English Original Writing – The Slime

I had detention because some of my so called friends told the teacher I did it when I never. I was on my way home when I heard something smash therefore I went nearer to the source of the sound. It was leading me to a dark deserted old alley. At any rate this way was quicker to my house so I strolled down. I never used to go home this way since my mum said not to for the reason that bad things happened to her when she went through the alley. The thought of the scream made me shiver and I felt a tingle down my spine. I heard the leaves crisp as I toddled along the footpath. The street was isolated I could even hear my self breathing. My stomach was churning so thus, I felt I was going to be sick. There it was I saw it, I was amazed of the features it had. He came closer and closer. It looked like he was horrified and his face was turning blue, pale blue. He made another impulsive move towards me and vomited. I felt the puke on my injured car bonnet. The bonnet got injured due to a hit and run ten minuets a go. The Schoolboy strolled towards the shimmering door and went inside me. He opened my shirt pocket gradually. He saw a creepy look in the mirror which gave a different image. I felt sick so I puked on the car. I hurried into the car and my eye was caught on this compartment, so therefore looked inside the box. I was shocked to see my self look like this. So I ran out of the motor vehicle, the engine was still running. I found out what made the crash it was this car so me and my conscience started to clean the vomit. I decided to restore it to its previous pristine condition as a mark of respect to the decease inhabitant of the car. He started to clean me additionally I started to undergo a feeling I have never felt before, cleanliness it felt so nice. He walked away from me but from my view I could see a silhouette following his every move. Something was saying to me go back the car or someone may need my help. I turned round ambled to the car. The car's engine went off I believed to think the battery ran out. The cars door opened, thus made my heart pound, erstwhile I was thinking the car was calling me in. I took the weight off my feet and the cars engine turned back on and the cars doors and front bonnet and rear bonnet were clanging and horning, it made me jump. I could not believe my eyes no one come out or looked to see what that noise was. I saw a house. I was very curious to see the house. He gathered the courage to go into the gloomy dark house. He walked through the front door and plodded up the stairs. He looked around; I went inside a mansion. I saw a bathroom door open. The bathroom was covered in slime. The sink was bubbling slime; the floor was flooding slimy slipper sludgy slime. I tried to run back out but the door slammed shut in my face so there fore I went for the window that too slammed shut. The house was flooding green slime. I was scared and could see my future passing through my eyes. Then suddenly I heard an engine start. There was slime coming out through the panes of the window and the door. I heard banging, I thought it was the boy, I was thinking should I go in. I was drowning in slime I did not know what to do. The gunk was going in my mouth and I had to breathe through my nose I had a few seconds left. I was thinking. Then it came to me ill ram the car into the house so I rammed it. I saw a bright light. I thought I was gone, but when I heard a bang I saw the car I owed my life to a realistic car.

America Foreign Policy

The trade embargo placed by the United States on Cuba involves financial, economic and commercial restrictions that were first placed on Fidel Castro’s government in 1962. It was as a result of the government expropriation of assets and properties of US nationals and corporations. The embargo was first suggested and implemented by president Kennedy’s government on the charge that there was lack of democracy in Cuba not only in respect to the Cuban nationals but also to other nationals.In essence, the embargo restricted certain economic and financial transactions between the nationals of the two countries whether directly or indirectly in regard to the use of a third country or national of such a country. The embargo started with the introduction of an import quota on sugar imported from Cuba by several millions. This was met by an agreement by the Soviet Union to by the rest of the sugar from Cuba. Still, the Cuban government under the leadership of Fidel Castro continu ed to take further actions on businesses owned by American national, confiscating most of it.The US government retaliated by expanding the trade restrictions even further especially because of the alignment of Cuba with the Soviet Union in the cold war which caused the Cuban missile crisis. Later, the US government imposed travel restrictions to its nationals restricting them from traveling to Cuba. Further down the line, the US government charged the Cuban government of hosting Soviet Union nuclear weapons and since the union was an enemy in the cold war, regulations were put in place to freeze any Cuban assets in the states and to further consolidate the restrictions put on the country.Various restrictions has since been put in place which include restriction on the amount of money spent by a US national on the Cuban island, restrictions on the forms and amount of gifts that a US national can give to a relative in Cuba or a Cuban national among others. Furthermore, the US governme nt restricted any company that is involved in trade activities in Cuba from entering the US economy on the argument that such a company would be trafficking assets from US to Cuba. To date, most of the trade restrictions placed on Cuba and expenditure restrictions placed on US nationals and corporations still stand.Despite efforts by some of the activists and United Nations has been meeting a dead end with previous and current presidents of the US suspending bills and efforts aimed at lifting the embargo. Despite the fact that some valid reasons were used in basing the embargo and the fact that the US government and its nationals are not affected much by the Embargo, the effects of it are not only affecting the unintended but also affecting the US economy in ways which were unintended. Efforts by activists and the UN are still unsuccessful despite the dire consequences that the embargo has had.In essence, while today the embargo is much founded on democracy issues in Cuba, it goes a step further to restrain the achievement of democracy in the country, punishing Cuban citizens as opposed to the Administration. The purpose of the paper is to expound on the benefits that can be achieved by lifting the embargo not only to Cuba but also to the US and its citizens in general. Why the Embargo should be lifted As observed earlier, various efforts to lift the restrictions on Cuba and American travelers have continuously been rejected both by the President and the congress.On the contrary, the US government has eased a little following pressure from some of the activists. For example, agribusiness organizations and American farmers put the government under pressure to lift some of the restrictions which saw the allowance of sale of medicine and agricultural goods only for humanitarian reasons. Still, many of the restrictions still are in place and there exist no evidence that these restrictions will be lifted any time soon. In light with the embargo, Cubans and scholars have argued that the embargo has and still is affecting negatively the resources of the Cuban nationals as opposed to those of the government.This raises many humanitarian issues in regard to the US government especially considering that the embargo was as a result of democracy issues in Cuba. It has been argued and it is true to a greater extent that the economic damage that arises as a result of the embargo is to some extent responsible for the problems associated with transportation and food shortage in Cuba. As argued by some governments and activist, the embargo has had dire effects on medicine supplies, food and other economic needs of Cubans.This by extension has resulted in vulnerability in infectious diseases and epidemics including malnutrition. The restrictions also have negatively affected the flow of medical information in the country thus resulting to diseases that would otherwise be easily dealt with. The rationing system that results as a result of food shortage hav e greatly affected men and the elderly since designed to give preference to women and children. On another view, the embargo has greatly influenced the capacity of US investors in Cuba but more so have affected non American investors in Cuba.In this context, investors who have interests in the US economy have been reluctant or have been restricted by the law from investing in Cuba. As such, the embargo is not only affecting the Cuban and the American nationals but also the nationals of other countries as well. Moreover, it has continuously threatened diplomatic relationship of US and other countries in regard to the dealings and transactions of these countries and Cuba. In any case, while the embargo gives the Cuban government a scapegoat for problems not directly associated with the embargo, it gives a head start for non US businesses in Cuba should it be lifted.In this regard, these businesses have already established firm foundations to be shaken by the competition that would ari se from the lifting of the trade embargo. In general, while the embargo is aimed at improving the democracy and the compliance with human rights, it has continuously affected these rights negatively making it non humanitarian itself. It is worth noting that it an inadequate reason for the US government to argue that it is involved in charity work aimed at giving medical and food supplies to Cubans.On the other hand, the bureaucracy involved in this charity work has greatly affected its effectiveness in Cuba. Charity organizations and other non governmental organizations have faced delays as a result of the licensing process involved and transportation problems. It also represent a violation of international law as provided for by the United Nations Charter. In this context, the fact that the embargo directly condemns the sale of certain food products and medical products abuses the human right of accessing life saving medical supplies.Further Arguments As it stands out, the trade em bargo imposed by US government hinders free trade between the two countries. While the US government is highly dependent on home production, it does not mean that it has a comparative advantage on all it consumables thus it is forced to import some of it consumables from other countries. This implies that there is an existence of free trade between US and these other countries. One of the major advantages of free trade is that it promotes liberalization of the economies involved.As such, by maintaining the trade embargo on Cuba, the US is denying the Cuban economy better grounds for liberalization. In essence, the Cuban economy can not be open to American investors nor is it open to non US investors who have interests in both countries. In this context, the US economy is and continues to lose the advantages that are associated with the liberalization of the Cuban economy just like any other economy. In fact, it would be irrational to argue that the economy of Cuba has little to offe r to that of US.On the other hand, Cuba has been famous of having a comparative advantage on sugar production. It is imperative that the US economy can obtain such goods from other economies but the question remain, how cheap would it attain them from the Cuban economy. A good example is the tourist potential of Cuba. Travel restrictions have greatly affected the realization of benefits in Cuban tourist industry as the US government restricts its nationals in visiting the island and in the maximum amount of dollars that can be spent on the island on any given day.Moreover, free trade allows the manifestation and improvement of diplomatic relationship between the countries involved. While the problem in Cuba is a political one, trade embargo does not help in solving other problems in the country especially social and humanitarian’s one. It has over and over been argued that as opposed to a trade embargo, the problems in Cuba can only be solved by changing the communist politic al organization in the country. In light with these, the US government should first lift the embargo then embark on measures that are aimed at filling the loopholes in the Cuban political system.In any case, the embargo like others placed on other countries such as Iraq will only give the Cuban administration a reason to cling further to it political system. While, the US government restrict the provision of certain services to Cubans as was evident in the situation where the US government stressed Starwood hotels to chase away Cuban delegate who had attended the US- Cuba Trade Association, the Cuban government is also justified to retaliate in any way they think will bring equality. Such retaliation will only worsen further the diplomatic relationship between the two countries.Still, free trade helps in increasing the amount of foreign currency held by a given economy. With the reduction of economic aid by the soviet, Cuba has been experiencing may economic problems most of which i s as a result of lack of foreign currency to service debts secured from Asian countries. As a result, the living standards of Cuban nationals have greatly depreciated. In this context, it is a fallacy for the US government to argue that all the humanitarian problems in Cuba are as a result of bad governance.In essence, the US governments and it allies whether countries, corporations or individuals have greatly contributed to the decline in humanitarian welfare in Cuba. By placing sanctions on allies dealing with Cuba and by closing it economy from Cuba, the US government denies Cuba a chance to earn foreign currency and by extension impacts heavily on the livelihood of Cubans. Perhaps the most obvious advantage of free trade is that it increases the living standard of the nationals of the two respective economies.In this regard, free trade increases the availability of a variety of goods and services to the populations of the two countries. For one, the population has a variety of q uality products to choose from and secondly, these products are available at a cheaper price keeping in mind the concept of comparative advantage. Buying these products a cheaper price will increase the real purchasing power of the constituents of the population giving them the capability to save and invest in other areas of the economy.It would therefore be worthy to the Cuban nationals if the US government lifts the embargo as this will help in not only reducing their dependence on other economies through charity works but it would also improve their living standards. Since the US government and economy is highly involved in charity work to help Cubans, the lifting of the ban would also go a long way in helping the economy to develop given the nature and the cost of the resources used for charity work. Another advantage of free trade is that it helps in improving the infrastructure of both countries and this is inclusive of both transport and communication.While the US trade embar go on Cuba can be seen as restricting the movements of goods and services, restrictions have been put in place which restricts the docking of Cuban ships on American docks. Similarly, there have been travel restrictions especially in regard to US citizens. In light with the restrictions and with the poor diplomatic relationship between the two countries, the infrastructures of the two countries have suffered though not in direct terms. For example, flights operating between the two countries have been rerouted as no of the country want the other to intrude in her air space.Situations as these have increased the cost of transport between the two countries and have even hindered the movement of goods and services especially for Cuba since it has to use long routes to import goods thus a high cost of importation. Such a poor infrastructure has also been accused of harboring poor flow of medical information into Cuba and by extension increasing the persistency of epidemics and diseases in the country. Free trade encourages the increase in the level of investment opportunities between the respective countries while at the same time increasing foreign direct investments.This on the other hand helps in raising the living standards of the population of the two countries. Should the government lift the trade embargo, investment opportunities will sprout in the two countries. As a result, even if the US does not directly participate in investing in the Cuban economy, other multinational companies will seek investment opportunities in the country. In essence, those allies of US who have been reluctant to invest in the country will reconsider their stand. Moreover, the multinational companies in Cuba will also seek investment opportunities not only in the American economy but also in the economies of its allies.This will earn foreign currency for all the participating countries but more so will help in raising the living standards of Cuban nationals. As evidence has shown , the confiscation of Cuban assets including money held in banks, the government is only further aggregating the problem as the Cuban government is bound to take equal measures of counter attack and this can only add up to a web of tit for tat game. In addition to the above, free trade is also important in that it helps in increasing employment opportunities in the respective countries.As is the case with the living standards, creation of employment opportunities is integrated with other factors such investment and specialization. As stated earlier, free trade creates investment opportunities which by extension create employment opportunities while at the same time improving the living standards of the nationals. In addition, free trade increases the economies of scale which means more investment and earnings from the existing investments. This will also help in creating employment opportunities for the citizens of the two countries.In this light, it would be more advantages if the US government considers the probability of lifting the embargo as this would benefit not only the economy of Cuba but also its own economy. It would help in raising the living standards of Cubans thus reducing the level of poverty and dependence in the country. Finally, free trade helps in the harmonization of labor policies between the two countries thus offering cheap and affordable labor term. On top of this, free trade allows increased mobility of factors of production.As stated earlier, the fact that the US economy is capable in producing most of its consumables does not necessarily mean that it has a comparative advantage in production of all of them. If the embargo is lifted, the US economy will be able to expand its base in relation to factors of production thus improving on the productivity of its economy. With the advantage arising from the geographical positions of the two countries, the US economy is capable of importing factors of production from Cuba at a lower cost an d in time thus increasing productivity in its industries.Goods can also be exported to Cuba not just for charity work but also for earning foreign currency. Conclusion As is evident following the above discussion, it is evident that the US by placing the embargo on Cuba, the US government has denied the Cuban economy to grow and by extension, it has denied Cubans the opportunity of enjoying a high standard of living. While the argument still remains that the embargo is aimed at improving the democracy in Cuba, it should be known to the US government that this has only resulted to more humanitarian problems than there was before the embargo.It is therefore important for the US government to accept the fact that what is needed in Cuba as opposed to trade embargos is to change the whole political system. As such, the US government should lift the ban and look for other economic and political ways of influencing Cuba. Reference: Arnson Cynthia, 1993. Crossroads: Congress, the President and Central America, 1976-1993. Pennsylvania, Pennsylvania State University Press, pp. 17 Bhaqwati Jaqdish, 2002. Free Trade Today. United States, Princeton University Press, pp.34 Fawn Rick, 2003. Ideology and National Identity in Post Communist Foreign Policies. London, Frank Cass, pp. 32 Gianaris Nicholas, 1998. The Northern American Free Trade Agreement and the European Union. Westport CT: Praeger Publishers, pp. 23 Louis A. 1995. Essays on Cuban History: Historiography and Research. Florida, University Presses of Florida, pp. 45 McGillion Chris, 2002. Unfinished Business: America and Cuba after the Cold War, 1989-2001. Cambridge, Cambridge University Press, pp. 19 Pierce Anne, 2004.The American Foreign Policy Tradition: Inspiration for Troubled Times. World and I, Vol. 19, pp. 56 Showalter D. 2007. Debating Franklin D. Roosevelt’s Foreign Policies, 1933- 1945. The Historian, Vol. 69, pp. 87 Ted Hopf, 2002. Social Construction of International Politics: Identities and For eign Policies, Moscow, 1955 and 1999. Cornell University Press, pp. 90 William M. 1998. Our Own Backyard: The United States in Central America, 1977-1992. United States, University of North Carolina Press, pp. 41

