Saturday, August 31, 2019
A day in Detroit Michigan
A day in Detroit Michigan It is a cold, cloudy, overcast morning in Detroit, Michigan. It is very remote here and there have only been a few people I have seen walking the streets. I have seen only about four people so far as I am walking downtown, and those were African Americans. I have not seen any white people though at this time. I feel as If I am In another country. Most of the city at this time Is very remote and there are not a lot of businesses that are still in business. I feel cold here and as I am walking the energy that I am feeling is very shut off and bare.I feel as If I am In a place where no one ants to be, and I am a little scared that I am walking these streets with Just my brother and l. Everyone that we have passed by have looked at us strangely probably wondering why we are walking these streets. It Is 10:00 am In October here In Michigan. Dead leafs surround the sidewalks and streets as the colored leafs start changing. This Is my favorite time of year In Michi gan. The sky is grey and the air is chilly so we are dressed pretty warm.The sun is trying to come through the clouds but so far it is still very cloudy and gloomy. No one is around and I am looking at the buildings in the city and how a lot of of Hess buildings are so different. There are a lot of abandoned buildings around and it looks as if non one wants to come and take care of them anymore. This is when that cold feeling really started kicking in as I'm realizing that this city is so dead and seems like no one wants to keep this city alive anymore. The sun is finally starting to peak through the clouds now.It is now 2:30 in the afternoon here in Detroit. I have seen more people at this time walking around. When the sun started coming out, I felt that it touched the city in a way and made everything have more hope that surrounded me as I walked up and down these trees. The city had more of a positive feeling at this time, and the sky was turning but and I even saw more people la ughing and carrying on conversation through each other. The birds were chirping in the trees and the environment seemed more alive.The only down fall that I came to realize was when the sun came out, the streets started smelling and the weather started getting humid and muggy. A lot of people that ââ¬Å"livedâ⬠in the city were homeless. That means the outside is their bathroom as well. As I started walking further away from downtown, I noticed some houses along the way. I was in a bad neighborhood but no one seemed to be outside so I kept my head down and continued on my way. The houses were old and not well kept that had trash along the side of them and metal bars on the windows.Every other house on the block was abandoned. I felt sad and blessed at the same time. Sad because I felt so bad for the people that were living their life this way and blessed that I was able to come from such an amazing home and a fortunate family. Night was falling and I cam back to observe the ni ght life In the city. I stayed In my car and drove around the city because I felt that at this time of day It was unsafe or me to be walking around. A lot of gang actively happens at this time and I would of been scared.There was a lot of traffic and I looked and followed it to see what was awesome because events stuck as a Detroit Red Wings game still took place in the city. It was a nice surprise seeing all these people wearing red wings Jerseys smiling with excitement about the game. I drove home with fulfillment that I got to experience a day in Detroit Michigan. Although at first it was a cold, gloomy, grey day, it turned out to be a good day. Being able to experience a day in Detroit reminded me to always be grateful for everything that I have.I think this experience will forever stay with me whenever I feel as though I am having a bad day. I will always look back and remember that it could always be worse. I think everyone should spend a day in a less fortunate area to keep i n mind how much you really do have and to not worry about the little things that life throws your way. To always remember that everyone you come in contact with is fighting a battle Just like you and to never treat those around you less than because we are all humans. Thank you for this humbling experience Detroit.
Friday, August 30, 2019
Ethical Issue in Public Health Essay
1. Ethical Leadership in the Hospital Business Due to the critical relevance of the healthcare service for the society, it is important for the organizations and institutions involved in this field to develop their operational system, administrative approaches, and patient care strategies to address effectively and efficiently the healthcare service needs of the community. Important in these institutions is the organizational aspect of their operation wherein the role of leadership becomes a critical material as this manifest as the key element in the ethical nature of their group. Indeed, leadership is important in the hospital institution as this serve as the focal point of the ethical nature and ideal identity of their organization. The leadership characteristics each hospital institution respectively defines their service and their ethical nature. Significantly, the leadership character needed in healthcare institutions is mainly based on their classification organized based on their facilities, potential, and ability to extend particular healthcare service. In relation to their classification, it is important for the organization to develop leadership principles and ethical values towards their purpose of providing healthcare service. In this aspect, the leadership characteristics of each hospital must be towards achieving success in the ethical purpose of their organization, maximizing their potential for effective service, and extending their services in their community. These elements must be fully integrated and must be effectively manifested by the leaders of the hospital organization for them to be able to influence and direct their institution towards the achievement of these missions. Developing the approach in the leadership system of a healthcare organization is often considered as a critical matter particularly the approach that will be taken by the leaders in influencing the entire organization. In motivating the personnel of the hospital towards their ethical agenda, it is important for the leaders to affect the views and ideology of its people through personally manifesting the values they wish to promote. An approach particular to this is ââ¬Å"servant leadershipâ⬠in which the leaders manifest the values of humility and humbleness in their actions thus, enabling them to lead their group through examples. In general, this approach is mainly means being the values that they wish to promote whereas through perception, the organization will be motivated to follow their leaderââ¬â¢s example. Indeed, through applying this leadership strategy in uplifting the ethical values of the hospital organization, the institutions can become effective healthcare service medium addressing the need of the people for better health and better life. The ethical system by which hospital leadership is based actually outlines the needed level of relationship that doctors and other health staff should have with the patients that they are attending to. The level of involvement that they are allowed to have with their patients is usually broken down through the different ethical principles that the said industry applies in the system. 2. Contemporary Neuroscience and the Notion of Freedom The aspect of neuroscience primarily relates to the determination and the analysis of behavioral development of the human being based on the physiological and biological nature of the brain in the human body. In this field, scientists try to explain and understand how human behavior and its characteristics are developed from the complex development of the brain structure from its basic origin of single-celled to the complex formation of the human body. During the past, this field has been limited by numerous hindrances namely the boundaries in the current technological capacity. However, in the present, recent technological advancement with the numerous studies and efforts in this field brought about new discoveries and advances in the scientific field of neuroscience. Among the recent advances in this field formulation of the procedural approach in researching brain characteristics and activities in its fundamental structure wherein scientists are not able to explore the relationship and possibilities in genetic influence with the behavioral development. With the experimentation procedures in animals and the technological advances that allow molecular reconfiguration, neuroscientists are now able to explore the influence of genetic altercation with neurological and behavioral characteristics. In application, this recent advancement paved the way for greater possibilities wherein scientist hope on curing neurological problems and detrimental behavioral problems and retardation during the initial development of the brain. With more research, scientist can learn how to determine and stop possible brain and psychological problems during the fetal development of the human body thus negating its unfortunate consequences in the future. With this possibility, the choice of living a healthy physiological and psychological life can be made possible and available for the every human being, which will be significantly assured even during his or her fetal development. In addition, positive traits and characteristics can be enhanced in each generation influencing the development of the society for the better towards the future. Ethical matters in this part of the medical aspect of development involves the consideration that practitioners place on the capabilities of the patient to decide for their own medications or the process of healing that they are likely to accept in such serious cases of neuro-medication.
The Silver Linings Playbook Chapter 28
I Will Have to Require a First-Place Victory ââ¬Å"Question number one,â⬠my father says. ââ¬Å"How many touchdowns will McNabb throw against the Saints?â⬠I can hardly believe I am actually eating a sit-down meal with my father. Mom smiles at me as she winds spaghetti around her fork. She even shoots me a wink. Now don't get me wrong, I am happy that Mom's plan has worked out, and I am delighted to be eating a meal with my father, having a conversation even ââ¬â and I am especially happy to see my parents playing with love again ââ¬â but I also know my father, and I worry that a single Eagles loss will turn Dad back into a grump. I worry for Mom, but decide to ride out the moment. ââ¬Å"Ten touchdowns,â⬠I tell my father. Dad smiles, pops a small sausage into his mouth, chews enthusiastically, and then tells my mother, ââ¬Å"Pat says ten touchdowns.â⬠ââ¬Å"Maybe eleven,â⬠I add, just to be optimistic. ââ¬Å"Question number two. How many touchdowns will undrafted rookie sensation Hank Baskett catch?â⬠Now, I fully realize that Baskett has only caught one TD in the first five games, but I also know my family is being overly optimistic tonight, so I say, ââ¬Å"Seven.â⬠ââ¬Å"Seven?â⬠Dad says, but smiling. ââ¬Å"Seven.â⬠ââ¬Å"He says seven, Jeanie. Seven!â⬠To me Dad says, ââ¬Å"Question number three. In what quarter will quarterback Drew Brees finally suffer a concussion because he has been sacked so many times by the Eagles' superior defense?â⬠ââ¬Å"Um. That's a tough one. The third quarter?â⬠ââ¬Å"That is incorrect,â⬠my father says, shaking his head in mock disappointment. ââ¬Å"First quarter is the correct answer. Question four. When are you going to bring home that broad you're always running with? When are you going to introduce your girlfriend to your father?â⬠When Dad finishes asking question four, he slurps a load of spaghetti into his mouth and then begins chewing. When I fail to respond, he encourages me with his left hand, tracing invisible circles with his index finger. ââ¬Å"Did you see that Pat found his wedding pictures and put them back up in the living room?â⬠Mom says, and her voice sort of quivers. ââ¬Å"Jake told me you were over Nikki,â⬠Dad says. ââ¬Å"He said you were into this Tiffany broad. No?â⬠ââ¬Å"May I be excused?â⬠I ask my mother, because my little scar is itching, and I feel as though I might explode if I don't start banging my fist against my forehead. When my mother nods, I see sympathy in her eyes, which I appreciate. I lift for a few hours, until I no longer feel the need to punch myself. In the new reflector vest my mother has recently bought for me, I run through the night. I was going to open Tiffany's letter this evening because I was so excited about having dinner with my father, but now I know I am most definitely not in a good mood, so opening the letter would be a violation of the rules Tiffany clearly laid out for me two nights ago. I almost opened the letter last night, when I was in an excellent mood, but it hadn't been forty-eight hours. As I run, I try to think about Nikki and the end of apart time, which always makes me feel better. I pretend that God has made a bet with me and if I run fast enough, He will bring Nikki back, so I begin sprinting the last two miles of my run. Soon I'm running so fast, it's amazing ââ¬â faster than any human being has ever run before. In my mind I hear God tell me I have to do the last mile in under four minutes, which I know is almost impossible, but for Nikki I try. I run even faster, and when I am a block away, I hear God counting down from ten in my mind. ââ¬Å"Five ââ¬â four ââ¬â three ââ¬â two ââ¬â â⬠And when my right foot lands on the first concrete square of my parents' sidewalk, God says ââ¬Å"One,â⬠which means I ran fast enough ââ¬â that I made it home before God said ââ¬Å"Zero.