The Tragic Hero Of Sophocles Antigone - 876 Words

Throughout history people have fought for what they believed in, so much that they grow to be legends. These historical figures are not unlike figures found in mythology with such tales as Sophocles’ Antigone.They do what they believe is beneficial or right despite the adversity they will meet. Sometimes their fight results in their death. This is true not only of Antigone, but also of Abraham Lincoln. While Abraham Lincoln may not be considered a tragic hero he is similar to Antigone because both were fulfilling a divine order. Antigone is the title character of Sophocles’ Antigone. She is the daughter of Oedipus, who coupled with his mother and murdered his father. As a result of her father’s fate she is a victim of circumstance. She is also considered a tragic hero. Aristotle s definition of a tragic hero is someone who starts out in a high position or in good standing with the world and then ends up in a low position because they went against what is accep table. In Antigone’s case she went from a place of security and being accepted, but because she decided to attempt to perform the burial rites for her brother, a traitor of Thebes, she was condemned to death. Abraham Lincoln is the sixteenth president of the United States. Lincoln came from a simple life and made his way to being considered one of America’s greatest heroes. He is widely known for abolishing slavery and maintaining the Union during the Civil War. Abraham Lincoln came from a family with noShow MoreRelatedThe Tragic Hero Of Sophocles Antigone1835 Words   |  8 Pagesbecome a hero until he can see the root of his own downfall.† Aristotle believed that a tragic hero was one who was noble by nature yet endowed with a tragic flaw or hamartia. This hero is oftentimes more dignified than us average people, but his/her* personality and character traits make their stories relatable. Over the course of his life, different virtues are revealed, but they eventually exhibit an imperfection which leads to his inevitable downfall. In Sophocles s tragic play of Antigone, Oedipus’sRead MoreThe Tragic Hero Of Antigone By Sophocles1075 Words   |  5 PagesGreek philosopher Aristotle, â€Å"A man cannot become a hero until he can see the root of his own downfall.† Thus, according to Aristotle, the tragic hero must be able to discern how his actions caused his demise. The tragic hero has a tragic flaw, known as hamartia, recognizes that this flaw contributes to his misfortune because of an error in judgment, but is nonetheless deserving of sympathy. Creon, the hero of the drama Antigone by Sophocles, fulfills this definition. He exhibits hubris, hisRead MoreThe Tragic Hero Of Sophocles Antigone1056 Words   |  5 Pagesthe title of tragic hero in the play Antigone Author by Sophocles. I would like to start off by saying that it will be very challenging for me to have the passion that I usually have. But I will still sta nd in front of you. As I said before I am here to argue the title of tragic hero in the play Antigone. I could see that some of you are confused by the word tragic hero. No need to concern for I will tell you. The great Aristotle was one of the earliest men who defined a tragic hero. His descriptionRead MoreThe Tragic Hero Of Sophocles Antigone1805 Words   |  8 PagesOne of the authors at the forefront of Greek tragedies was Sophocles. One of Sophocles most famous pieces of work is, Antigone. Written in 440 B.C in Athens, Greece, Sophocles uses this play to dramatize a series of events that unfolds when pride becomes more important than loyalty to family. Controversy still remains today of whom the tragic hero of Antigone is, but some scholars believe that Antigone herself is the tragic hero. Antigone goes past conventional expectations to stand up for her brotherRead MoreSophocles Antigone - The Tragic Hero1306 Words   |  6 PagesThe Tragic Hero in Antigone Being a human incorporates drama. It is part of living in society, and often inevitable. In theatre, successful drama plays use timeless issues that can still be found present in most civilization. Amongst the seven Sophocles’ plays that managed to survive 25 centuries in complete form, lies one of the most famous tragedies in human-history, Antigone. The main controversial conflict in this historically-influential play is the importance of divine law versus man-madeRead MoreThe Tragic Hero Of Sophocles Antigone1521 Words   |  7 PagesAn Aristotelian tragic hero is a literary character who makes a judgment that ultimately leads to his or her own destruction. An example of a true Aristotelian tragic hero is Creon from Sophocles’ play, Antigone. Creon is the tragic hero because he goes through the five stages of a tragic hero which leads to his destruction. His tragic flaw is him being afraid to admit that he has made a mistake. He is too proud of his power and his a bility to make laws which leads to his son and wife committingRead MoreThe Real Tragic Hero Of Sophocles Antigone3370 Words   |  14 PagesCarlberg English 102 9 December 2014 The Real Tragic Hero in the Play Antigone A tragic hero according to Aristotle is someone who is of high nobility, and has a major internal character flaw. That flaw will eventually by the characters ultimate demise which is most likely death. If their demise doesn’t end in a death the tragic hero usually goes through a catharsis. The most common flaws of a tragic hero are hubris, pride, and stubbornness. Tragic heroes can be found throughout most tragedy themedRead MoreThe Tragic Hero Of Sophocles Antigone Essay1357 Words   |  6 Pagesdraws on the emotions of the audience is to get them to relate to the tragic hero, and that is why it was so important for a tragedy to have a proper one. Antigone features the perfect example of a hero in a tragedy. In Antigone, King Creon is the tragic hero since he is adherent to a moral mean, he is life-like, he exhibits a tragic quality which results in a plot reversal, and ends in a moment of lament. Creon is the ideal tragic hero, since he’s morally upstanding but not blameless at the same timeRead MoreEssay on Creon as the Tragic Hero of Sophocles Antigone997 Words   |  4 PagesCreon as the Tragic Hero of Sophocles Antigone   Ã‚  Ã‚  Ã‚   Who is the true tragic hero in Sophocles Antigone?   This question has been the subject of a great debate for numerous years.   Equal arguments exist that portray Antigone as the tragic heroine in the play and Creon as the tragic hero.   Aristotle, in his study of Greek drama entitled Poetics, provided the framework that determines the tragic hero of a work.   Though Antigone definitely possesses the characteristics and qualities thatRead More Creon is the Tragic Hero in Sophocles Antigone Essay627 Words   |  3 Pages Creon is the Tragic Hero of Antigone nbsp; When the title of a play is a characters name, it is normally assumed that the character is the protagonist of the play. In Sophocles Antigone, most people probably believe Antigone to be the tragic heroine, even after they have finished watching the play. It may be argued, however, that Creon, not Antigone, is the tragic character. When we examine the nature and concept of the Greek Tragedy and what it means to be a tragic character, it becomes

The Ideal Body Images We See Lead Us Women - 1011 Words

Growing Up As a Hairy Mexican Being a kid and growing up was hard enough, but being a young girl and growing up hairy was traumatizing. Society has a way of creating beauty standards for us to follow and these standards mold young minds early. Society gives people a perception of how one should look, especially when it comes to women. Women are force fed messages that lead us to believe that we are to look like the super models we see in ads, television, and magazines. The ideal body images we see lead us women to compete with one another in achieving that perfect body. This battle can lead to depression, lack of confidence, and an unhealthy obsession with body image. For me growing up as a Mexican girl added more complications. I was†¦show more content†¦He stopped mid step to look at me, Jeanette introduced us. He then asked me, â€Å"what is that on your arm?† I was confused by what he was talking about. Then he said â€Å"You only have one eyebrow†, as he w alked away laughing. I was so embarrassed while my friend stood there and looked at me. She tried to apologize, but that didn’t stop the tears from running down my cheeks. Abruptly, I left running home as fast as I could and went straight to my room slamming the door behind me. My mom immediately came to console me. I could not control my emotions as I explained to her what happened. I asked her â€Å"why do I have to be so hairy?† â€Å"It’s not fair, Jeanette does not have a uni-brow!† My sorrow quickly turned into anger. My mom explained to me that I was Mexican and that I shouldn’t be ashamed of how I looked, instead I should be proud of my heritage. I was so ashamed of my looks. I didn’t want my uni-brow or hairy arms. That night my mom plucked my eyebrows so I didn’t have a uni-brow, but did not do anything about my hairy arms. The next morning as I was taking a shower I looked at my mother’s razor, I picked it up. I star ted debating if I should shave my arms, but was so nervous since I had never used a razor before. I took one stroke and froze in shock that I did it. I figured there is no turning back now. I shaved my entire arm, from my shoulder down to my knuckles. I chose to shave my arms because I wanted people to see me as normal.Show MoreRelatedThe Ideal Body Images We See Lead Us Women1006 Words   |  5 Pagesfor us to follow and these standards mold young minds early on in life. Society gives people a perception of how one should look, especially when it comes to women. Women are force fed messages that lead us to believe that we are to look like the super models we see in ads, television, and magazines. The ideal body images we see lead us women to compete with one another in achieving that perfect body. This battle can lead to depression, lack of confidence, and an unhealthy obsession with body imageRead MoreThe Effects Of Media On Body Image1453 Words   |  6 PagesIt is known today that media and body image are closely related. Particularly, how the body image advertising portrays effects our own body image. It has been documented in adolescents as they are more at risk for developing unhealthy attitudes toward their bodies. They are at a time where they re focused on developing their individual identities, making them susceptible to social pressure and media images. A major reason many people have a negative body image is because of the impact that mediaRead MoreThe Media s Influence On Society1560 Words   |  7 Pagesare. How many times have we heard this, yet we live in a society that appears to contradict this very idea. If looks don’t matter then why do women and girls live in a society where their bodies define who they are? If looks don t matter then why is airbrushing used by the media to hide any flaws a person has? What exactly is causing this, why do we feel like we are just not beautiful the way we are? Its the media. It’s becaus e the media promotes a certain body image as being beautiful, and it’sRead MoreSocial Media Allows People To Share Pictures And Ideas1057 Words   |  5 Pagesacross the world. Women and girls can use social media to earn approval for their appearance and compare themselves to others. Women during this time period that are so heavily impacted by the media can link their self-worth to their looks. I used scholarly articles all relating to how social media affects body image to decide what my view point was. After research, we can conclude that social media has a negative effect on a woman’s body image. The media consumption can lead to dissatisfactionRead More How Media Influences Women Essay example1074 Words   |  5 Pages We, the American public are hit from every imaginable direction every waking moment of our lives by slick advertising agencies trying to coerce us into or tell us why we need to buy their products. Their products will make us happier or thinner, or prettier. The advertisers often use the picture of youth and vitality so that the public will associate that particular product or service with being young and beautiful. They do this because of course in our society youth and beauty are to be covetedRead MoreThe Media And Body Image1453 Words   |  6 PagesToday we know that the media and body image are closely related. Particularly, how the body image advertising portrays affects our own body image. Research documented adolescents as they are more at risk for developing unhealthy attitudes toward their bodies. They are at a time where they re focused on developing their individual identities, making them susceptible to social pressure and media images. A major reason many people have a negative body image is because of the impact that the mediaRead MoreSocial Media And Its Impact On Society1224 Words   |  5 Pagesprovided to the public as a medium for expression and communication. Seemingly, social media could be viewed as a positive contribution to society, but one must consider the underlying effects of society. Many of us don’t take into account the role that social media plays in the way we perceive things, think, and live our lives. Social media plays a critical part in societal norms. â€Å"Social norms are rules of conduct that governs interactions among individuals within a reference group. Norm violationsRead MoreBody Image And Eating Disorders1375 Words   |  6 PagesBody Image and Eating Disorders Females and males are both under pressure to conform to societies idea of beauty. Women feel pressure to be thin, big chested, while men feel the urge to be lean and muscular. Society portrays these images of thinness and muscularity through media, magazines, and even toys. These images can have an impact on peoples body images, which can lead to eating disorders such as Anorexia nervosa and Bulimia nervosa. Body Image is the way you see your body, and how you feelRead MoreThe Impact Of Media On Self Esteem1732 Words   |  7 Pagesyoung age, girls are exposed to women with tiny waists and curves in all of the right places. Children grow up playing with stick figure Barbie dolls and watching emaciated Disney princesses on television. Kids come to realize, even before reaching puberty that this is what their bodies should look like. Older children see celebrities constantly flaunting their sculpted figures, which they magically attained effortlessly. The media broadcasts the thin ideal in almost every way possible. AsRead MoreEssay on Medias Unrealistic Portrayal of the Ideal Body1118 Words   |  5 Pagesadvertisements surround us every step of the way from the skies to subways, and from our work to our homes. It’s unthinkable what impact do these advertisements play in the lives of many people. Media is a very strong tool to have control of because it has great influen ce on the mind of the viewer and also sometimes creates norms that the society starts to incorporate in the â€Å"Normal norms.† Media promotes the young and adult to disfigure their bodies by portraying an â€Å"ideal† body image for men as muscular

