Friday, September 4, 2020

Complete Logistics Term Paper Guide

Complete Logistics Term Paper Guide A research paper in coordinations is a significant examination work should have been done toward the finish of each term. It should show the student’s information regarding the matter picked up during a semester, just as their capacities to scan for the significant data, examine it, and make a one of a kind bit of composing. To be acceptable at compose coordinations research project composing, you ought to think about the quintessence of coordinations and its practical regions. Coordinations is the field that is busy with arranging, overseeing, controlling, and managing the development of material and data streams in reality from their essential source to the end client. Thus, the quintessence of a coordinations research paper is to do broad exploration under the direction of an educator. The essential advance of the best coordinations research paper composing is to pick a precise and huge theme that will carry curiosity into the examination of the subject. 5 Fields of Logistics to Choose a Topic for Your Term Paper There is a huge assortment of points that could suit your examination. Choice of the subject is a confounded procedure that could hinder your exhibition. The most ideal approach to evade long believing is to pick a specific subject that you are keen on. It won't just fulfill your hunger for information, however it will likewise make the creative cycle increasingly agreeable and a lot quicker. As such, your theme can identify with any part of coordinations, including the accompanying: Coordinations Management; Methods of Transportation in Logistics; Coordinations Industry Analysis; Coordinations in an E-World; Chain Supply Strategies Those are the expansive themes that ought to be limited and centered around one specific subject. Along these lines, in your coordinations research project, you can focus the consideration on one explicit endeavor and dissect its usage of coordinations capacities. For example, your theme can seem like: â€Å"An Analysis of the Application of Logistics Operations in FedEx Enterprise†. As you see making the title of the coordinations research project is indispensable for your scholarly achievement. Your educator needs to peruse your research paper as he/she assesses it dependent on numerous evaluation models. Be that as it may, there are the individuals who will direct research on a similar theme or field of study. In what capacity can this specialist comprehend that your paper can be valuable for the person in question? You can help just by designing an instructive title for your paper. Furthermore, it ought to be short, pertinent to your point, and, what is progressively significant, eye-getting. For example, the title of your coordinations research project can seem like â€Å"Logistics in Top Enterprises: [Company] and Its All Logistics Operations Used Ever† thusly, your paper catches the eye of the peruser who is keen on the circle of coordinations and a specific organization. 3 Simple Pre-Writing Steps to Simplify the Writing Process After you pick the point that interests to your inclinations, there are some progressively basic issues that ought to be considered before the research project composing process. Peruse the Internet or printed messages to be certain that there are sufficient valid wellsprings of data that will bolster your paper. In the event that your theme is under-explored, your research paper will come up short on certain bits of proof. Be prepared to fill in some data holes all alone. So where to scan for the essential data for research project composing? The most proficient approach to scan for data important for coordinations from interior and outer sources. You can evaluate a few assets for coordinations at the present time. Consider the length of the coordinations research paper that may shift from 10 pages to 15 pages. Think about the amount it is in words? So contemplating an online word counter, it might shift from 5000 to 7500 words. Since the subject can be excessively expansive for a specific constraint of words, or too restricted to even consider including all the essential data. Besides, if your research paper should associate with 10 pages, you may confront the absence of data to compose on. In this way, you ought to return to the initial step and reevaluate the accessible writing that covers your chose subject. As you see other than the capacity to compose, you have to gather enough researcher materials to make your examination obvious. Follow an exacting structure of scholarly papers to which your coordinations research project is incorporated too. Composing for scholarly purposes suggests a prerequisite to well-organizing. The most critical segments of a scholarly bit of composing are the presentation, at least three body passages (writing survey, system, results, conversation), and end. Furthermore, since a research paper infers a lot of the content, it will be fitting to include a theoretical part. The Basic Structure for Your Term Paper on Logistics: Top Ticks from Our Writers Some of the time it might be difficult to concentrate on a specific subject without getting diverted. That is the reason it might be valuable to make a basic layout for yourself to see the succession of the thoughts that you need to cover in your exploration paper. With a basic layout before your eyes, the creative cycle will be significantly more agreeable and effective. It will likewise assist you with making your coordinations research project increasingly far reaching just as its examination thoughts progressively connected. 1. Abstract: Write or Not to Write and What to Write? It is a short passage on a different page toward the start of your research project. It should illuminate the perusers about the principle research thought of the entire paper before they start read it. In this manner, it ought to be exact and succinct, including the most critical issues examined in your content and watchwords. Now and again, the nonappearance of the theoretical part might be not basic. Analyze the paper educators cautiously. 2. Introduction Is Must-Have for Your Term Paper It is a section your research project should begin with. In any case, you can take a shot at it after you wrap up the principle parts. It’s up to you. Simply recollect what you have to incorporate. The primary sentence of the presentation is a subject sentence. The theme sentence should catch the eye of your peruser. It is a purported â€Å"hook† that will constrain everybody to peruse further to fulfill the examination intrigue. In this manner, the subject sentence of the coordinations research paper can incorporate the accompanying: â€Å"Recently, the coordinations the executives circle experienced so huge changes that made logisticians all the more requesting in the business industry.† After perusing this sentence, need to know what sort of changes occurred and why it impacted the interest? Right, you face a similar reason to get the peruser intrigued. At the point when the subject sentence is done to satisfy this reason, it is fundamental to give some foundation data that identifies with the theme. For example, the center piece of the presentation for the coordinations research paper can incorporate something to that effect: â€Å"Although coordinations has profound verifiable roots, it is a moderately a youthful science. The most fast advancement of coordinations was accomplished during the Second World War when it was utilized to unravel the precarious undertakings and an express connection of the resistance business, standard, and gracefully bases, and transport with the point of convenient providing the military with weapons, fuel, and food. These days, one of the main coordinations undertakings in the United States is the FedEx Corporation.† The proposal proclamation is the finishing up sentence of your acquaintance structured with control a peruser. For the most part, the proposal explanation is a one sentence (in some cases more than one since it relies upon the profundity of the exploration) where you ought to incorporate all the principle thoughts of your following coordinations research project. Just as the theoretical, it ought to be exact and compact since you should show all the essential data in this part so a peruser will get the familiarity with the entire research paper. 3. Body Paragraphs Make Your Term Paper The arrangement of body sections is the center piece of your coordinations research paper. Each body section ought to be spun around the specific thought, or they can have a typical point under a heading. The headings are very valuable since they help to sort out the paper, and make the content progressively lucid. So in the event that you assess the subject dependent on different discoveries, you compose a writing audit. In the event that you manage the examination discoveries you make, decipher them in the discovering segment, etc. Composing a coordinations research paper, it is basic to make your body sections around a similar size. To make your composing increasingly sound, it is essential to utilize references. At the point when a peruser watches your thoughts upheld by the solid specialists, it is simpler to make him/her persuaded of your perspective. The in-text references are isolated into direct references and rework or synopsis of one’s thoughts that must likewise be refered to so as to maintain a strategic distance from copyright infringement. An immediate statement infers the addition of the duplicated part from the source into your research paper. For the most part, it is just an expression or a sentence, however it could likewise be even a section (on the off chance that your bit of composing is sufficiently long) that is known as a coalition reference. The other method to make your coordinations research project apparent is to sum up the possibility of the chose source and to reword it into your own words. Such sort of reference additionally requests an in-text reference design. Considering the arrangements of in-text references, there are two broadly utilized styles of designing: APA (American Psychological Association) and MLA (Modern Language Association.) These two styles request the various organizations of reference. In APA, your in-text statement should resemble this: â€Å"taken material† (author’s last name, year of distributing). The page number can likewise be available on the off chance that it is required. In MLA, the reference looks marginally changed: â€Å"taken material† (author’s last name page number). There are a lot more quirks of referencing that you can get to know on the Purdue OWL site. 4. Conclusion Ends Your Term Paper L