An Evaluation of the Activities, Reading Books and Watching Movies

An Evaluation of the Activities, Reading Books and Watching Movies Books vs. Movies Which one is better reading a book or watching a movie? People always debate on whether reading a book is better than watching a movie. Movies are just a live action version of a book, but the movies tend to leave out a lot of details one can get from reading the book. Grant it, reading a book takes more time, but a person gets to tap into their imagination more from reading a book than watching a movie. Books are just as great as movies if not better because books have no time limit, give people a better understanding, and they have more detail. Reading a book has no time limit, whereas; movies have a certain time period to get finished in. The books that are made into movies usually do not turn out the way we want them to be. Movies can be ruined by bad actors. The length of the movies determines how much details from the book go into the movie. Sadly, movies are all about the actors more than the details from the book ever were. When reading a book maybe the reader’s imagination was not met when they watched the movie. While reading a book you get a better understanding of the characters thoughts, feelings, and actions because it is written throughout the book itself. Reading a book lets the reader’s imagination flow. When the reader taps into their imagination they can imagine what the book is like visually. One can picture the characters in their head. They can picture what the characters voices sound like. The reader can visualize the scenes and imagine what the places look like according to what they read. People can relate more to a book usually than a movie because books have more detail. Not all the details from reading a book can be pictured in the movies. Typically the movies are worse than the book. Details draw the readers in and the more details they gather the more intrigued they get. When people get intrigued they usually follow what intrigues them. So therefore if they are reading the first book throughout a series it will make them read the other books. When someone picks up a book that they like they tend to find other books that are like the book they read. Reading books are better than movies due to the fact of having no time limit, a better understanding, and way more details. Books draw the reader in more than when a person watches movie. People go watch a movie typically because of actors. Books and movies are both great but books will always last longer. Books have a higher demand than a movie ever will.

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Wk4 DQ elementary Math - Coursework Example The mind of an average student does not have this ability. My use of manipulative is to enhance understanding of abstract ideas. In addition, mathematics is not an attractive subject to most students. I therefore, use manipulative to make the subject interesting among students. The importance of set theory as an elementary mathematics course has often been overlooked. Set theory is the basis of mathematics (Vaugh, 2001). The importance of set theory is more evident in higher mathematic courses than in courses taught at elementary schools. In elementary schools, all mathematics problems are carried on the set of natural numbers (1, 2, 3†¦). This aspect makes people to assume basics factors about set theory such as axioms (Vaugh, 2001). Set theory is the basis of higher mathematics such as Algebra, Geometry and complex Analysis. To introduce set theory in an elementary school I will use real life scenarios. In this case, I will take the classroom as a set. Students will represent objects in the set while different groups of student who have similar characteristics will represent subsets within the main set. I will also use set builder notation to teach the

An analysis of cross-functional teams in procurement and acquisitions Term Paper

An analysis of cross-functional teams in procurement and acquisitions - Term Paper Example This indicates that the prime objective of logistics is to avail raw materials, commodities, and goods, satisfying four main requirements that include order, cost fulfillment, quality and delivery. Logistics as a result entails several value adding activities that include production, time, location, and control of the supply chain (Rodrigue & Hesse, 2012). It highlights the organizational and material support of globalization. Logistic activities include physical distributions of the goods (derived transport segment), and the materials segment (the induced transport segment). The objective of this essay is to analyze a logistics management case ‘Online Store’ and come up with a detailed discussion on how the business can develop a new online retail business. The discussion will focus on the following logistic activities: Singaporean sourcing operations supplier selection, evaluation and Procurement, International transportation from Singapore to Australia, and Australian Quarantine and inspection clearance (Eauc.hk, 2010). The essay highlights how the above logistic activities can help the business to produce its products at a lower cost, and add value to time and place utility. Singaporean Sourcing Operations Supplier Selection, Evaluation and Procurement Procurement entails more than mere purchase of goods and services. With the increased need for business competitiveness and the growing pressure to deliver value to shareholders, interest in global procurement has been accorded greater attention. Businesses have resorted to global supply chain and procurement as a means for survival and attainment of competitive edge. The amount of money that businesses spend on procurement is often substantial taking approximately 50% to 85% of the company`s revenues. In search for high quality goods but at a lor cost, businesses like the Online Store have turned their attention to Asia for a wide range of sourcing ranging from materials, supplier identification , services to outsourcing. Singapore as a country is strategically located in addition to having sufficient business infrastructure. Because of this attractiveness, global businesses have been attracted to Singapore in their procurement undertakings (Singapore Fact Sheet, 2012). Sourcing Operations A number of rules guide the exportation of goods from Singapore. In its sourcing operations, Online Store has to adhere to these rules. According to Singapore Customs (2012), the following rules have to be adhered to: Fist the company must obtain an out permit through TradeNet. If the goods are not controlled and they are exported through air or sea, the permit has to be obtained within three days of the export. If the goods ate controlled or are being exported to Australia via rail or road, then the permit has to be obtained before exports. As noted in the case, some of the goods will be manufactured in China and sourced to Australia through Singapore. In this case, the business must ob tain an Out re-imported goods permit through TradeNet before it exports the goods under the Temporary Export Scheme. By fully exploiting the free trade agreement existing between Singapore and Australia, the business can benefit in the form of reduced import charges which is passed on to the consumers in the form of low product prices (Dfat.gov.au, 2003). Exports from Singapore Non-Dutiable Dutiable Source: Singapore Customs (2012, p.1) Supplier Selection, Evaluation and Procurement The first process in

Career action plan Coursework Example | Topics and Well Written Essays - 2250 words

Career action plan - Coursework Example It will also have a detailed analysis of the skills/knowledge and experience that would be expected from the particular candidate aspiring for a job. The report further progresses with the development of the CV and the covering letter preparation that would be prepared to demonstrate the skills/knowledge and experience in order to apply for a graduate level job. After that the report will exhibit the gap analysis where the current knowledge and the skills of the applicants will be matched with the requirement that has been identified in the research. At this stage, an attempt will be made to identify the areas where the candidate lacks. The preparation of the career action plan will be carried out where the candidate will show his commitment in order to plug the lacuna. At this section, personal development planning and career related activities will be undertaken. A short conclusion of the overall report will be presented to the reader in order to reflect the feeling on completion o f the overall assignment and exhibit an understanding of the intention to use the career action plan. Since several years the marketing job has been extremely competitive. The marketing industry is growing which is good news for those aspiring to make their careers on marketing. In order to overcome the tough times such as the recent economic slowdown, the companies seek people who can help them to get through this kind of situations. In this case, utilising money for marketing seems to be viable. However, there are certain drawbacks about these marketing jobs as well. Although the job profile seems to be attractive, the candidates have to face tough competition in this field. If the candidate seems to be incredibly hardworking and seeking challenges, then he can get involved into the marketing jobs. As the industry is growing there seems to be greater demand for

Political Machines Essay Example | Topics and Well Written Essays - 1000 words - 1

Political Machines - Essay Example Therefore, the basis of political machines is on people who have dissimilar and varying interests. Theodore observes that the different people share a common link despite their fear and ignorance. Theodore perceives that the sole purpose of political machines were to develop American cities equally. This move aimed at promoting urban democracy (Lowi 84-85). Theodore allude that new machines replaced old ones. This essay rejects the arguments of Theodore Lowi. The new and old political machines display similarities signifying that nothing has changed in the governance of American cities. To start with, although some cities such as New York have experienced some reforms in their mode of governance, there are no considerable changes in others cities such as Chicago. For instance, Theodore asserts that Chicago maintained a strong hold of old political machines in the year 1967. This is opposite to the case of New York, which embraced new wave of political reforms. In the year 1967, Chicago reaffirmed and consolidated its old ways of doing political unlike New York, which ushered in political transformation (Lowi 85). This depicts that old machines is still in existence and did not disappear as Theodore claimed. The power of political machine still prevails in Chicago and there is no prediction of its disappearance. Second, new political machines depict many commonalities with the old ones. Methods of employment to senior positions resemble the old way of recruitment. This new method picks those candidates who have experience in their careers. This succeeds the dubious way of selecting candidates to the political seats. According to Theodore’s essay, the so-called reforms have painted politics as a dirt game. This is a perpetuation of the old political machines, which embraced such mode of electing people to occupy top ranks. Big cities such as New York have poor governance despite the fact that there is competent management team (Lowi 85-86).