Change in an Organizational Management-Free-Samples for Students

Questions: 1.Critically analyse the pros and cons of each option and critically evaluate the level of conflict they will lead to. 2.In your opinion, which of the four approaches should Oussama choose to follow in this situation? Or should an alternative approach be taken? Critically defend your arguments thoroughly. 3.Describe in detail the different change management phases that should be adopted in sequence. Critically evaluate the order of phases. 4.Provide a detailed communication plan to help implement the proposed organizational changes. Demonstrate how the communication plan will enhance the engagement and success of the experience. Answers: Introduction (background of the Case) Change in an organizational management is essential for maintaining the organizational performance, despite of the fact that same task performed by an individual employee increases the efficiency. It however, creates a stagnant and monotonous environment in the organization that decreases the performance of the employees. This is due to the decreased motivation in performing the similar task. There exists number of models that can help the organisations to adopt change in their system. Moreover, the process of change can be segmented into various steps. These can be summed up as understanding of change, planning for change, implementation of change and communication of change. The leader can further incorporate various models in the process as per requirement for receiving desired outcomes. The following report identifies the stages of change along with the models possible to implement in case of Moroccan Lights Co. The Moroccan Lights Co is an Arabic light manufacturing company situ ated in Marrakesh, which is currently in need of an operational change in the system to avoid monotonous work environment. The new manufacturing in-charge is however, facing troubling implementing as one of his subordinates is opposing the proposed job rotation scheme. The following will identify the change that can be brought in the organisation to increase the performance of the company. As identified by Chen et al (2015) job rotation is important in any field of employment. They conducted their study on 266 registered nurses in two of the Taiwan hospitals. The results came out in favour of job rotation as it contributes in job satisfaction of the employees. It further impacts on the organisational commitment of the employees. Hence, it will be unwise for rejecting the opinion of job rotation. Study conducted by Santos et al (2016) on the software firms concluded that the balance in job rotation is necessary, while keeping the balance as it has direct impact on the cognitive workload. It can also have adverse effect on the performance feedback. McGurk and Van Rossenberg (2013) reflected on the opinion of the HR consultancy firm Cornerstone OnDemand and supported their opinion. They linked job rotation with the employee morale and stated that job rotation contributes towards higher employee morality. It is often evidenced that the employees working in a single positio n for a longer time gets bored from performing similar activities. Moreover, it also limits the knowledge of an employee, in turn breaking the morale. Job rotation can potentially develop the greater sense of vale in the employees as they understand multiple, roles in the organisation. Disadvantages on the other hand will restrict the development of any particular skills within the employee. However, the situation will only occur if the job rotation takes place often than necessary. Hence, it can be avoided by implementing proper planning. The second disadvantage possible to point out is regarding the safety of the employees if they are not properly trained for their new role in the organisation. This can also be mitigated with proper training to the employees before shifting roles (McGurk and Van Rossenberg 2013). The second decision considered by Oussama is to impose the decision of job rotation on the subordinates is a reflection of autocratic leadership, which also has a number of pros and cons. The benefit of this leadership is the employees have little say decision making process and they have to follow whatever decision is made by the manager. This will help the organisation to increase discipline and order in the organisation. Though, autocratic leadership sounds effective for the organisations, it is no more efficient to increase the organisational performance in modern days (Vinkenburg et al 2011). The autocratic leadership will only decrease the satisfaction level of the particular employee. In the option proposes for a sequential switch between job rotations satisfying every subordinates opinion. According to Khan et al (2014), this decision represents the democratic leadership style. The benefit Oussama will receive from this decision will satisfy the need of every subordinates. Increased satisfaction will help in receiving greater employee performance. However, Grant (2012) argued that it is likely to have adverse effect by increasing the risk of failure. First, the company is likely to lose the control over the employees from this decision and lose its balance. Moreover, this fails in serving the purpose of job satisfaction the employee performing the task other than his choice is likely to decrease the motivation, which ultimately fails to reflect any improvement. The last decision made is the call for awareness program among the employees. This will communicate the advantages and disadvantages of job rotations to the employees enabling them to take more rational decision. As per Avolio and Yammarino (2013), this reflects a nature of transformational leadership where the leader will involve himself in the process to aware the employees about the benefits of job rotation. It will successfully address the issue of job satisfaction of the subordinates and also increases the morale. However, the only disadvantage of this process is the time required as stated by Garca-Morales, Jimnez-Barrionuevo and Gutirrez-Gutirrez (2012). This is a time consuming process as the leader has to make his or her subordinates understand the advantages of job rotation. As the third subordinate is quite stubborn about his negative view regarding job rotation, it will require considerable time, effort and resource for communicating the benefits of it. 2.The approach of spreading awareness among the subordinates on the job rotation strategy has the potential to bring sustainable change in the organisation increasing the employee performance. The possible success of this can be attributed to the transformational leadership style chosen by Oussama in handling the issue among the subordinates. This is useful as the transformational leadership style has the capability to achieve the unexpected or remarkable results. The role of transformational leaders is to supply motivation for performing a job. As according to Grant (2012) they have the capability to influence the followers way of thinking and perceived opinion. Moreover, attempt of changing the subordinates perception regarding job rotation will prove beneficial for the company in the long run. The statement can be justified on various grounds. First, the autocratic leadership chosen for the opinion of imposing will create unrest among the subordinates. This decision can considerably reduce the level of job satisfaction in case of the subordinate refusing job rotation strategy. Moreover, this imposition of the perception can also influence the other two subordinates leading them to perceive valueless in the organisation. The third opinion can be rejected basing on the limitations and risks previously identified. Hence, making the subordinates aware of the benefits they can attain from job rotation strategy will help Oussama avoid unnecessary conflicts in the organisation and maintaining the satisfaction level of the subordinates. This will further motivate the employees and increase their morale by understanding the value of job rotation. T hey will be able to learn the roles played by their co-workers in the organisation, which in turn enrich their value within and outside the organisation. 3.There are a number of change model exist in the market that can direct the change being implemented in the organisation. Situation and aspect of change considerably influence the decision of the leader in the model selection process. This is due to the approaches taken by various model of changed proposed by various scholars. A number of change models have been discussed below. Understanding change (Lewins Change Model) Kurt Lewin proposed three phase model of change. According to Kaminski (2011), this is the simplest model an organisation can implement. It incorporates unfreezing, changing and refreezing phases. The first phase identifies the need of change and spreads awareness among the employees. The next phase is the change implementation and the last one is the stabilisation of change. This model focuses more on understanding of change. Planning Change (ADKAR) ADKAR model is a more detailed in the process divided into five phases that are awareness, desire, knowledge, ability and reinforce. As identified by Kazmi and Naarananoja (2013) awareness is the identification of the need and opportunity for change; whereas the desire phase is the formulation of objective that will guide the change. Knowledge and ability is considered as the implementation phase of change. Reinforcement phase is the stabilisation phase of change where the changes are finalised. Implementing Change (Kotters Eight Phase of Change) Kotter divided the phases of change into eight starting from establishment of urgency to anchoring of change. As stated by Pollack and Pollack (2015) sense of urgency, coalition creation and development of vision are the developmental phase of change. Sharing vision, obstacles clearance and short term wins are considered as the implementation of change. Solidification of change includes the build on change and the anchoring phase as proposed by Kotter. As identified by Hayes (2014), above mentioned models can be broken down into three primary phases that are understanding phase, implementation phase and stabilising phase. It is important for the manager to follow the phases as they have specific role in the process of change. As stated by Cameron and Green (2015) the understanding phase helps the manager to in identification of the necessity of change and making preparation. The preparation involves spreading awareness among the subordinates, objective formulation and identification of change process. The later phase of change management is the implementation that involves the communication of change and preparing employees for change. The last phase involves finalising the decisions taken in favour of change to stabilising the implemented change. 4.Torppa and Smith (2011) identified the necessity of proper communication for surviving in the changing environment of the organisation. It is the responsibility of the manager to communicate the change that is being implemented in the organisation to maintain the efficiency of the employees. Transparency in communication will help the employees to understand the nature of change and adopt themselves accordingly to provide maximum output. Their study supports the statement with the result that indicates that 66% of the respondents the importance for structure, 57% find it important for motivating the employees and 42% identified the change in communication plan as adverse. An effective communication plan should incorporate the followings for supporting the changes in the organisation. Purpose The first step of the communication plan identifies the purpose of the change in the organisation. The manager for this case has to identify the necessity of changing to job rotation strategy. The shift in job rotation culture for this particular case is necessary as the job profiles in the organisation are becoming stagnant (Lipman and Ashlock 2015). Some of the employees started finding their job monotonous despite of the fact that it is increasing their efficiency. However, this further decreasing job satisfaction level of the employee that is resulting into performance degradation. Audience identification The primary stakeholders of this change are the employees who will get directly affected in this change. The other stakeholders involve the higher authority of the organisation and the applicants. The applicants are counted as a major stakeholder as the interesting rotational job profile will interest some of them to consider joining the company (Joseph 2017). Employees are considered as the primary stakeholders as they will be the one who will have to undergo the change. It is expected that the change will increase the organisational performance and job satisfaction, which makes the higher authorities of the organisation important consideration. Message to be Delivered The objective of the change can be considered as the message that has to be delivered to the major stakeholders. The objective in this case is to improve job satisfaction level of the employees working in the organisation. This is to retain the employees for longer period of time. It will further help in morale stability of the employees and increase their market value ((Joseph 2017). Finally, the change will serve as a promoter to increase the organisational performance. All these objectives are related to each other and facilitates in attaining the objectives. Media Considered It is important for considering multiple media for communicating the message to the stakeholders. Electronic mail, online update and physical mode of communication have to be considered in this case (Lipman and Ashlock 2015). The email and physical communication will be utilised for communicating the change to the employees and the higher authorities of the organisation through meeting. Online update of the job profile will be used for communicating the message to the possible applicants. Change Plan Implementation and Plan for Emergency The detail of the plan along with the emergency plan will be communicated only to the employees and the higher authorities of the higher authorities of the company. This will help maintaining the transparency of the plan, which will further help the stakeholders to act accordingly for achieving success from the change. Evaluation The evaluation of the plan will be done using the feedbacks received from the stakeholder involved. The feedbacks will help in understanding the efficiency and interest of the stakeholders for the change being implemented. Conclusion It is possible to conclude from the above that the transformational leadership will help Oussama to convince the subordinates regarding job rotation in the organisation. It will fulfil the purpose without affecting the job satisfaction of the employees. The discussion also identifies three primary phases of change management that are necessary and communicates the success of the implemented change. The order of the phases is necessary for properly planning and implementing the change. Kotters eight phase model of change can prove useful in this case. The eight phases of Kotters model can also be divided into the three phases identified in the change management. The further discussion communicates the importance of communication plan for implementing change as it helps maintaining transparency of the process. This further involves evaluation that communicates the efficiency of the change, which in turn helps in modifying the change plan accordingly to the stakeholders need. References Avolio, B.J. and Yammarino, F.J. eds., 2013. Introduction to, and overview of, transformational and charismatic leadership. InTransformational and Charismatic Leadership: The Road Ahead 10th Anniversary Edition(pp. xxvii-xxxiii). Emerald Group Publishing Limited. Cameron, E. and Green, M., 2015.Making sense of change management: A complete guide to the models, tools and techniques of organizational change. Kogan Page Publishers. Garca-Morales, V.J., Jimnez-Barrionuevo, M.M. and Gutirrez-Gutirrez, L., 2012. Transformational leadership influence on organizational performance through organizational learning and innovation.Journal of business research,65(7), pp.1040-1050. Grant, A.M., 2012. Leading with meaning: Beneficiary contact, prosocial impact, and the performance effects of transformational leadership.Academy of Management Journal,55(2), pp.458-476. Hayes, J., 2014.The theory and practice of change management. Palgrave Macmillan. Joseph, J.J., 2017.A Strategic Communication Plan for Dominica-America Scholarship and Culture, Inc(Doctoral dissertation). Kaminski, J., 2011. Theory applied to informatics-Lewins change theory.Canadian Journal of Nursing Informatics,6(1), pp.1-4. Kazmi, S.A.Z. and Naarananoja, M., 2013. Comparative approaches of key change management models-a fine assortment to pick from as per situational needs!. InInternational Conference on Business Strategy and Organizational Behaviour (BizStrategy). Proceedings(p. 217). Global Science and Technology Forum. Khan, F., Rasli, A.M., Yusoff, R.M., Ahmed, T., ur Rehman, A. and Khan, M.M., 2014. Job rotation, job performance, organizational commitment: An empirical study on bank employees.Journal Of Management Info,3(1), pp.33-46. Lipman, B. and Ashlock, M.Z., 2015. Engineering and Implementing an Executive-Level Communication Plan in a Global Professional Environment: A Case Study.Journal of Media Critiques [JMC],1(2). McGurk, J. and Van Rossenberg, Y., 2013. HR and its role in innovation: The innovation imperative: the challenge for HR. Pollack, J. and Pollack, R., 2015. Using Kotters eight stage process to manage an organisational change program: Presentation and practice.Systemic Practice and Action Research,28(1), pp.51-66. Vinkenburg, C.J., Van Engen, M.L., Eagly, A.H. and Johannesen-Schmidt, M.C., 2011. An exploration of stereotypical beliefs about leadership styles: Is transformational leadership a route to women's promotion?.The Leadership Quarterly,22(1), pp.10-21.