Monday, August 24, 2020

Arthritis, Osteoporosis and Rickets

Joint pain, Osteoporosis and Rickets Talk about three infections/issue of the skeleton; remembering for the conversation causes, side effects and treatment. The three maladies you have to talk about are Arthritis, Osteoporosis and Rickets. Understanding 1 A sixty multi year elderly people ladies presents with a broke rib after minor mishap. History incorporates the patient is inert with a horrible eating routine. Osteoporosis Osteoporosis is a condition wherein makes the bones become frail, permitting them inclined to breaking. This condition can create throughout the years, anyway it is possibly rewarded when a minor fall or unexpected effect on the issue that remains to be worked out the unresolved issue broke. Causes Osteoporosis happens as bones become not so much thick but rather more delicate. Bone thickness, quality and thickness is on the expansion until the periods recently 20s as youre your bone thickness will at that point start to slowly diminish in your 30s. Ladies are more in danger of creating osteoporosis than men as the adjustments in hormone that shows up in menopause legitimately influence the thickness of the bones. Estrogen is a basic hormone for solid bones and after menopause takes set, estrogen levels fall. Because of the quick diminishing of estrogen, it can cause a fast lessening in bone thickness. Ladies have a more noteworthy possibility of creating osteoporosis in the event that they are encountering menopause before the age of forty five years of age, or have experienced a hysterectomy before age of 45 and have had their ovaries expelled, or have over practiced or slimmed down an excessive amount of making them have missing periods. Osteoporosis likewise influence men, anyway the causes isn't known. Because of men having the testosterone hormone, the numbers experiencing osteoporosis contrasted with ladies endures are significantly less, as testosterone helps keep the bones solid. As the degree of testosterone diminishes with age, the more probable it is for men to create osteoporosis. The reasons for low testosterone level isn't obviously known, anyway the causes that are known incorporates the utilization of meds, for example, oral corticosteroid, liquor misuse/abuse and hypogonadism. Hypogonadism is a condition which causes the testosterone level to be unusually low The hazard factors which are hormone related that can add to the beginning of osteoporosis incorporates, an individual to have overactive thyroid (hyperthyroidism), a disarranges of the adrenal organs, lower levels of sex hormone or over dynamic parathyroid (hyperparathyroidism) Other hazard factors that contributes are family ancestry, a BMI of 19 or less, long haul high dosages of oral corticosteroid, dietary problem or rheumatoid joint inflammation. Side effects The are no signs in the beginning times of bone misfortune or debilitating of bones. At the point when osteoporosis have debilitate your bones you may understanding back torment brought about by a break or crumbled vertebra, step by step loss of tallness, a bone crack, or a stooped stance. Treatment The finding of osteoporosis is dictated by the consequences of the bearers bone mineral thickness filter. On the off chance that treatment is required, it depends on the people age, sex, danger of break and furthermore the past injury history. It is critical to keep up an adequate degree of calcium and nutrient D if no treatment is needed or required. Understanding 2 A multi year old youngster with a crack to the femur. Different side effects show distorted legs (bowed) and shorter than normal for age. History affirms the youngster was breastfed without any enhancements. Rickets Rickets makes the bones in youngsters become delicate and feeble, prompting bone disfigurements. Causes The under layingâ reasons for rickets comes from absence of nutrient D or calcium, anyway rickets can likewise be caused through hereditary deformities or another wellbeing condition. Nutrient D and calcium are both indispensable sources in a youngster improvement in solid and sound bones. Wellsprings of Vitamin D is daylight, as the skin produces nutrient D when it is presented to sunlight.Food, as nutrient D can be found in slick fish, eggs and certain morning meal oats and furthermore dietary enhancements Calcium can be found in dairy items, for example, eggs, cheddar, milk, yogurt and furthermore green vegetables. Kids that are in danger are those of Asian, Caribbean, African and center eastern starting points, as their skin is darker and requires more daylight to get adequate nutrient D. Additionally coddles conceived rashly are in danger of creating rickets as they have develop stores of nutrient D in the belly. Infants from birth to 1 year, solely or in part breastfed, ought to be given a day by day supplement containing 8.5 to 10mcg of nutrient D to guarantee the get enough, as children that are breastfed past the age of a half year might be in danger of nutrient D lack. Side effects A youngster may encounter torment and irritation influencing the bone. They may likewise encounter skeletal distortions which could cause thickening of the lower legs, wrist, knees and cause a bowed leg. The kid may likewise encounter postponed development and improvement as they could be shorter than the normal youngster their age. An issue with dental may emerge as the tooth lacquer is debilitated causing delays in teeth development and danger of tooth rots. Their bones will be progressively inclined to cracks as the have come to be delicate. Treatment As the rickets are brought about by low degree of nutrient D and calcium, it is treated by expanding the childs admission of nutrient D and calcium. This can be expanded by eating more food wealthy in these sources or taking day by day enhancements of calcium and nutrient D. Persistent 3 A multi year elderly person presents with inconvenience strolling because of a difficult knee joint. Different side effects incorporate growing, redness and warmth to the knee. Understanding likewise has a past filled with agonizing joints and has a weight record of 32. Joint pain Joint pain is a condition which makes the joint become excruciating and kindled. Inbetween joints, there is an adaptable connective tissue called ligament. Ligament ensures the joint by engrossing the weight and stun made when you move and discharge weight on them. At the point when the ligament tissue this can cause a few types of joint pain. There are 2 most basic types of joint pain, rheumatoid joint inflammation and osteoarthritis. Causes Osteoarthritis, is brought about by ordinary mileage. A physical issue or disease to the joints can cause the regular breakdown of the ligament tissue. On the off chance that you have a family ancestry of Osteoarthritis, there perhaps a higher possibility of having osteoarthritis. Rheumatoid joint pain is brought about by an immune system issue. This happens when the bodys safe framework assaults the tissues of the body. The synovium is assaulted by the resistant framework. The synovium is the delicate tissue in your joints that delivers a liquid that supports that ligament and greases up the joints. Rheumatoid can possibly annihilate the bone and the joint. Side effects of osteoarthritis The side effects of osteoarthritis may lead an individual to encounter joint agonies, just as solidness, growing, diminished movement and redness of skin around the joint. Manifestations of rheumatoid joint inflammation are sluggishness, loss of hunger, slight fever. Victims may possibly get sickly. An individual with serious rheumatoid joint inflammation may encounter joint deformations in the event that it is left untreated. Treatment There is no solution for joint inflammation, anyway there are medicines that can hinder the condition. Osteoarthritis, endorsed drug Painkillers Non-steroidal mitigating drugs Corticosteroids For serious cases, surgeries possibly suggested: Joint substitution Joint breaker Where bone is cut and re-arrangement Treatment for rheumatoid joint inflammation incorporates: Painkillers (analgesics) Malady changing enemy of rheumatic medication (DMARD) Physiotherapy Ordinary exercise References Anon, (2017). [online] Available at: http://www.arthritis.org/types-what-is-rheumatoid-arthritis.php [Accessed 5 Jan. 2017]. Nhs.uk. (2017). Indexed lists. [online] Available at: http://www.nhs.uk/Search/?q=osteoporosis [Accessed 5 Jan. 2017]. Nhs.uk. (2017). Indexed lists. [online] Available at: http://www.nhs.uk/Search/?q=rickets [Accessed 5 Jan. 2017]. Mayo Clinic. (2017). Outline Mayo Clinic. [online] Available at: http://www.mayoclinic.org/sicknesses conditions/rheumatoid-joint pain/home/ovc-20197388 [Accessed 5 Jan. 2017].

Saturday, August 22, 2020

Global warming Research Paper Example | Topics and Well Written Essays - 1250 words

An unnatural weather change - Research Paper Example This wonder can be seen as an expansion in the normal temperature on earth’s surface, which is brought about by the discharge of different gases, for example, carbon dioxide, methane, nitrous oxide and so on due the copying of non-renewable energy sources. In the advanced world, mechanical improvements have added pace and decent variety to the procedure of industrialization, which causes the arrival of poisonous gases into the air. The unfriendly impacts of innovation can be found in urbanization likewise, which involves deforestation and the resulting negative effect on the earth. In addition, the expanding number of vehicles additionally adds to exasperate the issue as it brings about enormous discharge of carbon dioxide into the environment. Proof proposes that â€Å"about three-fourths of the carbon dioxide added to the air originates from consuming non-renewable energy sources, for example, oil and coal,† which are basically utilized in enterprises and transportati on (Kowalski 2004 pg 12). Likewise, deforestation, which happens fundamentally because of urbanization, additionally causes voluminous arrival of carbon dioxide into the air. In this way, it becomes clear that human activities, all things considered, add to significant changes in the atmosphere of earth. A worldwide temperature alteration, in straightforward terms, can be characterized as the â€Å"continuing increment in Earth’s generally speaking temperature† (Farrar 2008 pg 7). ... This remaining parts a significant worry in the advanced world as it has extensive negative repercussions on the earth, which, thus, will antagonistically influence the life on earth. Along these lines, this examination mostly centers around three research inquiries as under: - I) What causes the event of the condition known as Global Warming? ii) What are the impacts of Global Warming? iii) What can the people never really resolve the issue? The specialist has endeavored to address these inquiries through the accompanying writing audit, which mulls over the accessible proof in distributed books, web articles and so forth. Survey of Literature (Definition of the Problem): Global Warming, as expressed prior, is an expansion in the surface temperature of the earth. Research contemplates show that on a normal, the surface temperature of planet earth has expanded by about â€Å"1.4 degrees Fahrenheit (0.76 degrees C) over the most recent 150 years (Farrar 2008 pg 7). In any case, a simi lar report additionally guarantees that a few spots have enrolled the ascent in temperature as high as 5 degrees Fahrenheit or 2.8 degrees C. While practically 99% of earth’s climate includes nitrogen and oxygen, ozone depleting substances, for example, carbon dioxide, methane, nitrous oxide and ozone comprise the remaining 1%. The issue emerges from the way that these ozone harming substances hold the warmth in the air, which is basic for people and other living creatures on earth to remain warm and to escape from freezing cold. Be that as it may, when petroleum derivatives, for example, oil and coal are scorched, enormous volumes of gases get discharged into earth’s climate. The nearness of such outflows will mean expanded limit of air to store heat, which will improve the warmth in the environment.

Assessing the Potential Risk of Earthquakes, Volcanoes, and Tsunamis Essay

Surveying the Potential Risk of Earthquakes, Volcanoes, and Tsunamis - Essay Example The explanation for the event of tremors is noted to be the extreme vitality that has been amassed inside the layers of earth. Eminently on account of Dallas, Texas, one might say that the vitality has been discharging through the event of quake each year which makes the likelihood of the seismic tremor unsurprising however with generally lesser extent. Considering the four regular geological states of Dallas, it very well may be said that the delocalization of outside is less aggregating. The event of tremors at Dallas has anticipated the span of tempests any longer. Likewise, the tropical storms and blizzards are unsurprising at Dallas essentially as a result of the event of quake that discharges vitality off the earth surface showing unsettling influence of the earth outside layer to minor degree (Resources for Environmental Literacy, 2007). The age of Tsunamis is because of the unsettling influence of the enormous measure of water waves underneath. This may occur because of the emission of well of lava, land sliding or the contact of structural plates of the earth. This may influence the influxes of water which may travel 600mph. Thinking about the instance of Tsunami in Dallas, Texas, there has been no movement on the dynamic structural layer of Dallas which makes Dallas a less powerless area for the age of Tsunami. The dynamic structural plates in Texas in entire is considered as an out of ready zone for tidal wave according to the forecasts. Tsunami’s age is bound to happen at the dynamic structural layer of Mexico and the close to beach front regions of United States (Hasiholan, 2007). The ejection of fountain of liquid magma happens when around 17 layers of earth are disassembled as well as broken. The layers of earth are then set underneath the ground as a rule on the more sizzling layer of the earth covering. Earth mantle is the most blazing calm zone which makes the stones and other natural components to

