worsening symptoms or if by the completion of the course of antibiotics symptoms had failed to resolve. Mrs A was also advised that, if a similar incident occurred, she should seek medical assistance early so that treatment could begin as soon as possible to reduce the risk of severe and long-term complications. In addition it was recommended that she should drink plenty of fluids to prevent dehydration, elevate the leg for comfort and to help reduce the swelling (CREST, 2005, Beldon, 2011). Mrs A was warned that there could be an increase in erythema in the first 24-48 hours of treatment (CREST, 2005). This advice and information empowered Mrs A and made sure that her discharge was as safe as possible. The practitioner brought the consultation to a close by asking Mrs A if she had any questions or if there was anything else she would like to discuss. This gave Mrs A the opportunity of clarifying any information given by the practitioner and the opportunity to divulge any information or concerns not previously mentioned. This re-assured the practitioner that she had addressed her problem appropriately. Housekeeping The practitioner made sure there was clear concise documentation of the consultation and choice of prescription in Mrs A notes (NMC Practice Standard 7, 2006). A discharge letter was also produced to send to her GP NMC Practice Standard 6, 2006). Once the prescription was ready, Mrs A was discharged. This case study has shown the practitioner the importance of effective communication in consultation. By following Neighbours consultation checkpoints it gave structure to the consultation and will be used by the practitioner in future practice. It has also helped the practitioner to gain an understanding of different prescribing options and how to explore these further. For example, the practitioner did find when reading around the subject that there has been some research on the use of corticosteroids in cellulitis to increase resolution, however, to the practitioners knowledge, this is not currently advised in any guidelines and further research is needed. The practitioner would also like to be involved in the development of a cellulitis pathway at her place of work. This could include an algorithm to aid practitioners to differential diagnosis so patients can receive appropriate treatment and reduce the incorrect prescribing of antibiotics. As there are no National Institute for Health and Clinical Excellence (NICE) guidelines on the treatment and management of cellulitis, treatment of patients is not standardised and consequently quality of care could be affected. The optimal choice for antimicrobial therapy requires review and definitive study in clinical trials. References Accord Healthcare Limited (2012) Summary of Product Characteristics for Clarithromycin Capsules 500mg. [online]. Electronic Medicines Compendium. Datapharm Communications Ltd. Available from: http://www.medicines.org.uk/EMC/medicine/25914/SPC/Clarithromycin+500mg+Tablets/ [Accessed 21ST September 2012] Byrne, P. Long, B. (1976) Doctors Talking to Patients. London, HMSO. Baird, A. (2004) The Consultation. Nurse Prescriber. (1) 3: 1-4 British National Formulary: No. 64 (2012) London: BMJ Group and Pharmaceutical Press. Bickley, L. (2008) Bates Guide to Physical Examination and History Taking. 6th Ed. London: Lippincott, Williams and Wilkins. Beldon, P. (2011) The Assessment, Diagnosis and Treatment of Cellulitis. Wound Essentials. (6): 60-68. Clinical Research Efficiency Support Team (2005) Guidelines on the Management of Cellulitis in Adults. Belfast: Clinical Research Efficiency Support Team. Charlton, R. (2006) Learning to Consult. Abingdon: Radcliffe. Department of Health (1999) Review Of Prescribing, Supply And Administration Of Medicines. (The Crown Report) London: HMSO. Epstein, O. Perkin, G. Cookson, J. De Bono, D. (2008) Clinical Examination. 4th Ed. London: Mosby. Eron, L. (2000) Infections of Skin and Soft Tissues: Outcome of A Classification Scheme. Clinical Infectious Diseases. (31) 287 Frankel, R. Quill, T. McDaniel, S. (2003) The Biopsychosocial Approach: Past, Present, and Future. Rochester: University Of Rochester Press. Gask L, Usherwood, T. (2002) ABC of Psychological Medicine: The Consultation. British Medical Journal (324) 7353: 1567-1569. Horrocks, S. Anderson, E. Salisbury, C. (2002) Systematic Review of Whether Nurse Practitioners Working in Primary Care Can Provide Equivalent Care to Doctors. British Medical Journal. (324) 7341: 819-823. Jarvis, C. (2008) Physical Examination and Health Assessment. 5th Ed. Missouri: Saunders Elsevier. Jennings, N., Lee, G., Chao, K., Keating, S. (2009) A Survey of Patient Satisfaction in a Metropolitan Emergency Department: Comparing Nurse Practitioners to Emergency Physicians. International Journal of Nursing Practice (15) 213-218. Kilburn, S., Featherstone, P., Higgins, B., Brindle, R. Interventions for Cellulitis and Erysipelas. Cochrane Database Systematic Reviews. 