There Are No Children Here 2 free essay sample

There Are No Children Here # 8211 ; Summary Essay, Research Paper There Are No Children Here Alex Kotlowitz was a free-lance journalist. In 1985 a friend came to him and asked him to compose a text for a exposure essay he was making on ( kids populating in poorness ) for a Chicago magazine. That is when he met the Rivers brothers, Lafeyette, age 10, and Pharoah age seven. He spent merely a few hours with them questioning for the exposure essay. Lafeyette had an impact on Kotlowitz. When asked what he wanted to be, Lafeyette responded with # 8220 ; If I grow up, I # 8217 ; vitamin Ds like to be a coach driver. # 8221 ; Meaning, at ten old ages old, he wasn # 8217 ; t certain if he # 8217 ; vitamin Ds make it to adulthood. In 1988 Kotlowitz suggested to the male childs # 8217 ; mother, LaJoe, the thought of composing a book about Pharoah, Lafeyette and the other kids in the vicinity. LaJoe liked the thought. We will write a custom essay sample on There Are No Children Here 2 or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page However, she so said, # 8220 ; But you know, there are no kids here. They # 8217 ; ve seen excessively much to be children. # 8221 ; Alex Kotlowitz entitled his book, There Are No Children Here. It is a narrative of two brothers turning up in a lodging undertaking of Chicago. By the writer following the male childs throughout their twenty-four hours to twenty-four hours lives, we, the readers, are besides enveloped in the male childs # 8217 ; milieus. We learn about their mundane lives, from how they pick out their apparels, to how they wash them. We go to school with them and we play with them. Throughout the book, we are much like flies on the wall. We see and experience everything the boys # 8217 ; travel through at Henry Horner Homes, the undertaking where they live. LaJoe moved into the Henry Horner Homes in 1956 with her female parent and male parent. Back so it was a beautiful topographic point. There was a green, grass baseball diamond, which was on a regular basis mowed. For the kids there was a resort area with swings and jungle gyms. The bricks were smooth, the Windowss were shimmering, and the walls were newly painted white. The striplings joined male childs and misss nines, processing sets, and other constructive organisations. Now things are different. The leftovers of grass are dry brown spots, largely soil. Where there was one time a resort area, there is now a shot. The bricks are now worn and tatterdemalion. The Windowss are either translucent or broken. And the walls are no longer white, instead a dull, xanthous colour. Worst of all, alternatively of fall ining male childs and misss nines, the striplings joined packs. At the Henry Horner Homes, it was the Conservative Vice Lords that reigned. Led by Jimmie Lee, the pack was in charge of the undertaking. Lafeyette and Pharoah knew all about Jimmie Lee. They knew to maintain their distance, but Lee was non entirely a scoundrel. To foreigners he was simply a condemnable, involved in drug-traffic, place invasions of pot flats, and other offenses. To the occupants of the undertaking, Lee was respected out of more than merely fright. He ne ver Lashkar-e-Taiba immature teens fall in his pack. He spoke to pull the leg of against packs and drugs. He would set nutrient on tabular arraies for households in demand. He would shoe the kids with lacerate places. Even a constabulary officer referred to Lee as a gentleman. He had a love for kids and truly helped the childs at Henry Horner Homes. On the other manus, the childs who did fall in Jimmie Lee # 8217 ; s ground forces, had another destiny. Bird Leg, ( a.k.a. Calvin Robinson ) was a wise man for Lafeyette. He looked up to Bird Leg and tagged along with him for a piece. Finally, Bird Leg joined the Conservative Vice Lords. It wasn # 8217 ; t long before he was changeable point space through the thorax by rival pack members. Calvin died in forepart of the Henry Horner Homes. In wide daytime, another one of Lafeyette and Pharoah # 8217 ; s friends had been murdered. Lafeyette and Pharoah had a long and blowy route in front of them. Sing their demographics they were faced with serious challenges. Lafeyette and Pharoah had about opposite personalities. Lafeyette easy began to populate a life he vowed to neer populate. He began following in the footfalls of his older brother Terrence. It started with petit larceny larceny and shrinkage, stealing confect and the similar. Finally Lafeyette broke into a auto. Pharoah succeeded in school. He was an first-class pupil, he had admirable survey accomplishments, and thrived in spelling. He even placed in a spelling bee. Later, Kotlowitz sent and paid for the two brothers to go to a private school called Providence-St. Mel. Pharoah is booming at that place. He enjoys holding two hours of prep every dark. He started out behind in math and reading and is easy catching up. His reverie and forgetfulness sometimes interferes with his success. He besides has problem doing it to school on clip. Despite the challeng es he faces today, he is now on a consecutive way for prosperity. Lafeyette on the other manus encountered much trouble at the new school. He found himself unable to maintain up with the needed work and subsequently returned to public school. Though he left after less than a twelvemonth, he learned rather a spot from St. Mel # 8217 ; s. He learned how to be a good pupil, and how to concentrate on his surveies. He besides learned to inquire for aid, something that was peculiarly hard for him. He played hookey and smoked pot when he returned to public school. That seems to be the extent of it though. He graduated from the 8th class. He seemed genuinely happy and expressed love and gratitude towards his female parent and friends. This book was genuinely an eye-opener. There is non a secret plan, nor a existent narrative line, it is merely # 8216 ; a twenty-four hours in the life of # 8217 ; type of narrative. It is more like # 8216 ; a few old ages in the lives of # 8217 ; in this instance. I would urge this book for anyone who wishes to spread out their cognition of life and civilization beyond the sheltered land of our hometowns.

IDEAS Advanced Programmability essays

IDEAS Advanced Programmability essays DEPARTMENT OF INDUSTRIAL AND MANUFACTURING SYSTEMS ENGINEERING I-DEAS ADVANCED PROGRAMMABILITY FEATURE: Submitted in partial fulfillment of the requirements for Computer-Aided Design and Manufacturing Utilizing the advanced programmability features of the I-DEAS software package, it is possible to create a macro to run within the I-DEAS modeling environment that would automatically generate commonly used parts or geometries to supplement and speed up the modeling process. To define a macro within I-DEAS a user may simply capture the commands through a Program File -> Create option, create the program file directly through any text editor or use a combination of the two methods. Currently I-DEAS allows the user to retrieve various primitives from the Parts Catalog to aid and speed up the modeling process, but this does not account for more complex geometries that maybe repeated quite often in various modeling applications. Quite often these geometries, although commonly used for one particular company are in actuality company specific and do not warrant their inclusion in the mainstream I-DEAS Parts Catalog. Since creating the geometry from scratch would prove to be too time consuming and including company specific geometries within the Parts Catalog is not feasible, I-DEAS has created two options for defining parameterized complex geometries: (1) define a macro (which I-DEAS calls program files) to prompt the user for parametric information from the command-line interface and generate the geometry using predefined commands programmed within the macro or (2) create the part geometry manually and use the parameterized parts option to store the par ...