Friday, August 21, 2020

Labor Law Essay Example | Topics and Well Written Essays - 1750 words

Work Law - Essay Example These are the moral issues that a purchaser from a designing organization needs to confront when purchasing electrical segments from these sorts of organizations. As it were, he will be in a roundabout way advancing kid work. He will likewise should know about the way that in such processing plants kids become weakened, sincerely and genuinely, from not exactly suitable working conditions. With severe wounds, they can't go to class and give the opportunity to have a superior life for themselves. Those that endure face mental and physical scars that will stay with them for the remainder of their lives. This is an especially delicate case. There has been a great deal of cash contributed and there is by all accounts a ton in question. Additionally, it is the last open door for the group to gain distinction, cash and wonder. The issue for the individual who thinks about the failings of the vehicle is justifiable, particularly as he happens to be the enhanced one in the task. It is hard to voice feelings in the event that you have been the latest contestant into an undertaking. There is constantly an implicit chain of command in circumstances of this nature, and the estimation of the least in the hierarchy is never paid attention to as well. In any case, the individual's greater obligation is t... It is clear that the vehicle may run wild over the span of the race, and the outcomes could be anything. While the remainder of the group may contend that the hazard is negligible - and you can't blame them from imagining that way - the driver could be at risk for his life. The best activity for this situation is to dissuade his colleagues. Stopping is the simpler arrangement however that doesn't help the clueless driver in any case.If his partners would prefer not to haul the vehicle out of the race significantly after much persuading then the best activity is to advise the coordinators regarding the race to make a move. The individual may lose companions simultaneously yet he could well be sparing a real existence. Exercise 3 This is dubious for Paul. He is left to pick between his work and his marriage. Unbiasedly, the decision doesn't appear to be that troublesome. Nonetheless, for the individual confronting the bind it could be an intense issue.Paul needs to take a gander at his genuine feelings of serenity when settling on this choice. Expertly, he is under commitment to take the errand. In the event that others in the group are happy to work extended periods of time, Paul might want to do likewise, just out of expert pride, particularly in the event that he happens to head the task. Additionally, the motivator of cash is an extraordinary draw. Paul is considering this to be a lifelong making opportunity. Be that as it may, it is outlandish for him to stand firm on proficient morals when his marriage is at threat. He has three youngsters and his better half to take into account. In a circumstance like this the best activity is open up to the organization's pecking order and clarify the issues. He might not need to tell all subtleties; giving a trace of what is in question can be superbly

Thursday, July 23, 2020

What Not to Say to Someone Having a Panic Attack

What Not to Say to Someone Having a Panic Attack Panic Disorder Coping Print 4 Things to Not Say During a Panic Attack By Katharina Star, PhD facebook linkedin Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial policy Katharina Star, PhD Updated on January 05, 2020 JGI/Getty Images More in Panic Disorder Coping Symptoms Diagnosis Treatment Related Conditions Panic attacks are characterized by a combination of mental, emotional, and physical symptoms. These attacks typically begin with a sense of dread, nervousness, and fear. Feelings of anxiety often increase in intensity as the person begins to experience sensations such as, shortness of breath, heart palpitations, chest pain, excessive sweating, tingling, shaking, and even nausea.?? These uncomfortable physical symptoms are frequently met with fearful thoughts and emotions, such as being afraid that the attack will cause one to lose control, go insane, have a medical emergency, or even possibly die. During a panic attack, it is not uncommon for a person to go through feelings of depersonalization and derealization in which the person feels detached from the self and reality.?? Panic attack sufferers often have no control over when their symptoms will strike. For people with panic disorder, these attacks come on suddenly, without any warning or cause. Those with specific phobias may only have panic attacks when exposed to their specific fear; however, these feared stimuli may not always be easy to avoid. Given that attacks can occur at any place or time, some people may try to jump in and help the person through the panic attacks. It is truly kind for someone to try and help a person through these challenging symptoms. However, well-meaning friends, family, and even strangers may try their best to help, only to say the wrong thing to the person having the attack. Read ahead for some ideas on what not to say to someone during a panic attack. Just Calm Down If told to calm down, the panic attack sufferer may feel as though you are suggesting that he has complete control over their symptoms. The fact is that if a person going through a panic attack could just calm down, he would! You may think you are helping to redirect the person by telling him to calm down, but in reality, it can just cause him to be more aware and self-conscious of his symptoms. Instead of being verbally directive, try to get the person to calm down using one of the many strategies to get through panic attacks. For example, you may try to help him through a relaxation technique such as deep breathing, guided imagery, or progressive muscle relaxation (PMR). By utilizing such techniques, you will be able to redirect the person while making them feel secure and understood. You Have Nothing to Be Nervous About Most likely, the panic attack sufferer is aware that there is no reason to be anxious. When going through a panic attack, a person’s flight-or-fight stress response is triggered, making her mind and body prepare for an actual or perceived threat. Even if she is not in any real danger, she still may not be able to stop the attack from running its course. Reinforcing that the person’s fear is unfounded can increase one’s sense of anxiety. Instead of bringing the lack of threat to her attention, try being a voice of encouragement. Use a soothing voice and simply remind the panic sufferer that you are there for her. I Wouldn’t Do That, You’re Embarrassing Yourself This just comes across as a truly insensitive comment. Many people already feel embarrassed about having to manage a panic attack in public, so there is no need to bring this to the person’s awareness. Instead of further shaming the person, try affirming her strength. Let her know that you are there to be supportive and that she has no reason to feel shame. She may already feel humiliated, so it can be most helpful to remain positive. Phrases such as, “You’re doing a great job,” “You will get through this,” or “I am here for you,” can all go a long way in helping a panic sufferer feel more confident at such a vulnerable time. You’re Just Overreacting These few words can be tremendously discouraging for a person facing a panic attack. It can be hard enough to have to deal with uncomfortable symptoms, but even more challenging when others are minimizing a panic sufferer’s experience. Panic attacks are a real set of symptoms and should not be confused with emotional reactions that are within one’s control. The panic sufferer often perceives these attacks as frightening, and by telling the person he is overreacting you may make it harder for him to calm down. You will get better results if you try to put the person at ease. He may like to be in a quiet area, away from other people, outside where he can get some fresh air, or inside where he may feel less distracted and more secure. If you feel uncertain of what to say or if you are feeling a little frightened yourself, try silently staying by his side as the panic attack subsides.

Wednesday, June 24, 2020

Identitiy Crisis The Inward Voyage - Literature Essay Samples

At the first scene of Tony Kushner’s drama Angels in America (1993), Rabbi Isidor Chemelwitzs eulogy for Sarah Ironson exposes the plays crucial themes and motifs. The Rabbi, a member of the â€Å"Bronx Home for Aged Hebrews† (Millennium, 9), commemorates Sarah’s life and in particular her great voyage to America. However, he continues to express pessimism about the present world by saying, â€Å"You can never make that crossing that she made, for such great voyages in this world do not any more exist† (Millennium, 10). However, due to the Rabbi’s age and his clear bias against today’s life in â€Å"the melting pot where nothing melted† (Millennium, 10), his speech is juxaposed with one of the play’s re-definition of identity. The Rabbi may be correct in stating that there are no longer physical voyages of mass migration in the world; however, when concerning metaphysical voyages, the play’s primary characters present th e antithesis to Rabbi Chemelwitz’s theory. Today’s life journeys no longer pertain to physical expansion, but rather mental expansion, which lead us into discovering our personal identities while at the same time resisting social expectations and standards. Harper, Louis, and Joe best exemplify this inward expansion of identity despite overwhelming social pressures. Harper Pitt travels frequently throughout the play in order to find her true identity and escape her marriage. Subsequently, she cathartically breaks free from Joe in order to pursue her individuality. Upon meeting Harper for the first time, the audience is aware of her strange disposition and fear of solitude. In her first scene, Mr. Lies, her imaginary travel agent, appears to directly reflect her subconscious need to voyage far away from her husband and her current lifestyle. Furthermore, Harper goes on various voyages with the help of her Valium addiction. She travels to Antarctica, and even into Prio r’s dream on her trips, which further stresses Harper’s desire to get away from her current lifestyle. The play also portrays her dependence on Valium as more than just an addiction, but also as a desperate method of escape. When Harper finally breaks free from her marriage with Joe, she has reached the turning point in her voyage. She decides to give her entire stash of Valium to Joe because she no longer needs to escape through drugs, and instead will escape on her own, without the help of the pills or Mr. Lies. Harper is next seen on an airborne jumbo jet, which effectively ties Harper’s metaphysical life voyage with a physical one. Louis Ironson’s voyage of identity is both dynamic and contradictive, which results in a journey that is successful in some areas, but still incomplete at the play’s close. While he thinks his inward journey is complete and he has come to terms with the world, he progresses from selfishness to a level of extreme remo rse. This supplies his character with contradicting qualities. In Perestroika, Louis criticizes Joe for hiding his sexuality; however, in Millennium, Prior reveals to us that Louis has an overtly â€Å"butch† facade at family events in attempt to hide his own sexuality. Louis is an extreme liberal who is somehow attracted to a sexually confused republican. Furthermore, while he was raised as Jewish, he considers himself an agnostic and can’t seem to find a religion that suits him. These contradicting character traits augment the confusion of Louis’s voyage. Louis begins the play in fear of Prior’s disease, showing his weakness and selfishness; however, as the plot progresses, Louis finds himself missing Prior and his guilt growing. Louis finally does realize his mistakes, and attempts to apologize despite Prior’s appropriate harassment, and Louis goes as far as to cover himself in bruises and cuts to match the physical pain that Prior has been feel ing. While Louis has made strides in improving himself, he was unable to complete his journey in the course of the play. Louis’s voyage successfully resulted in his self-improvement, but at the conclusion of the play, Louis is still arguing politics and religion with Belize, which reflects the ongoing search for his true identity. Joe Pitt’s identity crisis is perhaps the most interesting and clearly represented voyage in the play, as he progresses from trying to change his identity to ultimately accepting it. Similar to Louis, Joe is a character full of contradictions regarding his lifestyle. Being raised Mormon in Salt Lake City, Utah, it is apparent that Joe’s homosexuality is not an appropriate practice within his cultural context. When Joe comes out to his mother over the phone, she rebukes him by categorizing his identity as â€Å"a sin† and she claims she â€Å"thought [she] raised [him] better than that† (Millennium, 16). Not only does Jo e try to hide his homosexuality from his mother, he tries to deny it by marrying Harper. Furthermore, he is employed through a law firm that denies rights to homosexuals. Upon meeting Louis, Joe becomes infatuated, and they even share a short relationship together despite his marriage to Harper. Joe shares an immensely important moment with Louis on the beach in which they are discussing Joe’s Mormon faith. Louis notes the temple garment that Joe is wearing and Joe refers to it as â€Å"Protection† and â€Å"A second skin† (Perestroika, 69). In a rush of utter ecstasy, Joe removes the garment saying â€Å"No past now. I could give up anything† (Perestroika, 73). This portrays Joe’s sincerity in his voyage, and his willingness to commit to becoming a new person. However, at the play’s conclusion, Joe is unable to reap the benefits of his identity reformation despite his attempts to shed his â€Å"skin†. He is ultimately left with two u nsuccessful relationships, both homosexual and heterosexual. While the Rabbi argues there are no more great voyages in our generation, he excludes the growing social dissatisfaction toward personal orientations, and inward struggles in the approach of the new millennium. Overcoming societal pressures in order to reach a true personal identity is the true voyage of our time. Joe’s voyage is unsuccessful at the close of the play because Joe knew he needed change, but he did not know what to change. Whereas Harper knew exactly what she wanted, and consequently she achieved it. The concept of change is a powerful theme in the play; however, without knowledge of what lies ahead change is a futile attempt.