Marketing Mix Paper Research Example | Topics and Well Written Essays - 1250 words

Marketing Mix - Research Paper Example The products are high priced. Apple as a brand is regarded as a symbol for high status and trendy fashion. So it can be said that though being a market leader, Apple competes with itself and launches better and improved versions of its own product. Table of Contents Introduction 4 Marketing Mix 5 Product 5 Price 5 Place 6 Promotion 6 Implementation of Marketing Mix in Apple Inc 6 References 8 Introduction Apple Inc is a US based multinational organization engaged in manufacture of digital electronics and computer hardware equipments. The company was founded in the year 1976 by the name of Apple Computers Inc and since then it has grown into a mammoth organization with a formidable brand image. In the year 2007 the company renamed itself as Apple Inc. The company is presently listed on the bourses of the NASDAQ and the New York Stock Exchange. The company is presently headed by Tim Cook one of the most dynamic business leaders of the modern world. The company is known for its innovati ons in technology and bringing out cutting edge technology products that are unmatched by any of its competitors in the market. Apple Inc was one of the pioneers in the industry that designed computers like mackintosh (Apple, 2011). The mission and vision of the organization is to be an innovative market player that manufactures products that are unique, distinctive and highly innovative in the market. The main mission statement of the organization is an apple at every desk. The company aims to create innovations that are simple yet elegant and are highly technology intensive. The company’s mission is to provide the best quality and innovative products to customers across the globe. The company aims to be a global leader in its product category and has accordingly made a global presence by having a dedicated presence in almost all the major economies of the world. The vision and mission statements can be largely correlated with its business strategies that involved launch of products like I-phones, I-pad’s that are highly technology intensive and have attracted a huge attention from the target market audience by virtue of their innovative features. Marketing Mix Product Apple Inc has an impressive product portfolio comprised of a large array of innovative product offerings. Apart from the company’s traditional products like Mac the company also manufactures a range of other products including iPod’s, iPhone, and iTunes. IPod’s include portable music players that have a sleek design and highly attractive features that allows audio as well as video files to be run by the user. I-phone is yet another innovation developed by the organization in the lucrative mobile telephone segment. The unique product tries to amalgamate the excitement of a mobile phone with innovative features like excellent graphics and computing options. The delightful looks make it an attractive option for any individual. Apple also made a foray into the sof tware industry with the launch of the Apple I tunes. This product is essentially a music player that is compatible with both iPods as well as personal computers. In addition to this the company has also produced software’s like I sync, Mobile Me etc that are essentially in the software segments. Apple in its most recent activities has launched the

The Positive Results and the Expansion of the Company Essay - 3

The Positive Results and the Expansion of the Company - Essay Example Looking at other management styles such as the strategy and democratic, there is a clear indication that the command and control belittle human beings. Kazmi (2008, pg401) asserts that strategists and Democrats in management are more open-minded in that they allow participation of the employees in the development of the organization. He also adds that, in the quest of having the best rules, there must be regular refining of the existing ones. Everyone should be involved in decision making geared to bring change is significant. In the video presentation by Job Stains (public conversation website, n.d.), attention is herein brought on the validity of a participative managing style rather than the command and control. He demonstrates that the mind of a human being works better when relaxed. Once threatened, hormones that would compel the person to revenge are produced. The person may just freeze just like in the military when soldiers are told to do so by their commander. The idea is tr ying to have a constructive conversation to work out properly. Just from the lecture, a good manager should have qualities that allow him to have the audacity to inquire. He should ask what went wrong and what should be done to attain stability. A dialogue formula is the best. Being innovative and proactive will help find solutions amicably. This means everybody will be satisfied, and respect will be upheld. There will be no hatred within the juniors and the superiors. The narrative therapists (Morgan, 2000) have it in mind that, for an appropriate management style, conversations are the key to achievement.

Privatization in India Essay Example for Free

Privatization in India Essay Ram Mohan Visiting Faculty, Finance and Accounting Area Indian Institute of Management Ahmedabad, India Abstract The proposed research is intended to survey the process of privatization in India and assess its impact on the Indian economy. The central issue we will address is the impact of privatization that has taken place so far on profitability and performance of PSUs. Going beyond this, we will attempt to understand what explains the impact of privatization on performance. Is it the use of market power by oligopolistic firms whose pricing power had been constrained under government ownership ? Is performance bought at the expense of labour through extensive layoffs so that what we see is essentially a transfer from workers to shareholders ? Or are we confusing the impact of privatization with the more generalised impact of deregulation in the economy, which in itself could spur efficiency ? The research output will comprise the following: 1. A survey of the literature on privatization, particularly with respect to less developed countries. 2. A review of the role of the public sector in the Indian economy, and the process of economic liberalization and privatization in India upto this point. 3. Impact of privatization on firm performance. 4. Explanation for the impact of privatization 5. Assessment of mechanisms of corporate governance in India. -2- I. Background: privatization in theory and practice A great wave of privatization has swept the world in the past two decades, embracing the industrial economies, the transition economies of East Europe and large parts of the less developed world, and it continues to roll on. It is interesting, however, that its basis in theory was somewhat shaky to start with. Moreover, a sizable enough body of empirical evidence, on which hypotheses about its impact could be tested, became available only several years down the road. So much of the initial impetus to privatization entailed a leap in faith, and, as happens all too often in the development of knowledge, attempts to explain its impact have followed on the heels of widespread existing practice.