Grant Writing - sources and tips for writing grants part 1

Grant Writing - sources and tips for writing grants part 1 One of the greatest challenges for educators is finding sources of money to allow for innovation and technology in the classroom. Funding is barely available to pay salaries and buy basic supplies. Therefore, teachers and administrators who truly wish to try new ideas that require additional funds have to personally find sources for this money. Grants can be a godsend to solve financial shortcomings. However, two major stumbling blocks are associated with attaining grants: locating them and writing them. Locating Grants Assessing Needs Before your search even begins, you must have a project that you wish to fund. What is it that you want to accomplish? Any project you support must align with the needs of your school or community. Grant providers want to clearly see the necessity of your program. To make sure that your project fulfills a need, compare what your school or community has now to what you feel it should have. Use this information to create possible solutions. The upfront time spent investigating this chasm between your schools reality and your vision for it will pay off when it comes time to write your grant proposal. Do some preliminary research to find a solid educational basis for your idea. Map out the steps necessary to complete your project including necessary funding at each step. Remember throughout your design phase to keep in mind how you will evaluate your project using measurable outcomes. Make a Project Worksheet Make a preliminary worksheet concerning what you believe you will need for your project. By doing this, you can get a clear picture of what the grant you are searching for must look like. Some items your chart could include are: Project Overview Need for Project Research Sources Amount Needed Special School/Community Circumstance Evaluation Methods Searching for Options The most important piece of advice you can get when beginning your grant search is to carefully match your project with the grantors award requirements. For example, if the desired grant is only given to schools in inner cities, only apply if you meet that criterion. Otherwise, youll be wasting your time. With that in mind, three major sources for grant money exist: Federal and State Governments, Private Foundations, and Corporations. Each has its own agenda and differing levels of requirements concerning who can apply, the application process itself, how the money must be spent, and the methods of evaluation. So where can you search for each type? Luckily there are some awesomesites on the internet. You are welcome to modify and use this basic grant match rubric to determine how well the grant fits your project. Writing grant proposals is a complicated and time-consuming process. Here are some great tips to help make grant writing easier. I would like to acknowledge Jennifer Smith of Pasco County Schools for generously sharing many of these tips. Start with outcomes. Be specific in what you wish to achieve and design your project back from these outcomes.Carefully match your goals and outcomes with those required by the grant advertisement. You can use the Grant Match Rubric to help make your decision.Talk to the grant contact person to receive specific information about the purpose and goals of the grant.Find research to support your project idea. Programs that have been previously validated have more merit because they have shown success in the past.Find a district sponsor. Get them to help with any red tape or information you might need to complete your grant proposal.Make your grant proposal interesting to read through good formatting. Remember that people are going to judge your ideas against others and a pleasing and well-organized presentation will get you further. Include pie charts. Set off your information with appropriate indentations.Use language to your advantage. Quote from notable sources.Make a column to accen t exactly where in your grant proposal each component of the grants grading rubric is met. As you write your strategies for the grant proposal, keep assessment methods in mind. Think about how you are going to measurably show what you will accomplish.Look closely at any funding rules to make sure you do not ask for items that the grant will not fund. For example, Florida state grants do not allow food items to be bought with grant money.Check out the grant to see if matching funds are required. Many school districts will not have the money to match even if you are awarded the grant. However, professional volunteers can count as in-kind contributions.Check with your School District to find out the rules concerning salaries for any individuals working on the project. Many districts require you to account for benefits in your funding model.Find out whether the grant requires outside evaluators. If so, you might have to pay for them out of your funding.Make sure your budget narrative and your budget summary match exactly.Grants are stamped when they are received. Try to send i n your grants a few days early so that it appears you are on the ball. Because school districts are limited in the number of Federal and State grants they can apply for, many districts must approve of your grant proposal before it can be sent out. Because of the time constraints on many of these grants, you must plan ahead. Also, make sure you are not competing with others at your own school or district for the same money.Make a database if one is not currently available in your district of important demographic numbers and statistics. Place this information in your grant proposals as requested highlighting special needs.Get to know your states grant contact personnel. If they see your name cross their desk and they can place you, you have a better shot.If you plan to write numerous grants, create templates for commonly needed forms. This is especially useful for state and federal grant that repeat a lot of the same information.Be honest both in the grant proposal itself and with yourself concerning what you can actually accomplish. Remember, you have t o follow through with whatever plans you make.Other Articles

Choose a recently published policy compare to What we have learned( Research Paper

Choose a recently published policy compare to What we have learned( Roman Republic, French absolutism, French Revolution) - Research Paper Example The transformation was done through a series of civil wars. The wars were between the patricians and the ordinary Romans who were not from famous families. The policy of balanced distribution of power led to the weakening of the patrician’s power to run big government offices as bound by the law. During this period, the Roman constitution was also amended to accommodate republican form of government. The Roman republic extended due to the many alliances from Italian peninsula and central Italy as well as conquests (Holkeskamp. 47). New laws and policies that prevented individuals from obtaining permanent political powers were established. The political system became free and democratic as the constitution prevented political supremacy among individuals but supported political ideologies. This is because Rome was undergoing a political transition thus the new government system needed ideas to establish peace, political stability and development. Roman Republic was forced to ada pt to the new constitution, which was designed to promote republican form of government. After the transition, the Roman Republic introduced a set of guiding principles, which acted as a new set of policies that would ensure civilized leadership. In the new constitution, the government was divided into three sections. ... The new system of government portrayed a practice of democracy as powers were centralized in the three branches of government, which was made by a set of elected representatives from all parts of the Roman Republic. However, the republic system of government was corrupted by dictatorship rule, which led to its collapsing. Absolutism is a monarchical form of government that gives the monarch great powers and is given much reverence. However, the powers of a monarch are limited to by the need of support from the aristocracy. The aristocracy provides the monarch with political and military support thus may challenge the authority from time to time. Absolutism system of governance was associated with King Louis XIII and Louis XIV of France. This form of rule centralized powers to the monarch who was given unlimited powers by the divined law. In this case power was confined to one person who had the rights to regulate as well as change the political system and make decisions. This form of rule is prone to was as a country using absolutism can descend into a civil war after its collapse. In the French absolutism, the king’s word was considered to be law. Most of the revenue is collected and managed by the army. The French monarchy depended on farming and Agriculture as the main economic activities. In this case, farmers were taxed heavily in order to maintain the economy of the monarchy. The absolutism form of government was mainly focused on dictatorship as the ruler was granted the powers to do as he or she pleased by the law. Absolution also used natural laws which were affiliated to cultural practices thus could not create room for modern

Develop a business idea Assignment Example | Topics and Well Written Essays - 1000 words

Develop a business idea - Assignment Example However, Joparadise Flower Shop intends to do things differently to create a strong customer base and meet their needs and expectations. Therefore, the Joparadise Flower Shop will demonstrate expertise in flower arrangement and give clients great offers (Chadwick 2015, p. 62). The flower shop will focus on fresh cut flowers as well as the artificial ones and focus on occasions such as birthdays, weddings, funerals, debuts, anniversaries and other special occasions. The Joparadise Flower Shop will give its esteemed customers special offers and discounts. As mentioned above, Joparadise Flower Shop intends to do things differently. Therefore, the business will exhibit expertise in creating unique flower arrangement for customers while offering them quality flowers at reasonable prices (Daniel 2004, p. 54). Flowers by Rosemary offers expensive deals and the Joparadise Flower Shop will offer quality at a reduced price. Moreover, the Joparadise Flower Shop will combine both cut and artificial flowers in order to have a diverse customer base (Desch 2011, p. 34). Without a doubt, the Joparadise Flower Shop flower shop will surpass the expectations of customers. A close analysis of the market reveals that Joparadise Flower Shop can focus on males between the age of 20 and 60 who are likely to buy flowers for different occasions. Some of the identified occasions are weddings, birthdays, anniversaries, valentines, funerals, and other special occasions (dpala@metroland.com 2015, p. 4). Women are also potential customers, especially for funerals and anniversaries. Individuals who buy flowers are more likely to belong to the middle or upper-class society with high incomes. Therefore, they can spare a part of their income and invest in expensive flowers (Flower shops braces for busy season, 2015, p. 23). Mostly, men who purchase flowers are either married, engaged, or on committed relationships. For this reason, they are likely to buy flowers for their

Implications of Development in the Environment Essay Example for Free

Implications of Development in the Environment Essay This paper deals with the implications due to the development in Northern Canada. The effects of these developments in the environment and people are included in this paper. Also, the groups that are established to eliminate or rather reduce the pollutants emitted in the atmosphere due to these developments and their goals are stated in this paper. Northern Canada is the northernmost region of Canada which can also be called as far north that may refer to the Canadian Arctic’ the portion of Canada which is near to the north of Arctic circle. Canada is known as the largest supplier of crude oil and refined products to the United States. Different explorations are conducted to find oil wells and processed into useful products. Other industrial activities are done to add up into the economic development being raised in Northern Canada. These industrial activities are mineral extraction and processing, forest products and hydroelectric generation. Hence, these developments are the major factors that contribute in destructing the rich land of northern Canada. According to an article these industrial development continued to contaminate the soil in Canada. This contamination leads to denude the land and places that are ecologically significant in Canada’s flora and fauna. Moreover, different test methods are conducted to evaluate this contaminated soils thus, this test methods shows the toxicity of the land. Oil refineries play the foremost destruction of ecosystem. Refining oil leaves a bitumen deposit in soils. Bitumen deposits include extra heavy oils or tar sands and oil sands. Large amount of these sands are can be in Canada. These are dense and viscous form of petroleum which is naturally occurring mixtures of sand and clay. Most of these sands are can be seen in the arctic region of Canada. Accordingly, like all non-renewable resource developments projects, operations related to this mining event have a great impact in polluting the environment. The water used in the separation during the separation process is not dispose properly nor recycled by the processing plant. A large volume of water used in producing synthetic crude oil ends up in ponds. These ponds are connected to Athabasca River which is one of the largest rivers in Canada. Consequently, aside from water pollution, air is also abused in processing crude oil. Most of the petroleum is being burned this action emit carbon dioxide as well as other air pollutant. Of course the huge amount present in the air is carbon dioxide. Aside from this the other pollutants specified are carbon monoxide, nitrogen oxide, ozone, particulate matter and sulphur dioxide. These gases are highly toxic in humans it is a major treat in our health based on different studies as well as in our environment. These are the main cause of global warming that we are experiencing right now. Also, hydrogen sulfide and mercury are found to be present in burning fossil fuels and refining oil. Hydrogen sulfide is a gas that naturally occurs in crude petroleum and natural gas. As for mercury, it is associated in burning fuels. Furthermore, lands are also not safe in refining oil because oil sands are used to produce barrels of oil. This oil sands are mined which means that to be able to mine these sands clearing of trees is must be done. Removing of topsoil, sand, clay and gravel that is present in top of the oil must also be done. Climate change bound to be the major effect of these developments. As I have said earlier gases with high toxicity are emitted in land, water and air. These gases are named to be as green house gases which are huge in Canada, thus, making the environment clearly denuded. Effects of these developments vary from agricultural, forestry, infrastructure, industry, transportation, water resources, marine ecosystem and terrestrial ecosystem. Since soils are widely affected a lot of aspects with regards to soil greatly suffered. Soils and climate conditions in the North of Canada are now unfavorable to agricultural production. Somehow, hope has its chance for in some areas in Yukon have been seen that there is a moderate capability in terms of agriculture but this takes a long term of cultivation and longer growing seasons may increased the risk of greenhouse production. Moreover, this production is limited due to soil condition. Forestry is also greatly affected. This deals with the hunting and gathering of people. Although forestry is a small contributor in their economy, it plays an important role for them because there is an interest in the growth of this part. Due to extreme heat that we are all experiencing forest fires particularly in Yukon has been emerging in the past few years. This event is expected to continue if developments do not prioritize our environment also. Excessive heat also triggers the stability of transportation and infrastructures in Northern Canada. In some areas, permafrost melt increase the risk of landslides that can cause unwanted damages. It also threatens the water supply, foundation of old buildings and waste disposal infrastructure. Since it is in the Arctic region, it was quite icy there therefore permafrost melting may cause the buckling of pipes and storage tanks that are used in water and sewage. Roads also rely on the ground stability. Transportation in most areas in north relies in this stability. Warmer winters made transporting goods to the communities more difficult because ice roads are freezing later then suddenly melts earlier during spring. Accordingly, this problem will increase if the temperature continues to rise. Economic Impacts are also inter related in climate change, this phenomena has a deep impact in the commercial and industrial activity of Northern Canada. This unfavorable change in weather could require costly upgrades and redesigning of dams structures in mining industry. This can also hinder explorations of oil well which is somehow good and bad. Good, because it means that there will be a reduction in greenhouse gases emitted in the atmosphere. It is bad, because as I stated a while ago oil exploration and refineries is the major factor in economic abundance of Canada. In addition, water resources are also significant in North Canada. The hydrology of North Canada is at risk because an increase in temperature will also increased the possibility of melting of snow and ice. Peat lands may dry out because of increased evaporation and plant transpiration. This climate change may affect hydropower generation in the Yukon. Effect is uncertain; increasing amount of water runoff may boost the capacity of hydropower, while possible heavy storms may reduce its potential. Also, due to the problems arise together with the developments. Thickness of sea ice is also in line with the devastating threats that these developments brought up. Du to climate change extent and thickness of sea ice are expected to reduce in many areas of the arctic. The victims here are those animals that are dependent or those who are living in these areas. These animals include polar bears, walrus and seals. However it may be an advantage as it becomes open water. But it was very unfortunate to those animals. Thus, this is important to all that are included in marine ecosystem because their entire food chain relies on the abundance of plankton and other microorganisms. If the thickness and distribution of sea ice are affected this will be a vast tragedy in the whole marine food chain. Terrestrial ecosystems are also not safe in these changes. Species composition varies as the temperature continues to warm or suddenly change. Due to this extreme heat, parasites and other insect bone disease continue to promulgate in the land infecting the animals that leads to declination of animal population. In addition, since northern Canada is near arctic region warming the region is not a good sign for those animals that are herbivores. Most of the plants are suddenly dying due unwanted climate change, so an herbivore animal will look for their food in other place making them move in other places where they can get their food. As a result those carnivorous animals follow them because they are their prey. This is not a good sign for a country because they will not able to preserve their wildlife. For birds, it is somehow a good sign for them because they can decrease their chick mortality thus; this may decrease the foraging ability of migrating birds. I suppose these changes in marine ecosystem, terrestrial ecosystem, etc mostly affect the traditional lifestyle of Canadians especially those who are in north. It greatly affects their hunting and gathering practices and threatened their long existing traditions. Uneven increased of temperature makes the animals leave and find a more comfortable habitat. Numbers of these animals in particular fishes and plants species greatly affect those people that rely on these; the indigenous people. These probably leads to their traditional way of living such as hunting and harvesting moreover, those traditional foods they eat or sell might be lost now. These changes however are being taken care of different agencies of the government of Northern Canada and other civilian groups that are concern in preserving our environment. Based on an article, several test methods are used to monitor the toxicity of soil in North Canada. They examine the soils to assess or detect the toxic wastes present in that soil. And they identify them individually. These several tests are done for them to develop a better risk assessment plan to punish those polluters and to maintain the rich resources of Canada. Industry sectors are also mandated to provide effective remediation methods at contaminated areas and to monitor every progress that complies with environmental policies. Arctic Council Action Plan to Eliminate Pollution of the Arctic (ACAP) and Arctic Monitoring and Assessment Programme (AMAP) are two of the leading bodies that protect the environment. Their goal is to reduce emissions of pollutants present in the environment and they encourage Arctic governments to make preventive actions that relates in reducing pollutants that are released by processing plants. Conservation of Arctic Flora and Fauna is also one the concern of the citizens of northern Canada. This deals with the conservation of Arctic ecosystems and habitats. Its goal is to maintain and enhanced the integrity of ecosystem in the Arctic and to avoid the degradation and fragmentation of habitats. The scope of their goal is not just only the flora and fauna of the Arctic thus, they include the physical environment and the socio economic environment of those people who live there. Another is the Emergency Prevention, Preparedness and Response (EPPR) Group. This group deals with as they were called, prevention, preparedness and response to environmental emergencies in the Arctic caused by human activities. And the last group would be Protection of Arctic Marine Environment (PAME). This group deals with the protection of Arctic marine environment. It is directed to respond to emerging knowledge of the Arctic marine environment, determine the adequacy of regional or international commitments and promote their implementation and facilitate program and cooperation and support communication, reporting and outreach both within and outside the Arctic Council. Somehow this leads to only one thing, government and industry sector are required to create a strong array in creating methods that appraise the risks that could lead to massive destruction of our environment. Reference Biological Methods Section and ST Liaison Protecting. Canadas Boreal Forests and Northern Ecosystems: Developing Biological Methods to Assess and Preserve Canadas Soil Environments of the North. Retrieved: July 5, 2010. From: http://www. ec. gc. ca/scitech/default. asp? lang=Enn=4B40916E- 1xsl=privateArticles2,viewfullpo=3AB28EB3