Friday, May 22, 2020

Macbeth s State Of Mind - 1464 Words

Throughout Shakespeare’s tragedy of Macbeth, the motif of time plays a significant role as Macbeth’s state of mind progresses throughout the play. Time serves as a vital role in a tragedy, for as time progresses, a character’s inevitable and ill-fated end draws closer and closer. In Shakespeare’s play, Macbeth becomes completely consumed by time as he is fixated on an illusory future and becomes haunted by his inescapable, bloodstained past. Essentially, throughout the play, Macbeth continually fights for his royal future, yet realizes too late that, due to the unavoidable passing of time and mortality of life, his position as King of Scotland will be transient and momentary. Nevertheless, throughout the course of the play, Macbeth’s state†¦show more content†¦Yet, he also recognizes that if he were to disturb the natural time and progression of events in this â€Å"bank and shoal of time† (I.vii.6), he would be jeopardizing his futu re, for he would â€Å"still have judgment here† (I.vii.8). As Macbeth ponders whether or not to kill his king in order to try to become king himself, his main hesitations arise from the fact that, if he does kill Duncan, he will be consumed by guilt and will suffer judgment and consequences in both this world and in the afterlife. Paralleling Hamlet’s â€Å"to be or not to be† speech, Macbeth’s uncertainty about the afterlife and what will arise from his mortal actions cause him to desire to â€Å"proceed no further in this business† (31). Thus, Macbeth’s attention on the afterlife reveals his state of mind relative to time at this point in the play as he focuses on the future while debating whether to essentially overleap time and make himself King of Scotland, or wait and see if the witches’ prophecy will come true. However, in regards to the prophecies, the witches never mention when anything will take place. Thus, Macbeth is left with an internal struggle as he ponders whether to let nature run its course and hopefully become king naturally, or whether to disturb the normal order of the world and overrun the natural progression of time to ensure his crowning. Although Macbeth concludes at the end ofShow MoreRelatedMacbeth Change in Personality765 Words   |  4 PagesMacbeth is a very complex character. His personality changes drastically from the beginning of the play to the end of the play. Macbeth constantly declines in his level of morality until his death at the end of the play. His change of character from good to evil and Macbeth s attitude towards other characters, specifically Duncan, Banquo, Lady Macbeth is significantly affected. Macbeth interacts with Duncan only a minimal amount before Duncan s death; Macbeth s attitude towards him changes veryRead MoreThe Tragedy Of Macbeth By William Shakespeare1023 Words   |  5 PagesTragedy of Macbeth. The Tragedy of Macbeth was a turn from glory to tragedy. A story of a true tragic hero. Macbeth is a brave soldier in a war for Scotland. A tale of a great soilder that was highly praise in his kingdom turn to a tragic murderous sinful king. Macbeth kill his friends and his king to take the throne and power to fulfill a witches prophet .The focus of Macbeth’s tragic story is self ambition,his unrelentless guilt, greediness , and poor judgement. All serve a purpose to macbeth destructionRead MoreMacbeth, By William Shakespeare975 Words   |  4 PagesSince Macbeth believes that he must kill Duncan to achieve his goal of becoming king quickly, Macbeth subdues his feelings and thoughts to become more masculine. From the start , Macbeth recognizes his need to separate his mind from his actions, because his mind overpowers his will to act. Macbeth has the capacity to perform the deeds necessary to achieve his goal; obviously, from the first description of him in the play describing his prowess on the battlefield, he can kill Duncan. However, heRead MoreLady Macbeth960 Words   |  4 Pageswholesome. To lower somebody s character through a very quick period of time of fast decisions and unsure actions is going to expose them to danger or injury. In the play Lady Macbeth proves this to be true. The emotional mistakes shredded the journey Lady Macbeth puts down throughout this play and eventually ends in her death. She feels overpowered by everything that is happening in two ways, both mentally and physically and decides to end her own life. Play Macbeth by William Shakespeare showsRead MoreMacbeth Is A Good Soldier1336 Words   |  6 PagesThroughout The Tragedy of Macbeth, we see Macbeth change from a nob le and brave soldier into a mere shadow of his former self. We meet Macbeth after a battle, the result of which has him named Thane of Cawdor. From this position, he falls to a paranoid man willing to do anything to remain in power. We can see his deterioration from the murders of Duncan and Banquo,Macbeth s second meeting with the witches, his treatment of Macduff s castle and his mental condition just before he is murdered.   Read MoreWilliam Shakespeare s Macbeth 1363 Words   |  6 PagesMacbeth is without a doubt one of the most captivating plays, in my opinion written by William Shakespeare. Throughout this play there is definitely a numerous amount of things that can catch your attention, whether it is a trio of witches appearing, committing murder, or keeping secrets. However, what really catches my attention is the way Shakespeare uses language and unique style to create a distinct mood, and reveal characters’ inner thoughts. In the play Macbeth written by William ShakespeareRead MoreAct II Of William Shakespeare s Macbeth998 Words   |  4 PagesII of William Shakespeare’s Macbeth is about how Lady Macbeth meets her spouse in the lower patio as he rises up out of the ruler s room itself. Macbeth s still, small voice is unmistakably irritated by what he has done, and again his wife scrutinizes his absence of immovability. The accomplishment of their plot is likewise in peril in lig ht of the fact that Macbeth has carried the knifes with him. Lady Macbeth comes back to the scene of the homicide keeping in mind the end goal to put the knifesRead MoreWilliam Shakespeare s Macbeth, Othello, And King Lear1479 Words   |  6 PagesWilliam Shakespeare s Macbeth, was the last of four great tragedies, including Hamlet, Othello, and King Lear, written during the Elizabethan Era. Herbert Courson states the play as, â€Å" â€Å"a powerful even for the mature Shakespeare. [which]... demands that we share its experience intensely, that we fell the strength of Macbeth’s thirst for kingship, the force of Lady Macbeth’s persuasions, the anguish of Macbeth’s struggle before the murder, and the impact of nature’s retribution after the murder†Read MoreThe Supernatural World Of Macbeth1103 Words   |  5 Pagesthe people in the 15th century. Following superstitions and indulging in mystical magic was habitual; darkness was taking over. Slowly , but surely the malicious, foul, and unholy world was raiding the souls and minds of the people in the 15th century. The supernatural world in Macbeth was represented through three evil immoral and foul women. These three women had immense powers that could tell the weather and most importantly tell the future. There vast powers were uncontrollable and their predictionsRead MoreMacbeth Appearance Vs Reality1747 Words   |  7 Pagesan answer in his play, Macbeth. The way individuals follow-up (act) on the outside and who they truly are within might be two entirely unexpected things. Some may change since they feel they do not fit in while others put on a show to be someone they are not. Regardless of which way one looks at it, if an individual attempt to be someone he is not, his reality will eventually show up at last. This is precisely what occurs in William Shakespeare s play, Macbeth. Via Macbeth, William Shakespeare exploits

Monday, May 18, 2020

Building A Foundation For Health Promotion Essay - 1277 Words

1. Partner with patients and other health care professionals to provide primary health care through health promotion, protection, and restoration, and end of life care. When we are signed patients for our shift we are not only concerned about what the patient can provide us with about their health care, but we are looking at everything that the health care team has addressed and documented. When it relates to understanding the health concern we must understand the patient and their social network to establish a foundation for health promotion. Health promotion is meant to protect the patient and keep health services going in a positive direction. Protection is utilized in many ways. Examples of this are written policies, consents and dignity for our patients. Protection allows the patient to speak freely about their health concerns. By doing so we have a greater understanding of their needs. Restoration is another step to completion of what we have set out to improve the health care of others. This also is seen with end of life care. Every area needs to be addressed with a plan of care based on interventions and outcomes. 2. Apply the nursing process, based on current knowledge and theory, to provide holistic care directly or indirectly to diverse patients across varied environments. Nursing process is taught to us to help patients from the very start. That starts at admissions and all the areas of health care until we reach discharge. Without understanding theShow MoreRelatedHealth Promotion Among Black or African Population Gcu1095 Words   |  5 PagesHealth Promotion Among Black or African American Population [Your Name] Grand Canyon University: Family-Centered Health Promotion(NRS-429V) January 10, 2016 Health Promotion Among Black or African American Population The Center for Disease Control and Prevention [CDC] (2015) notes that â€Å"Starting in 1997, the Office of Management and Budget (OMB) requires federal agencies to use a minimum of five race categories: White, Black or African American, American Indian or Alaska NativeRead MoreReady, Set, Step ( Rss ) : Moving On The Fast Track Of Fitness Essay1465 Words   |  6 PagesNational Minority Health Month was launched in response to the health promotion and disease prevention initiative, Healthy People 2010. Celebrated annually in April, National Minority Health Month presents an opportunity to increase awareness of the health disparities that continue to affect racial/ethnic minority populations. This year’s theme, â€Å"Accelerating Health Equity for the Nation,† focuses on the critical role of fast track methods to reducing health disparities. The health status and outcomeRead MoreHealth Promotion Program Proposal On Lyme Disease Prevention1634 Words   |  7 Pages Health Promotion Program Proposal on Lyme disease Prevention My health promotion program will focus on Lyme disease. My state-Maryland is number one in the list of top ten states for Lyme disease in United States. According to Physicians Now (2016), Although there were fewer cases of Lyme disease reported in 2012 than in previous years, the illness is still more common in Maryland than in many other states. There were 1,113 confirmed cases and 538 suspected cases in 2012, according to the CentersRead More Health Promotion and Teaching as Tools for Nursing Essay1325 Words   |  6 PagesLaying the Foundation for a Healthier Future Health promotion and teaching are important tools for nursing. By promoting health and health teaching, nurses can help lay the foundation for a healthier future. Major Concepts and Definitions Belief–a statement of sense, declared or implied, that is intellectually and/or emotionally accepted as true by a person or group. Attitude–a relatively constant feeling, predisposition, or a set of beliefs that is directedRead MoreEssay about Heritage Assessment981 Words   |  4 Pagessignificant social movement in America has amplified public awareness toward the promotion of health and disease prevention, known as Healthy People 2000 and 2010. It has been beneficial in changing the focus of health care from a reactive standpoint to a proactive one, which endorses national health and prevention of disease (Edelmam Mandle, 2010). However delivery of health care objectives is not enough. Health providers must recognize and incorporate cultural group patterns, and variations withinRead MoreImpact of the Iom Report1178 Words   |  5 Pageschanging at a very quick pace (Robert Wood Johnson Foundation, 2011). This transformation is due to a number of factors like demographic changes, the shortage of health care professionals, economic downfalls on the health care system, and evolving technology (Robert W ood Johnson Foundation, 2011). In an effort to support and promote the future of nursing and advancement in health care, the Institute of Medicine (IOM) and Robert Wood Johnson Foundation (RWJF) took on a 2 year initiative that consistedRead MorePoor Health Habits Of Employees1383 Words   |  6 Pages INTRODUCTION The issue of poor health habits of employees has resulted in growing rates of chronic disease, together with the rising cost of health benefits, increased absenteeism and reduction in productivity (Mujtaba, 2013). The decline in workforce health also adds to increased health related expenses. This includes both direct medical payments and indirect expenses resulting from absenteeism or presenteeism (loss of productivity when employees not fully functioning because of illness or medicalRead MoreSleep Health : Essential For An Individual s Health And Well Being1418 Words   |  6 PagesAnn Dickerson Sleep health is essential for an individual’s health and well-being. Sleep disorders and sleep deprivation is an unmet public health concern. It is estimated that fifty to seventy million Americans chronically suffer from some type of sleep disorder, which in turn, effects daily function and negatively affecting health and longevity (The National Academy of Sciences, 2006). Sleep is increasingly identified as important to public health, for it has been linked to motorRead MoreDiarrhoea in Children under the Age of Five1163 Words   |  5 Pagespurpose of this report, based on the alarming statistics presented above. They are at risk both because their age means they have not got fully developed immune systems, and also because their personal hygiene practices are only just developing. A Health Promotion Tool designed to introduce students in the Prep year at IGGS to good hand washing practices was developed. This tool proved very effective in teaching the young students h ow to wash their hands properly. A 2004 paper on Acute Infectious DiarrhoeaRead MoreCardiovascular Disease : A Heart Failure, Arrhythmia And Mitral Valve1071 Words   |  5 Pagescardiovascular disease includes complete heart failure, arrhythmia and mitral valve prolapse (heart valve problems). Affecting one in six people and contributing to 43,603 deaths in Australia (2013), we need to become aware, as a country, on how our physical health affects us. Risk Factors There are many risk factors which can contribute to cardiovascular disease, with no singular cause for it. The risk factors can be separated into two main groups, lifestyle factors or changeable factors and unchangeable or