â⬠I am so happy. I am so impossibly happy! My parents' bedroom door is closed when I go upstairs, so I shower and then slip under my comforter. I pull Tiffany's envelope from under the mattress of my bed. I take a deep breath. I open the letter. As I read the several typed pages, my mind explodes with conflicting emotions and awful needs. Pat, Read this letter start to finish! Do not make any decisions until you have read the entire letter! Do not read this letter unless you are alone! Do not show this letter to anyone! When you have finished reading this letter, burn it ââ¬â immediately! Do you ever feel like you're living in a powder keg and giving off sparks? Well, there was nothing I could do to bring my Tommy back, and the inability to accept his death kept me ill for two whole years ââ¬â but then you came into my life. Why? At first I thought, God is sending me a new man, a replacement for my Tommy, which made me mad, because Tommy is irreplaceable (no offense). But when I listened to the way you talked about Nikki, I realized God had sent you to me so I might help you find the end of apart time. This was to be my mission. And so I have been working on it. ââ¬Å"What?â⬠I can hear you saying right now. ââ¬Å"How can my friend Tiffany end apart time?â⬠Well, this is the part that might make you mad. Are you ready, Pat? Brace yourself. I've been talking to your Nikki on the phone ââ¬â regularly. Every night for the past two weeks. I got the phone number from Veronica, who ââ¬â through Ronnie's conversations with your mom ââ¬â has been providing Nikki with information about you ever since you were permanently assigned to that neural health facility in Baltimore. It turns out that your family banned Nikki from obtaining information about you, which they could do because Nikki divorced you soon after you were permanently admitted. I know this bit of news has most likely upset you terribly. Sorry, but it's best just to state things plainly at this point. Don't you think? Okay, this next part is bad too. Nikki was able to divorce you because you committed a crime, which you do not remember. (I am not going to tell you what that crime was, because you have probably blocked it from your memory intentionally; most likely, you are not yet mentally ready to deal with this very frightening reality. My therapist Dr. Lily and I theorize that you will remember committing this crime when you are mentally and emotionally ready.) Nikki was granted a divorce and all your assets, and in exchange, someone else dropped all charges against you. Of course, the deal also sent you to the bad place indefinitely for ââ¬Å"rehabilitation.â⬠You agreed to all of the above at the time and were deemed to be ââ¬Å"of sound mindâ⬠by your therapist Dr. Timbers, but soon after being put away for good, you ââ¬Å"lostâ⬠your memory and your marbles as well. I am not telling you all of this to be mean ââ¬â quite the contrary. Remember, God put me in charge of helping you end apart time. It turns out Nikki has wanted to communicate with you very much. She misses you. This is not to say she wants to marry you all over again. I want to be clear about this. She still remembers what you did ââ¬â the crime you committed. And she is a little afraid of you as well, as she fears you might be mad at her and want to retaliate. But she was married to you for years and she wants to see you well, and maybe even become friends again. I have reported your desire to reconcile with Nikki. To be honest, your desire is much stronger than hers. But you never know what might happen if you begin to communicate again. Two problems: One. After you committed that crime, Nikki took out a restraining order against you, so technically it is illegal for you to contact her. Two. Your parents ââ¬â on your behalf, and probably in retaliation ââ¬â took out a restraining order against Nikki, claiming any contact she made could jeopardize your mental health. So it is also illegal for her to contact you. Even still, Nikki would like to communicate with you, if only to smooth over what happened. Her guilt is glaring. She walked away with all your assets, and you had to spend years in a mental institution, right? So. Coming to the point. I am offering myself as a liaison. The two of you can communicate through me, and there will be no trouble. You will be able to write Nikki letters ââ¬â one every two weeks. I will read these letters to Nikki over the phone. She will be able to dictate her responses to me, again over the phone, which I will type up on my laptop, print out, and present to you. Pat, we are friends, and I value our friendship very much. That having been said, you must appreciate that what I am offering puts me in a very precarious position. If you decide to take me up on my offer, I would be putting myself at risk legally, and also I would be jeopardizing our friendship. I need to inform you that I will not be your liaison for free, but am offering you a trade. What do I want? Remember when I said I was scouting you? Well, I want to win this year's Dance Away Depression competition, and I need a strong man to do it. ââ¬Å"What is Dance Away Depression?â⬠I hear you asking. Well ââ¬â it is an annual competition organized by the Philadelphia Psychiatric Association that allows women diagnosed with clinical depression to transform their despair into movement. The sole focus is supposed to be diminishing depression through use of the body, but judges award a wreath of flowers to the second-best dance routine and a golden trophy to the first-place dance routine. Dancing solo, I have won that fucking wreath two years straight, and this year I want to win the golden trophy. This is where you figure in, Pat. God sent me the strongest man I have ever met in my entire life; tell me this isn't divine intervention. Only a man with your muscles could perform the type of lifts I have in mind ââ¬â award-winning lifts, Pat. The competition will be held at the Plaza Hotel in center city, on a Saturd ay night ââ¬â November 11th. Which gives us just under a month to practice. I know the routine already, but you'll be starting from scratch, and we both will have to practice the lifts. This will take a lot of time. I told Nikki about my conditions, and she wants to encourage you to be my dance partner. She says you need to broaden your interests, and that she had always wanted to take dance lessons with you. So it is more than okay with her; she encourages you to do this. Also, I'm afraid I will have to require a first-place victory in exchange for being your liaison. Lucky for you, the routine I have choreographed is first-rate. But in order to win, you will have to immerse yourself in dance. Below are the non-negotiable conditions. Should you decide to be my dance partner, you will: Give up Eagles football for the duration of our training. No going to games. No watching games on television. No discussing Eagles football with anyone. No reading the sports pages. You may not even wear your beloved Baskett jersey. End your weight training by two o'clock each afternoon, at which point we will go for a five-mile run, after which we will rehearse from 4:15 p.m. to 11:00 p.m. on weekdays. On weekends we will rehearse from 1:00 p.m. to 10:00 p.m. No exceptions. Make sure at least 15 of your friends and relatives attend the dance recital, because the judges are often swayed by applause. Do whatever I say without asking any questions. Assure I win the competition. MOST IMPORTANTLY: Tell no one about our arrangement. You can tell people you are training for a dance competition, but you cannot tell anyone about my demands and my contacting Nikki on your behalf ââ¬â never ever. Should you meet all six demands, I will act as a liaison between Nikki and you; I will attempt to end apart time, and then who knows what will happen between you and your ex-wife. If you fail to meet my demands, I am afraid you might never talk to Nikki again. She says this is your only shot. Contact me within 24 hours with your decision. Reread my list of demands, memorize each, and then burn this letter. Remember, if you want me to be your liaison, tell no one I am in contact with Nikki. With best intentions, Tiffany I reread the letter over and over all night. Parts I do not want to believe are true ââ¬â especially the parts about my committing a crime and Nikki divorcing me, which are ideas that make me feel like smashing my fist against my forehead. What type of crime would put me in such a situation, and who would drop charges when I checked myself into a neural health facility? I can understand Nikki's divorcing me because I was a bad husband, especially because, well, I was a bad husband. But I have a hard time believing I actually committed a crime that could result in such drastic legal measures. And yet Tiffany's letter seems to explain so much ââ¬â my mother's taking down my wedding pictures, all the awful things Jake and Dad said about Nikki. If I am really divorced, everything my family has done to keep Nikki out of my memory would have been for my protection, especially since they are not optimistic enough to realize that I am not dead and therefore still have at least a shot at getting Nikki back, which I don't have to tell you is the silver lining to the letter. Of course, I cannot be sure about anything, since I have no memory of the past few years. Maybe Tiffany made up the story just to get me to perform in her dance competition. This is possible. I certainly would not have volunteered to be her partner, even if I am practicing being kind now. I realize that Tiffany's letter might be a trick, but the possibility of communicating with Nikki is too good to chance ââ¬â as it may be my last opportunity. Also, Tiffany's mentioning God's will seems to suggest that she understands what apart time is all about. It makes sense that Nikki would want me to take dancing lessons. She always wanted me to dance with her, but I never did. The thought of dancing with Nikki in the future is enough to make me accept that I will be missing the three Eagles games before the bye week, including the home game against Jacksonville. I think about how angry this will make my father, Jake, and maybe even Cliff, but then I think about the possibility of finally living out the happy ending to my movie ââ¬â getting Nikki back ââ¬â and the choice is obvious. When the sun comes up, I open the window in the downstairs bathroom, burn the letter over the toilet, and flush the charred remains. Next, I run across Knight's Park, jog around the Websters' house, and knock on Tiffany's door. She answers in a red silk nightgown, squinting at me. ââ¬Å"Well?â⬠ââ¬Å"When do we start training?â⬠I ask. ââ¬Å"Are you ready to commit fully? Ready to give up every-thing ââ¬â even Eagles football?â⬠I nod eagerly. ââ¬Å"Only I can't miss my therapy sessions on Fridays, because some judge will send me back to the bad place if I do, and then we won't be able to win the competition.â⬠ââ¬Å"I'll be outside your house tomorrow at two o'clock,â⬠Tiffany says, and then shuts the door. The first floor of Tiffany's in-law suite is a dance studio. All four walls are completely covered by full-length mirrors, and three have railings like you see ballerinas using. The floor is hardwood, like a pro-basketball court, only without any painted lines and with a lighter varnish. The ceiling is high, maybe thirty feet tall, and a spiral staircase in the corner leads to Tiffany's apartment. ââ¬Å"I had this built when Tommy died,â⬠Tiffany says. ââ¬Å"I used the insurance money. Do you like my studio?â⬠I nod. ââ¬Å"Good, because it's going to be home for the next month. Did you bring your photograph?â⬠I open the bag that Tiffany instructed me to bring and pull out my framed picture of Nikki; I show it to Tiffany, and then she walks over to the stereo system behind the spiral staircase. From an iron hook on the wall she removes a pair of headphones ââ¬â the kind that cover your entire ears like earmuffs ââ¬â and brings them to me. A very long cord is attached. ââ¬Å"Sit,â⬠she says. I drop to the floor and sit with my legs crossed. ââ¬Å"I'm going to play our song, the one we are going to dance to. It's important that you feel a deep connection with this song. It needs to move you if it's going to flow through your body. I've picked this song for a reason. It's perfect for both of us, which you'll soon see. When I put the headphones on you, I want you to stare into Nikki's eyes. I want you to feel the song. Understand?â⬠ââ¬Å"It's not a song played by a soprano saxophonist, is it?â⬠I ask, because Kenny G is my nemesis, as you know. ââ¬Å"No,â⬠she says, and then places the headphones on my ears. My ears are enveloped in the padding. Wearing the headphones makes me feel as if I am alone in this large room, even though if I look up, Tiffany will be there. With the frame in my hands, I stare into Nikki's eyes, and soon the song begins to play. Piano notes ââ¬â slow and sad. Two voices taking turns singing. Pain. I know the song. Tiffany was right. It is the perfect song for both of us. The song builds, the voices become more emotional, and everything inside of my chest starts to hurt. The words express exactly what I have felt since I was released from the bad place. And by the chorus, I am sobbing, because the woman singing seems to feel exactly what I am feeling, and her words, and her emotion, and her voice â⬠¦ The song ends with the same sad piano notes that began the number. I look up and realize that Tiffany has been watching me cry, and I begin to feel embarrassed. I set my photo of Nikki down on the floor and cover my face with my hands. ââ¬Å"I'm sorry. Just give me a second.â⬠ââ¬Å"It's good that the song makes you cry, Pat. Now we just have to transform those tears into motion. You need to cry through your dancing? Understand?â⬠I do not understand, but I nod anyway.