Expressiveness And Effectiveness Of The Visualization Computer Science Essay

Expressiveness And Effectiveness Of The Visualization Computer Science Essay Visualization is a method or a transformation of data or information into images, diagrams, or animations. Concise Oxford Dictionary states that visualization means to imagine or remember as if actually seeing. Besides, in Websters Ninth New Collegiate Dictionary, it has defined visualization as the act or process of interpreting in visual terms or of putting into visual forms. [1] In another words, visualization is the communication of information using graphical representations. There is no longer an obstacle for collecting data or information though extracting necessary values from collected information has turned out to be gradually more complex and complicated. Since early days before the written language has formalized, we have been using pictures for communication and visual imagery has been an efficient way to correspond both tangible and abstract ideas. We, humans, have complex and great vision system which we utilize and rely for everything we do on a daily basis while the speed of analyzing text is quite limited for us by the sequential process of reading. Purpose of Visualization The main reason of visualization is to convey, explore and analyze information. To be more specific, visualization is used to present large amount of information compactly from various view points and at several levels of details. Furthermore, it helps us extract the important information which is hidden within the data. Visualization is essential to manage todays world information of computers, satellites, digitized systems and etc. Some data sets are naturally better to be represented visually since we possess the abilities of powerful human vision system. Graphical representation makes easier for analyzing the data especially when all the information and its relation are segregated with different colors, shapes, and size. [1] As todays technology is tremendously growing and with the inventions of all the computers and their capabilities to generate large data sets, visualization is the most suited technology to extract and study the information from collected raw data. Some examples of visualization comprise mapping the blogosphere, web trend map which is a detailed study of the current online trends, and hierarchical structure of the internet that displays the connectivity and how it is being managed. In addition, visualization offers considerable financial advantages in todays competitive world. Computer simulation together with visualization can save product expenses and time required for production. Types of Visualization Therere few terminologies which can be used to represent visualization. Scientific visualization in computer science field means the method of graphically displaying real or simulated data. It is a fundamental process in the innovative realization of scientific ideas and its basic visualization techniques contain surface rendering, volume rendering, animation, processing algorithms and other sensory presentation such as sound or touch. [1] Another phrase to express visualization is data visualization. Data visualization is more general compared to scientific visualization as its data sources involve business, marketing and financial data which are beyond sciences and engineering fields. [1] Moreover, it consists of statistical processes and other standard data analysis techniques. Information visualization is used to visualize abstract information and abstract structures, directory files on computers, hypertext documents on World Wide Web, etc. [1] It draws on the intellectual history of several customs like computer graphics, human computer interaction and statistical graphics. Visualization can be classified based on context in which data exists. Based on the data sets, the techniques of visualization are differed. Scientific visualization methods are used when data exists up to three spatial coordinates and time dimension whereas information visualization is for data in higher dimensional or abstract spaces. Scientific visualization and information visualization overlap each other and they are allied fields. [1] The relationship of three different visualizations can be found as in figure 1. Figure 1: Types of Visualization Visualization Process Figure 2 illustrates the steps of visualization process. [2] The very first step of designing visualization is about analyzing the data to be visualized. It is necessary to find out whether data from a database, a file or some source, simple or complex, is able to be structured and allows for easy modification to suit its visualization. The designer needs to take note of the presentation of the visualization results and the information the users wish to extract from the enormous data set. Raw data will be then transformed into symbolic representations. Secondly, the data values themselves or the data attributes are mapped as graphical objects, such as shapes, lines, color, position and size. The last component of visualization process is rendering of graphic objects by the computer onto the display and generation of visualization for the users interpretation. Figure 2: Visualization Process from High Level View Visualizing Information One of the fundamental questions in information visualization is how to describe expressiveness and effectiveness, the two mathematical measures of visualization, which can be applied at all stages of visualization process. Besides when visualizing, therere some important parameters to consider such as visualization and symbols, graphic features and the eight visual variables. Expressiveness and Effectiveness of the Visualization Jock D. Mackinlay, an American visualization expert, states a visualization is expressive if a visualization encodes all relevant information and only that information. [3] That denotes the person may see all information he/ she wants to examine without any distractions. Therefore, expressiveness measures the concentration of information. Perfect visualization means with ideal expressiveness and it is tough to achieve in reality. Expressing too much information will lead to interference of interpreting essential information and expressing less information will miss out important datasets need to be visualized. Effectiveness means that all information is presented clearly and quickly in a cost effective manner. [3] Hence effectiveness measures a precise cost of information awareness. Beshers Feiner, the scientists, adapt these two measures and express it as potential expressiveness and potential effectiveness. [3] A visualization is potentially expressive, if it has the potential and under the user control to display all essential information over time. It is potentially effective, if the information presented is sufficiently clear over time. Visualization and Symbols In visualization, symbols create a wide range of new possibilities for visual effects. Symbols have been used to connect with many intentions and they play as valuable roles in information visualization. Visual objects are graphical symbols which are parts of visualization like arrows, labels, dots and etc. To discover relations or patterns of visualization, Cleveland states that there are two major steps. [4] The first step is a mapping between graphic symbols and the represented data. Lastly finding patterns on the screen that imply the patterns in the data. Graphic Features Graphics are represented in three or more dimensions. Every single point of a graphic is construed as a relation between two positions x and y with a third variable value z. Graphics can be analyzed in three main steps. [2] First is to perceive groups of objects pre-attentively, followed by characterizing those groups cognitively. The final step is to examine special cases which are out of the group. The Eight Visual Variables To represent different aspects of the same information, choosing visual variables is crucial and can affect the perception and understanding of the presented information. Thus, it is essential to understand graphic primitives and their variables. The eight visual variables are as below. [2] Position It is the most important visual variable and changes in x, y location. In visualization, the spatial arrangement is the very first thing to be done. That is the reason why positioning has the greatest impact on the display of information. Shape Shapes or marks refer to points, lines, areas, volumes, and their compositions, and they are graphic primitives that represent data. There are infinite number of shapes and they are used for categorization. Size Size changes in area, length or volume. It influences the way of individual data representation and display. Brightness Brightness or luminance is good for large interval and continuous data. However, there is a limitation to distinguish among all those different levels of brightness. Color It changes according to two parameters, hue and saturation. It requires mapping of data values to individual color codes. Orientation Orientation changes in alignment. It cannot be used for all marks. For example, circles look the same even their orientations change. Shapes with natural single axis are the best to apply orientation. Texture It is a combination of many other visual variables including marks, color, orientation and so on. Motion Motion describes all visual variables change over time and it can convey more information. Human Perception System Visual perception means the ability to interpret and process information from visible light in the surrounding environment. Not everyone perceives data exactly the same. Different viewers differently interpret the identical visual representations. When designing visualization, to reduce the confusion later on, the designers need to take account of color usage of graphical entities for accurate measurement, quantity of distinct entities, and etc. Besides, we also need to consider the primitives that humans usually detect pre-attentively and the level of accuracy we perceive various primitives. Consequently, when we visualize data, it is a basic requirement to learn the limits of human perception since we need to factor in these limitations and avoid producing images with vague or deceptive information. Visual System The human eye is composed of many parts. [5] They obtain visual images, focus them accurately and send messages to the brain. The main sensory component of vision assembles light scattered from objects and forms a two dimensional function on the photoreceptors, the small sensory devices which respond in the presence of photons making up light waves. Information related to the external objects in the environment is captured through the visual system. Light rays from an object enters through the outer part of the eye, named the cornea. It helps the eye to focus to make things look sharp and clear. Then, the light rays travel towards an opening called the pupil, the dark round circle in the middle of the colored part of the eye. The colored eye is called the iris and the pupil is just a hole in the iris. The iris controls the amount of light goes into the eye. Besides, your eye also possesses a lens to focus the light rays. Light passes through the lens till the back of the eye, the retina. It has millions of tiny light sensitive cells sending messages to parts of the brain, the optic nerves. Field of View A pair of normal healthy human eyes can view about 200 degrees horizontally where approximately 120 degrees of which are shared by both eyes and giving rise to whats known as binocular vision. [6] It has a field of view of 135 degrees vertically. However, as we get older, these values decrease. Both of human eyes are positioned more or less on the front of our heads and it is common in prey species as it helps increase an animals total field of view. Angular Resolution Angular resolution refers to the minimum distance at which our eyes can differentiate things of the same size and shape from each other. [6] The typical set of human eyes has an angular resolution of one minute of arc. It means objects one degree apart from each other can be distinguished. Therefore, angular resolution is useful when we need to differentiate similar objects. Nevertheless, every human eye is different and their angular resolution varies based on eyesight strength, eye shape and age. The Blind Spot The photoreceptor cells in our eyes are used to perceive light and information being received is relayed to the brain via the optic nerve. Blind spot is the visual field where it lacks the light detecting photoreceptor cells on the optic disc of the retina. [6] A small part of the field of vision is not perceived as there are no cells to detect light. Normally, with two eyes, the brain interpolates the blind spot based on surrounding details and information from the other eyes so that the blind spot would not be detected. However, blind spot can be perceived easily with one eye closed. Perceptual Processing Attention acts as a critical role in perceiving information. Perception can be pre-attentive or attentive. Usually the flow of perceived information starts from the low level pre-attentive towards the high cognitive stages. Professor Treisman states perceptions that can be performed in less than 200 to 250ms are regarded as pre-attentive. [7] Initiating random locations of the elements in display by human eyes normally take at least 200ms. That determines attention cannot be pre-focused on any particular situation and information is processed in parallel by the human visual system. Pre-attentive perception requires its objects to possess a unique feature, such as color and size. For attentive perception, it uses short term memory and it is selective. Attentive tasks convert premature image effects into a well-structured objects. Attentive perception is generally slower and often signifies aggregates of what is in the scene. When designing visualization, the designers should take note of pros and cons of the human visual system and provide well-suited visuals to the viewers for easy analysis. Thus, in order to use the visual features effectively and not to produce visual interference effects masking information in a display, the visualization creators should be aware of the attentive tasks and the pre-attentive visual features like length, width, hue, intensity, lighting direction, and so on. Data Foundation The very primary step of visualization is the data to visualise. It is a must to explore and examine the characteristics of the data since it can be from many different kinds of sources and has a wide variety of attributes and features. Data Types Data can be differentiated into two main types: ordinal (numeric values) and nominal (non-numeric values). [2] To be specific, ordinal values mean: Binary values those with only 0s and 1s Discrete values integer values from a very particular division Continuous real values Nominal values are: Categorical values from list of possibilities Ranked categorical variables with significant ordering Arbitrary infinite range of values without significant ordering Scale is another useful technique of sorting data variables since each graphical attribute from raw data possesses scale associated with it. There are three attributes of scale: Ordering relation ranked nominal variables and ordinal variables which can be ordered in some manner Distance metric all ordinal variables where the distances of different records can be calculated Existence of absolute zero variables with fixed lowest value Data Pre-processing In reality, real world data that is to be analyzed can be incomplete, noisy, incoherent and cumulative. Those raw data need to be transformed somehow into an understandable format and the process of its transformation is known as data pre-processing. Data pre-processing can greatly improve the quality of data visualization results. There are some different aspects of data pre-processing: Metadata and statistical Missing values and data cleansing Normalization Segmentation Sampling and sub-setting Dimension reduction Mapping nominal dimensions to numbers Aggregation and summarization Smoothing and filtering Raster to vector conversion For more information about data pre-processing techniques refer to [2]. Visualization Techniques for Different Types of Data Visualization techniques will be differed for different types of data since they comprise special characteristics. Main types of data and useful visualization methods for them will be discussed in this section. Spatial Data Spatial attributes identify data in 1,2 or multi dimension. Visualizing spatial data is defined as mapping spatial data to spatial attributes on the screen. [2] Techniques of visualization of those data include histograms, linear probes, flow visualization, vector field visualization, slice plus isosurface, isosurface plus glyphs and so on. Geospatial Data Geospatial data or geographic information classifies geographic locations and boundaries in the real world. [8] They include coordinates and topology on earth. Examples of geospatial data consist of climate, environmental, economical and sociological and credit card payment locations. Visualization methods of such data can be completed using dot maps, pixel maps, network maps, choropleth maps and cartograms. [2] Multivariate Data Multivariate data is lists or tables of data that arises from more than one variable. It normally doesnt have an precise spatial attribute. [2] Multivariate data can be visualized by point based techniques like scatter-plots and force based methods, line based techniques like graphs, parallel coordinates, andrews curves and radial axis techniques, and region based techniques which are bar charts, histograms and tabular displays. Combination of above techniques are also applied sometimes. Trees, Graphs and Network Bertin declares that trees, graphs and network visualization demonstrates the relationships of each data recorded, similarities among values and attributes, parent and child nodes, connectedness such as networks between countries around the world, shared classification and derivation. [9] Space filling methods, non space filling methods, displaying arbitrary graphs and networks, and node link graphs are some of the methods for trees, graphs and networks visualization. maps, pixel maps, network maps, choropleth maps and cartograms. [2] Text and Documents By applying suitable visualization techniques, valuable information can be obtained from huge resources of information such as digital libraries, text files from your computer and billions of words in your thesis paper. Searching comparable patterns and outliers within the text or documents will be painful without visualization. Tag clouds, word trees, text arcs and arc diagrams can be used for visualizing single documents. Visualization practice for collections of documents are self organizing maps, themescapes and document cards. [2] Interaction Concepts Techniques John and his group clarify that interaction within data visualization is a helpful structure for transforming what the users see and how they perceive it. Interactions will transform visualization images to better and smooth transitions. Summary of interaction techniques are discussed as below. [10] Navigation It allows the users to adjust the cameras position and scale the vision. Examples include panning, rotating and zooming. Selection Selection refers categorizing an object or collections of objects. To be precise, it grants the user to control the regions of interest. Highlighting, deleting and modifying are types of selection. Filtering The size of data mapped on the screen is reduced by filtering techniques by reducing or omitting dataset, dimensions or both. Reconfiguring It is to change the way analyzed data is mapped to visualization graphical attributes like reordering data layouts in order to provide a diverse way of viewing data. Encoding Users are permitted to control graphical attributes such as point size, line colors to discover different features of visualization. Connecting Connecting means linking different views or objects. Abstracting and Elaborating It is to modify the level of detail. Hybrid Hybrid defines combining the above techniques together. Effective Visualization In fact, visualizations implemented by the designers have larger risks of being ineffective than being effective. It is not very simple to build effective visualizations where the users satisfy as there are many chances of data being distorted and lost during the mapping process, or data presented is too confusing and complex for the users to interpret, and so on. A successful and effective visualization efficiently and accurately transmits the preferred information to the viewers. Therefore, the designers should take in consideration of what the targeted users really want to observe from the results so that they will be able to visualize effectively. Intuitive Data Mappings Ed H. Chi explains that it is essential to consider the importance of data semantics and the context of the user. [11] To avoid any misinterpretation, the designers should be able to predict the users expectations. Choosing data-to-graphics mappings that provides the users mental model will significantly support in interpretation. The designer should take note of the compatibility between scale of data and graphic attributes on the screen. Besides, they should utilize humans abilities to correlate position on the screen medium with position in real world. Selecting and Adjusting Views It is obvious that one view is hardly satisfactory to express all the information enclosed in the dataset. Expecting the view modifications which are most useful to the users is one of the major factors of developing an effective visualization. Common view operations are as follows. [2] Scrolling and Zooming Operations This operation comes in handy when the dataset is too huge to be presented as one whole at the resolution that the viewer wants. Color Map Control It allows the user to make changes of individual attribute colors or entire palette. Mapping Control Mapping control helps the viewers to toggle among different ways of visualizing the same data and to discover the distinct features which might be hidden. Scale Control The user can focus on specific data subsets by applying scale control where they can modify the range and distribution of values. Information Density The designers decision, to verify how much information to display, plays an important role for an effective visualization and representation. Alexandru [12] points out that if there is too little information to present, it is the best to display the results as text. Conversely, if the data has too much information to present, it might cause confusion, lose essential information within the data, and face with obscurities in interpretation. In such cases, the user should be permitted to disable or enable different components of the presentation. Keys, Labels and Legends Most of the visualizations are ineffective because they lack useful and supported information to aid them. [2] Keys, labels and legends are therefore very helpful. Examples include captions, mappings used, grid marks, units of axes, key for symbols, color bar and etc. Using Color with Care Color can add significant visual appeal to a visualization but can also significantly decrease the effectiveness of the communication process. [2] Usage of color is context dependent and the characteristics of dataset itself can influence how the colors are noticeable. The designers should not forget there might be some color blind users as well. The Importance of Aesthetics Visuals, with both informative and pleasing to the eye, are known as the best representations. If the visualization is aesthetically pleasant, it attracts the viewers to analyze it in greater details. [2] Some useful guidelines for attractive visualization designs are as below. Focus The users attention should be drawn towards the most vital part of the visualization. Balance Balancing the screen space is another aspect to take note of designing pleasing visualizations. The most important components should be placed in the center. Simplicity Representing too much information will confuse the viewers. The designers should get rid of features which can be removed without losing information wanted to pass on since it is the best to be as simple as possible. Misleading Visualizations b c