The Most Traumatic Night of My Life :: essays papers

The Most Traumatic Night of My Life It happened about a month ago on a warm Tuesday night in august. Nothing seemed out of the ordinary, but I was soon to find out differently. I was about to experience the most traumatic event of my life. I was at my boyfriend Will’s band practice in downtown with him and his three friends. We decided to go check out some abandoned rooms in the old, run down three-story apartment building in the search of cool stuff for their practice spot. We walked into one room that turned out to be an old after hours club that was no longer in use. There were some useful things, someone grabbed a couple chairs, someone else took a couple speakers that looked like they would still work, and I carried a full-length mirror. As we proceeded into the hallway, I led followed by the rest of the crew and we headed back to their room. When we were about ten feet from where I was going to put the mirror down, for some reason the mirror just broke in half in my hand. I tried saving the other half from smashing on the ground and a jagged piece sliced deep into my wrist. Everyone saw the mirror smash but didn’t realize what had happened to me. I could barely speak. I was so shocked I just pointed down to my wrist. It all happened so quick probably in a matter of about 5 seconds. Every time my heart beat, blood would gush out of the wound. Everyone was talking to me but their words were sort of blurred together. My boyfriend took his shirt off and wrapped it tightly around my wrist. He said to hold my arm above my heart to slow the bleeding. Luckily we were only about five minutes away from Mercy Hospital. So we got in the car I was feeling really light headed and was afraid I would pass out. My mother used to work in the emergency room so I got in pretty quickly. I was still in horrible pain though. Then a nurse came in and put an antiseptic liquid on my wrist I asked her what it was for and she said â€Å"the doctors going to be in soon to stitch you up.

Department of Planning Essay

Prescribed Text There is no prescribed text for this course. Course materials will be provided electronically via Cecil. Lecturers will provide additional reading lists for their particular sections of the course. Preparation Approximately 1 hour preparation is expected for every one hour of class time. You will be required to complete readings allocated in class, in preparation for the next class. However, students are encouraged to add time for background reading. This is particularly important for international students and students for whom English is not their first language. Course Assessment Course assessment is comprised of: Law Assignment (15%)Friday 23 August 2013 at 10AM Class Test (15%)Friday 30 August 2013 at 9AM (1 hour) Politics Essay (20%)Thursday 17 October at 10AM Examination (50%)3 hour examination scheduled for the end of semester 2 When submitting assignments and essays, please use the Planning cover sheets provided beside the assignment hand-in boxes on level 4. Please ensure that you read the academic policies and procedures information in the Planning Undergraduate Handbook at the outset of this course. You will be treated as having read this information. Brief Description of the Course Content This course introduces students to key aspects of New Zealand’s legal system. This is complemented by consideration of the development of local government legislation and by comprehensive discussion of the functions and relationships between essential institutions of a representative democracy. Treaty of Waitangi issues are an integrated aspect of this course. Learning Outcomes The learning outcomes of this course include: * acquisition of basic statutory interpretation skills and case law analysis; * an understanding of the core structure, processes and issues inherent in the New Zealand legal system; * an overview of local government reform since 1989; * an understanding of the relevance of the Treaty of Waitangi to institutional and legal frameworks in New Zealand; and * an understanding of key political institutions and processes in New Zealand. Structure Julia Harker will begin the course by lecturing on the New Zealand legal system. This will be followed by a series of lectures given by Ian Munro on local government. After the mid-semester break, Vernon Tava will give a series of lectures on the New Zealand political system. Lena Henry will take the remainder of the course, lecturing on Treaty of Waitangi issues. Reading list relating to the New Zealand Legal System In addition to the prepared course materials: R Miller (ed) New Zealand Government and Politics (OUP, 4th ed, 2006), in particular: Part B – chapters 2.1, 2.2, 2.3, 2.4 and chapter 3.7. Webb, Sanders and Scott The New Zealand Legal System: structures, processes and legal theory (Butterworths, 5th ed, 2010). R D Mulholland Introduction to the New Zealand Legal System (Butterworths, 10th ed, 2001). G Palmer Unbridled Power (OUP, 1987). G Palmer and M Palmer Bridled Power (OUP, 2004). K Palmer Local Authorities Law in New Zealand (Brookers, 2012). See The Constitution Conversation website for resources

Blood vessel Essay

Identify at least five organ systems in this region of the arm that the surgeon would have marked for reattachment. 2. List the names of the specific structures that had to be reattached. 3. What organ system was most likely not reattached? Explain. 4. Why was a clean bite so important? 5. Why was the bone shortened? 6. Identify the movements associated with the arm, forearm, wrist, and fingers. 7. Explain how the movements of the reattached arm might be altered after the reattachment. 8. Define collateral circulation and identify the regions of collateral circulation that would be found in the upper extremity. 9. Identify the specific vessels that provide the collateral circulation to the elbow. 10. Identify specific types of activities that might cause Jim problems after recovery. 11. Why would full use of his arm be unlikely? 12. Assume the role of the surgeons as they explain the procedure to Jim’s parents. Write a one- to two-paragraph explanation about the surgery, paying particular attention to what you would say about regaining use of his arm, forearm, and hand. 13. Assume the surgery to reconnect blood vessels was successful and blood flow was re-established immediately throughout the arm. Would the nerves of the arm recover as quickly and completely as the muscles? Explain why or why not. 14. How might this situation have been different if Jim had been 80 instead of 8 years old? Source: National Center for Teaching Case Studies in Science

Impromptu Speech Activities for Elementary Students

Impromptu Speech Activities for Elementary Students Learning how to deliver an impromptu speech is part of meeting the oral communications standards. Use the following activities to help students practice their presentation skills. Activity 1: Speech Fluency The purpose of this exercise is for students to practice speaking clearly and fluently. To begin the activity, pair students together and have them choose a topic from the list below. Next, give students about thirty to sixty seconds to think about what they are going to say in their speech. Once they have gathered their thoughts, have students take turns presenting their speech to one another. Tip - To keep students on track, give each group a timer and have them set it for one minute for each presentation. Also, create a handout that students must fill out after their speech to give their partner feedback on the positives and negatives of their presentation. Possible Questions to Include in the Handout Was the message clear?Were the ideas organized?Did they speak fluently?Was their audience engaged?What can they do better next time? Topics to Choose From Favorite bookFavorite foodFavorite animalFavorite sportFavorite school subjectFavorite vacationFavorite holiday Activity 2: Impromptu Practice The purpose of this activity is for students to gain experience delivering one to two-minute impromptu speech presentations. For this activity, you can put students into groups of two or three. Once the group is chosen, have each group select a topic from the list below. Then allow each group five minutes to prepare for their task. After the five minutes is up, each individual from the group takes turns delivering their speech to the group. Tip- A fun way for students to get feedback is to have them record their presentation and watch (or hear) themselves on tape. The iPad is an excellent tool to use, or any video or audio recorder will work just fine. Topics to Choose From Any of the aboveGood newsExplain the rules of your favorite gameExplain how to make your favorite mealExplain your daily routine Activity 3: Persuasive Speech The purpose of this activity is for students to gain knowledge on how to give a persuasive speech. First, use the list of persuasive language techniques to give students examples of what should be included in their speech. Then, group students into pairs and have them each choose a topic from the list below. Give students five minutes to brainstorm a sixty-second speech that will persuade their partner to their point of view. Have students take turns delivering their speeches and then fill out the feedback form from Activity 1. Tip- Allow students to jot down notes or key words on an index card. Topics to Choose From Any current eventConvince listeners why you should be the presidentTry to sell the listeners the clothes you are wearingConvince the teacher to not give homework for a weekTry to convince the school board why they should have better food in the cafeteria Persuasive Language Techniques Emotional appeal: The speaker plays on peoples emotions, can manipulate the reader by triggering an emotional response.Descriptive language: The speaker uses words that are lively and vivid and engages the reader by inducing an emotion or producing a picture for them.Emotive language: The speaker uses language that plays on peoples feelings. There is a deliberate use of words to provoke an emotional response.Inclusive Language: The speaker uses language that engages the audience and sounds friendly.Alliteration: The speaker uses the same letter in two or more words to persuade by adding emphasis and reinforcing the meaning. (ex. cruel, calculating, and crooked)