Thursday, August 29, 2019
Destination Recent Development for Study Trip Essay
Destination Recent Development for Study Trip - Essay Example spite various advantages that the economy is facing at the recent time, still a careful evaluation is required in order to enhance its growth potentials in the future. International business in Brazil International business describes the overall business transaction occurring between two nations. The objective of every international business transaction is to increase the sales and reduce the amount of risk. BP is reported to increase its business with Brazil in order to produce ethanol from sugarcanes. The company also wants to increase itââ¬â¢s the share in the Bio fuel company in Brazil which is named as Tropical BIO Energia (BP global, 2011). In order to strengthen the countries business relation with the immigrants, the ââ¬Å"Chattanooga area chamber of commerce international business councilâ⬠is supposed to plan a meeting on 22nd of September (The Chattanooga.com, 2011). Following the regime of globalisation and privatisation, Brazil has been successful in encouraging inflows of private investment in many sectors. In terms of internet development, Brazil is among the most promising nations. Sale of E commerce has doubled over the years. The electronic business sales have also increased in recent times. The mobile phone company in Brazil has expanded too over several years. As per the reports of National telecommunication Agency, a tremendous growth in the data market had taken place. The Anatel statistics reveals that the telecom market plays an important role in increasing the revenue of the nation (The economist, 2011). Recently there has been an agreement between Brazil and America to expand the mainstream business in telecommunications such as the mobile and online business. Previously the combined ventures between the nations have helped in expanding business... Brazil is among the fastest growing economies of the world. The Brazilian economy together with China, India and Russia forms the BRIC nations, which is predicted by the Goldman Sachs to the global powers by 2050. Brazil encourages various foreign investments and is also the major recipient of foreign direct investment. Brazilââ¬â¢s growth potential and high rate of interest makes it an attractive destination for the investors. It is however believed that despite various advantages that the economy is facing at the recent time, still a careful evaluation is required in order to enhance its growth potentials in the future. BP is reported to increase its business with Brazil in order to produce ethanol from sugarcanes. At present Brazil comprises of 37% of the pharmaceutical company of Latin America. Following the regime of globalisation and privatisation, Brazil has been successful in encouraging inflows of private investment in many sectors. Companies all over the world are willin g to expand their business in Brazil due to its excellent market opportunities as well as fine climatic conditions Most of the international services, fraternal and social organisations are present in Brazil.
Wednesday, August 28, 2019
Introduction to the Web Coursework Example | Topics and Well Written Essays - 2500 words
Introduction to the Web - Coursework Example After the passage of almost two decades, Tim Berners Lee devised a mechanism for individuals to access information at CERN in Switzerland. He developed a new file format hypertext and a new protocol hypertext transfer protocol. The combination of the file format and the protocol became to be known as World Wide Web. The year 1994 marked the launch of the first graphical web browser that increased the popularity of internet. The project that began with the endeavours of few members turned out to be the biggest information storage platform and source of a diverse range of services. The progression of the concept of internet can be evaluated from the fact that there were only 562 hosts till the year 1983, whereas the number of systems arose to 2 million by the year 1993. According to the latest figures from Internet Society (2010) for July 2010, there are 768, 913, 036 hosts on the internet. 2. Contributions of the Internet There has been a significant impact on individuals and societie s, due to the advent of internet. The field of communication has witnessed such great developments that people in one part of the world can be aware of the happenings in the other end. The field of education has also revolutionized to a great extent as it enables the students to attend their class sessions from the vicinity of their choice. The field of business has been made more structured and organized due to the incorporation of information management systems. Earlier, students and researchers had to make uncountable trips to the libraries to find research related to their research domains. The invention of internet has provided an ocean of knowledge for the modern man, where he can get guidance about any field of life. The impact of internet on the society shall be analyzed in detail with the help of some available web applications: 2.1 Email The web application of electronic mail (email) has made two words very important in the modern world: efficiency and speed. Email provide s effective delivery of required content in a low cost manner. The speed of email has reduced the geographical barriers of the world since recipients get emails from senders within seconds, irrespective of the place on the planet. An internet connection has to be possessed by the participants of the email; otherwise there is no cost of sending an email. The conventional modes of delivery (like postal mail, telegram) of messages were dependent on the location of the recipient. It even eliminates the need to possess a stamp or envelope. The effectiveness of the delivery of the email is almost 100% unless the email address is not correct or the recipients email inbox has no space to receive new messages. It is often considered even better than making a traditional phone call since the recipient does not have to be present to receive the email. It saves time of the sender as he does not have to attempt making contact with the recipient several times; the recipient can check the message at his own time and convenience. Email has made life simpler and fast paced. People tend to feel closer to their peers who might be residing thousands of miles away due to the speed of email. A message can be sent to multiple recipients at the same time which also saves times of the sender. Attachments can be sent via emails that may contain word documents, pictures, videos etc. Formal emails serve as professional records of communication between the colleagues and form
Tuesday, August 27, 2019
Cary Grant Essay Example | Topics and Well Written Essays - 1500 words
Cary Grant - Essay Example He worked tirelessly and with great determination in ensuring that, the US authorities adopted fair economic and social integration practices. Cary Grant who was a comedian of the 30s was a renowned English actor and film producer. He exhibited great knowledge of acting and film production that facilitated his career. He had a great profession that was characterized with excellent activities and negotiation practices. The negotiations were set to aid the realization of favorable economic performance and social integration in US. This was critical since monetary and social integration are fundamental elements that drive success in various societal setting. Consequently, Cary Grant is under consideration as one of the classic Hollywood star and a leading actor. He used his leadership capacity and skills to influence decision making on policies with an aim of empowering individuals. He is credited for producing educative and informative comedy plays that held immense relevance in facili tating social and economic integration. His strong persona enabled him to provide transformative information that is socially relevant and culturally acceptable. The information he conveyed through comedy work helped in transforming US into a modern state where individualââ¬â¢s rights were respected. His best films that hold immense relevance in transforming individualsââ¬â¢ character setting include the awful truth, bringing up baby, and catch a thief. The comedy films had social and financial information in their content. This was to, assist in passing critical information to help in the development of an amicable solution to the evident absurdities that the people of US were facing. Evidently, his works were instrumental especially when the US was facing economic depression during the screwball period. The period exposed the nation to high unemployment rate and homelessness. This paper gives an essay on the politics of Cary grant, how his persona was established, screen per sona and great comic films. What is so funny Cary Grant Cary Grant had unique speaking skills that explain his undisputable eloquent and fun as evident in his works. His eloquent capacity had great contribution in the establishment of his persona as a star by the end of 30s. He had strong elements of elegance, charm, humor and resourcefulness. These elements made him a great and influential actor that is comparable to a politician (Britton, 1986, P, 36). This enabled him to gain the political persona despite being an actor and playmaker. Consequently, the eloquence, openness and charming nature facilitated fun in his works that are highly comical. How grant persona was developed As noted Cary Grant was, an actor with a strong strength of character who made a huge contribution in providing solutions to the screwball complications that threatened to paralyze economic and social performance in the US. The development of the actorââ¬â¢s strong strength of character was evident from h is childhood. He acted responsibly and with determination to ensure that, his ideological mission was under fulfillment (Britton & Grant, 2008, P, 9). The actor provided viable ideological tenets that facilitated liberation in the nation and creation of a unified industry. His noble actions led to the improved social integration and understanding. Cary realized his national mission as he participated as an actor in Hollywood. He identified his influential capacity and the ability to unite people through acting. Ideally, he capitalized on his charming nature, tolerance, elegance, sense of humor and resourcefulness. The elements enabled him to relay essential information that had immense contribution in advancing unity and economic integration. According to Britton & Grant (2008), various stakeholders had
Monday, August 26, 2019
How shipowners deal with bad freight rates in a shipping recession and Dissertation
How shipowners deal with bad freight rates in a shipping recession and compare liner freight rates with dry bulk freight rates - Dissertation Example There are significant gaps in knowledge research on the Greek maritime shipping industry created by publicly-owned companies and lack of data on operations, pricing, and general business strategies. This study added to the limited domain of knowledge by discovering high dependency in debt, currency, exchange rates, port efficiency and asset value as it relates to price establishment during recessions. The study further identifies low dependency variables related to price-setting during difficult economic periods of recession. Unpredicted phenomenon in this industry was also identified, with a discussion of implications to this maritime shipping industry. TABLE OF CONTENTS 1.1 Introduction................................................................................................................... 1.2 Research aims and objectives........................................................................................ 2.0 Literature review........................................... ................................................................. 2.1 Demand and crude oil prices.......................................................................................... ... .................................................................................................................. 2.6 Investment strategies...................................................................................................... 2.7 The competitive marketing environment........................................................................ 2.8 A discussion of knowledge gaps..................................................................................... 3.1 Research methodology.................................................................................................... 3.2 Ethical and other considerations...................................................................................... 4.1 Summary of results.......................................................................................................... 4.2 Presentation of results...................................................................................................... 5.1 Discussion of results........................................................................................................ 5.2 The nature of price setting in maritime industry.............................................................. 6.0 Conclusion........................................................................................................................ References Appendices LIST OF FIGURES Figure 1: Stability of Crude Oil Shipment Demand................................................... Figure 2: Aframax Tanker Asset Values..................................................................... Figure 3: The Clearing Process of Buyer-Seller FFA Swaps..................................... Figure 4: Mean Questionnaire Scores for High Dependency Variables Related to Pricing