Essay --

During the eleven year long Sierra Leonean civil war, reports of systematic sexual violence against women and girls during the war resulted in international concern over a potential ‘crisis’ of HIV/AIDS in the country. In order to manage the imagined impending outbreak, the Ministry of Health and Sanitation (MoHS) in Sierra Leone received $15 million from the World Bank to create the Sierra Leone HIV/AIDS Response Program [SHARP]. In this paper, I point to the work that the global crisis narrative of HIV/AIDS does to shape specific forms of intervention. In Sierra Leone, the global health interventions associated with HIV/AIDS are further targeted at vulnerable populations, particularly war-affected women and girls, who are often framed as both abject victims in need of care (read: at risk) and potential vehicles of HIV/AIDS transmission in need of control (read: risky). In my conclusion, I ask whether the vision of HIV/AIDS vulnerability communicated by SHARP is indica tive of an uneven or differential landscape of health citizenship in post-war Sierra Leone. The contemporary model of global health intervention is rooted in colonial and post-colonial histories of debt, structural adjustment, the devolution of the state and the rise of multilateral aid-driven health development. As Sparke (2013) illustrates, the growing global health industry increasingly relies on a ‘new Washington Consensus,’ which frames improvements in population health as integral to social and economic development in nations of the Global South. Combating ‘diseases of poverty,’ such as HIV/AIDS, global health interventions often take the form of short-term ‘technocentric’ solutions that are limited in scope and vertical in implementation (Foley & Henrixson 2... ...ent-funded initiatives act as ‘quasi states’ that produce state-like effects of control, regulation and legitimacy. The involvement of these entities in the creation and implementation of HIV/AIDS policies in Sierra Leone simultaneously disrupts national narratives of health citizenship and creates a global moral politics of intervention (Benton 2012; Kenworthy forthcoming). Through the continued utilization of a crisis model of care to address global health emergencies, the international community perpetuates the mobilization of differential forms of health citizenship that are envisioned at the global scale yet enacted and negotiated in a variety of ways at the national and local scales. In the context of the global health industry, such differential health citizenships are practiced through the prioritization of certain bodies for care to the detriment of others.

American Foreign Policy Caused the Vietnam War Essay -- Vietnam War Ess

War in Vietnam is the longest military conflict U.S. were involved in during 20th century. However, 20 years before the official war declaration, in 1944, no one would have ever guessed that the area of South East Asia is going to experience such development. Having approached the Vietnam situation with wrong policy, underestimating the motivation and determination due to historical memory, in the hostile conditions caused US were unable to suppress the communist insurgency in South Vietnam, which later turned into a David vs. Goliath type of conflict. Origins of Conflict In the colonial era, the world was divided into the colonies of European empires. France, among others, used military force and presence to rule in Vietnam and bordering countries, at that time called French Indochina. The French ruled with its army between 1854 and 1884 in the country, and about this time the aversion and disgust of Vietnamese people initiated against the French and other supremacy powers. One of the many effects of World War II was that European states, lost its imperialist and superpower status, as the World slowly shifted into the bipolar era - United States contra Soviet Union. As a consequence, September 2nd, 1945, Vietnam declared independence from French imperialist and the Japanese military, which invaded Indochina (Vietnam) during the World War II. Kevin Reilly in his Readings in the World Civilizations recorded Ho Chi Minh’s speech while declaring the independence of Vietnam in 1945, where Ho Chi Min captured the frustration Vietnamese felt over the 80 years of French dominance. Ironically, Ho Chi Min, out of respect started his speech with the citation of American declaration of independence. He talked about unequal laws, role in ... ...d perhaps applied more reunification talks, consensual & diplomatic politics combined with economic aid and cooperation and tried to persuade Vietnamese just like they did in Western Europe (even though Europe was probably the easier case), instead of supporting undemocratic means of French puppet regime, there might as well would never been a communist insurgence to suppress and Vietnam war to fight. Bibliography Akins, John. Nam Au Go Go, 2005 (1-10). Grantham, Dewey W. Recent America: The United States since 1945, 1998. Herring, George C. â€Å"The Nightmare of Vietnam,† in Oates, Stephen B., Portrait of America, 1987: 410 – 425. Ho Chi Minh, â€Å"The Vietnamese Declaration of Independence,† in Kevin Reilly, Readings in World Civilizations Vol 2., 1992: 278 – 281. Verrone, Richard Burks, Voices from Vietnam: Eye-witness Accounts of the War, 1954- 1975, 2005.

Maharaja Dalip Singh :: European Europe History

Maharaja Dalip Singh Maharaja DALIP SINGH, the youngest son of Maharaja Ranjit Singh, who was born in Lahore, on Feb. 1837, to mother Maharani Jind Kaur. His date of birth is disputed by some and alternately suggested as Sept. 4, 1838. Many foreign journalists have wrongly named him as Dhalip Singh and Duleep Singh. However, it should be noted that his correct name is Maharaja Dalip Singh. He assumed the Punjab throne as a child, after Maharaja Sher Singh, on Sept. 18, 1843. During his reign several wars were fought with the British. Unfortunately, he was surrounded by corrupt advisors as illustrated by the following quote. "Among the Sikh barons who stood around the throne of the young Maharaja Dalip Singh, there was not one, who honestly labored for his country, or who have made the smallest sacrifice to save her." - The Punjab Chiefs by L.H. Griffin The agreement of March 9, 1846, after the first Sikh war with the British, included the following conditions: 1) There shall be peace and friendship among Maharaja Dalip Singh and the British government. 2) Lahore darbar would have to relinquish control of the region between Satluj and Bias. 3) War compensation of one and a half crore rupees to be paid by Lahore darbar. Since this amount was beyond the capabilities of Lahore Darbar at that time, Kashmir region was offered for 75 lakhs. However, Maharaja Gulab Singh stepped forward and paid this amount to buy back this region from the British. 4) Maharaja Dalip Singh's forces were restricted to 50 platoons and 12,000 horse-back soldiers. 5) No foreigner from Britain, Europe, or America could be employed in Lahore Darbar without explicit permission of the British government. 6) British government shall refrain from interference in the internal affairs of the Lahore Darbar. However, towards the end of this year, another set of arrangements were made, under which a council was established to run the Punjab affairs. This council was headed by a British Resident. Further, British forces were brought in to maintain peace in the country. Lahore darbar was charged 22 lakh annually for the maintenance and upkeep of such forces. However, this arrangement did not last for too long. As in April of 1848, a war erupted among the Sikhs and British. At the end of this war, Sikh kingdom was annexed and Maharaja Dalip Singh was sent out of Punjab to FatehGadh (Uttar Pradesh, dist.

Identify the Diffenent Reasons People Communicate Essay

We need to communicate with others in order to be able to successfully carry out daily activities, especially in the work place. This can be done in many different forms and have positive and negative effects. Being aware of these forms and implementing them is vital when working with young children and adults. People communicate in both personal and professional capacitites for a variety of different reasons. In a work setting people may communicate to: build relationships; maintain relationships; gain and share information; gain reassurance and acknowledgement; to express needs and feelings and to share thoughts and ideas. Building relationships can be a simple form of communication such as a smile/wave/ ‘hello’ when we first meet a new parent/child. Each time we do this we are maintaining a relationship with the parent/child, although this may not be strictly for a professional ‘reason’, for example; asking what they are doing tonight? By building and maintaining relationships via communication we are gaining information, which by sharing will help in the way we work, for example; with children, parents and other professionals. We can also provide trust, reassurance and acknowledgement by praising, physical reassurance by providing eye contact or by taking an interest in what they are doing. People also communicate in order to express their needs and/or feelings. As humans most of us need to do this and we should respect and allow a child’s need to as well, if they don’t have the opportunity to do this they can become very frustrated. The same applies to being creative by sharing their ideas and thoughts as children and young people will need to share these with others. Read more:  Describe the different ways that people communicate  essay L.O 1.2: Explain how communication affects relationships in the work setting Communication is vital in the work setting as it helps to establish good relationships with young people, children, their families and colleagues, and these are essential in order to be able to work effectively with them. Relationships and communication skills compliment each other, therefore carers who have good communication skills are more likely to have good relationships with children, parents and other adults. We communicate via body language and facial expressions and relationships are influenced by this. Relationships and communication is pivotal in the early year’s sector. By sharing and gaining information, for example, on a child’s feelings, routine and/or long term health we can help establish different needs and/or the need for intervention. We can also help the child settle in more easily, as when they feel comfortable with us so will their parents and vice versa, this also helps the child feel more relaxed which in turn helps them play and learn more effectively and benefit from it. As pointed out on www.helpguide.org it can also â€Å"†¦improve relationships at home, work and in social situations by deepening your connections to others, and improving team work, decision making, caring and problem solving.† By working together as a team via communicating, job satisfaction can be gained as can easier transitions if the child is moved from one setting to another. Communication is something that we do in our everyday life in every type of setting. We can build and maintain relationships from this with a variety of people. This in turn can have positive or negative effects on the things we do. By communicating via facial expressions, body language or verbally we are establishing and maintaining relationships with their practitioner as it can help identify needs, spot things that occur repeatedly and help the child develop holistically, therefore it is essential that we all communicate effectively.