2010 Issue 6, Art. No. CD004299. DOI:  10.1002/14651858. Koerner, R. Johnson, A. (2011) Changes in the classification and management of Skin and Soft Tissue Infections. Journal of Antimicrobial Chemotherapy. (66) 232-234. Kurtz S, Silverman J, Benson J, Draper J. (2003) Marrying Content and Process in Clinical Method Teaching; Enhancing the Calgary-Cambridge Guides. Academic Medicine (78) 8: 802-809. Marwick, C. Broomhall, J. McCoowan, C. Phillips, G. Gonzalez-McQuire, S. Akhras, K. Merchant, S. Nathwani. Davey, P. (2011) Severity Assessment of Skin and Soft Tissue Infections: Cohort Study of Management and Outcomes for Hospitalised patients. Journal of Antimicrobial Chemotherapy. (66): 387-397 Morris, A. (2008) Cellulitis and Erysipelas. Clinical Evidence. [online] BMJ Publishing Group Ltd. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907977/ [Accessed 10th September 2012] Moulton L. (2007) The Naked Consultation: A practical Guide to Primary Care Consultation skills. Abingdon: Radcliffe. National Prescribing Centre. (1999) Signposts for Prescribing Nurses General Principles of Good Prescribing. Prescribing Nurse Bulletin. (1): 1-4. Nazarko, L. (2012) An Evidence-Based Approach to Diagnosis and Management of Cellulitis. British Journal of Community Nursing. (17) 1: 6-12. Neighbour, R. (2005) The Inner Consultation. How to Develop an Effective and Intuitive Consulting Style. 2nd Ed. Oxford: Oxford-Radcliffe. Nursing and Midwifery Council (2006) Standards of Proficiency for Nurse and Midwife prescribers. London: Nursing and Midwifery Council. Nursing and Midwifery Council (2008) The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives. London: Nursing and Midwifery Council. Pendleton, D. Schofield, T. Tate, P. Havelock, P. (1984) The Consultation: An Approach to Learning and Teaching. Oxford: Oxford University Press. Silverman, J. Kurtz, S. Draper, J. (2005) Skills for Communicating with Patients. 2ND Ed. Oxford: Radcliffe. Silverman, J. Kinnersley, P. (2010) Doctors Non-Verbal Behaviour in Consultations: Look at the Patient Before You Look at The Computer. British Journal of General Practice. (60): 76-8. Simon, C. (2009) The Consultation. InnovAiT (2) 2: 113-121. [online] Available at http://rcgp-innovait.oxfordjournals.org/content/2/2/113.full. [Accessed 13th September 2012] Stott, N. Davis, R. (1979) The Exceptional Potential in Each Primary Care Consultation. Journal of the Royal College of General Practitioners. (29): 201-5. Wingfield, C. (2009) Lower Limb Cellulitis: A Dermatological Perspective. Wounds UK. (5) 2: 26-36. Wingfield, C. (2008) Cellulitis: Reduction of Associated Hospital Admissions. Dermatological Nurse 7(2): 44-50. Wilson, A. Shifaza, F. (2008) An Evaluation of the Effectiveness and Acceptability of Nurse Practitioners in an Adult Emergency Department. International Journal of Nursing Practice. (14): 149-156. Young, K. Duggan, L. Franklin, P. (2009) Effective Consulting and History-Taking Skills for Prescribing Practice. British Journal of Nursing. (18) 17: 1056-1061. Drug Monologue. Name of Drug Clarithromycin Drug Classification Macrolide Therapeutic Uses(s) Clarithromycin film-coated tablets are indicated in adults and adolescents 12 years and older for the treatment of the following bacterial infections, when caused by clarithromycin-susceptible bacteria. à ¢Ã¢â€š ¬Ã‚ ¢ Acute bacterial exacerbation of chronic bronchitis à ¢Ã¢â€š ¬Ã‚ ¢ Mild to moderate community acquired pneumonia. à ¢Ã¢â€š ¬Ã‚ ¢ Acute bacterial sinusitis à ¢Ã¢â€š ¬Ã‚ ¢ Bacterial pharyngitis. à ¢Ã¢â€š ¬Ã‚ ¢ Skin infections and soft tissue infections of mild to moderate severity, such as folliculitis, cellulitis and erysipelas Clarithromycin film-coated tablets can also be used in appropriate combination with antibacterial therapeutic regimens and an appropriate ulcer healing agent for the eradication of Helicobacter pylori in patients with Helicobacter pylori associated ulcers Dose range and route(s) of administration Adults and adolescents (12 years and older) à ¢Ã¢â€š ¬Ã‚ ¢ Standard dosage: The usual dose is 250 mg twice daily. à ¢Ã¢â€š ¬Ã‚ ¢ High dosage treatment (severe infections): The usual dose may be increased to 500 mg twice daily in severe infections. Children younger than 12 years: Use of Clarithromycin film-coated tablets is not recommended for children younger than 12 years. Use Clarithromycin paediatric suspensions. Clinical trials have been conducted using clarithromycin pediatric suspension in children 6 months to 12 years of age. Elderly: As for adults Dosage in renal functional impairment: The maximum recommended dosages should be reduced proportionately to renal impairment. In patients with renal impairment with creatinine clearance less than 30 mL/min, the dosage of clarithromycin should be reduced by one-half, i.e. 250 mg once daily, or 250 mg twice daily in more severe infections. Treatment should not be continued