The History of the Kitchen Blender

The History of the Kitchen Blender In 1922, Stephen Poplawski invented the blender. For those of you who have never been in a kitchen or a bar, a blender is a small electric appliance that has a tall container and blades that chop, grind, and puree food and beverages. Patented in 1922 Stephen Poplawski was the first to put a spinning blade at the bottom of a container. His beverage mixer blender was developed for the Arnold Electric Company and received Patent Number US 1480914. It is recognizable as what is called a blender in the United States and a liquidizer in Britain. It has a beverage container with a rotating agitator that is placed onto a stand containing the motor that drives the blades. This allows drinks to be mixed on the stand, then the container removed to pour out the contents and clean the vessel. The appliance was designed to make soda fountain drinks. Meanwhile, L.H. Hamilton, Chester Beach and Fred Osius formed the Hamilton Beach Manufacturing Company in 1910. It became well known for its kitchen appliances and manufactured the Poplawski design. Fred Osius later began working on ways to improve the Poplawski blender. The Waring Blender Fred Waring, a one-time Penn State architectural and engineering student, was always fascinated by gadgets. He first achieved fame fronting the big band, Fred Waring, and the Pennsylvanians, but the blender made Waring a household name. Fred Waring was the financial source and marketing force that thrust the Waring Blender into the marketplace, but it was Fred Osius who invented and patented the famous blending machine in 1933. Fred Osius knew that Fred Waring had a fondness for new inventions, and Osius need money to make improvements to his blender. Talking his way into Fred Warings dressing room following a live radio broadcast in New York’s Vanderbilt Theatre, Osius pitched his idea and received a promise from Waring to back further research. Six months and $25,000 later, the blender still suffered technical difficulties. Undaunted, Waring dumped Fred Osius and had the blender redesigned once again. In 1937, the Waring-owned Miracle Mixer blender was introduced to the public at the National Restaurant Show in Chicago retailing for $29.75. In 1938, Fred Waring renamed his Miracle Mixer Corporation as the Waring Corporation, and the mixers name was changed to the Waring Blendor, the spelling of which was eventually changed to Blender. Fred Waring went on a one-man marketing campaign that began with hotels and restaurants he visited while touring with his band and later spread to upscale stores such as Bloomingdale’s and B. Altman’s. Waring once touted the Blender to a St. Louis reporter saying, †¦this mixer is going to revolutionize American drinks. And it did. The Waring Blender became an important tool in hospitals for the implementation of specific diets, as well as a vital scientific research device. Dr. Jonas Salk used it while developing the vaccine for polio. In 1954, the millionth Waring Blender was sold, and it is still as popular today. Waring Produces are now a part of Conair.

Lost in Digital Wonderland Finding a Path in the Global Knowledge Essay

Lost in Digital Wonderland Finding a Path in the Global Knowledge Society - Essay Example Such a transformation took place mainly due to the increased need for innovation. As the rate of trade dealings is enhancing in the entire globe, the ratio of competitiveness is also expanding. However, in order to cope up with such type of competitive needs or demands of the citizens, the labours or the producers need to develop highly extensive abilities and knowledge (Max-Planck institute for history and science, n. d.). Such type of demanding skills and knowledge might be attained only through varied types of learning programs, training programs such as on-the –job, household trainings etc. Only then, the employees or the individual might easily cope up with the risks or changing demands of the citizens in global economy. By doing so, the producer or the employees might position itself as a successful individual or organization in this global knowledge society as compared to others. Knowledge is described as a resource that helps to generate values and creativity. In this age of digitalisation, it is the knowledge that helps in enhancement of the dealings of trade leading to economic growth and development of a nation in the entire globe among others. Other than this, it is the knowledge that helps an individual entrepreneur to cope up with the changing requirements of the citizens by presenting inventive products. However, the inventive products are mainly developed with the help of new ideas and suggestions as well as advanced technologies (Huws, 2005). Only then, the employer or the employees in this revolutionary age might create a specific position for itself. Thus, it might be stated that knowledge is the prime requirement of an employee or employer to tackle global competitiveness. Knowledge society is recognised as a place, where all sorts of activities or actions take place with the help of both tacit and codified knowledge. Both tacit as well as codified knowledge is utilised in order to perform the knowledge works in this information age

Employee engagement is crucial for effective, corporate decision Essay

Employee engagement is crucial for effective, corporate decision making. Discuss using examples from two global companies - Essay Example Employee engagement profoundly affects an employee’s willingness to learn, cooperate, and work together with others (Karsan & Kruse 2011). Employee engagement can therefore be identified as a fundamental element of teamwork. Engagement should, however, not be confused with satisfaction and motivation. Different individuals might find parts of their job which offer satisfaction and motivation yet they might not be fully engaged. The concept of employee engagement remains an essential element of business management, which can effectively assist in corporate decision-making. Employee engagement could be defined as the willingness and ability for employees to assist the organisation to succeed, through offering discretionary effort, continuously (Wellins et al. 2005). Business decisions regarding human resource can be effectively undertaken through the understanding of various aspects of employee engagement. The element of engagement could be measured through the continuous mo nitoring of individuals behaviour, consequently understanding their engagement to work related activities (Seijts & Crim 2006). Proper knowledge of the engagement level possessed by employees can assist human resource management decisions by identifying individual’s skills and motivators. ... Employees to stay within the organisation commonly display the employee commitment through the desire. Many international corporations engage in the assessment of employee engagement in enhancing the decision-making process. This enables the corporations to make informed business decisions regarding the organisational operations. There are several aspects of employee management which managers must undertake in order to ensure their employees remain engaged to their respective jobs. Among these drivers of employee engagement, the top three could be identified as management’s interest in employee well-fare, work related challenges, and the decision making authority (Saks 2006). Employee engagement notable among many employees remains the capacity to fell valued and involved within the company operations. This significantly concerns the decision-making process utilised within an organisation. Involvement of employees in decision making helps in increasing their morale. Conseque ntly, the ultimate results of decision-making involvement are increased engagement of employees with corporate operations. The involvement of employees in decision-making includes seeking their opinions regarding various issues surrounding corporate operations. Though their ideas might not be implemented, the thought of having voiced their ideas becomes a source of encouragement. Managers remain the key to achieving engagement of an entire corporate workforce. In achieving considerable engagement of employees the managers must undertake various responsibilities aimed at improving the morale of employees (Baumruk & Gorman 2006). Firstly, managers

Information Technology Application in Marketing Essay

Information Technology Application in Marketing - Essay Example Facebook, unlike other social networking websites, has a clearly defined target market that starts from students who are enrolled in high schools, college and university. The differentiating factor for Facebook is that it is all focused towards students only through creating study groups, keeping in touch with distant friends and getting information. Students use it to make their social life prominent through using various features of Facebook such as uploading, sharing and commenting on photos. Facebook earns its profit mainly through advertising. It gets involved in three different ways of advertising. One is banner ads, sponsored groups and text announcements. The visitors’ traffic and the time spent on the site also serve as a major indicator for Facebook success (Mitchell, n.d.). GOOGLE Another social media website selected is Google. Google is the most visited website that provides solutions and answers for almost all the questions through its search optimization system. Google is primarily a search engine and serves almost everyone in thirst of some knowledge or information regarding anything. Google generates its profits through online advertising (Channel 4, 2012). Google has involved in an activity called targeted advertising through which organizations use Google Adwords and Adsense to get their names or articles to get displayed on the top (Splatf, 2011). WIKIPEDIA Wikipedia is another social media network that helps individual to gain information on related topics. The business model that Wikipedia has implemented is that people who love to write and want to make their contribution can write an article and then hence upload it. Wikipedia provides a feature to make amendments to article or edit it. And even if any conflict is observed in the provided information it is then resolved by Wikipedia resolution party. The writers or authors here are voluntary writers. They do not do it for any monetary rewards but for internal satisfaction and inte rest. Wikipedia has some donors as well who provide funds to the site, and they are called wiki donors. Wikipedia does not display advertisements as other sites do and also does not charge any subscription fees. It still earns through the web traffic it has, and the number of time spent on the site by each visitor. It does not employ more than 35 employees in its organization and has managed to reduce its administration and operation costs to the least. Sustainability of the models All these three sites are sustaining because of the differentiated service and user interface experience they provide. The value that they are providing to their users is of immense importance. Their business models are different from others and quite uniquely profitable in nature. Facebook earns through its online advertising whereas Google earns through its online search optimization and its own advertising techniques and Wikipedia earns profits through minimizing its overhead cost. Future of Social Med ia Sites The future of these sites would be a more co-operative and user friendly one. These sites would progress now more towards working on virtual reality and making some efforts towards surprising users through adding features more inclined towards 3D virtual reality. How Social media sites are adapting to cell phones and PCs As technology is advancing, access to these websites is to be made from multiple devices that are