Thursday, May 7, 2020

It Is Not Too Different From The Wild - 962 Words

Just UPS and Me Life for me so far has been short-lived. But in my measly amount of time on this planet, I have learned enough to survive. Some of the knowledge I have acquired while working at United Parcel Service (UPS) is that not everyone gets along, some people have it better than others, no matter how hard a person work favoritism always wins, and that sexism is a real thing; however, it does also have some benefits. Life in civilization is not too different from the wild. Sometimes, I like to think of UPS as being an exhibit of wild animals in a zoo. Especially since I work the early day shift from 4 a.m. to 10 a.m. When people are tired, hot (or cold), and grumpy, they are not at their best, especially that early in the morning. They are extremely irritable and easily agitated. Which can cause problems. Recently there was a fight that broke out during break. It involved five very large men. All of whom were immediately fired when the fight was broken up. Since UPS is predomi nantly male, the testosterone gets out of hand which results in fights, arguments, very excessive amounts of cursing, and even plays of dominance. That much testosterone in one building with no heating or AC can only lead to trouble, which for the most part it does -hence my zoo reference. At UPS we are a â€Å"team†, and by team, I mean it is every man for himself. Everyone typically wants to get as many hours as possible while doing the least amount of work as possible. Which causes trouble forShow MoreRelatedBanning Wild Animals As Pets985 Words   |  4 Pages Prohibiting Wild Animals as Pets Exotic animals never cease to amaze and capture the hearts of humans. Young or old, everybody is fascinated by them and wants to be in close proximity to such magnificent creatures. Some want to be so close to the wonderful animals that they are interested in owning them. Little do they know owning a wild creature can come with a hidden cost. Animals belong in the wild, and they are not meant to live in a house or be cared for by the average person. A federalRead MoreInto the Wild Essay1026 Words   |  5 PagesDec 9, 2009 Paper #2 Into the Wild Into the Wild is a book about a young man named Chris McCandless and his decision to go off and live in the wild. He decided to walk deep into the Alaskan wilderness and abandon all of his possessions and family. This book is the authors, Jon Krakauer, version of Chris McCandless’ story put together through interviewing and speaking with people who knew Chris as well as by using letters Chris wrote to his loved ones. In my opinion on what motivated Chris McCandlessRead MoreNotes On Buffalo Wild Wings1210 Words   |  5 PagesBuffalo Wild Wings Buffalo Wild Wings first opened their doors in 1982 with one restaurant in Columbus, Ohio and has grown into a popular, mainstream restaurant with a store in every state in the United States. They have even begun to open up stores around the world. Their slogan is â€Å"Wings. Beer. Sports.† This restaurant prides itself on being the ultimate place to gather with friends to grab some excellent wings, drink one of their many beers on tap, and watch sports. (About Buffalo Wild Wings.Read MoreKeeping Orca Whales in Captivity Should Be Banned Essay1336 Words   |  6 PagesFor many years, we’ve been going to such places like, SeaWorld, and Six Flags, to see vast animals, like Orcas, also known as the killer whale, which we wouldn’t normally see out in the wild. Orcas have been around for millions of years; it’s known to be one of the smartest mammals, closest to humans. Since of their friendliness, people have taken advantage of them. For the past sixty year s people have brought these massive creatures into their aquariums to make profit out of it, but never thoughtRead MoreNotes On Buffalo Wild Wings1209 Words   |  5 PagesBuffalo Wild Wings Buffalo Wild Wings first opened their doors in 1982 with one restaurant in Columbus, Ohio and has grown into a popular, mainstream restaurant with a store in every state in the United States. They have even begun to open up stores around the world. Their slogan is â€Å"Wings. Beer. Sports.† This restaurant prides itself on being the ultimate place to gather with friends to grab some excellent wings, drink one of their many beers on tap, and watch sports. (About Buffalo Wild Wings.Read MoreThe Importance Of Wild Mustangs1665 Words   |  7 Pages The Importance of Wild Mustangs Over four hundred years ago, wild horses or â€Å"mustangs† as we call them, were introduced to North America by the Spanish. As a result, these marvelous creatures have been roaming the land of the United States ever since, and they have become a part of our history. Mustangs have played an active role in our history by providing a means to travel, an expansion of our country, and as a natural beauty to see in the wild: therefore, it is crucial to protect and overseeRead MoreBildungsroman Is Defined As A Novel Of The Novel And The Wild Things 1662 Words   |  7 Pageseducation.† The subject of this novel is the development of the protagonist’s mind and character, in the passage from childhood through varied experiences and often through a spiritual crisis into maturity, which usually involves recognition of one’s identity and role in the world† (M.H. Abrams, A Glossary of Literary Terms). Lewis Carroll’s Alice in Wonderland and Maurice Sen dak’s Where the Wild Things Are use this literary device through their main characters, Alice, and Max, as they grow either physicallyRead MoreCompare and Contrast Call of the Wild Essay1375 Words   |  6 PagesCALL OF THE WILD The book and the movie of The Call of the Wild are both similar yet different. Like any movie based on a book, the movie of The Call of the Wild presents different characters and events than the book so it can be unique and enjoyable. In this essay, I’ll like to compare and contrast the book and the movie. The book and the movie of The Call of the Wild are fairly similar. In both the movie and the book, Buck first lives on Judge Miller’s estate and is kidnapped by Manuel, theRead MoreThe Old Man And The Sea1176 Words   |  5 Pagesand Lord of the Flies by William Golding, that show a very clear line that divides man from nature, and how nature is for the most part the enemy. However, in other stories, the line between civilization and nature is blurred. Stories such as True West by Sam Shepard, The Metamorphosis by Franz Kafka, and â€Å"The Rememberer† by Aimee Bender display examples of how the two distinct world of the civilized and the wild can cross into one another. In True West, the two main characters are complete foilsRead MoreAnimals Should Not Be Held Captivity1590 Words   |  7 Pagesanimal captivity is wrong. â€Å"Hundreds of thousands of wild animals across the world are snatched from natural habitats, forced into captivity and subjected to abuse, both mentally and physically, in the name of entertainment and profit.† (World Animal Protection 1) Places such as the circus use abusive training methods such as, hooks, chains, whips, electric rods, and blunt instruments. (Born Free USA 1) Animals deserve to live freely in the wild. Their freedom is taken away the moment they are put