Prevention of High School Dropout Essay

Having critically analyzed the consequence of high school dropout in the recent time and future implication to the United States, it is important for me at this juncture to forward this practicable way forward to the Office of Mr. President, United State of America for suggested actions and policy implementation in order to curb the trend. Every lost student from the school into the world of illiteracy is a threat to our future economy and the intellectual human fertility. Firstly, the understanding of the reasons of what seems to have precipitated dropout is critical to the solution drives. Since struggling poor students account for the highest statistic among the dropout students, aid at getting these people for necessary assistance need to be facilitated through the informed teachers who are most close to them. The involvement of State administrative officers is equally important for information relay. There is a need to bring available resource centre to the target school. Aid officers need to work in partnership with school officers in charge, the community leaders and youth friendly organizations within and outside the school premises for more productive concerted effort. Secondly, establishment of network of model program between school counseling unit and Government or non-governmental organizations on youth mentoring will assist in the prevention of high school dropout. The counseling unit needs to be well supported in every high school. A mere companion with students can save a future of misfortune. Through interactions of students with the counselor, the school will recognize the prevailing need of a potential dropout student and initiate a networking scheme to appropriate quarters for rescue. Some may have psychological or psychosocial re-orientation need about the importance of staying in school as against whatever reason for intending dropout. Easy accessibility and companion gesture must be advocate through student survey after visit. Through efficient and friendly students/counselor interaction, the school management and the State can come up with a biannual statistics on findings. These findings are then used as the basis for teaching and curricula drawn-up. Personal problems are best treated privately; hence, counselor needs to respect individuals’ privacy irrespective of the age to avoid discouraging attendants. Through this plan, causes of dropouts such fear of violence in school, family poor financial status, consequence of parental divorce, unfriendly teacher-student relationship, teachers’ poor knowledge of student learning technique, and self-emotional issues will not cause dropout. Thirdly, enforcement of curriculum to help students discover the relationship between what is learnt at school in connection with the real world is vital to sustain student mood to always desire for more in school and never get bore to have thought of dropping out. Through the State education policy, one would suggest the creation of an intermediary arm that organizes programs and trainings for school teachers. It is likely for teachers to lose touch with the reality of the industrial world, this Intermediary program will keep reminding the instructors and teachers of the expected values in the labor force or entrepreneurship (Raby 1990). In summary, the suggested aforementioned ways of preventing dropout in the United States point at real-time educational policy reform in line with latest findings. Reforms need to be dynamic with the modernizing world. A check at policy performance is as important as the policy itself, therefore, concerted effort must be instituted to avert wasting of effort in policy formulation. Our educational system will soon be wiped out of dropout cases if these measures are harnessed together. Long Live the America! Work Cited Raby, M. (1990). â€Å"The California Partnership Academies. † Redwood City, CA: Sequoia Union High School District. Robledo, M. R. , & Rivera, C. (1990). â€Å"Partners for Valued Youth: Dropout prevention strategies for at-risk language minority students. † San Antonio, TX: Intercultural Development Research Association. Jay Smink, (2009). 15 Effective Strategies for Dropout Prevention. National Dropout Prevention Center at Clemson University. Online article. Site Available at: http://www. schargel. com/index. php? s=prevention+of+dropout. Retrieved on 04-15-2009. http://www. americaspromise. org/APAPage. aspx? id=10158

QNT Final

What will be the probability that z is greater than 1. 75? 0. 0401 z end up in the higher than 1. 75. 22) A null hypothesis will make a claim about what? A Population parameter Explanation: A null hypothesis is the general default position in a survey and requires a claim off population parameter. 23) Describe the level of significance? Probability off Type I error Explanation: A type 1 error happens when the null hypothesis is true, but rejected at he same time. 24) Let's perform a statistical test of the difference between two proportions at the 0. 05 level of significance.If the computed z is -1. 07, what will be the correct decision? Do not reject the null hypothesis. Explanation: The z is of -1. 07 is acceptable within the range of a . 05 level of significance. 25) What condition must be met to perform a test for the difference of two sample means? Data must be at least of interval scale and populations must be normal. 26) Consider a hypothesis test that compares two population means. The combined degrees of freedom equal 24. What statement about the sample sizes is NOT true? Let's assume the population standard deviations are equal. Sample A = 11.Sample B = 13 Explanation: This must NOT be true because it is outside the limits set by the degree of freedom. 27) What type of chart do we call it when paired data is plotted? Scatter diagram Explanation: Paired data must be plotted in a way that shows the relationship 28) When a variable is used to predict the value of another variable, it is called: Independent variable Explanation: The independent variable is useful for determining the values of variables that are not explicitly known. 29) 20 randomly selected online students were given 1 5 multiple-choice problems ND 15 open-ended problems that cover the same topics.The teacher wanted to know which questions the students scored better on. What kind of test is this? A paired t-test Explanation: The paired t-test evaluates the mean values that result form a s et of data. 30) The weights of 100 units of a product created by two identical processes have same mean, but the standard of process A is 15 while that of B is 7. What is true about this scenario? Unit weights in process B will be grouped closer than in process A. Explanation: A wider standard of process is going to create greater deviation in the end products.