Case Study On A Patient With Pulmonary Tuberculosis

Case Study On A Patient With Pulmonary Tuberculosis The case that is about to be discussed here revolves around a patient diagnosed with pulmonary tuberculosis. The patient that was clerked, Mrs A, was a 61 year old woman. She was a Malay housewife. Her Body Mass Index value of 26.0 kg/m2 based on her height of 1.58 m and weight of 65 kg indicated that she fell into the overweight range. The patient was admitted to the Accident Emergency mode transferred in from another hospital via an ambulance. She presented symptoms such as shortness of breath(SOB) and her respiratory rate was 20 breaths per minute. She appeared pale and weak and her blood glucose levels were low (2.1 mmol/l) and her blood pressure values indicated she was hypertensive with a value of 152/93 mmHg. Upon physical examination, mild leg swelling was observed. Based on her past medical history, patient was diagnosed with pulmonary tuberculosis for the past 3 months, hypertension for the past 5 years, diabetes for the past 5 years and advanced renal failure for the past 6 months. Upon enquiry, she was seen to be a non-smoker and a non alcoholic. Patient lived with her daughter. Several investigations were performed to evaluate the patients condition. A positive sputum smear test indicated that the patients tuberculosis was still active. Upon renal function assessment, creatinine clearance was calculated and a value of 5.5 ml/min indicated Stage 5 renal failure. Her potassium and urea levels were also above range based on Table 1. Upon haematology assessment, her low blood sugar levels indicated hypoglycaemia and patients haemoglobin count was also low signifying anemia. Chest X ray was conducted on this patient and minor lesions at the apical segments of the upper lobe were seen. This is a typical radiographic representation of patients with tuberculosis. Table 1: Results of the investigations performed Laboratory Test Readings Normal range Sputum Smear Test Positive Renal Function Creatinine, Cr Urea Potassium, K+ 912 ÃŽÂ ¼mol/l 37.8 mmol/l 5.5 mmol/l 44-80 ÃŽÂ ¼mol/l 1.7 8.5 mmol/l 3.5 5.0 mmol/l Haematology Assessment Blood Sugar Level Haemoglobin 2.1 mmol/l 9.8 g/dl 4.5 6.0 mmol/l 13.5 18 g/dl Table 2 provides details about patients drug history giving information about patients drugs and their respective doses. Upon interview, patient informed that she had not been purchasing any over the counter medications. She also has no known drug allergy. Table 2 : Drug History and their respective doses and their indication Drug Dose Duration Indication Rifampicin 300 mg OD 2 months Anti TB Isoniazid 200 mg OD 2 months Anti TB Pyrazinamide 750 mg OD 2 months Anti TB Ethambutol 600 mg OD 2 months Anti TB Pyridoxine 20 mg OD 2 months Treatment of neuropathy Gliclazide 40 mg OD 5 years Anti diabetic Prazosin 2 mg TDS 5 years Anti Hypertensive Furosemide 80 mg OD 5 years Anti Hypertensive Nifedipine 20 mg TDS 5 years Anti Hypertensive Based on the investigations performed, the patient was diagnosed to be suffering from pulmonary tuberculosis and diabetes mellitus. Patients daily condition was monitored and appropriate management was undertaken to control the patients condition. Patients overall progress is tabulated in the table 3 and the observation is recorded. Table 3 : Patients clinical progress and management Day Clinical Progress Management 1 Hypoglycemia = 2.1 mmol/L AFB test positive Chest X ray performed SOB Hyperkalaemia ( 5.5 mol/L) Anemic ( 9.8 g/dL) BP : 152/93 mmHg Strict fluid intake IV Dextrose 10%/24 hours Refer to chest physician Lesions at upper lobes NPO2 to resolve SOB Start on Calcium polystyrene Start Ferrous (IV) sulphate Start antihypertensives Monitor input output 2 AFB test +ve Blood Sugar Level = 3.0 mmol/L BP : 140/90 mmHg Start TB regimen (EHRZ) Continue IV Dextrose 10% Monitor Blood Glucose Continue antihypertensives 3 Blood Sugar level = 3.2 mmol/L Severe renal impairment ( CrCl =5.6 ml/min ) Chest X ray done time to time BP : 130/70 mmHg Continue dextrose infusion Send patient for dialysis Lesions still present Continue antihypertensives 4 No SOB Hypoglycaemia resolved = 5.5 mmol/L AFB +ve BP : 130/75 mmHg Remove nasal prongs Stop Dextrose. Monitor blood glucose Continue TB regimen 6 K+ level in normal range ( 4.5 mmol/L) Blood Sugar level = 6.0 mmol/L CrCl = 7.7 ml/min BP : 130/65 mmHg Stop Calcium polystyrene. Monitor blood glucose Send patient for dialysis 8 Hyperglycemia = 11.1 mmol/L BP : 125/75 mmHg Start on Insulin DM counselling 13 AFB -ve DXT = 10.2 mmol/L BP : 120/70 mmHg Transfer out of isolation Continue insulin. Monitor blood glucose Based on patients presentation and results from investigations performed on day 1, patient was started on dextrose and her blood glucose levels were regularly monitored. Based on patients previous history, a sputum smear test was ordered and two consecutive positive results resulted in the patient being referred to the chest physician. A chest X ray was performed and lesions in the apical segment were present. To resolve patients SOB, patient was started on Nasal Prongs at 3L/min. To control her hyperkalemia, patient was given calcium polystyrene sulphonate powder. Patient was also started on ferrous sulphate infusion to help her cope with her anaemia. A strict fluid intake was imposed on patient to resolve her leg swelling and this was monitored through an input output chart. Her blood pressure (BP) levels were also elevated and patient was given antihypertensives such as nifedipine, prazosin and furosemide to control her BP. On day 2, her sputum smear remained positive and patient was commenced on the intial phase therapy for tuberculosis which consists of isoniazid, rifampicin, pyrazinamide and ethambutol. There was not much improvement in her blood glucose levels and patient was remained on the dextrose infusion. Moving on to day 3, not much improvement was observed and due to patients deteriorating renal function, patient was sent for peritoneal dialysis. By day 4, patient could breath normally and no shortness of breath was seen. Nasal prongs were removed. When her blood glucose levels were monitored, the results indicated patient was within the normal range and dextrose was withheld. Blood glucose levels were still monitored to prevent sudden drops and increase in blood glucose. Her potassium levels were within range by day 6 and calcium polystyrene sulphonate was stopped and potassium levels were monitored as well. Patient suffered from a hyperglycemia episode on day 8 and the patient was given biphasic insulin to treat this condition. By this day, her BP was also in the normal range but the antihypertensives were still continued. On day 13, patient was transferred out of the isolation ward as her sputum smear test produced negative results. Patients condition for tuberculosis was still being monitored. Her blood glucose levels were still in the high range and patient was to be continued on insulin. To summarize this case, patients active tuberculosis state should be managed well to ensure patient does not suffer from further complications that might arise in the future. Patients history was well noted and this helped in treating the patient in early stages. Adequate investigations were performed to assist the healthcare professional team to diagnose the patient and also to manage the patient. Patient was admitted for a long period but the appropriate management that was undertaken resulted in improvement in patients condition. Further care for the patient would improve the patients quality of life in the future Pathophysiology and Incidence Tuberculosis (TB) is an infectious disease that has plagued many nations across the world. Based on the report by World Health Organization (WHO), almost 9.4 million cases of TB were reported 3. It is highly common of those with TB to contract the Human Immunodeficiency Virus (HIV) and a prevalence of almost 1.7 million deaths from TB among HIV-negative people was recorded around the globe 3. In the United Kingdom, an increasing trend in TB incidence has been reported and this is shown in Figure 1. In 2008, a rate of 14 per 100 000 population in the UK were reported to be suffering from TB 4. Malaysia on the other hand has a higher record of TB cases with 103 per 100 000 population being reported in 2007. Table 1 summarizes some of the data obtained from World Health Organization 3. Figure 1: Number of TB cases reported in the UK from 2000 to 2008 4 Table 1: Statistics displaying number of TB cases in Malaysia in 2007 3 All In HIV + people Incidence All forms of TB (per 100 000 population) 103 17 Mortality All forms of TB (per 100 000 population) 121 8.3 Multi-drug Resistant TB (MDR-TB) MDR-TB among new cases (%) 0.1 Notified relapse cases (per 100 000 pop/yr) 61 The bacteria that is responsible for this disease is the acid fast bacilli aerobic bacterium Mycobacterium tuberculosis 1. A key feature that enables this bacterium to survive would be its unique cell wall. Mycolic acids are linked covalently to arabinogalactan that provides a barrier to host defense mechanism. Antigens such as lipoarabinomannan present on the exterior of the cell wall facilitate the survival of the organism within macrophages 1. Tuberculosis is spread usually spread within droplets containing the microorganism that are produced when an infected person coughs, sneezes or even talks 1,2. Figure 1 gives a schematic impression of the progression of the disease. The inhaled droplets are initially trapped by dendritic cells that act to expel any foreign particles out. Most mycobacteria are able to surpass this defense mechanism and travels further to the alveoli where it gets ingested by macrophages 1. It then undergoes intracellular replication that might take duration o f 4 to 6 weeks. Cytokines are further released during this period and this attracts T lymphocytes that are involved in mediating a cell immune response. The next natural defense system step would be the formation of granuloma that contains the activated T lymphocytes and macrophages. These nodular lesions disable further spread of the disease as the environment within restricts the growth of the bacilli and a latent period occurs 1. For less immunocompetent individuals, the granuloma will not be able to contain the bacilli and the active disease takes form 1. Figure 1: Image depicting the progress of tuberculosis 2 The diagnostic tests available are summarized in Table 2. TB can be divided to latent and active and to diagnose each different test has been recommended. For latent TB, Mantoux test can be carried out and those with positive results can be considered for QuantiFERON TB test 5. To diagnose active pulmonary TB, a chest X-ray would be taken followed by multiple sputum samples that are sent for smear test 5. Table 2: Diagnostic tests available for tuberculosis 1 Variable Purpose Time required for results Sputum smear Detect acid fast bacilli Sputum culture Identify M tuberculosis 3-6 weeks with solid media, 4-14 days with high-pressure liquid chromatography Tuberculin skin test/ Mantoux Detect exposure to mycobacteria 48 72 hours QuantiFERON TB-test Measure immune reactivity to M tuberculosis 12 24 hours Chest radiography Visualize lobar infiltrates with cavitation Minutes The drugs that are commonly used in tuberculosis are isoniazid, rifampicin, pyrazinamide and ethambutol. Rifampicin is a bactericidal agent that inhibits RNA synthesis by binding to the ß subunit of RNA polymerase. It can be given via oral administration and can even be distributed to the central nervous system due to its lipophilicity. Metabolism of this drug occurs in the liver and it is usually excreted in the urine. Isoniazid is a bactericidal pro-drug that inhibits ketoenoylreductase enzyme, InhA, that is responsible in synthesizing mycolic acids. Isoniazid can be administered orally, intramuscularly or intravenously and is acetylated in the liver and subsequently excreted in the urine. Pyridoxine 10 mg is given concurrently to minimize this risk. Pyrazinamide is another prodrug that is activated by nicotinamidase to pyrazinoic acid. This component at low pH carries proton into the cell and collapses the proton motive force present in the mycobacterium which results in cell d eath. It is only bactericidal against non growing bacilli forms.. Ethambutol works by binding to arabinosyl transferase enzyme and inhibits the polymerization of the cell wall arabinan component. Table 3 gives the details of the dose and side effects reported with the administration of the tuberculosis drugs. Table 3: Tuberculosis drugs with their respective doses and side effects 6,7 Drug Dose Side effects Isoniazid 5 -8 mg/kg (max 300 mg) Peripheral neuropathy, hepatotoxicty Rifampicin 10 15 mg/kg (max 600 mg) Nausea, vomiting, thrombocytopenia, orange discolouration of urine Pyrazinamide 20 40 mg/kg ( max 1.5 g 50 kg) Nausea , vomitting, hyperuricemia Ethambutol 15 25 mg/kg Neuropathy, red green color blindness Evidence based medication review Treatment for Tuberculosis In the past three decades, no new drugs have been discovered in fighting TB. The 4 drugs have been the gold standard in treating TB The chemotherapy regimen available for tuberculosis therapy can be divided to the initial phase and the continuation phase. In the initial phase, drugs such as rifampicin, isoniazid, pyrazinamide and ethambutol are used 6. These drugs act to decrease the amount of bacteria present and also prevent resistance from emerging from the strains. This regimen is usually for 2 