Wednesday, May 6, 2020

The Audit Report Was Timely, but at What Cost - 18721 Words

CHAPTER AUDIT REPORTS THE AUDIT REPORT WAS TIMELY, BUT AT WHAT COST? 3 LEARNING OBJECTIVES After studying this chapter, you should be able to 3-1 Describe the parts of the standard unqualiï ¬ ed audit report. Specify the conditions required to issue the standard unqualiï ¬ ed audit report. Understand combined reporting on ï ¬ nancial statements and internal control over ï ¬ nancial reporting under Section 404 of the Sarbanes–Oxley Act. Describe the ï ¬ ve circumstances when an unqualiï ¬ ed report with an explanatory paragraph or modiï ¬ ed wording is appropriate. Identify the types of audit reports that can be issued when an unqualiï ¬ ed opinion is not justiï ¬ ed. Explain how materiality affects audit reporting decisions. Draft appropriately modiï ¬ ed audit†¦show more content†¦The audit report is the ï ¬ nal step in the entire audit process. The reason for studying it now is to permit reference to different audit reports as evidence accumulation is studied throughout this text. These evidence concepts are more meaningful after you understand the form and content of the ï ¬ nal p roduct of the audit. We begin by describing the content of the standard auditor’s report. STANDARD UNQUALIFIED AUDIT REPORT To enable users to understand the language of audit reports, AICPA professional standards provide uniform wording for the auditor’s report, as illustrated in the auditor’s standard unqualiï ¬ ed audit report in Figure 3-1. Different auditors may alter the wording or presentation slightly, but the meaning will be the same. Parts of Standard Unqualiï ¬ ed Audit Report OBJECTIVE 3-1 Describe the parts of the standard unqualiï ¬ ed audit report. The auditor’s standard unqualiï ¬ ed audit report contains seven distinct parts, and these are labeled in bold letters in the margin beside Figure 3-1. 1. Report title. Auditing standards require that the report be titled and that the title include the word independent. For example, appropriate titles would be â€Å"independent auditor’s report,† â€Å"report of independent auditor,† or â€Å"independent accountant’s opinion.† The requirement that the title include the word independent is intended to convey to users that the audit was unbiased in all aspects. 2. AuditShow MoreRelatedWorldcom s Management Team : A Lack Of Professional Skepticism1640 Words   |  7 Pages2) WorldCom’s management team was hesitant to communicate with Arthur Andersen, this an issue that revealed a lack of professional skepticism that Andersen exercised. There are many examples and observations that show a lack of professional skepticism shown by Anders en. Some of these observations include; 1) A failure to request supporting evidence for recorded transactions that needed it; 2) Several request for interviews and information were denied by WorldCom when Andersen asked for these request;Read MoreU.s. Health Care System1611 Words   |  7 PagesThe cost of healthcare has and will continue to rise in the United States. Some factors that contribute to those hikes are due to the consumer demanding more complex services from health care providers. Things such as new technology, equipment, research and testing procedures, along with pharmacy, and the number of uninsured are all dynamics of the increased cost in health care. The U.S. health care system relies heavily on third-party payers; these payers include commercial insurers and the FederalRead MoreEvaluation Of A Project Management Audit Essay950 Words   |  4 PagesWhat should be done to ensure appropriate closure of this project and why? There will be several areas of â€Å"clean-up† to address before announcing the project success and closure. First, before the closure of the project, it is better conduct an interim project audit to analysis the result. A project management audit is an examination designed to determine the true status of work performed on a project and its conformance with the project statement of work, including schedule and budget constraintsRead MoreActivity-Based Management in Shell Gabon (Case Study) Essay1718 Words   |  7 PagesIs a barrel of oil the cost driver for all the activities that go on within RDS? Comment on why RDS chooses to monitor costs per barrel. The UOC per barrel for SG is $3.21. OPEX | $140,640,200 | 120,000 | barrels/day | | | 365 | days/year | Total | $140,640,200 | 43,800,000 | barrels/year | Unit Operating Cost (UOC) | $3.21 | | | *UOC = (Total Operating Expense – Exploration – Depreciation Depletion) / Barrels Produced Barrels of oils produced may be a cost driver for some activitiesRead MoreThe Adequacy Of The Current Deterrence Model Of Tax Compliance1020 Words   |  5 Pagesa combination of penalties and rate of audits. Does it provide the proper balance in light of our â€Å"voluntary compliance† system in the United States? The federal tax system in the US is founded on the principle of self-assessment. Self-assessment is also referred to as voluntary compliance. The IRS does not compute taxpayers tax liabilities but the Code requires taxpayers to determine their own tax liabilities. The IRS enforces the tax laws through audits, civil tax penalties, and a number of taxRead MoreComtemporary Auditing1155 Words   |  5 Pagesof the practices that you identified in responding to the previous question. What implications, if any, do those practices have for the company’s independent auditors? Manipulating earnings can be detrimental to a company and the auditors. Some implications that can occur for the auditor’s include: higher risk clients and requirement that more testing be conducted which results in more auditor hours allowing the audit firm to charge a â€Å"premium fee.† In most cases, the auditor’s reputation is atRead MoreDhb Industries Inc888 Words   |  4 PagesFINAL CASE 1.10 1. There were many adjustments that were made in the original balance sheet to properly record overstatements made by DHB Inc. In the current assets, one major entry that was heavily overstated was inventory. Inventory went from $47,560,000 to $38,231,000. The difference of $47,742,000 is a material due to the magnitude of the difference. Another material difference is deferred income tax assets that went from $483,000 to $19,094,000. Totaling a significant difference ofRead MoreA. Lead Auditors Roles Lack Definition and Authority The common problem with informal leadership1300 Words   |  6 PagesFor DCAA senior auditors, the role of lead auditor matches this scenario perfectly. The lead auditors in a DCAA audit engagement teams lacks the authority and influence on how audits are conducted because of its organizational structure. DCAA field audit offices (FAOs) are organized as a â€Å"weak matrix organizational structure†. Figure 1: Sample DCAA FAO Organizational Structure and Audit Engagement Team DCAA’s organizational structure is hierarchical where each employee has one clear superior andRead MoreControl Mechanisms Paper1593 Words   |  7 Pagesunderstand what control means in the management world. 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This brings the cost of an automated solution for the foodservice operator down to a price

Protein Article Research Free Essays

Anonymous Dr. Louis Cohen SCI/241 Protein Article Research January 3, 2012 According to Centers for Disease Control and Prevention, protein is found in every cell in the body. Protein provides our bodies with energy that is ready to be used. We will write a custom essay sample on Protein Article Research or any similar topic only for you Order Now After it is digested, it becomes amino acids. There are 23 amino acids which are very essential to the body and are needed for the body to function properly. Amino acids are needed in order to build muscle strength. Protein can be found in animal foods, and it can also be found in plant foods. Animal foods such as meats, cheeses, and dairy products are complete sources of protein, while plant sources are an incomplete protein source because they are low in at least one of the essential amino acids. Plant sources need to be consumed with a complementary protein source in order to be certain that protein needs are being met. For example, if you eat chicken, that would be a complete source of protein, whereas if you eat rice for a meal, you should add beans to make the protein consumption complete. A few examples of plant sources or an incomplete protein source is as follows: corn, tofu, grains, some vegetables and fruits. Because I am a 19 year old woman, I need 46 grams of protein a day. I can easily meet and exceed the amount that is necessary by eating all of my meals in a day and by consuming all other essential nutrients. Although getting just the right amount of protein is healthy for the body, getting too much can be harmful. When people consume too much protein, they increase their risk of weight gain. Also, high protein diets can put a strain on the kidneys because they rid the protein from the blood, may contribute to cancer because it increase blood levels of IGF-1, and may cause nutritional deficiencies. Just as high protein diets can cause medical illnesses, low protein diets can do the same. A diet with a lack of protein can cause skin pigmentation, diarrhea, swollen bellies, rashes, and change in texture or color of the hair. Protein is on the body’s essential needs, however, too much or too little of any nutrient that is essential can harm the body. It is vital that people learn the amounts of nutrients their body requires in order to become or remain healthy. How to cite Protein Article Research, Essays Protein Article Research Free Essays Protein Article Research Sara Langrell December 15, 2011 Nutrition SCI/241 Dr. Venessa Lee Abstract: Athletes have been searching for years for a way to reduce the amount of recovery time between work outs. Based on this issue there has been quite a lot of research conducted to find out what can be done, if anything, to either reduce or eliminate recovery time. We will write a custom essay sample on Protein Article Research or any similar topic only for you Order Now One of the theories is to increase protein intake above the daily recommended amount, thereby providing the body with additional amino acids that promote recovery. Although this seems like the perfect solution, there are some flaws. It would appear that not only do you need additional proteins but an additional source of fuel to allow the proteins to do their job, therefore all in all a balance must be struck. The recovery time needed from an intense work out is a direct result of the lengthening, or even sometimes, tearing of muscles. If the work out is too intense muscles can actually be damaged. The damage can be classified into three different categories: Type I, Type II and Type III. Type I muscle damage is classified as the soreness that occurs 24-48 hours after unaccustomed exercise. Type II is classified as an acute disabling pain either from the complete tearing of the muscle and facia or the disruption of a few fibres with the facia remaining intact. 1 Type III is classified as a cramp or soreness that occurs either during or directly following a workout. 1 Because of these issues, many hours of research have been conducted to try to determine if there is anything that can be done to slow or even elimi nate the damage done to the muscle during exercise. When muscles are stretched or damaged proteins are both broken down and synthesized all at the same time. The breakdown is not all bad for the body, as it regulates potentially damaging and dysfunctional proteins. 2 In direct response to the breakdown, the synthesis that occurs would seem to be good for the body; however it can cause an imbalance in muscle proteins. 1 Based on research it has been determined that replacing amino acids during and after exercise helps to balance the protein deficiency and assist in the repair process. Many of the recommended ways to do this is to increase protein intake or possibly opt for an amino acid replacement supplement. Dependent upon the type of exercise you are prone to will determine the type of supplement that would be recommended. Checking with a physician would be the best bet before beginning any type of therapy. Bibliography: 1. ) Nosaka, Kazunori PhD, Muscle damage and amino acid supplementation: Does it aid recovery from muscle damage? International SportMed Journal, Vo. 8 No. 2, 2007, pp. 54-67 2. ) Phillips SM, Protein requirement and supplementation in strength sports. Nutrition, Vol. 20, 2004, pp. 689-695. How to cite Protein Article Research, Papers