Sunday, August 25, 2019
BUSINESS PROPOSAL FOR LEXILIAP FASHION BOUTIQUE Research Paper
BUSINESS PROPOSAL FOR LEXILIAP FASHION BOUTIQUE - Research Paper Example This proposal therefore illustrates the various economic factors that will influence the operations of Lexiliap Fashion Boutique. This report lays particular emphasis on the economic dynamics of the proposed fashion boutique by including assumptions about the elasticity of demand and the market structure in the operational environment. Revenue To begin, revenue is an important factor for the success of Lexiliap Fashion Boutique. Capozzi (2013) highlights the importance of looking at the revenue prospects of a fashion boutique by recognizing the challenges of setting up and deriving gains from one. Fashion boutiques present a challenge to owners because they should find a balance between attracting and retaining customers on one hand whereas striving to achieving or even surpassing the set revenue limits (Gerring, 2007). The fashion boutique intends to use multifaceted promotional campaign to ensure that it drives sales volumes that will surely lead to increased volumes. In particular , the boutique will have an active online presence that will make sure that many clients are targeted and are aware of the enterpriseââ¬â¢s products (Ferguson, 2008). Market segmentation strategies will be used to ensure that promotions are custom made to target the youth, women, men and children separately. The shop will also offer competitive pricing so that customers from competing firms are attracted. Determining the Profit-Maximizing Quantity The boutique will deal with different fashion items and accessories. As such, the challenge is to constitute a viable and standard profit maximizing quantity for each of the items. Since items like jewelry and clothing may have defects especially when volume purchases are used to source for the products, the proposed structure relies on this conditionality to propose a standard quantity to be ascertained. Given a unit cost of 10 USD, each productââ¬â¢s price; is it a dress, pant, bangle or ring will be compared against the unit cost value. Taking into consideration that the more items are sold, the higher the revenue; the report then sets the revenue threshold at 100USD meaning ten unit items. As a result, the more valued the item in the boutique, the lower will be its profit maximizing quantity. The projected dollar value for the business is shown in Appendix 1. Profit Maximization Profit maximization is at the core of any enterpriseââ¬â¢s operations (Mankiw, 2011). The proposed Fashion Boutique will ensure that there is value for customers on one hand, and value to the owner on the other. To be able to strike this delicate balance between satisfying the needs of the customer whilst maximizing the profits needed for business growth. The marginal cost and marginal revenue concept can be applied to illustrate the technique that will be used to ensure profit maximization. This will be done mainly in the area of stocking for some commodities. Given that fashion industry is dynamic, it is important to stock the current trends for profit maximization (Boyes & Melvin, 2011). As a result, the boutique will review fast moving products and stock them in large number to derive more gains from the sales volumes resulting from the trending items. This is in accordance with the concept that marginal revenue should always be equal to marginal cost for profit maximization (Taylor, 2006). Subsequently, the boutique will require market information on the trending products. This can be obtained from relevant agencies, the media and other
Saturday, August 24, 2019
Developing Sociological Imagination Essay Example | Topics and Well Written Essays - 2000 words
Developing Sociological Imagination - Essay Example They hide at the first sign of trouble, withdrawing into indifference and fear. "Faced with issues they do not understand, with structural forces that they cannot comprehend and over which they appear to have no power, ordinary people withdraw into apathy or anxiety," observed C. Wright Mills, the social scientist who in 1959 blazed the trail on developing a quality of mind that could help ordinary people dissociate themselves from the ostriches in dealing with danger and problems. A false sense of security is all the ostrich example can give us. By developing what came to be known as "sociological imagination," we would know what we are up against. This knowledge will then help us understand any problem that gets in our way to effectively cut it down to size and hopefully cease to elicit fear in us since it is no longer an unknown entity. When we don't feel any threat to the set of values we cherish, it is believed we experience well-being. In the presence of these threats, we experience a crisis. And when we are unaware of any cherished values and feel no threat, this becomes an experience of indifference, apathy if it concerns all our cherished values. However, when unaware of any cherished value but aware of a threat, this results in an experience of uneasiness and anxiety which, if total enough, becomes a deadly unspecified malaise. Sociological Sociological imagination, Mills explains, is the quality of mind urgently needed in our cultural period to cope with the anxiety, uneasiness and indifference that prevail in today's world. Uneasiness and indifference are considered the signal features of our age as a result of the dizzying changes happening in our midst. Governments that used to function as democracies, for example, suddenly fell into the control of despots. In states that were once political colonies, new and subtler forms of imperialism were installed. Societies once relatively peaceful became the object of random and senseless terrorist attacks. Such changes send people out of kilter, giving them the sense of being trapped. We get this sense of being trapped, sociologists believe, when we are not aware of the intricate connection between the pattern of our own lives and the course of history, and what this connection means for the kinds of people we are turning into and the kinds of history-making in which they mi ght take part. To let ourselves out of this trap, we must employ sociology ethically, through sociological imagination, to allow us some sense of control over events by showing how public issues are interconnected with our lives, our history, biographical experiences and social structure milieus. By understanding the larger historical scene in terms of its meaning for the inner life and the external career of a variety of individuals, we will be equipped with information necessary for developing reason that would "achieve lucid summations of what is going on in the world and what may be happening within ourselves." Sociological imagination will enable us to shift from one perspective to another - from the political to the psychological, from examination of a single family to comparative assessment of the world's national budgets, from the theological school to the military establishment, even from studies on the oil industry to that of contemporary poetry. With such
Friday, August 23, 2019
Comparison of the U.S. Healthcare System with the United Kingdom and Essay
Comparison of the U.S. Healthcare System with the United Kingdom and Canada - Essay Example The United States healthcare is provided primarily by the private sector; the government provides about 65 percent of all the healthcare insurance while the rest is provided by the private sector insurance. The United States healthcare uses the highest amount of money in the world per person as compared to other countries, though its structure leaves over 16 percent of its citizens with no medical cover or policy. While the United States healthcare is decentralized, the United Kingdom has a semi-centralized healthcare system whereby each country has its own healthcare that is free to all residents. The United Kingdom healthcare has a relatively small private sector as compared to the public sector that spends much less than the United States, at 8 percent. Canada, on the other hand, has a fully centralized system funded by the government with the private sector only covering the medical procedures not covered by the governmentââ¬â¢s system. Though elaborate, Canadas healthcare sys tem only accounts for about 10 percent of the gross domestic product, much less than that of the United States. In the United States, 40 million residents are not covered by any healthcare insurance, in contrast with the United Kingdom and Canada, whose medical care is free for all; mainly because the latter two largely depend on taxes while the former depends on the contributions of individuals. According to residents of the three countries, Canadaââ¬â¢s have the greatest level of satisfaction in their healthcare system, followed by United Kingdom residents while United States residents are the most dissatisfied. In addition, the United States healthcare is the most expensive among the three.Ã
Thursday, August 22, 2019
Is the American presidency too powerful Why or why not Essay
Is the American presidency too powerful Why or why not - Essay Example A president has the constitutional power to either assent or dissent a bill that has been approved by the Congress. The president acts as the last ââ¬Ëprocessââ¬â¢ through which a bill passes before being adopted as a law. All the citizens in America are governed by the same standard laws and, apparently, they are under the spell of the presidency. Despite the Congress having similar powers of revoking a presidencyââ¬â¢s initiative, it is the Congress that is constitutionally required to make laws. Intrinsically, the presidency has trivial contravention in the making of laws (Lowi 2012, p.177). Moreover, the presidency is better positioned if its party dominates both houses. The presidencyââ¬â¢s influence in the appointment of the bureaucratic positions is a vital element. In order to mitigate the conflicts of opinion in between the presidency and the Agencies, the presidency can appoint his top supporters into the bureaucratic appointments. In essence, the presidency will be commanding power through the automatic support that is anticipated from his supporters in the bureaucracy (Lowi 2012, p.195). The support grants his excessive powers. Even with least congressional and public support, the presidencyââ¬â¢s powers are still a notch higher. The presidency has the option of expanding the roles of the direct presidential governance and executive orders. Similarly, the presidency has the capacity to increase the control of the White House over the federal the bureaucracy (Lowi 2012, p. 195). This tactic of power works in the presidencyââ¬â¢s advantage by enabling it influence the decisions of the bureaucracy, indirectly Executive agreements are excessive powers granted to the presidency. In the normal diplomatic powers of the presidency, more than two-thirds of the senate is required to have vote for a treaty before it becomes legally practicable. However, in executive agreements, there is neither regulation nor restrictions encountered by the presidency
European imperialism Essay Example for Free