Genetic Testing For Haemophilia Health And Social Care Essay

MFA presented to the day care of the Paediatric section with left mortise joint swelling for one twenty-four hours after hitting his mortise joint on a rock while playing in the flushing one twenty-four hours prior to admittance. There was hurting and bruising seen at the mortise joint articulation after the injury. The swelling increased in size and became more painful throughout the dark. His parents so brought him to the day care early the following forenoon. Physical scrutiny revealed swelling and tenderness at the left ankle joint every bit good as decreased scope of motion on both inactive and active motion due to trouble. There were besides multiple ecchymosis in different phases seen at the upper and lower limbs. A diagnosing of haemarthroses of the left mortise joint articulation was made. MFA was transfused with 200IU of Factor VIII. The hurting and puffiness were reduced in badness but persisted throughout the twenty-four hours. MFA returned to the day care the following twenty-four hours for more Factor VIII. He was given Factor VIII transfusion 200 IU twice daily for the following two yearss. The hurting and puffiness subsided after 3 yearss. MFA was diagnosed with terrible Haemophilia Angstrom when he was eight months of age. The diagnosing was made at the national blood bank. Familial testing besides done at the national blood bank revealed that his female parent was a haemophilia cistron bearer. MFA receives transfusion of Factor VIII when he develops haemarthroses or shed blooding due to trauma. He requires factor transfusion on an norm of one time every three months. He has had repeated hospital admittances with an mean continuance of stay for three to four yearss. MFA has good household support and is a member of the haemophilia society. He and his household have adapted good to his unwellness. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: PediatricssPATIENT ‘S DETAILSI/C NUMBER: ( B ) 630902-01-6092 Age: 9 old ages old Sexual activity: Male DATE OF ADMISSION: 23/04/09 R/N NUMBER: N/A2 ) CLINICAL HISTORYChief ailment: MFA is a nine twelvemonth old male child who was diagnosed with haemophilia A since eight months old. He presented with swelling in the left mortise joint for one twenty-four hours. History of present unwellness: MFA was running in the field at school when he knocked his mortise joint against a big rock in the land on the eventide of the twenty-four hours prior to showing at the day care. There was hurting after he hit his mortise joint but he was able to bear weight and walk. There was some bruising but no hemorrhage at the site of hurt. The joint became more painful towards the dark and there was some puffiness, heat and inflammation which increasingly increased. The hurting increased in badness so much so that MFA was unable to bear weight and used a wheelchair belonging to his brother to travel about the house. The hurting caused him some uncomfortableness but he was able to kip. He did non take any analgesia for the hurting. The following twenty-four hours, MFA ‘s parents brought him to the day care of the pediatric section for a factor transfusion. Systemic reappraisal was everyday. MFA was foremost diagnosed with haemophilia A when he was 8 months of age. His parents noticed that he developed contusions at his custodies and articulatio genuss. This occurred when he was tilting to creep. A blood trial was done in the national blood bank, and his parents were told that MFA had terrible hemophilia A. His immediate household underwent testing and his female parent was found to be a bearer of the haemophilia cistron. MFA receives factor VIII transfusion on an norm of one time every three months. The transfusions are required when he develops haemarthroses or gum hemorrhage due to tooth decay. The joint most normally affected is his right articulatio genus articulation. He has non developed any contractures. He does non normally seek medical intervention for contusions which are a common happening. He has non had mucosal shed blooding as nosebleed or hematuria. MFA would sometimes necessitate hospital admittance for factor VIII transfusion. This is normally when he has hemorrhage or terrible hurting due to a haemarthroses or a hematoma. At other times he would have the transfusion at the day care and return place. His parents would convey him once more to the infirmary for the following dosage till the hurting and puffiness in the joint resolutenesss. If a transfusion were required at dark when the day care is non unfastened, MFA would travel to the pediatric ward where the medical officer would be able to administrate the factor VIII. His symptoms would better with the factor VIII transfusion. MFA is an active male child who likes playing and running about. However his instructors in school restrict his physical activity to non-contact athleticss such as badminton and running. He is besides discouraged from unsmooth drama with his classmates. He wears elastic guards around his cubituss and articulatio genuss to protect them from hurt. However the elastic guards do non assist much as he still develops haemarthroses at those articulations. MFA is presently casting his decidual dentition. As such he requires factor VIII transfusion screen prior to tooth extraction. MFA is under followup at the pediatric clinic of Batu Pahat. He has defaulted the followup as his parents feel that nil much was done during the visits. He merely presents to the day care when necessitating factor VIII transfusion. MFA has besides been referred for physical therapy after episodes of haemarthroses which limit motion in the articulations. He has attended a few Sessionss of physical therapy in order to forestall contracture at articulations which have haemarthroses. He does non hold regular assignments. MFA is a member of the haemophilia society. His parents on a regular basis attend meetings where negotiations are given to educate parents on caring for haemophiliac kids. The members besides relate their experiences and promote one another. MFA has a medic qui vive necklace which says that he has haemophilia A. However, he rarely wears the medic qui vive. Past medical history MFA has non had any other infirmary admittances other than those due to haemophilia. Family history MFA is the youngest of three siblings. His senior sister is twenty old ages old and is good. His senior brother is 15 old ages old and has a bone cyst. He has undergone eight surgeries to mend the bone cyst every bit good as due to complications such as refractures. The wheelchair which MFA used at place was bought for his brother ‘s usage. MFA ‘s parents are good. There is no household history of hemophilia on his maternal side even though she is a bearer. MFA ‘s female parent has 3 brothers but all of them are good and do non hold hemophilias. There is no history of shed blooding upsets in the household. Social history MFA ‘s parents are both instructors. However they have to lose traveling to work frequently due to MFA ‘s status which necessitates frequent visits to the infirmary. As such, MFA ‘s female parent has a particular agreement with her schoolmaster which allows her to learn from 11 to 4 autopsy. As such, she is free in the forenoon to convey MFA to the infirmary when he needs it. His parents besides provide good support for MFA in that they frequently attend haemophilia meetings to update themselves on agencies to outdo attention for their kid. Birth history MFA was born at term in Hospital Batu Pahat. He was delivered through an elected cesarean delivery subdivision due to a breech presentation. There were no prenatal abnormalcies detected during everyday prenatal medical examination. There were no perinatal or station natal complications. He was nursed with his female parent after birth and discharged uneventfully. Developmental history MFA is presently in primary three of a spiritual school. He is an above mean pupil who finishes in the top 10 of his category. His instructors have no ailments about his school assignment. Developmental mileposts prior to this were all achieved at the appropriate times. Dietary history MFA is on an grownup diet now. He eats balanced repasts which are normally prepared by his female parent. He was breastfed till the age of seven months. Weaning was with porridge at the age of five months. Immunization history MFA has been immunized harmonizing to the immunisation agenda. After he was diagnosed with hemophilia A, his immunisations were done at the pediatric clinic under factor VIII screen. His last immunisation was at seven old ages of age. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss3 ) Findings ON CLINICAL EXAMINATIONOn general scrutiny, MFA was friendly and communicative. He was sitting in a wheelchair with a patch around his left mortise joint. There were some ecchymosis seen at his weaponries and thighs. He looked good nourished. He was non in terrible hurting. Anthropometric measurings: Weight: 24kg ( 10th to 25th centile ) Height:130cm ( 25th to 50th centile ) His critical marks were normal: Pulsation: 82 beats per minute Respiratory rate: 18 breaths per minute Blood force per unit area: 108/72 Temperature: 37 grades Celsius Examination of the lower limbs: There were ecchymosis seen on both lower limbs at the thigh every bit good as at the shin and calf. The left mortise joint was swollen and there was a contusion seen on it. It was stamp on tactual exploration but there was no addition in temperature. There was reduced motion of the left mortise joint articulation due to trouble. The right mortise joint articulation every bit good as both the left and right articulatio genus articulations were normal. There were no contractures seen. Examination of the upper limbs: There was besides some contusions seen on both the upper limbs. The cubitus and wrist articulations were normal on both custodies. The scope of motion for all the articulations on both upper limbs were normal. Examination of the cardiovascular and respiratory systems every bit good as scrutiny of the venters was normal. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss4 ) PROVISIONAL AND DIFFERENTIAL DIAGNOSES WITH REASONINGProbationary diagnosing: Haemarthroses of the left mortise joint articulation — — Evidence for: MFA has been diagnosed with hemophilia since the age of eight months. The articulations are a common site of shed blooding for hemophiliac. In add-on, MFA has had anterior episodes of hurting and puffiness in the joint similar to this episode. The hurting reduced when he was given factor VIII transfusion which farther supports this diagnosing. He besides has multiple contusions on his weaponries and legs which indicate that he has a hemorrhage upset. Differential diagnosing: 1 ) Juvenile Rheumatoid Arthritis The pauciarticular type of juvenile rheumatoid arthritis nowadayss with hurting and puffiness in the big articulations such as articulatio genuss, mortise joints and carpuss. It may show as symmetrical arthralgia or may merely impact one articulation. Evidence against: Juvenile rheumatoid arthritis normally nowadayss during childhood while MFA has been holding episodes of joint hurting and puffiness since he was an baby at eight months of age. Juvenile arthritic arthritis is besides associated with forenoon stiffness which MFA does non hold. MFA besides has easy contusing which is non a characteristic of juvenile rheumatoid arthritis 2 ) Septic arthritis Patients with damaged articulations are predisposed to infected arthritis. As such, a haemophiliac patient who has repeated haemarthroses may hold damaged articulations which are susceptible to infection. Evidence against: Patients with infected arthritis normally have fever while MFA did non. They are besides more common in patients who are immunocompromised. On physical scrutiny, there was no increased heat in the joint which would be more declarative of infected arthritis. 3 ) Ankle ligament hurt A sudden turn of the mortise joint may do a wrenching of the soft tissue and ligaments around the mortise joint doing hurting and puffiness. Evidence against: Master of fine arts did non writhe his mortise joint while playing. He simply knocked it against a stone. As such the mechanism of hurt does non propose that the ligaments were strained. He was besides able to bear weight after hitting his mortise joint and the puffiness and hurting bit by bit developed. This is contrary to what is expected in a sprained mortise joint where there would be immediate puffiness and hurting around the mortise joint. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss5 ) IDENTIFY AND PRIORITISE THE PROBLEMS1. Swelling at the left mortise joint MFA has hurting and puffiness at the left mortise joint articulation. He was in moderate hurting which he rates as 6 out of 10 on the hurting mark. Analgesics such as acetylsalicylic acid and NSAIDS are non recommended for him as they cause shed blooding in hemophiliac. As such the best agencies for rapid alleviation of the hurting and the swelling would be Factor VIII transfusion. 2. Hazard of joint devastation MFA is presently eight old ages old and is an active male child who enjoys playing with his friends. As such he is prone to injury from even mild injury. He has developed haemarthroses on an norm of every 3 months. Perennial haemarthroses at the same articulation could do devastation of his articulations taking to osteoarthritis, restriction in motion and development of contractures. A hold in intervention could besides do harm to the joint. As such, prompt and equal factor VIII transfusion is indispensable for MFA. He should besides be referred to the physical therapy section when the hurting has subsided. Physiotherapy would assist in forestalling the development of joint contractures 3. Hazard of shed blooding Due to his active nature, MFA is besides at hazard of terrible hemorrhage if he injures himself. He was last admitted to the infirmary for one hebdomad due to shed blooding when he fell while playing. There was terrible hemorrhage from his oral cavity and gums when he hit his face on a tabular array. MFA is besides presently casting his decidual dentition. As such, he is at hazard of gum hemorrhage from the site of tooth extraction. The most unsafe hazard is that of an intracranial bleeding 4. Hazard of perennial factor transfusions MFA requires frequent factor transfusion. As the factor VIII used in Batu Pahat is derived from human plasma, there is a hazard that MFA may acquire Hepatitis B, Hepatitis C or HIV infections. In add-on, MFA has non been screened for any of these infections. As such it is necessary for MFA to be screened as recommended by the Malaysian protocol for the direction of hemophilia. 5. Consequence of unwellness on school assignment and day-to-day activity MFA misses school for about a hebdomad on an norm of one time every three months. This may impact his public presentation in school. In add-on there is an addition demand for him to acquire good academic consequences as he would necessitate to believe about a hereafter with a calling that does non necessitate heavy physical activity due to his status. Trouble faced by caretakers MFA ‘s male parent and female parent are both working and frequently are forced to lose work in order to take attention of MFA when he develops episodes of hemorrhage. Both the parents are instructors who have understanding schoolmasters who sympathize with them and give them much leeway in order to care for their kid. However the uninterrupted emphasis of taking attention of a inveterate sick kid demands to be addressed. Support groups such as the haemophillia society would be able to assist the parents by giving them entree to other parents who face similar troubles. These parents would be able to promote one another and portion tips on caring for haemophilliac kids Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss6 ) Plan OF INVESTIGATION, JUSTIFICATIONS FOR THE SELECTION OF TESTS OR PROCEDURES, AND INTERPRETATION OF RESULTSProbes done at 8 months of age by the national blood bank: 1. Curdling profile Justification: MFA presented with peliosis at his limbs which indicates that might hold a hemorrhage upset. As such a curdling profile would be utile to see if the curdling tracts are affected. Consequences: APTT prolonged. More than 90 seconds Interpretation: The drawn-out APTT indicates that the intrinsic tract is affected and that one of the factors in the intrinsic tract may be deficient. 2. Serum factor VIII degree Justification: To determine which specific factor that is lacking doing the hemorrhage upset. Consequences: Factor VIII degree: 0.6 % ( No inhibitors detected ) Interpretation: MFA has severe haemophilia A due to his Factor VIII degree being less than 1 % . He will react to factor VIII transfusion as there are no inhibitors to factor VIII detected. No probes were done for this presentation at the day care. I would propose the undermentioned probes: 1 ) A field radiogram of the ankle articulation AP and sidelong position Justification: In order to govern out other causes of the joint hurting such as infected arthritis or break at the joint. Possible grounds why it was non done: The clinical presentation of the patient did non propose that he has infected arthritis as he did non hold a febrility and the articulation was non ruddy. As the clinical image was typically implicative of a haemarthroses given that he is a hemophiliac, it would be unjust to the patient to subject him to an ten beam as this would intend he would be exposed to radiation every three months. 2 ) Full blood count Justification: A full blood count would be utile to see if there is an increased white cell count which may bespeak an infection. Possible grounds why it was non done: MFA is clinically good with no symptoms of infection such as febrility. As such a full blood count may non be necessary as it would likely be normal. There is besides a hazard of shed blooding or hematoma from venepuncture. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss7 ) Working DIAGNOSIS AND PLAN OF MANAGEMENT ON ADMISSIONWorking diagnosing: Haemarthroses of the left mortise joint due to Haemophilia A My proposed program of direction: I ) Factor VIII transfusion with a mark serum factor degree of 30 % eight hourly till the puffiness and hurting resolutenesss two ) Elastic patch and ice battalion around the left mortise joint three ) To rest the mortise joint articulation by non-weight bearing boulder clay swelling and hurting reduces four ) To analyze patient for joint malformation or contractures prior to dispatch from day care V ) Refer the patient to physiotherapy for joint rehabilitation of the affected articulation. six ) To educate the parents on attention for their kid and protective steps to forestall hurt. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss8 ) Summary OF INPATIENT PROGRESS ( INCLUDING MAJOR EVENTS, CHANGE OF DIAGNOSIS OR MANAGEMENT AND OUTCOMES )MFA was given 200 IU of Factor VIII transfusion. He was so asked to return the following twenty-four hours to be reviewed by the medical officer in charge. Merely one transfusion was deficient for the puffiness and MFA had to digest much uncomfortableness and hurting throughout the dark. This is despite the Malayan Paediatrics protocol recommendation that factor VIII is given every 8 to 12 hours. The ground for this could be the prohibitory cost of the factor. The following twenty-four hours MFA was given another 200 IU of Factor VIII transfusion in the forenoon and once more in the eventide, 12 hours apart. He was given two more transfusions on the 3rd twenty-four hours. The transfusions were given at the day care in the forenoons and at the pediatric ward at dark by the medical officer who was on call. The hurting and swelling resolved on the 4th twenty-four hours post hurt. He was examined by the medical officer and was told to merely return to the day care if he had another episode of joint puffiness or open hemorrhage. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss9 ) DISCHARGE PLAN, COUNSELLING AND MOCK PRESCRIPTIONDischarge program: I ) MFA was asked to rest him left mortise joint and to partly bear weight till it was wholly pain free. two ) Referral to the physical therapist for joint rehabilitation to be done Guidance: I ) MFA was advised to avoid athleticss which involve physical contact as the even minimum injury may do a bleed. two ) MFA ‘s parents were told to convey him back to the day care if there were any longer episodes of shed blooding into the articulations or self-generated hemorrhage. They were given a eventuality program to travel straight to the pediatric ward and see the medical officer on call if any hemorrhage were to go on when the day care is closed. three ) MFA and his parents were besides educated on complications that they need to look out for such as intracranial bleeding. They were taught about the marks and symptoms that they should be wary of. four ) MFA was encouraged to travel for physical therapy which he had antecedently defaulted. He was told about the dangers of joint devastation due to recurrent haemarthroses and how physical therapy may help in forestalling contractures. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss10 ) REFERRAL LETTER ( MANDATORY )Dr Tan Hai Liang, Paediatric Department, Hospital Batu Pahat Physical therapist, Physiotherapy section, Hospital Batu Pahat 27 May 2009 Dear sir, Patient ‘s name: Mohammad Faiz Affizuddin Patient ‘s I/c figure: ( B ) 630902-01-6092 Problem: Haemarthroses of the left mortise joint articulation Thank you for seeing this nine twelvemonth old male child who was diagnosed with Haemophilia A for the past eight old ages. He has had recurrent episodes of shed blooding into the articulations. The articulations most normally affected are the articulatio genus articulations and elbow articulations. His current presentation is for a haemarthroses of the left mortise joint articulation. Physical scrutiny: Inflammation and puffiness of the left mortise joint articulation. Tenderness on tactual exploration. Reduced scope of motion both active and inactive. He has been given Factor VIII transfusion which has reduced the puffiness and hurting. Kindly reexamine the patient and execute joint rehabilitation for him. He has good household support and his household could besides be taught exercisings to forestall joint contractures that can be done at place in position of his recurrent shed blooding into the articulations. Thank you. Yours genuinely,______________( Dr Tan Hai Liang ) Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss11 ) Learning ISSUES IN THE 8 IMU OUTCOMES1 ) Family and community issues in health careHow are parents affected by holding a hemophiliac kid? I had the chance to speak to MFA ‘s parents and inquire them about the challenges faced when caring for him. They related many of their experiences and confided that many alterations to the life style of the household were done in order to accommodate to populating with and caring for a hemophiliac. Both parents have had to lose work on a regular basis due to MFA ‘s frequent infirmary admittances. Family activities besides are limited to light physical activity with minimum hazard of hurt. Furthermore MFA ‘s female parent admitted to ab initio experiencing guilty as she was the bearer of the cistron that leads to his status. As such, I wondered if hemophilia had an impact on parent ‘s quality of life in visible radiation of the many accommodations that they had to do to their life style. A survey by Beeton et al [ 1 ] involved 12 parents of kids with hemophilias whose age ranged from 18 months to 16 old ages of age. The parents were interviewed and qualitatively assessed on their experiences in caring for a kid with hemophilia. It found that medical direction often focused on assisting the hemophiliac adjust to his or her status with small accent on the wider household web. The early old ages of the kid ‘s life after diagnosing were characterized by the parents missing experience and feeling uncertain. This is coupled with the frequent demand of factor transfusion and the associated trouble in venous entree in babies and immature kids. Quality of life at the early old ages post diagnosing was found to be hapless due to parents experiencing ‘out of control ‘ . Parents caring for a hemophiliac kid besides reported that the manner in which they engaged with the people around them had changed. There was a necessity in being more self-asserting in order to protect their kid. This was confirmed by MFA ‘s female parent who relates that she had statements with the infirmary manager and schoolmaster of MFA ‘s school in order to take a firm stand on particular steps to be put into topographic point to better MFA ‘s quality of life. The survey besides found that female parents normally took up a greater duty in caring for the kid. Fathers who were at work during the twenty-four hours did non hold the same degree of experience and this could be a beginning of struggle between parents. Parents were besides found to hold higher degrees of emphasis and anxiousness. However the degree of the emphasis and anxiousness was dependent upon on the phase that parents had achieved in pull offing the status every bit good as successful version. Another survey by Bullinger et al [ 2 ] showed that the quality of life for patients and households with hemophilia was higher when compared to patients with other chronic unwellnesss such as asthma. This shows that households with hemophiliac are able to populate a comparatively normal life with good quality of life if certain stairss were taken to accomplish successful version. The survey found that betterment in quality of life can be attained by supplying an environment in which patients and parents experience understood and good informed. In decision, I learned that hemophilia has a profound consequence, non merely on the kid who has the disease but besides on his primary caretakers which are his parents. As such I need to besides ask about how parents are get bying and offer professional aid such as reding if necessary.2 ) Critical thought and researchIs coagulating factor dressed ore prophylaxis effectual in the direction of patients with hemophilias?A paper by Ljung [ 3 ] proposed that direction of a patient with hemophilia should travel off from concentrating on the upset itself and alternatively look towards keeping a healthy kid. This means that patient ‘s should non be repeatedly managed with factor transfusions when they present with shed blooding but alternatively be kept healthy by forestalling the hemorrhage from go oning in the first topographic point. As such the writer proposed that primary contraceptive therapy should be the gilded criterion in the direction of patients with hemophilias. However is coagulating factor dressed ore prophylaxis effectual in pull offing patients with hemophilias, and what are the associated factors which prevent this direction from being a practical option? I looked at a Cochranre reappraisal by Stobart et Al [ 4 ] which analysed four separate surveies affecting 37 patients. The consequences of the reappraisal showed that there was a statistically important difference in the decrease of shed blooding episodes in patients who were given standard prophylaxis when compared to a placebo. It besides found that secondary results such as clip loss to school and employment due to the unwellness was statistically significantly reduced among those having primary prophylaxis compared to a placebo. The reappraisal besides quoted one survey which showed that a twice hebdomadal extract of higher dosage of factor dressed ore had a statistically important advantage in cut downing the figure of bleeds a twelvemonth when compared to a lower dosage and less frequent disposal of transfusion. However the writers concluded that there was deficient grounds from randomized control tests to urge the usage of primary contraceptive factor extract in the direction of patients with hemophilias. An independent retrospective survey by Khoriaty [ 5 ] showed that primary prophylaxis has some promise. The survey recruited 133 patients with Haemophilia A and B with a average age of 27.93. It compared the 91 patients who were on primary prophylaxis and the staying 42 patients having on-demand intervention when they developed shed blooding. The survey found that there was a statistically important decrease in the figure of self-generated shed blooding per twelvemonth. Patients on primary prophylaxis were found to hold 3.2 bleeds per twelvemonth while those who received on-demand therapy bled 5.7 times per twelvemonth. It found no statistical difference between the two groups in footings of hemorrhage after injury. However the consequences for this survey needs to be read with attention due to the big age scope. Further surveies need to be done for the pediatric age group due to differences such as a higher leaning for injury and hurt in active kids compared to grownups who are better at caring for themselves. One ground why primary prophylaxis is non used in the intervention of haemophiliacs despite its promise is the high cost of the factor VIII. One phial of 200 IU costs in the part of RM 800. As such it may non be cost effectual for primary prophylaxis to be carried out particularly in the context of the Malaysian health care system with its limited budget. A cost effectivity analysis by Miners et al [ 6 ] in England showed that it would be & amp ; lb ; 547 to forestall one episode of shed blooding from go oning. This cost is mostly prohibitory in the Malayan context. In decision I found that there is grounds that primary prophylaxis has much promise in the bar of shed blooding among haemophilia patients but extra surveies need to be carried out particularly in the local environment in order to determine the cost-effectiveness of primary prophylaxis.3 ) Self directed life long larningWhat is the hereafter in footings of direction of hemophilia? The direction of hemophilia is presently with factor transfusions which aim to halt hemorrhage when it has already happened. The other option is primary prophylaxis with regular factor extracts to forestall hemorrhage. However this attack is dearly-won and does non cover with the job of patients developing inhibitors which make transfusions uneffective. As such, research workers are looking into a agency for a remedy of hemophilia. This remedy is by utilizing cistron therapy. The aim of cistron therapy is to redact a faulty cistron sequence to accomplish complete reversion of disease phenotype in the life-time of the patient. Haemophilia is seen as the ideal campaigner for cistron transportation therapy as foremost there are many cell types which are able to synthesise biologically active coagulating factor. Second, there is a broad remedy window which makes it unneeded to hold rigorous cistron look. Third there are big and little animate being theoretical accounts that permit the survey of safety and efficaciousness prior to induction of human tests. [ 7 ] Phase 1 clinical tests are presently being done utilizing largely viral vectors to infix the cistron. Retroviruss have shown promise in this therapy. The cistrons are inserted via developing hepatocytes or hematopoietic root cells. Presently safe long term look of coagulating factors has been successfully achieved in big carnal theoretical accounts of hemophilias utilizing multiple cistron transportations. [ 8 ] Gene transportation therapy nevertheless still faces many obstructions before it can be seen as a feasible therapy for hemophilia. There is hazard of experimentation in worlds in order to formalize this therapy. Many inquiries besides remain unreciprocated such as inhibitor development after the interpolation of the cistron and besides the transmittal of the extra cistron to the kids of the patient who receives the cistron therapy. One paper suggested a generous timeline of at least 20 to 30 old ages before the potency of cistron therapy can even be considered. These issues are ‘merely medical ‘ issues. Religious and ethical issues besides have to be taken into consideration before prosecuting this direction. In decision, I learned that though there is much potency in this field of cistron therapy, much research still has to be undertaken to determine its safety every bit good as efficaciousness. However it has been a valuable experience in larning about new modes of intervention and to catch a glance of what the hereafter holds. This has taught me to go on larning as there are ever new sentiments and therapies available in the direction of any unwellness. 4 ) Professionalism, moralss and personal development What are the ethical deductions of familial proving for haemophilia? After MFA was diagnosed with haemophilia, his immediate household underwent familial testing. The proving revealed that his female parent was a bearer and that his senior brother and senior sister were normal. The familial testing was done voluntarily. There is no recommendation in the Malayan Paediatric protocol for familial testing to be done. Familial testing is normally done in patients with no clear household history in order to determine which parent is a bearer so that farther stairss of direction can be carried out. These farther stairss may include offering familial testing to the siblings of the bearer parent and besides reding about hazard of holding extra kids. However familial testing besides raises many ethical inquiries. First there is guilt, heartache and ego incrimination when a female parent with no known household history of hemophilia discoveries that she was the cistron bearer that passed it on to her kid. A paper by Thomas et al [ 9 ] on attitudes towards familial proving in an Australian community found that female parents who were ‘sporadic ‘ bearers ( no known household history of hemophilia ) were had feelings of guilt. Performing familial testing to determine that a female parent of a haemophiliac kid is a bearer would merely be of value if extra stairss were taken such as offering familial testing to the female parent ‘s siblings. This in itself would raise inquiries of confidentiality and revelation since offering the testing would necessitate the physician to unwrap to the other household members that the female parent is a bearer. This revelation could so take to stigmatisation. In this specific instance, MFA ‘s female parent was found to be a bearer. She related that she felt anguished at ‘causing ‘ her boy to endure much hurting. The cognition that the female parent was the bearer who had passed on the cistron to her boy did non change the direction of MFA. As such there was small virtue in executing the familial testing in this instance. A 2nd consideration of familial testing is the deductions that it has on a individual ‘s determination of whether or non to hold kids. This is once more more relevant for female bearers. Carriers should be counseled that there is a 50 per centum opportunity that their kid would hold hemophilias if he were a male child. However the ethical issue arises when there is no agency of correlating between the genotype and phenotype. [ 10 ] Just because the kid may hold hemophilia does non foretell the grade of badness of the hemophilia. The lone means to cognize for certain about the position of a foetus in footings of whether he would hold hemophilias and the grade of badness is by making antenatal familial proving such as chorionic villi sampling. Prenatal familial proving itself is associated with many ethical issues such as the deductions of transporting out such a trial. Would the foetus be terminated? There is legal leeway for expiration if it can be proven that the kid ‘s unwellness would convey about mental hurt to the female parent. Where do we pull the line to make up one's mind that such a foetus has excessively terrible a haemophilia so as to justify expiration? Who makes the determination? In the instance of MFA, the parents decided non to hold any more kids due to the hazard of holding another hemophiliac kid. It ca be seen that the familial testing had a profound impact on their determination. However proper and thorough familial guidance was non given to the parents. In decision I learned that familial proving for hemophilia is fraught with many ethical considerations. It should merely be offered when proper followup such as guidance, support and options can be offered to those undergoing the trial. In the absence of proper model of support, it may be better to keep back familial testing.