Renaissance and Baroque comparison

Renaissance and Baroque comparison These two historical periods had many similarities, yet also differences in which made the historical periods very unique. The Renaissance period had many characteristics that were not common with any other historical period in history. Italian scholars and artists started re-examining the use of art and sculptures and were reawakened by the ideals of Roman and Greek times (Renaissance Art, 2013). The Renaissance art was distinctive in its style of paintings and sculptures. New techniques were developed such as introduction of oil nettings, linear perspective, aerial perspective, and chiaroscuro (The Renaissance, 2013). There were many great artists of this period, but three great masters were Leonardo dad Vinci, Michelangelo, and Raphael who dominated the period known as High Renaissance (Renaissance Art, 2013). Leonardo best known works include the Mona Lisa and The Last Supper. Michelangelo was known for his many sculptures and paintings which included the decoration of the ceiling of the Sistine Chapel in the Vatican (Renaissance, 2013). Raphael, who learned and was influenced by both Leonardo dad Vinci and Michelangelo, painted most notably The School of Athens which expressed classical ideals of beauty. The Catholic Church was a huge influence with the Renaissance art period as many arts had depicted religious images, such as the Virgin Mary (Renaissance Art, 2013). The Baroque period began around the 17th century in Rome. It was a period of new discoveries of science, exploration, and broader art diversity. During the Reformation movement, the Roman Catholic Church believed that art was to serve as a means of extending the publics faith in the church. The Baroque style that evolved from this movement was to convey an impression of sensual and spiritual, yet naturalistic to the religious images and paintings. Accuracy and Carving, two Italian painters whose styles of paintings arouse into Rome, started the decoration and the monumental painted ceilings of many churches. This started many artists of that time to use vivid colors and luxurious materials to evoke sensual delight (Baroque . In Baroque paintings, the touch was on the dramatic style and use to contrasting light and shadow for deep colors. In all the visual arts, there was a distinctive use on harmony and unity often using religious themes and stories (Baroque Art, 2013). There are similarities and differences in both the Renaissance and Baroque periods and are both unique in different respects. The Baroque period is said to have been generated at the end of the Renaissance era, which progressed to a dramatic and sophisticated form of art. The techniques of the Baroque art period united the techniques and advances used from the Renaissance along with the emotion, intensity and drama of the High Renaissance. The Baroque period continued from the Renaissance with the use of light and color, the focus on realism, strong perspective effects, and religious themes (Baroque period, n. D. ). Two pieces of art that show similarities and differences of the Renaissance and Baroque periods are The Mona Lisa by Leonardo dad Vinci and The Straw Hat by Peter Paul Rueben. Both paintings illustrate a young lady in almost identical poses with a slight grin on their face. The backgrounds of both paintings are mysterious and foggy. The background of the Mona Lisa is different from that of The Straw Hat due to Leonardo dad Vines precise details. His use of colors, dramatics, and intensity in the painting is illustrated from that of the Renaissance Era (Dad Vinci, 1504). In The Straw Hat, Rueben uses no distinct background, and Just focuses on the main subject. The color schemes are differentiated from the deep, dark colors of the Mona Lisa to the bold, daring color tones of The Straw Hat from the Baroque area that makes the image stand out (Rueben, 1625). The Renaissance and Baroque periods were both influential in generating the greatest masterpieces that the art world has seen.

Monday, April 27, 2020

When Communications Undermine Knowledge Management

Abstract Jensen’s 1998 article Communication or knowledge management? highlighted the developing kinship between organizational communications and knowledge management as a balm for mounting employee frustration. The following essay analyzes the state of organizational communications and knowledge management as of 2010.Advertising We will write a custom essay sample on When Communications Undermine Knowledge Management specifically for you for only $16.05 $11/page Learn More The bond between these two disciplines, such as Jensen predicted, has cooled considerably, if indeed it ever did truly form. Reasons for this distance include the dynamic and often fractious relationship between communication, knowledge management, organizational structure and organizational culture. Prompted by what Bill Jensen, president and CEO of The Jensen Group characterized as a misinterpretation of roles on the part of organizational communicators, Jensen’s 1998 article Communication or knowledge management? highlighted the developing kinship between organizational communications and knowledge management as a balm for mounting employee frustration (Jensen, 1998). Jensen’s article highlighted an excessive focus on change announcements and context setting materials amongst organizational communicators at the time and a dearth of â€Å"clear, effective, useful day-to-day information and sense making† (Jensen, 1998). Employees seek â€Å"help in making sense of, using, and leveraging the information around us† Jensen argued (Jensen, 1998). â€Å"We’re seeking the ability to navigate through change for ourselves, but just too much information is buzzing past us to do so† (Jensen, 1998). Jensen urged communicators to shift away from the busy work of â€Å"key messages† and â€Å"town meetings† and focus more on â€Å"performance information† deemed pertinent to employees making decisions on the ground (Jensen, 1998). Jensen proposed a union of communication and knowledge management as the solution; in his words, communication and knowledge management are â€Å"very similar,† however knowledge management remains â€Å"more disciplined about capturing, organizing and tracking what we need to make decisions† (Jensen, 1998). Jensen defined knowledge management in 1998 as composed of â€Å"two basic disciplines: facilitating dialogues [and] organizing data for operations use;† Jensen lamented the absence of both disciplines from communication practice of the time (Jensen, 1998).Advertising Looking for essay on business communication? Let's see if we can help you! Get your first paper with 15% OFF Learn More The following essay analyzes the state of organizational communications and knowledge management as of 2010. The bond between these two disciplines, such as Jensen predicted, has cooled considerably, if indeed it ever did truly form. R easons for this distance include the dynamic and often fractious relationship between communication, knowledge management, organizational structure and organizational culture which Jensen’s jocular and rosy call to action appears to have overlooked. Everything that happens or doesn’t happen in an organization begins and ends with that organization’s culture. Given that organizations operate according to a hierarchy, the effectiveness of organizational communications remains wholly dependent on the communication skills of its leadership (Anaeto, 2010). Similarly, the overall vision and utility its leadership ascribes to organizational communications and knowledge management affects the perceived value of each by the organizational culture as a whole; if organizational communications and knowledge management receive only lip service from the leadership, they will be largely disregarded by employees. Similarly, if both organizational communicators and knowledge man agement professionals compete for credibility within an organization, employees receive conflicting information that serves personal interests, or worse, may feel â€Å"awash in so many change initiatives† (Abrahamson, 2004). Organizational communications undermines and in some cases damages knowledge management when the organization’s leadership either sees no value in it, or lacks the skills to implement it on the highest level of organizational culture. Organizational culture goes beyond language and communication materials, and how an organization’s culture understands (or doesn’t understand) knowledge management will be the determining factor in the overall success of communication. The bias for or against a union of organizational culture and knowledge management appears often in the â€Å"language that people use in their everyday conversation with other employees as well as formal organizational documents and communications† (World Bank, 20 10).Advertising We will write a custom essay sample on When Communications Undermine Knowledge Management specifically for you for only $16.05 $11/page Learn More It is important realize, as Anaeto (2010) astutely observes, that â€Å"it is difficult for culture to develop, survive, extend and generally succeed without communication. It follows therefore that when we talk of an organizational culture, we are looking at what is happening in the organization in terms of communication† (Anaeto, 2010). Organizational communications in essence communicate organizational culture both explicitly through employee communications, and implicitly through codified cultural assumptions about â€Å"how things are done around here,† and more to the point, â€Å"how people get ahead in this place†. Organizations themselves develop their own code of spoken and unspoken language, which typical ties in deeply with job security, promotion and financial reward. Tacit knowledge, the elusive content of employees’ minds that Jensen called â€Å"what we know but [have] not yet ‘captured’ in script- or database-format†¦is still best transferred during†¦communication. It’s estimated that 50 percent to 95 percent of transferred knowledge†¦occurs during oral communication† (Jensen, 1998). This may be true. However what is missing from Jensen analysis is the fact that an organization’s culture will necessarily affect the flow and availability of said tacit knowledge during oral communication. Underlying organizational culture assumptions drive communication. As Anaeto (2010) asserts, â€Å"the language of the organization member is the key to understanding the organizational culture† (Anaeto, 2010). For example, in an organization that promotes competition and in fighting amongst its employees, tacit knowledge becomes personal leverage. As a result, all knowledge, tacit and oth erwise, will be carefully guarded and managed and only shared strategically; in some cases jealously, and in other cases withheld altogether. The degree to which organizational communications can really be â€Å"managed† depends wholly on leadership buy in and support, since employees pattern their behavior, including their communication styles, based largely on their own perception of what type of communication succeeds in the organization (Anaeto, 2010). Incentives for participating in knowledge management then hinges on its perceived value in the organization’s culture. In a team oriented organizational culture, where knowledge sharing occurs freely and the leadership rewards teamwork financially or through titles, then knowledge management will tend to be embraced.Advertising Looking for essay on business communication? Let's see if we can help you! Get your first paper with 15% OFF Learn More Conversely, in an organizational culture that values employee competition, communication and knowledge management activity will likely resemble more of a faà §ade, since employees tend to share only that knowledge that furthers their individual goals as opposed to the goals of the organization. The leadership of any given organization defines its culture, and an organization’s culture defines its communication approach (World Bank, 2010). This reality, though hinted at in Communication or knowledge management, Jensen downplayed significantly and somewhat naively: â€Å"it’s likely that there are many factors preventing you from shifting from communication deliverables to knowledge management practices. Leadership, technology, budgets, staffing or even bad hair days may be legitimate reasons you’re being held back† (Jensen, 1998). A leader who is an effective communicator can balance â€Å"needs to create strong interpersonal relationships and accomplish tasks, maintain a balance between order and chaos within the organization, and use rewards and punishments to motivate followers† (World Bank, 2010). In order for organizational communications to facilitate effective knowledge management objectives, communication and knowledge management must be presented as â€Å"clear elevating goal[s]† for employees, and not simply by the communications department or knowledge management specialists, but by the organization’s leadership itself. â€Å"High performance teams have both a clear understanding of the goal to be achieved and a belief that the goal embodies a worthwhile or important result† (World Bank, 2010). The leader of an organization also sets its mode of communicating; the leader’s communication style of choice will influence the perceived value of knowledge management in the organization. If the leadership communicates the value of knowledge management through organizational communication materi als such as key messages yet employees perceive no action or implementation as a result of knowledge management, it will be seriously undermined and in some cases disregarded entirely. Leadership also defines how communication occurs in the organization. In a centralized network â€Å"information is funneled through a small number of individuals within an organization,† and leaders tend to value a rigid hierarchy within the organizational structure (World Bank, 2010). In such cultures, organizational communications and knowledge management are likely to be in competition with each other for attention from leadership, nullifying any net impact of either discipline on employee’s desire for â€Å"sense making† (Jensen, 1998). Conversely, a â€Å"decentralized network exists when information is shared widely among and flows through many individuals within an organization† (World Bank, 2010). On the whole these types of organizations â€Å"employ relatively f lat hierarchies by relying on flexible emergent communication†¦develop flexible relationships with the network of organizations that go beyond the local country bound network†¦use information technology to coordinate units and members located in different geographic locations†¦[and] emphasize the use of autonomous, self-managing teams† (World Bank, 2010). Organizational cultures of this ilk likely support and nurture organizational communications, and knowledge management becomes a core value of organization’s leadership. In conclusion, Jensen’s vision of a working partnership between organizational communications and knowledge management can materialize only if and when the organization’s leadership encourages such a union. Should the organizational culture place low value on communications and knowledge management, or if the organization’s culture remains deeply hierarchical and lacks the skills and interest to implement organizatio nal communication and knowledge management as a core value of leadership, organizational communications will run the risk of discrediting knowledge management. References Abrahamson, E. (2004). Change Without Pain: How Managers Can Overcome Initiative Overload, Organizational Chaos and Employee Burnout. Cambridge, MA: Harvard Business School Press. Anaeto, S.G. (2010). Managing organizational culture for effective communication. The Social Sciences, 5(2), 70-75. Jensen, B. (1998). Communication or knowledge management? Communication World, 15 (6), 44-48. Web. World Bank. (2010). Organizational communication. Washington DC: World Bank. Retrieved from http://siteresources.worldbank.org/EXTGOVACC/Resources/OrganizationalCommweb.pdf This essay on When Communications Undermine Knowledge Management was written and submitted by user Ayla Velasquez to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Friday, April 10, 2020