months. The continuation phase would consist of drugs such as isoniazid and rifampicin. Isoniazid was the first drug to be introduced into combating tuberculosis back in the 1950s. Rifampicin , an antibiotic, was later added to the market and was added to the isoniazid regimen in 1967. This resulted in shortening the duration of treatment from 12 months to a 6 to 9 month treatment 9. Addition of pyrazinamide to the regimen decreased the chemotherapy duration further. Clinical studies have indicated that a pyrazinamide containing short course regimen had a sputum negative conversion rate of 70-95% in the first two months compared to the treatment without pyrazinamide 11. The relapse rates recorded from these studies also were only 4%. A clinical study conducted in East Africa compared the four 6-month daily regimens that comprised of Streptomycin, Isoniazid and Rifampicin (SHR), Streptomycin, Isoniazid and Pyrazinamide (SHZ); Streptomycin, Isoniazid and thiacetazone (SHZ) and Streptomycin and Isoniazid (SH) 10. The SHZ regimen that was the most effective amongst all the regimens and the SHR regimen had the lowest relapse rate of 2% 30 months post treatment 10. No significant difference results were obtained from the treatment regimen that was carried out for 18 months 10. This study gives an impression of the efficacy of the isoniazid, rifampicin and pyrazinamide regimen when used together In a Poland study, the efficacy of the 4 different drug regimens containing rifampicin, isoniazid and ethambutol were assessed. During the initial phase, patients were given isoniazid 300 mg, rifampicin 600 mg and ethambutol 25 mg/kg 8. In the continuation phase the regimens given to patients comprised of rifampicin 600 mg, isoniazid 15mg/kg(Regimen A), isoniazid 15 mg/kg rifampicin 600 mg twice a week (Regimen B), Isoniazid 15kg/mg, rifampicin 600 mg ethambutol 50mg/kg once a week (Regimen C) and Isoniazid 15mg/kg, rifampicin 600 mg, ethambutol 50mg/kg twice a week (Regimen D) 8. The result of this study demonstrated that Regimen D had 47% of its patients displaying a significant change in their sputum result to a negative result compared to the other regimens. There were no significant differences in rates between all regimens by the end of the fifth month as all patients had their sputum converted to negative. This study had the limitation of not including pyrazinamide in its regi men but it can be seen that to achieve a quicker rate of sputum negative cultures a regimen containing ethambutol could be used in the continuation phase. A trial conducted by Jindani et al. assessed the effectiveness of daily dosing of the intial phase drugs compared to the intermittent thrice weekly dosing. The drugs that were assessed were isoniazid, rifampicin, pyrazinamide and ethambutol. The doses that were given to the patients were based on WHO recommendations. The outcome measured after 2 months had 77% of the patients with negative sputum cultures after their 2 month stint (p=0.001) 13. A similar study was conducted in Hong Kong with the difference being a 12 month follow up period. By the end of the second month, 94% of patient receiving the daily regimen had improved. 90% of those under the intermittent regimen also had improved by the second month. Over the long term follow up, more relapse cases were recorded but the values were not significant 14. Hypoglycemia Treatment Patient was hypoglycemic upon arrival and dextrose infusion was provided to restore the patients normal blood glucose range. Two forms of treatment are usually available for hypoglycemic attacks namely glucagon and dextrose infusion. A study compared the efficacy between both the options and it was observed that both were capable of treating hypoglycemia effectively. The only disparity observed was the recovery. Patients on dextrose infusion are capable of regaining consciousness by 4 minutes compared to 6 minutes for patients that were on glucagon ( p Table 4 : Results of 51 hypoglycemic patients treated with dextrose 10% and dextrose 50% 27 Dextrose 10% Dextrose 50% Median time needed to attain recovery (minutes) 8 8 Median total dose administered 10g ( p 25g (p Median post treatment blood sugar levels 6.2 mmol/l (p=0.003) 9.4 mmol/l (p=0.003) Diabetes Treatment Oral antidiabetic agents such as gliclazide in the patients drug history would not be sufficient for her to have proper control over her glycemic levels. It was reported that tuberculosis affects the hormonal secretion by interfering with endocrinal organs such as pancreas 15. Rifampicin reduces the concentration of gliclazide by inducing liver microsomal enzymes CYP 2C9 that rapidly eliminates gliclazide from circulating in the system 15,16,17. In a study by Park et al., patients given with 80 mg gliclazide had the concentration of the drug present in the body reduced by 70% on day 7. The elimination half life of the drug also increased 3 fold 17. All these contribute to the inability of the sulfonyluea to reduce the glucose levels in this patient. According to the stepwise approach in NICE guidelines, the next step to manage this patient would be to start the insulin regimen18. The type of insulin that was given was biphasic Mixtard insulin analogue that consists of a short acting analogue and also a long acting analogue. P.V. Rao reported that, due to the insulin resistance present in patients started on anti Tb therapy, the doses of insulin needed to manage these patients increase 15. It is well proven that insulin can achieve better HbA1c levels as a clinical trial by United Kingdom Prospective Diabetes Study (UKPDS) revealed that after 9 years monotherapy with insulin, 28% of patients achieved HbA1c levels below 7% and 42% patients achieved fasting plasma glucose levels below 7.8 mmol/l 19. Hypertension Treatment Patient was suffering from Stage 5 renal disease and the target for blood pressure in this patient would be 125/75 mm Hg 20. First line treatment for this patient would be loop diuretic, furosemide 20. They act by inhibiting the Na+/K+/2Cl- transporter on the ascending limb of loop of Henle which results in natriuresis and hence a fall in blood volume 21. This loop diuretic also performs its vasodilator actions via prostaglandin (PGE2 and prostacyclin) formation. This results in an increased blood flow in the medulla 21. In accordance to SIGN guidelines as well, long acting dihyrdopyridines such as nifedipine and ÃŽÂ ± blockers can be added as supplementary therapy 20. Nifedipine, a calcium antagonist acts by causing vasodilatation due to reduction in peripheral resistance. ÃŽÂ ± blockers such as prazosin block ÃŽÂ ±1 receptors and this results in vasodilation. A study by Vadasz displayed that Furosemide doses at 40 mg did not display any significant changes in systolic blood pressure. However, when the dose was increased to 60 mg, there was a significant reduction in blood pressure 21,22. A combined dose of 40 mg and 60 mg were effective in reducing the diastolic blood pressure. Based on this evidence, it is clear that furosemide on its own is not capable of decreasing blood pressure. When nifedipine was combined with diuretics it was observed that a statistically significant lower risk of cardiovascular events was observed compared to the non-statistically significant difference that was noted with nifedipine monotherapy 22. In another study by Psaty et al, nifedipine did not demonstrate an increase of risk in myocardial infarction compared to the other calcium channel blockers 25. Prazosins efficacy in lowering blood pressure was studied and the lowest effective dose that is capable of reducing blood pressure was noted to be 10mg 26. Doses below 10 mg per day did not significantly reduce the blood pressure compared to the placebo arm. Treatment of Anaemia Patient had very low haemoglobin levels and this was indicative of anaemia. NICE guidelines have recommended that in order to manage anemia, patients are usually given eryhtropoetin stimulating agents and also iron supplements to help produce haemoglobin 23. There has been no evidence in the use of iron supplements in patients with chronic kidney disease prior to treatment with erythropoietin. But it is recommended that the erythropoietin therapy should not be commenced in conditions of complete iron absence 23. In some conditions, where patients were in Stage 5 renal failure also diagnosed with other co-morbidities, treatment with erythropoietin stimulating agents is decided based on clinical judgment by the professional team if the patient were to benefit from the treatment 23. Treatment of Hyperkalaemia Patient was suffering from mild hyperkalemia and it was necessary that this was be treated before it progresses to severe hyperkalemia that might lead to adverse events such as cardiac arrest. A study compared the effectiveness between sodium polystyrene sulfonate and calcium polysterene sulfonate and it is noted that treatement with sodium increases sodium concentration in the body and this escalates the risk of hypertension 24. Treatment with calcium polystyrene sulfonate resulted in 50% decrease in potassium content and an additional advantage of increase in calcium concentration was observed as well 24. Conclusion Based on all the evidence provided for the patients condition, it is clear that the guidelines were adhered in treating the patients individual disease with some minor differences. Tuberculosis treatment for the initial phase was extended for more than 2 months due to the positive result obtained from sputum smear. Patient eventually achieved negative sputum smear and the patient was to be monitored before the patient was commenced on the continuous phase drugs. Effective treatment was undertaken to treat patients hypoglycemia condition, and based on the evidence gathered, dextrose 10% is the suitable treatment option for the patient. The antihypertensive regimen that was chosen was due to the patients renal failure. Nifedipine, prazosin and furosemide collectively controlled the blood pressure of the patient. Ferrous sulphate was chosen as her treatment compared to erythropoietin and this was based on the doctors clinical judgement. Her hyperkalemia which was treated with calcium su lfonate did benefit the patient as her potassium levels were within the normal range at the end of the treatment. PATIENT MEDICATION PROFILE PATIENT DETAILS Name Mrs A Consultant General Practitioner Address Kuala Lumpur Gender Female Weight 65 Height 158 Community Pharmacist Date of Birth (Age) 61 Known Sensitivities None Social History Non smoker Non Alcoholic PATIENT HOSPITAL STAY Presenting complaint in primary care / reason for admission Admission date April Low Sugar Level : 2.1 mmol/L Discharge Date Discharged to Not Known Shortness of breath RELEVANT MEDICAL HISTORY RELEVANT DRUG HISTORY Date Problem Description Date Medication Comments Feb Pulmonary Tuberculosis Feb Rifampicin 6 months Advanced Renal Failure Feb Isoniazid 5 years Hypertension Feb Pyrazinamide 5 years Diabetes Mellitus Feb Ethambutol Feb Pyridoxine 6 months Prazosin 6 months Nifedipine 6 months Furosemide Gliclazide RELEVANT NON DRUG TREATMENT Peritoneal Dialysis Prescribed Medication Start Stop Clinical/Laboratory Tests Date Result 1 Rifampicin Day 1 Sputum Smear Test Day 1 Positive 2 Isoniazid Day 1 Creatinine Day 1 912 Â µmol 3 Pyrazinamide Day 1 Urea Day 1 37.8 mmol/l 4 Ethambutol Day 1 Potassium Day 1 5.5 mmol/l 5 Pyridoxine Day 1 Blood Glucose Day 1 2.1 mmol/l 6 Prazosin Day 1 Blood Pressure Day 1 152/93 7 Nifedipine Day 1 Haemoglobin Day 1 9.8 g/dl 8 Furosemide Day 1 Chest Xray Day 1 Lesions in the apical segment 9 Dextrose Solution Day 1 Day 4 Blood Glucose Day 8 11.1 mmol/l 10 Ferrous sulphate Day 1 Sputum Smear Day 13 Negative 11 Calcium polystyrene sulphate powder Day 1 Day 6 12 Insulin Mixtard Day 8 CLINCIAL MANAGEMENT Diagnosis Pharmaceutical Need Pulmonary Tuberculosis Continue patient on intial phase drugs Hypoglycemia Start patient on dextrose Hypertension Continue antihypertensive treatment Hyperkalaemia Start calcium polystyrene sulphonate powder Anaemia Start ferrous sulphate Advanced Renal Failure Send patient for peritoneal dialysis PHARMACEUTICAL CARE PLAN Date Care Issue/Desired Output Action Output Sub therapeutic doses For Anti TB drugs Discussed with the pharmacist and patients diabetic condition was the reason for the dose regimen Doses were not changed Drug sensitivity testing was not performed Patient is diabetic and is more susceptible for MDR-TB No test was performed Management of patients compliance towards anti tuberculosis drugs -Patient might be hospitalised for a long period of time due to renal failure -DOTS scheme to be implemented upon discharge -Adequate patient education on the importance of completing the regimen is important Hospitalisation or DOTS scheme Renal failure Ethambutol excreted by kidney. Suggest change of medication to 2 Isoniazid + Rifampicin + Pyrazinamide -If treatment continued, monitoring essential Continue treatment as before and patient being monitored AFB test Another 2 samples should be taken for AFB tests before switching to the continuous phase Action yet to be taken Monitor drug toxicity Lab investigations on full blood count, liver function, serum uric acid, serum bilirubin, should be done to ensure no toxicity Eye examination for ethambutol side effects Scheduled appointments for patient Education on side effects of drugs To inform patient about anti Tb drugs side effect and advise patient not to stop the drug and side effects can be controlled ( PZA and arthralgia ) Counseling by pharm