European imperialism Essay Mortimer Chambers et al define imperialism as a European states intervention in and continuing domination over a non-European territory. During the Scramble for Africa in the late nineteenth century, the most powerful European nations desired to conquer, dominate and exploit African colonies with the hope of building an empire. According to Derrick Murphy, in 1875 only ten percent of Africa was occupied by European states. Twenty years later only ten percent remained unoccupied. There were several factors which attracted European imperialists to Africa. There were opportunities for profitable investment and trade. Raw materials, which Africa possessed in abundance, were also desired. A cheap source of labour was required as it would result in higher profits. In addition, there was international rivalry among European nations. Domestic political interests and social Darwinism may also be blamed for attracting European imperialism to Africa. European imperialists were lured to Africa by the potential economic benefits she possessed. Industrialization caused a mass productivity and there became an artificial need for foreign markets to invest in. According to Brian Levack et al, with the onset of economic decline in 1873 industrialists were faced with a declining demand for their products in Europe. Imperial expansion, it was thought, would provide a solution with annexed territories seen as captive markets. It was believed that the unfavorable balance of trade that Britain and other industrial countries were experiencing could be counterbalanced by the income from overseas investments. Also, surplus capital could be profitably invested in Africa where cheap labour and limited competition would result in higher profits. Prominent European imperialists decided to use the public resources of their country to find lucrative means of using their capital. The English radical economist J.A. Hobson, argues that the intention was to level out inequalities of wealth to increase domestic consumption. Local merchants, traders and bankers were optimistic towards the idea of imperial expansion and capital investments outside of Europe became an increasingly vital sector of its economy. There was an increasing demand for raw materials in Europe in the late nineteenth century. According to Brian Levack, the new technologies characteristic of the industrial revolution meant that industrial Europeà became increasingly dependent on raw materials. European nations felt the urge to control lands that possessed great quantities of raw materials. Africa was rich with raw materials as well as many treasure reserves. As a result, many major industrial companies attempted to gain a monopoly of raw materials in Africa. Stuart Miller believes that specific trade links were important to particular industries. Some raw materials in Africa were of great importance; the vegetable oil of the Niger was vital for lubricating industrial machinery and the rubber of the Congo was not only essential for the tires on the new automobiles but also for insulating the electrical and telegraph wires now encircling the globe. The plentiful elephant herds could be slaughtered to provide the ivory for many of the new consumer goods such as piano keys, billiard balls and knife handles. In Togoland, Germans were able to cultivate plantations where they grew cocoa and rubber. Other raw materials included peanuts, cotton and tea. There were also many important minerals and South Africa possessed gold and diamonds. International rivalry among European nations contributed greatly to imperialist ventures in Africa. Britains rivalry with France and Germany accounted for a large part of the colonization. The British government wished to maintain its dominance in the colonial regions. Other European powers desired to expand their colonial spheres as well and Britain responded by seizing colonies. Certain territories were important for their location. The Suez Canal was key waterway between East and West Africa. The immense interior between the gold and diamond rich Southern Africa and Egypt had a strategic value as domination of this region was important to secure the flow of overseas trade. The British wanted to link their possessions in Southern Africa with their territories in East Africa, and these two areas with the Nile basin. Obtaining the Sudan was vital to the fulfillment of these ambitions especially since Egypt was already under British control. This red-line through Africa was made famous by Cecil Rhodes and Lord Milner who advocated for a Cape to Cairo empire linking by rail the Suez Canal to the Southern part which possessed many minerals. According to Brian Levack, there was also a certain level of nationalist competition. The unification of Germany upset the balance of power in Europe. In this climate of tension, governments looked towards enforcing national strength. Theà newly formed nations of Italy and Germany now sought empires outside Europe as a means of gaining power and prestige within Europe. In the nineteenth century, a German historian Henrich con Treitschke stated All great nations in the fullness of their strength have desired to set their mark on barbarian lands and those who fail to participate in this great rivalry will pay a pitiable role in time to come. Under the leadership of Bismarck, Germany soon embarked on a quest of expansionism. Bismarcks distrust of England under Gladstone was one of the reasons he decided to do this. Germany became engaged in an arms race with Great Britain and it desired as many military and naval bases as it could obtain. France needed to restore its damaged national pride after its defeat by Germany in the Franco-Prussian war and therefore embarked upon expansionism. Their aim was to have an uninterrupted link between the Niger River and the Nile, thus controlling all trade to and from the Sahel region, by virtue of their existing control over the Caravan routes through the Sahara. Domestic political interests also contributed to European Imperialism in Africa. As stated by Brain Levack, in the age of mass politics, political leaders needed to find issues that would both appeal to new voters and strengthen the status quo. Imperialism led the ordinary European people to believe that they were part of a superior, conquering people. Bismarck used imperial issues to help him find political allies in Germany and once remarked all this colonial business is a sham but we need it for the elections. According to Lawrence James, in the 1890s witnessed a rapid expansion of newspaper readership with the appearance of a new type of daily designed to attract the working and lower middle class. Social Darwinism and missionary intentions are two excuses that are used to justify European imperialism in Africa. Rudyard Kipling characterized the Africans as sullen, new caught peoples, half devil and half child. The Europeans believed it to be their duty to civilize the wild savage Africans. Liberalism, which may be defined as a dedication to self-improvement and the belief that there were discoverable rules of general conduct that everyone could follow, contributed to the paternal manner in which Europe acted and arguments of racial and cultural superiority that pushed Europeans intoà Africa to civilize the local populations. Lawrence James states that nations who had now reached the highest stage of civilization were taking control over those which had lagged behind, or races, like the Asante, who were not seen as fit to control their own affairs. In an issue of the Dublin Review in the late nineteenth century it was stated that The future of Africa under any form of Europea n tutelage must be better than the dark and evil nightmare of the past. These Social Darwinists were able to persuade the natives that what was being done was to their ultimate benefit. According to Derrick Murphy et al, there existed the idea that imperialism was a moral duty as a means of spreading Western civilization and Christian values. Many Europeans bought this excuse while others did not. Africans were forced to adopt the Christian religion. In some cases they were killed for continuing to practice their own faiths. Some historians believe that the whole motive for Christian evangelism in Africa was simply to disrupt and destroy and that it was always politically motivated. First, missionaries were brought to the continent. Secondly, after some natives were converted and there was a considerable amount of confusion among them, the troops were sent to exploit them. Their main intention was to divide to control. According to an African chieftain The white man is very clever. He came quietly and peaceably with his religion. We were amused at his foolishness and allowed him to stay. Now he has won our brothers and our clan can no longer act like one. He has put a knife on the things that held us together and we have fallen apart.Various factors attracted European imperialism to Africa in the later nineteenth century. Europe was changing and their colonial empires were associated with the ideas of national greatness and the survival of the fittest. This caused a massive drive for empires. There was a yearning for raw materials, national power and prestige. Each nation which possessed a colonial territory also possessed a sense of superiority. Bibliography 1.) Chambers Mortimer, Hanawalt Barbara, Rabb Theodore, Woloch Isser, Grew Raymond, The Western Experience, 1999, The McGraw-Hill Companies Inc., United States of America2.) James Lawrence, The White Mans Burden? Imperial Wars in the 1890s Spielvogel Jackson, Western Civilization, Mc Graw Hill, Connecticut, 1999(pgs 100-105)3.) Levack Brian, Muir Edward, Maas Michael, Veldman Meredith, The West, Encounters and Transformations, 2004, Pearson Education Inc., United States of America4.) Miller Stuart, Mastering Modern European History, 1997, Palgrave, United Kingdom, Hampshire5.) Murphy Derrick, Morris Terry, Europe 1870-1991, 2000, Harper Collins Publishers LTD, United Kingdom, England6.) The Church as a Tool of Imperialism
Wednesday, August 21, 2019
Examining the strategic location of South Face Mine
Examining the strategic location of South Face Mine The strategic location of the South Face Mine, owned by Mountain Mining Canada Ltd (MMCL), catches the attention of Can-Do to make an offer for purchasing the mine. If our company successfully acquires it, the combination of better surface logistics and optimal location of new drift mines could provide an annual cost saving of up to $1.5 million for 20 years. However, MMCL has closed the mine and currently been spending on closure and reclamation of it; undoubtedly MMCL would like to transfer those costs to us. The purpose of this memorandum is to determine the walk-away point, which is the highest amount Can-Do would agree to offer in the negotiation with MMCL, with the use of data from the management budget provided by MMCL, the discounted cash flow model and sensitivity tests on various assumptions. Given the data in the MMCL management budget with removal of costs which are not transferred to Can-Do or can be internalizedà [1]à , and assuming a 6% interest rate for discounting, the 15% contingency allowance used in MMCL implies an inflation rate of 2.55%. Having studied various assumptions, the sensitivity tests indicate the variance of short-term duration is the most important risk underlying as a 1-year extension of short-term costs reduces the value of acquisition by $6.6 million from $15.5 million to $8.9 million (58% of original value). A 2-year extension further reduces the value by 6.4 million to $2.5 million (16% of original value).à [2]à The recommended walk-away point would be $14 million, a value lower than the net values of acquisition calculated in most sensitivity tests excluding those with respect to short-term duration and estimated cost saving. It also means that an efficient cost control should be performed to avoid an extension of short-term cost and a failure to realize the estimated cost saving. It is also worth noting that there are large discrepancies of cost items between the 2006 and 2005 budgets. A detailed review on financial data is suggested so as to find out any hidden problems or risks. Introduction The purchase of the South Face Mine, currently owned by Mountain Mining Canada Limited (MMCL), can provide Can-Do a very large reduction in operating cost of North Fork Mine, located adjacent to South Face Mine, by an estimated amount up to $1.5 million annually for the next 20 years, attributed to the optimal location of new drift mines and the improved logistics. However, it is expected that MMCL would require us to bear the closure and reclamation costs. Therefore, the net value of the acquisition is the value of cost saving net of the value of those additional costs. By considering the data provided and computing the net value of acquisition, it comes up with the walk-away point, which is critical and crucial to our negotiation with MMCL. The remaining parts of this memorandum explain the determination of the walk-away point. In particular, the purpose of this study is to: Review the financial data provided Do sensitivity tests for assumptions with respect to the closure and reclamation costs Set a reasonable walk-away point Identify other possible risks for the determination of the walk-away point There are different types of costs, including short-term costs which will be incurred within five years and long-term costs which will be incurred during the whole reclamation period. There are also salvage values of equipments remaining on site (i.e. Inventory Disposition), and they will accrue to Can-Do. Moreover, MMCL has included a 15% contingency allowance in its calculation. From the table above, it is clearly observed that large discrepancies exist for most cost items between 2006 and 2005 budget, and this indicates a deficiency of the contingency allowance in 2005 to cover the adverse development of costs estimated from 2005 to 2006. It concerns us about the accuracy and reliability of the predictions. It is suggested a detailed review of financial data as well as other information related to the situation of the mine be conducted in order to discover any potential problems which may put our company at risk. Data Adjustment The data provided is subject to adjustments so as to calculate a more reasonable walk-away point. They include: Removing costs not to be transferred from MMCL to Can-Do (e.g. severance costs) Removing costs which could be realized from internalizing them in Can-Do (e.g. inspection costs) Analysis: Methods Assumptions Contingency Allowance Inflation Rate MMCL has included a 15% contingency allowance in its budget while has not considered the time value of cost items. Assuming the allowance is totally for the inflation, the implied inflation rate that is equivalent to the 15% contingency allowance is found to be 2.55% (using the Excel function à ¢Ã ¢Ã¢â¬Å¡Ã ¬Ãâ¦Ã¢â¬Å"goal seekà ¢Ã ¢Ã¢â¬Å¡Ã ¬Ã ), after the data adjustment aforementioned. Sensitivity Tests, Risks Walk-away Point To investigate the risks underlying, sensitivity tests have been performed to examine the uncertainties associated with the assumptions of cash flow projections (all with 0% contingency allowance). Table 