Sample Job Application Essay Questions - How To Write Great Essays And Get Hired

Sample Job Application Essay Questions - How To Write Great Essays And Get HiredIf you're in college, job hunting or just in a position that is available, it's very important to take a few minutes and write a sample job application essay questions. One of the more important aspects of applying for a job is developing an outline for a resume. Writing a sample resume will also help you prepare yourself to give the same information during the interview.Using sample job application essay questions is not difficult, but it's important to remember that no two applicants will be the same. So when writing your own, be sure to keep your applicant to the point and make it easy for them to read. Sample job application questions will also have your resume in it that helps your prospects better understand how your life works.Just like any other essay writing, job application questions should consist of a question that they are trying to figure out, a statement, and then a conclusion. Be sure to b e concise and avoid using buzz words or unnecessary words to impress your reader.Many people are intimidated by the thought of writing an essay, so you can help them through this process by following this order when writing your job application essay questions. First, ask yourself what is the main reason for their interest in your resume.Next, give your reader a statement to read about why they should hire you for the job. This is usually what they are looking for to begin with.Finally, give your readers a conclusion about what to expect if they chose to hire you. Avoid getting too detailed, but let them know that your plan is to make your dream job your job and then get hired for it.Following these steps will help you be able to use the sample job application essay questions for applying for jobs you are qualified for. There are many websites that offer free samples of resume writing for job searching and many of them have sample application essay questions that you can easily writ e. If you follow these tips, you'll be well on your way to bettering your chances of getting hired.

Thursday, March 19, 2020

Diagnosing Malaria †Case Study

Diagnosing Malaria – Case Study Free Online Research Papers Diagnosing malaria can be missed when there is a significant time lag from exposure and negative initial tests. As clinicians we must always consider the diagnosis in the appropriate clinical setting as a missed diagnosis can potentially result in serious consequences. A 27 year old female student from Nigeria presented with a two day history of headaches, mild photophobia, sweats and fever. She arrived from Nigeria eight months previously and had not been back since. On admission she was unwell with a temperature of 38.5?C, pulse 110/min but otherwise haemodynamically stable. Examination revealed a soft ejection systolic murmur and signs of meningism, but her neurological assessment was otherwise entirely normal. Her initial investigations showed a haemoglobin level of 11.8g/dl, white cell count 3.9109/l, lymphocytes 0.5109/l, platelets 118109/l, C-reactive protein 121mg/l; urea and electrolytes and liver function tests were normal. She was commenced on ceftriaxone 2g daily with a presumptive diagnosis of meningitis. She had a normal CT head, which was followed by a normal lumbar puncture. Two sets of blood cultures and a mid-stream urine sample had no growth after 48 hours. The initial admission pyrexic thick and thin blood film and malarial antigen test (Optimal, DiaMed) were negative. She improved initially with antibiotics and intravenous fluids. 24 hours into her admission, having been reviewed by a number of senior doctors, her working diagnosis was changed to one of a viral illness and plans were made for her discharge. Malaria was felt to be unlikely given that not only was she eight months post exposure for malaria, her blood film and antigen test were negative. However, on the day of discharge she was found to spike a temperature of 38?C and remained thrombocytopenic (108109/l). It was decided that in view of her origin (Nigeria) and the fact that she remained thrombocytopenic, malaria still needed to be considered. Even though a thick and thin blood film and malarial antigen test (Optimal, DiaMed) were negative, we felt three negative blood films were needed before excluding malaria and labelling her as a patient with a viral illness. Interestingly a repeat blood film showed malarial parasitaemia of 5% Plasmodium falciparum [Figure 1]. Her haemoglobin dropped to 9g/dl and platelets dropped to 93109/l over the next two days, which then recovered. She was treated with intravenous quinine (10mg/kg) for 48hrs and converted to oral quinine for seven days followed by three tablets of oral pyrimethamine with sulfadoxine (Fansidar). She was discharged home with a negative parasitaemia. Comment The Office of National Statistics reports increasing international travel in our population with 25 million visitors to the UK and 61 million trips abroad in 2003. According to the Health Protection Agency (HPA) there were 1722 cases of malaria in the UK in 2003, 78% were Plasmodium falciparum, all of which were diagnosed within five months of arrival in the UK. Their statistics also show that 59% of malarial cases in UK are from those of African ethnicity, and patients who were infected in Nigeria contribute one third of all Plasmodium falciparum cases in UK and 2 out of 16 deaths in 2003. Immunity to malaria is acquired slowly, is incomplete and on leaving the infectious environment falls over about 1-2 years. Those who have been out of exposure for greater than 1 year or been born in UK are classed as non-immune. These individuals if exposed usually develop malaria within one month of leaving the endemic area. In contrast those who are from endemic areas and arrive in the UK as an immigrant, visitor or student (our patient) are classed as semi-immune. In these individuals and those who have taken malaria prophylaxis, incubation can be significantly prolonged, and may have milder symptoms. In those countries with high transmission rates, severe disease is usually a disease of the young (1 month to 5 years) or non-immune adults (vast majority of travellers to endemic areas). Children in areas of high transmission often show tolerability of the parasites due to constant parasitaemia without signs of disease, and paradoxically those living in low transmission areas have high clinical disease burden 1. Reviewing the HPA statistics, of the 1722 cases reported in 2003, 52% were visiting family and friends in their country of origin and probably non-immune as they had been born or lived in the UK for some time, 22% were from endemic areas (immigrants, visitors, students), and 26% were almost certainly non-immune (business travel, holiday, expatriates). Diagnosis of malaria in the 22% group, who arrive from an endemic area and are semi-immune, is often difficult because they can present late with clinical malaria, as demonstrated with our patient being in the UK for eight months prior to presentation. Our case was notable in that our patient had an initial negative microscopy and malaria antigen test. The latter is a new method for detecting malaria. It is a rapid dipstick immunoassay that detects circulating antigens of either histidine rich protein-2 of falciparum (HRP-2f) or plasmodium lactate dehydrogenase (pLDH). These are near-patient testing kits that have recently been developed to ease and speed up diagnosis, particularly in places that do not have access to microscopes or trained laboratory staff. The malarial antigen test Optimal (DiaMed) used in this case detects presence of pLDH. This assay can detect parasitaemia levels of 100-200 parasites per ?L of blood, equivalent to 0.002% 2 and has been found to have a sensitivity of 95.3% and a specificity of 100% for Plasmodium falciparum 3. However, a meta-analysis of ten popular brands showed that HRP-2 was more accurate than the pLDH tests 4. Though quick to use and easy to read they are not as accurate nor as good at dete cting species as microscopy using thick and thin films, hence why microscopy remains the method of choice. We believe most general physicians would have felt that on initial presentation our patient was unlikely to have malaria. She presented with non-specific symptoms and signs of meningism; over eight months had elapsed since her return from Nigeria and lastly initial investigations were negative for malaria. Many might have put her presentation down to a viral illness, though she had the characteristic lymphopenia and thrombocytopenia for malaria (sensitivity for thrombocytopenia in those with malaria is 60%, and specificity is 95%) 5. It is noteworthy however that a study in Nigeria found that headache, fever, chills and rigors were the commonest malaria symptoms in adults6. Further, a fact that we all forget is that the HPA advises us to consider malaria in a patient who has been potentially exposed up to 12 months. Finally if the clinical suspicion for malaria is high, three sets of malarial blood films must be taken before suggesting a negative result – easily forgotten by clinicians. In conclusion we would like to reinforce to all clinicians the advice by the Health Protection Agency that it is important to consider malaria due to Plasmodium falciparum as a differential in those who have had malaria exposure in the last 12 months and to always take three blood films if there is any clinical suspicion to make a diagnosis of malaria. Figure 1: Patients blood film showing malarial parasites References: 1. Reyburn H, Mbatia R, Drakeley C, Bruce J, Carneiro I, Olomi R, Cox J, Nkya WMMM, Lemnge M, Greenwood BM, Riley EM Association of Transmission Intensity and Age With Clinical Manifestations and Case Fatality of Severe Plasmodium falciparum Malaria Journal of American Medical Association 2005; 293:1461-1470 2. Palmer CJ, Lindo JF, Klaskala WI, Quesada JA, Kaminsky R, Baum MK, Ager AL Evaluation of the OptiMAL Test for Rapid Diagnosis of Plasmodium vivax and Plasmodium falciparum Malaria Journal of Clinical Microbiology 1998; Jan: 203-206 3. Kolaczinski J, Mohammed N, Ali I, Ali M, Khan N, Ezard N, Rowland M Comparison of the OptiMAL rapid antigen test with field microscopy for the detection of Plasmodium vivax and P. falciparum: considerations for the application of the rapid test in Afghanistan Annals of Tropical Medicine and Parasitology 2004; 98(1): 15-20 4. Marx A, Pewsner D, Egger M, Nuesch R, Bucher HC, Genton B, Hatz C, Juni P Meta-analysis: accuracy of rapid tests for malaria in travelers returning from endemic areas Annals of Internal Medicine 2005; 142(10): 836-46 5. DAcremont V, Landry P, Mueller I, Pecoud A, Genton B Clinical and laboratory predictors of imported malaria in an outpatient setting: an aid to medical decision making in returning travelers with fever American Journal of Tropical Medicine and Hygiene 2002, 66: 481-486 6. Harrison NE, Odunukwe NN, Ijoma CK, Mafe AG Current clinical presentation of malaria in Enugu, Nigeria Nigerian Postgraduate Medicine J. 2004; 11(4): 240-5 Research Papers on Diagnosing Malaria - Case StudyPersonal Experience with Teen PregnancyStandardized TestingResearch Process Part OneWhere Wild and West MeetLifes What IfsThe Relationship Between Delinquency and Drug UseEffects of Television Violence on ChildrenRelationship between Media Coverage and Social and19 Century Society: A Deeply Divided EraMarketing of Lifeboy Soap A Unilever Product