beyond 14 days in these patients. Patients with hepatic impairment: Caution should be exercised when administrating clarithromycin in patients with hepatic impairment Administered orally. Pharmacodynamics Mode of Action Clarithromycin is a semi-synthetic derivative of erythromycin A. It exerts its antibacterial action by binding to the 50s ribosomal sub-unit of susceptible bacteria and suppresses protein synthesis. It is highly potent against a wide variety of aerobic and anaerobic gram-positive and gram-negative organisms. The 14-hydroxy metabolite of clarithromycin also has antimicrobial activity. The MICs of this metabolite are equal or two-fold higher than the MICs of the parent compound, except for H. influenzae where the 14-hydroxy metabolite is two-fold more active than the parent compound. Side Effects Dyspepsia, tooth and tongue discoloration, smell and taste disturbances, stomatitis, glossitis, and headache; less commonly: arthralgia and myalgia; rarely: tinnitus; very rarely: dizziness, insomnia, nightmares, anxiety, confusion, psychosis, paraesthesia, convulsions, hypoglycemia, renal failure, interstitial nephritis, leucopenia, and thrombocytopenia Interactions Aprepitant Clarithromycin possibly increases plasma concentration of aprepitant Atazanavir Plasma concentration of both drugs increased when Clarithromycin given with atazanavir. Atorvastatin Clarithromycin increases plasma concentration of atorvastatin. Cabazitaxel Avoidance of clarithromycin advised by manufacturer of cabazitaxel. Calcium-channel Blockers Clarithromycin possibly inhibits metabolism of calcium-channel blockers (increased risk of side-effects). Carbamazepine Clarithromycin increases plasma concentration of carbamazepine. Ciclosporin Clarithromycin inhibits metabolism of ciclosporin (increased plasma concentration). Colchicine Clarithromycin possibly increases risk of colchicine toxicity-suspend or reduce dose of colchicine (avoid concomitant use in hepatic or renal impairment). Coumarins Clarithromycin enhances anticoagulant effect of coumarins. Disopyramide Clarithromycin possibly increases plasma concentration of disopyramide (increased risk of toxicity). Dronedarone Avoidance of clarithromycin advised by manufacturer of dronedarone (risk of ventricular arrhythmias). Efavirenz Increased risk

Outsourcing Essay -- Economics Economy Consumerism Essays

Outsourcing Outsourcing has become a very popular issue, and it has reached an all-time climax. Firms are starting to do this a lot more than than in the previous decade. What is outsourcing? Outsourcing is defined as â€Å"The procuring of services or products, such as the parts used in manufacturing a motor vehicle, from an outside supplier or manufacturer in order to cut costs.† And it has become a big issue in our country. There are thousands of articles and books written on it, and you can attend numerous classes and speeches on the subject. The use of outsourcing is quite simple really†¦ Either pay an American worker $15 an hour, or pay someone in India to do the same job for $2 an hour. There are lots of other advantages and disadvantages to outsourcing but I will address those later in the essay. So what does an average American really know about outsourcing? Most people would say sending our jobs to another country in order to save money isn’t justified. It would cos t a lot of people jobs, which would send them into distress and possibly debt. But that’s not the whole story behind outsourcing. People hear about outsourcing and automatically decide that it is bad for our economy. What about the good things that outsourcing brings to our economy? We are sending jobs to India, their consumers will start making more money, and in return buy more of our goods and services. In this essay I will show you both points of the debate and you can decide for yourself whether or not outsourcing is bad for our country. A firm’s primary objectives are cutting un-necessary costs, reducing overhead, and cutting labor costs. America has one of the highest GDP’s, with the minimum wage law in the US being $5.15 an hour. Most people woul... ...l comes down to the American consumer, and how they view the topic. In the end†¦ the choice is yours. BIBLIOGRAPHY 1. Pew Research Center/Council on Foreign Relations survey conducted by Princeton Survey Research Associates International. July 8-18, 2004. N=1,003 adults nationwide. MoE  ± 3.5. Available at: http://www.pollingreport.com/trade.htm 2. Network Computing online, Online article, available at: http://www.nwc.com/shared/article/printFullArticle.jhtml?articleID=115201900 3. TechWeb online, â€Å"IT salaries are Rising†, online article, available at: http://www.techweb.com/wire/story/TWB20030402S0002 4. Information Week, â€Å"IT salaries Show Upward Trend, Outsourcing Overblown†, TechWeb article written by W. David Gardner, available at: http://www.informationweek.com/story/showArticle.jhtml?articleID=50500043