3: Sensitivity Tests The table consists of the net value of the acquisition under different combinations of short-term duration, long-term duration, inflation rate and discount rate (Scenario Base and #1-10). From the table, it shows that under most scenarios the value of acquisition is around $14-15 million. Therefore, it would be appropriate and conservative to set $14 million as the walk-away point. In addition, an extra sensitivity test on estimated cost saving are conducted (Scenario #11-12). When compared to Scenario #4, it demonstrates that a 10% decrease in cost saving causes the value of acquisition below $14 million. It implies a strong control is needed to monitor that the realized cost saving is close to the estimated one. As shown in the tables, the short-term duration should be the key risk factor as an increase in it leads to a tremendous decrease in value (by comparing Scenario Base to Scenario #1-2 or Scenario #4 to Scenario #5-6). Can-Do should therefore pay much attention to the extension of short-term cost projections. Conclusions and Recommendations Based upon the modified cost budget and assuming a 6% discount rate, a 15% contingency allowance implies an inflation rate of 2.55%. Also, after a study of various assumptions by sensitivity tests, a walk-away point of $14 million will be sufficient for the acquisition of South Face Mine. However, a few issues have to be highlighted: The large variances between the 2006 and 2005 budget raise concerns of the validity and reliability of the estimated values in the budget. The implied inflation rate of 2.55% is less than the lower bound of inflation rate projected by our economists. The net value of acquisition is very responsive to the duration of short-term costs according to the results of sensitivity tests. The determination of walk-away point is based on the assumption that $1.5 million can be saved annually over 20 years. A slight decrease in it can be enough to cause an overall loss for the acquisition provided that the final purchase price of South Face Mine is close to the walk-away point. For some costs including water treatment operation/maintenance costs and salaries of accountant/environmental person, they may be internalized to a certain extent; yet they are not removed for the determination of walk-away point due to their specialty. This also provides a relatively conservative walk-away point implicitly. It is recommended that a detailed investigation should be carried out to verify the estimated costs in the budget as well as to locate any other problems. It is also proposed that an efficient cost control should be established in order to keep the cost be aligned with the prediction if Can-Do successfully purchases the South Face Mine from MMCL
Tuesday, August 20, 2019
Management Control, Employment Equity and Skills Development
Management Control, Employment Equity and Skills Development Gabriella Greyling Management Control, Employment Equity, Skills Development Table of Contents (Jump to) Introduction Background Understanding the Scorecard Compliance of the Advertising Industry in Cape Town Conclusion Bibliography Introduction In the case study, Duffett, van der Heever Bell argue that transformation within the advertising industry is vital due to the influence this sector has over social norms and trends (Duffett, van der Heever Bell, 2009). They further argue that the advertising industry in Cape Town has implemented BEE and is making progress in complying with the targets set out in the Codes, although admit that there are some challenges that may impact on success of the Codes to achieve transformation goals. Compliance with three of the seven elements of the Broad-Based Black Economic Empowerment Codes of Good Practice of 2007 (ââ¬Å"Codesâ⬠) (namely Management Control, Employment Equity and Skills Development) of the advertising industry in Cape Town, has been critically analysed using the 2009 study by Duffet, van der Heever and Bell. The study looks at factors that hinder or promote transformation in this industry, in relation to the B-BBEE Codes and applicable transformation charters. The advertising industry falls within the scope of the Marketing, Advertising and Communication (ââ¬Å"MACâ⬠) Transformation Charter, gazetted in terms of Section 12 of the Broad-Based Black Economic Empowerment (ââ¬Å"B-BBEEâ⬠) Act (Act No. 53 of 2003). Under Section 12, a transformation charter is not binding on the industry, unlike the Codes, which were gazetted in terms of Section 9(1) of the B-BBEE Act (B-BBEE Codes, 2007, p15). This is mentioned as one of the factors impeding success of transformation in the advertising industry, as it has created some confusion for scorecard preparation. Furthermore, at the time of conducting the study, SANAS had delayed the process of accrediting Verification Agencies to July 2008. This meant that many companies were performing self-assessments to determine their compliance in terms of the B-BBEE Codes in order to save money on costly verifications. Consequently, the results from the study may not be entirely reliable, but they ne vertheless form a useful basis to understand B-BBEE compliance in the advertising industry in Cape Town. Background The B-BBEE Act of 2003 was introduced as a model for growth for the South African economy. Encapsulated in this model is the notion that ââ¬Å"no economy can grow while the majority of its population are excludedâ⬠. (Okharedia, 2014) The Codes, which were subsequently gazetted in 2007, provided a tool for measuring empowerment (and by implication, transformation) within a company, known as the ââ¬ËScorecardââ¬â¢. Seven elements to this scorecard cover various forms of empowerment, known as direct empowerment (Equity Ownership and Management Control), human resource development (Employment Equity and Skills Development) and indirect empowerment (Preferential Procurement, Enterprise Development and Socio-Economic Development). Specific targets are set for all entities, and these targets are weighted out of 100. Once the scores for each element are added up, they will result in a total number of points out of 100, which indicates the B-BBEE Status (Level 1 to 8) and Procurement Recognition Level (135% 0%). If a sector-specific code is issued in terms of Section 9(1) of the B-BBEE Act, it may have different targets and weightings to that of the Codes of Good Practice, which are applicable to that industry/sect or only). (B-BBEE Codes of Good Practice, 2007, p15). Due to the focus on the Management Control, Employment Equity and Skills Development elements, the table that follows presents only these three (3) elements, rather than all seven (7). Understanding the Scorecard Table 1: the Management Control, Employment Equity and Skills Development scorecards B-BBEE Element Total Weighting Measurement Criteria (Indicator) Indicator Weighting Target (0-5) Target (6-10) Management Control 10 Exercisable Voting Rights of black Board members using the Adjusted Recognition for Gender 3 50.0% 50.0% Black Executive Directors using the Adjusted Recognition for Gender 2 50.0% 50.0% Black Senior Top Management using the Adjusted Recognition for Gender 3 40.0% 40.0% Black Other Top Management using the Adjusted Recognition for Gender 2 40.0% 40.0% Bonus points: Black Independent Non-Executive Board Members 1 40.0% 40.0% Employment Equity 15 Black disabled employees as a percentage of all employees using the Adjusted Recognition for Gender 2 3.0% 3.0% Black employees in Senior Management as a percentage of all such employees using the Adjusted Recognition for Gender 5 43.0% 60.0% Black employees in Middle Management as a percentage of all such employees using the Adjusted Recognition for Gender 4 63.0% 75.0% Black employees in Junior Management as a percentage of all such employees using the Adjusted Recognition for Gender 4 68.0% 80.0% Bonus points for meeting or exceeding the EAP targets in each category. 3 Exceed EAP targets Exceed EAP targets Skills Development 15 Skills Development expenditure on black employees as a percentage of Leviable Amount using the Adjusted recognition for Gender. 6 3.0% 3.0% Skills Development expenditure on black employees with disabilities as a percentage of Leviable Amount using the Adjusted Recognition for Gender. 3 0.3% 0.3% Number of black employees participating in In-service Training Programs as a percentage of total employees using the Adjusted Recognition for Gender 6 5.0% 5.0% As one can see from Table 1, each element is further split into sub-elements or indicators. Each indicator has a point weighting, and a target. We will be focusing on the target for years 0 to 5 (since the Codes came into effect in 2007, and the applicable case study was published in 2009, which is within the first 5 years of the Codes). The Management Control score card measures board participation of black people in general, and black females specifically. Additionally, participation by black people at Senior Top Management level and ââ¬Å"Other Top Managementâ⬠level is encouraged in this element of the Codes. Emphasis is also placed on participation of black Executive Directors. Participation of black women at board and top management level is further encouraged through the Adjusted Recognition for Gender (ââ¬Å"ARGâ⬠) provisions of the Codes. This provision places a greater weighting on black women, by dividing the percentage of black people by 2, and then adding the percentage of black females. The enhancement does have a limitation, in that when adding back the black female percentage, this figure cannot exceed 50% of the target for that indicator (in other words, if the target is 40%, then one can add back a maximum of 20% to the total black percentage representation which had been divided by 2. Similarly, the Employment Equity and Skills Development score cards also utilise the ARG in order to encourage equality between men and women (black females should make up half the target of black people, which is also statistically feasible, as females constitute half of the population in South Africa (Commission for Employment Equity, 2013). The Employment Equity scorecard measures four areas of employment; Senior Management, Middle Management and Junior Management, as well as disabled employees, while Skills Development measures expenditure on skills training for black employees in general and black employees with disabilities specifically. It also measures the number of employees engaged in Learnerships (or Category B, C or D Learning Programs, as per the Learning Program matrix contained in Annexe 400A of Code 400) as a percentage of the companyââ¬â¢s total staff compliment. Comparison of the Codes and MAC Transformation Charter Upon closer inspection of the targets contained in the Management Control, Employment Equity and Skills Development Scorecards of the MAC Transformation Charter and the Codes of Good Practice, the weightings are different, and the targets are phased in from 2006 to 2014 such that the 2014 targets match that of the Codes (or are higher than targets contained in the Codes); Points available under Board participation for the MAC Charter are 5, and targets will be phased in from 25% in 2006, to 50% in 2014 (whereas the Codes offer 3 points for 50% black board participation) The same target applies to Executive directors, Senior Top Management and Other Top Management under the MAC Charter set the target to 25% at first, increasing to 30% in 2009 and finally 50% in 2014 (which is higher than the Codes for Senior Top and Other Top Management targets of 40%, un-staggered) while the available points under the MAC charter are higher in all three categories (4 and 3 points available, instead of 3 and 2 respectively). The target for Independent Non-executives is lower under MAC at 30% (and is phased in from 10% in 2006), as opposed to 40%. Under Employment Equity, the MAC Charter imposes one target for Senior, Middle and Junior Management of 25% in 2006 gradually increasing to 60% in 2014, unlike the Codes, which indicate 2 phases of targets, for each level of management separately. The Skills Development element is more similar between the Codes and the MAC Charter, unlike the previous 2 elements, however, the total skills expenditure on black employees as a percentage of the Leviable Amount target phased in from 1% in 2006 to the full 3% (as per the Codes) by 2014. These different targets make MAC Charter slightly easier to comply with, in terms of absolute targets. Compliance of the Advertising Industry in Cape Town According to Duffet, van der Heever and Bell, the advertising industry in Cape Town reported an increase in black employees from 35.2% in 2004 to 40.2% in 2006. They further reported that black female employees increased from 21% in 2004 to 23.9% in 2006. With regard to management positions, there was a reported increase in black female managers, from 13.8% in 2004 to 17.7% in 2006. One of the challenges noted from the study, was that there was a shortage of skilled black Previously Disadvantaged People (ââ¬Å"PDIâ⬠) leading up to 2008, particularly in the advertising industry. Further, the 2007 B-BBEE baseline study referred to in the study also reported a high turnover of black staff, further confirming the desire for black employees in the advertising industry to ââ¬Å"job-hopâ⬠. This becomes costly, as companies try to offer comparative salaries to retain talent, not only in their company, but in Cape Town, since salaries are known to be higher in Johannesburg than in the Cape. Training programmes would need to be used to improve job satisfaction with the view that they may result in improved staff retention rates. It was reported that the advertising industry has come up with some innovative training and mentorship programs in order to address both skills and staff (Employment Equity/Management Control) requirements. A further challenge in relation to B-BBEE spoke to attitudes that companies had toward compliance. In one instance, it was noted that some larger companies were more focused on compliance with BEE regulations, than acting in the true spirit of BEE, and that in some instances dishonesty and deceptive practices were used to achieve better scores, as this can result in increased business. Despite concerns by white males who took part in the study, that they were effectively working themselves out of jobs by embracing B-BBEE, many viewed B-BBEE as an opportunity to engage with their target market. Rather than stifling out diversity, encouraging it could create further business opportunities, especially in terms of growing the target market (through job creation, but also through understanding the new emerging target market of empowered black South Africans, and being able to create purchasing desires that would stimulate the economy during a difficult global financial period). The risk faced by the advertising industry was losing their white employees if these employees felt prejudiced by the opportunities being afforded to black South Africans only. The only possible way for this to succeed would be through growth of the industry, in order to generate more revenues to pay all employees equitable and comparable salaries, regardless of race. These challenges can heavily impact the compliance of companies for the Management Control, Employment Equity and Skills Development elements; when B-BBEE is seen as a cost, the true potential envisioned in the objectives of B-BBEE is easily lost. It was however reported that over 80% of advertising agencies had utilised the services of B-BBEE verification agencies, despite the industry being in its infancy, and that a majority of these agencies had positive attitudes towards B-BBEE. This resulted in the advertising industry being ahead of the national B-BBEE status, in terms of their level of compliance achieved. However, compliance within the MAC Charter targets, which as previously discussed is not binding, and has lower, phased-in targets than the Codes, may have led to these higher status levels. Conclusion Due to the uncertainties existing in the B-BBEE verification and compliance sphere at the time of the study, it is difficult to assess whether or not meaningful transformation had taken place. Despite this, there are indications of compliance by the advertising industry in Cape Town. While the industry was mostly self-regulated, around 80% of agencies confirmed they had engaged with Verification Agencies to confirm their B-BBEE credentials. Standardising and formalising the verification process may result in greater compliance, along with the imposition of penalties for misrepresenting information in order to achieve a favourable score. As stated by the authors of the study, ââ¬Å"The ratio of success to failure in BEE is determined on a daily basisâ⬠(Duffett, van der Heever Bell, 2009; 109). Regular monitoring is required to continuously assess compliance with the Codes, and to evaluate transformation achievements as a result of B-BBEE. Even with the wrong intentions, B-BBEE can promote changes and improvements in the lives of previously disadvantaged individuals. However, true success for B-BBEE would be to bring about meaningful improvements in the lives of all South Africans, rather than a select few. Bibliography R.G. Duffett, I.C. Van der Heever D. Bell. 2009. ââ¬ËBlack economic empowerment progress in the advertising industry in Cape Town: Challenges and benefitsââ¬â¢, Southern African Business Review, 13(3): 86-118. South Africa, Department of Trade and Industry. 2003. Broad-Based Black Economic Empowerment Act, No. 53 of 2003, No. 25899, Government Gazette Volume 463. Pretoria: Government Printers. South Africa, Department of Trade and Industry. 2007.Broad-Based Black Economic Empowerment Codes of Good Practice,No.29617, Government Gazette Volume500,Section 9(1) of the Broad-Based Black Economic Empowerment Codes of Good Practice Act 53 of 2003.Pretoria: Government Printers. South Africa, Department of Trade and Industry. 2008. Marketing, Advertising and Communication Sector Transformation Charter, No. 31371, Government Gazette Volume 518, Section 12 of the Broad-Based Black Economic Empowerment Act, No. 53 of 2003. Pretoria: Government Printers. Okharedia, A.A.. 2014. ââ¬ËB-BBEE Legislative and Strategic Frameworkââ¬â¢ [PowerPoint Presentation] 10 March. UNISA Graduate School of Business Leadership. Midrand, Gauteng. South Africa, Department of Labour. 2013. Commission for Employment Equity; Annual Report 2012-2013, Pretoria: Government Printers. Available at http://www.labour.gov.za/DOL/documents/annual-reports/Commission%20for%20Employment%20Equity%20Report/2012-2013/annual-report-comission-for-employment-equity-report-2012-2013> [Accessed 25 March 2014]
Monday, August 19, 2019
Woman and Abortion :: essays research papers
Woman and abortion has always been an issue concerning everyone else except the female who is having the child. Most US citizens today believe that abortion is the wrong way to go, the unborn fetus has no chance at life. It is against the Catholic religion to do this but many people have to do this. Abortions are usually wanted by the teenagers in our society, whether they had made a mistaken and forgot to wear a condom or just chose not to wear one. This article is stating that our government is going to start testing the mothers who are caring a child. They want to ensure that the rights of the unborn fetuses are upheld. The rights of the baby should be upheld, and I believe that it will be but I also believe that there are groups that will not agree with this. These groups will protest at this trial to ensure what they wish to happen occurs. Ã Ã Ã Ã Ã The Supreme will decide whether pregnant women can be tested for drugs. If being tested for drugs just means taking blood then it would not be harmful towards the unborn fetus. In this case the Supreme Court is deciding whether or not a woman can be given an injection to be tested for a drug. But will this injection hurt the baby, or is it for the good of the baby so that the mother may be given help if she is in fact a drug addict. It was recorded in 1985, in South Carolina, that a hospital in the south would take any measure necessary to make it possible for the unborn fetus has a healthy birth. Ã Ã Ã Ã Ã The unborn fetus should have rights, but how do we know when the unborn child is in danger. We need to use and make laws to ensure that pregnant women in no way possible can harm their babies. Unfortunately this is nearly impossible to accomplish, for it can only be accomplished when the pregnant woman comes into her doctors office for a check up. When she does come in for a check up, as of now, the doctor can only advise you on what to do. Unless you are tripping over your own feet, or there is something visibly wrong with the way you look the doctor can not do anything with out your consent. Ã Ã Ã Ã Ã The hospitals, doctors, and whom ever else there is out there in the world who is out to help you should have more rights than they have now.
Sunday, August 18, 2019
Free Essay on Nathaniel Hawthornes Scarlet Letter - Three Scaffold Scenes :: Scarlet Letter essays
Three Scaffold scenes - Progression of Dimmesdale In The Scarlet Letter, Nathaniel Hawthorne portrays Arthur Dimmesdale as a troubled individual. In him lies the central conflict of the book. Dimmesdale's soul is torn between two opposing forces: his heart, his love for freedom and his passion for Hester Prynne, and his head, his knowledge of Puritanism and its denial of fleshly love. He has committed the sin of adultery but cannot seek divine forgiveness, believing as the Puritans did that sinners received no grace. His dilemma, his struggle to cope with sin, manifests itself in the three scaffold scenes depicted in The Scarlet Letter. These scenes form a progression through which Dimmesdale at first denies, then accepts reluctantly, and finally conquers his sin. During Hester Prynne's three-hour ignominy, Dimmesdale openly denies his sin. Hawthorne introduces Dimmesdale as "a being who felt himself quite astray and at a loss in the pathway of human existence" (64). The author made it obvious that a grim secret lies hidden in the depths of Dimmesdale's soul. This secret, however, does not reveal itself immediately, since Dimmesdale hides it from the closely watching town. In addition, he magnifies his own denial of his sin when he charges Hester to "speak out the name of thy fellow-sinner and fellow-sufferer"(65). By deliberately speaking to Hester as if the sinner were not himself, the pastor makes sure that nobody suspects him. One may also interpret Dimmesdale's speech as a hint to Hester not to name him. He feels he must "add hypocrisy to sin" in order to keep his standing in the town. He thinks that if the town finds out about his sin, they will never forgive him, much like his belief system tells him that God will never forgive him. So great is his relief when he finds that "she will not speak" that he stands in awe of the "wondrous strength and generosity of a woman's heart"(66). Despite an inward wish for his sin to be discovered, Dimmesdale feels better knowing that Hester will not willingly expose him. In this scene in front of the town, Dimmesdale shows his original strength of character, which will diminish along the course of the book. In the middle of the night, seven years after Hester's punishment, Dimmesdale holds a vigil on the scaffold where he finally accepts his sin. The battle within Dimmesdale between "Remorse, which dogged him everywhere" and "Cowardice, which invariably drew him back"(144) leads to a temporary compromise in his midnight vigil.
Saturday, August 17, 2019
The Chronic Lyme Disease Health And Social Care Essay
Lyme disease is a terrible public wellness issue. It is the most common tick-borne infection in the northern hemisphere of the universe ( Feder et al 2007 ) . In North America it is caused entirely by Borrelia burgdorferi sensu strict ( henceforth referred to as B. burgdorferi ) , while in Europe it is caused by B. afzelii, B. garinii, B. burgdorferi, and infrequently by other sorts of borrelia ( Feder et al 2007 ) . Lyme disease can be reasonably easy to handle in some patients. However, for some patients, it can go like an eternal conflict. Chronic Lyme disease ( CLD ) , which has been making much contention, is a systemic, disabling status which persists in malice of the therapy. There is an on-going argument if there is such a disease that can be classified as a CLD among scientists. Because of the fact that there is no defined trial for the presence of CLD, health care suppliers have to trust to a great extent on patients symptoms in most of the instances of reoccurrence. Furthe rmore, as CLD patients represent a instance of Heterogeneity of Treatment Effect ( HTE ) which indicates patient ââ¬Ës response to the same intervention varies in different patients, it makes it harder to generalise the definition of CLD. Different Lyme patients have different responses to a standardised intervention. ( Green 2009 ) Furthermore, the intervention of the CLD is ill-defined at this minute ( Marques 2008 ) ; hence making the uncertainty if there is of all time a disease to be cured. Some scientists suggest utilizing antibiotics as a intervention for CLD ( Stricker 2007 ) while others consider it as a mistreatment ( Hodzic et al 2008 ) . In this paper, I will get down with the general information of Lyme disease and analyze the groundss of the being of CLD. Furthermore, I will discourse the way of the farther surveies for the intervention of the disease based on the surveies that were conducted throughout the clip. Besides, I will take a expression at the opposing side of the statement claiming nonentity of CLD and discourse the exposure that their claim possesses.Why does the being of CLD affair?Lyme disease in the United States of America is bit by bit increasing over old ages, and the coverage instances of Lyme disease in 2009 is making 38,000 instances which is twice every bit much compared to the instances in 2006 which was 20,000. ( Centers for Disease Control and Prevention 2009 ) ( Figure 1 ) The country of infection has broadened, and health care suppliers have seen Lyme disease instances in about all provinces in the United States. However, it is still true that most reported instances are significantly con centrated in the Middle atlantic States, Minnesota, coastal Northeast, and northern California. Lyme disease can be found in the other continent including Asia and Europe. ( NIH 2008 ) Therefore, a batch of patients are enduring from Lyme disease and it is estimated that more than 30 % of Lyme disease patients reach the phase where the symptoms are relentless more than few hebdomads despite the intervention. ( NIH 2008 ) However, irrespective the figure of patients who are enduring from these conditions referred as CLD, there is still an on-going argument sing being and intervention of this disease. Approximately 11,400 people were enduring from CLD in 2009 harmonizing to the coverage instances of 38,000 and 30 % rate of going CLD. In a terrible instance ( Cameron 2006 ) , about 66 % of 215 Lyme disease patients diagnosed in Westchester County, New York, USA remained sick after intervention for an norm of 3.2 old ages. If this affair remains unsolved, it will ensue a effect where pa tients can non acquire a proper intervention for CLD. It is an pressing affair for scientists to happen out a solid intervention to profit those patients.So, does CLD be?Lyme disease, a many-sided infection, has a legion aim symptoms including febrility, concern, stiff cervix, and fatigue. The most typical and common symptom of Lyme disease is a characteristic tegument lesion called erythema migrans ( EM ) roseola which appears in the early phase of Lyme disease. On the other manus, the most common symptom that can be seen in CLD is pauciarticular arthritis, and certain neurologic and cardiac manifestations, all of which normally respond good to conventional antibiotic therapy. ( NIH 2008 ) Other than symptoms, there are several groundss to turn out the being of CLD. As mentioned in the beginning, it is estimated that 30 % of Lyme disease patients develop farther status called CLD. Although after the antibiotic intervention take attention of the infection in most instances ( Klempner et al. 2001 ) , a minority of patients have musculoskeletal hurting, concentration trouble, short-run memory trouble, weariness, or all of these symptoms with or without clinical or serologic grounds of old early or late Lyme disease. ( Feder et al. 2007 ) It is thought to be a CLD when a patient exhibits these self-limiting and normally mild conditions longer than about 6 months. ( Nau et al. 2009 ) Thirty-four per centum of a population-based, retrospective cohort survey in Massachusetts was discovered to hold neurocognitive damage, arthritis or recurrent arthralgias, and neuropathy or myelopathy, a mean of 6 old ages after intervention for Lyme disease. ( Cameron 2010 ) In a cohort survey of 215 in turn treated Lyme disease patients in Westchester County ( Asch et al. 1994 ) , 62 per centum of patients had symptoms such as arthralgias, arthritis, and cardiac or neurologic engagement with or without weariness a mean of 3.2 old ages after intervention. ( Cameron 2010 ) In the tests of Klempner et Al. ( 2001 ) , there were studies that 41 % of topics exhibiting with well-documented, antecedently treated Lyme disease had relentless musculoskeletal hurting, neurocognitive symptoms, or dysesthesia, frequently associated with weariness and were ill during a mean of 4.7 old ages after oncoming. In a survey utilizing mice ( Hodzic et al. 2008 ) , relentless infection was documented by feeding ticks upon the mice and so proving the ticks for spirochaetes ( xenodiagnosis ) after 30 yearss of antibiotic ( Rocephin or Vibramycin ) intervention. This infection could be detected by xenodiagnosis for about 3 months after antibiotic intervention. Besides, relentless infection was confirmed by sensing of low degrees of spirochetal DNA in tissues for up to 9 months. Furthermore, Four National Institutes of Health ( NIH ) sponsored tests were conducted as double-blind randomised placebo- controlled tests ( RCTs ) corroborating the being and badness of CLD ( Cameron 2010 )There are still uncertaintiesThe 2006 Infectious Diseases Society of America ( IDSA ) Lyme disease intervention guideline panel inquired the being of CLD despite the documented grounds that were presented including the 1s provinces above. The IDSA panel questioned the being of CLD and concluded by stating that there is considerable contention and confusion exist over the cause and frequence of this procedure and even over its being. ( Cameron 2010 ) Besides, some of CLD patients have negative consequence with the trials provided to find Lyme disease thereby does non measure up for the intervention. ( Green 2009 ) CDC ( 2010 ) proposes a two-step process when proving blood to find manifestation of Lyme disease. The first measure uses an ELISA or IFA trial. If ELISA or IFA is negative, it is considered that patient most likely does non hold Lyme disease, and no farther testing is recommended. If they are positive or ambiguous, a 2nd measure should be carried out to verify the consequences. These trials can give a falsified consequence due to its sensitiveness of the trials are comparatively high. Therefore, about everyone with Lyme disease, and some people who do non hold Lyme disease, will prove positive. The 2nd measure employs an immunoblot such as a Western smudge or striped smudge trial. When used suitably, this trial is designed to be specific, significance that it will typically be positive merely with an septic individual. It suggests that the first trial was a false positive if the Western smudge is negative. Furthermore, the fact there is no definite trials to name or intervention to bring around CLD causes a uncertainty whether there is an existent disease to be treated. ( Green 2009 )Further groundss of CLDLyme disease is diagnosed based on physical findings, symptoms, and a history of possible debut to infected ticks.A ( Klempner et al. 2001 ) Validated laboratory trials such as ELISA, IFA, and immunoblot could be really utile but are non recommended in general when a patient has erythema migrans.A Several signifiers of research lab proving for Lyme disease are offered ( Table 1 ; Feder et Al. 2007 ) , some of which have non been sufficiently validated such as urine antigen trials, immunofluorescent staining for cell wall-deficient signifiers of B. burgdorferi, and lymphocyte transmutation trials ( CDC ) Most normally used and recommended trials are blood trials that step antibodies made in response to the infection. These trials are rather reliable for naming ulterior phases of disea se, but it can be falsely negative in patients with early disease. Some patients with early Lyme disease who are treated with antibiotics will non bring forth antibody response to infection, which will ensue in continuously negative serologic trial consequences. ( Ogden et al. 2008 ) Even with those methods of diagnosing, it is really difficult to stipulate CLD from the early phases of Lyme disease. In some patients, symptoms reoccur after the intervention or symptoms ne'er go off in other instances. ( Klempner et al. 2001 ) The word ââ¬Å" chronic â⬠has been used to Lyme disease widely. There are some illustrations where other diseases use the term ââ¬Å" chronic. â⬠For case, there is a ââ¬Å" chronic neuroborreliosis â⬠in Europe, and it is referred as when patients show late neurologic manifestations of untreated or inadequately treated infection. Besides, United States has studies patients with recurrent or relentless arthritis that lasts for up to several old ages, most likely because of active infection. ( Feder et al. 2007 ) However, although there are no definite trials to name CLD yet, there are four classs that can be used as a diagnosing of CLD depending on patient ââ¬Ës status. ( Feder et al. 2007 ) ( Figure 2 ) Class 1 patients do non hold laboratory grounds or nonsubjective clinical manifestations of B. burgdorferi, and they receive a diagnosing based on the presence of non-specific symptoms such as dark perspiration, weariness, depression, and concern. Category 2 patients have identifiable unwellnesss or syndromes other than Lyme disease, and patients may or may non hold a history of Lyme disease. Category 3 patients have symptoms of unknown cause, with antibodies against B. burgdorferi but no history of nonsubjective clinical findings that are consistent with Lyme disease. Last, category 4 patients have symptoms associated with post-Lyme disease syndrome. Sing the tests and the experiments presented, it is non difficult to state that the decision should be tilting towards to the being of CLD. Although symptoms vary among patients showing HTE ( Marques 2008 ) , these classs can be a good index to place a patient in CLD patient pool. Furthermore, although there is no trial to corroborate presence of CLD, there is besides no clinically available proving up to day of the month to turn out that B. burgdorferi infection has been eradicated. However, there has been some proving demonstrated, that B. burgdorferi can stay in animate beings and worlds in an infective province, even after with recommended antibiotic intervention. ( Hodzic et al. 2008 )TreatmentThe following inquiry that arises sing CLD is its intervention. Since authorities ( CDC ) clarified their place with the being of CLD and confirmed it as a legitimate diagnosing, except some of those scientists who strongly deny the diagnosing, the contention about CLD moved onto the intervention of CLD. Some scientists claim that antibiotics should be used as a intervention ( Green 2009, Klempner 2007, and Fallon et Al. 2007, ) while other scientists say antibiotics should non be recommended as a intervention. ( Hodzic et al. 2008 ) Generally, for early Lyme diseas e, a short class of unwritten antibiotics such as Vibramycin or Amoxil is curative in the greater portion of the instances. In more complex instances, Lyme disease can normally be successfully treated with 3 toA 4 hebdomads of antibiotic therapy, and so far, it is the lone intervention for Lyme disease. ( Fallon et al. 2007 ) However, there is no solid remedy for CLD and it is a really sensitive issue whether antibiotics should be used or non for this diagnosing. There are several surveies conducted demoing reoccurrence of Lyme disease symptoms and betterment of symptoms with drawn-out antibiotic intervention. ( Green 2009, Klempner et Al. 2001, Fallon et Al. 2007, and Oksi 2007 ) Some patients treated with antibiotics for CLD in a dual blind, placebo-controlled re-treatment surveies ( Fallon et al. 2007 ) , which have neurocognitive via media and weariness, acquire better upon re-treatment with 3-10 hebdomads of Ceftriaxone. ( Fallon et al. 2007 ) discovered that patients re-treated for partial response/failure improved in parametric quantities of weariness, hurting and functionality. They besides found that neurocognitive via media did non heighten, even though Fallon found that patients improved at the three-month measuring, but did non keep betterment at the six-month measuring. Oksi ( 2007 ) conducted a partial re-treatment test and partial new patients. All patients were treated with Ceftriaxone for 3 hebdomads and improved 79 % for both new oncoming borreliosis and return or continuity. This survey was intended to prove if longer interventions after 3 hebdomads of IV Ceftriaxone had an improved result. In this survey, 10 hebdomads of farther intervention with unwritten Amoxicillin ( 1500mg a twenty-four hours ) did non advance better result. This test has statistical restrictions due to HTE which makes it complicated to generalise the result to all station intervention Lyme patients. Although non all parametric quantities in survey of Fallon et Al. ( 2007 ) continued betterment, betterment in weariness is an highly of import result, frequently allowing handicapped patients to return to household life and work. Because of the power of these three surveies, length of the surveies, dependable methods they used, and big figure of topics, these surveies should be considered pilot surveies. As indicated earlier, there are several classs among CLD patients. Although antibiotics intervention was effectual in some patients, it is non clear whether it should be introduced to all patients who suffer from CLD, since the maltreatment of antibiotics could ensue in have considerable damage in their health-related quality of life. A survey was conducted by Mark Klempner in 2001 ( Klempner 2001 ) demoing the serious damage of health-related life quality after the long period debut to the antibiotics.DecisionAs demonstrated, response of Lyme patients to the same therapy is different from patient to patient, clear uping that Chronic Lyme patient exhibit Heterogeneity of Treatment Effects ( HTE ) . This besides makes it difficult to name the presence of CLD in persons. However, clinical groundss indicate that there is a disease that can be classified as CLD. CLD can go terrible. The restrictions in physical operation can be harming quality of life in a serious manner. One survey ( Klempner 2001 ) described the quality of life for patients who suffer from CLD as the same to that of patients with degenerative arthritis or congestive bosom failure, and patients physical damage was greater than damage of patients with type 2 diabetes or a recent myocardial infarction. Fallon et Al. ( 2007 ) described the weariness reported by patients with CLD was likewise to that of patients with multiple induration ( MS ) and their hurting was similar to those of postsurgery patients. Cautiously designed, placebo-controlled surveies have been successful to demo that drawn-out antibiotic therapy is good in certain instances. Even though stray success instances are ever good to hear, such studies entirely are non plenty evidences to prolong a curative attack. Therefore, it is of import for clinicians to recognize the significance of intervention in single patients who is enduring from CLD and the effort to happen a clear declaration should be pursued in farther tests and experiments.
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