International Financial Reporting Essay Example | Topics and Well Written Essays - 2750 words

International Financial Reporting - Essay Example It is expected that the framework would assist the IASB in not only developing new international accounting standards, but also in the revision of the existing ones. It may also help in reducing the many alternative accounting treatments which are outlined by various accounting standards and regulations (Pounder, 2009). The conceptual framework presents key issues relating to the preparation and presentation of the financial statements. These include objectives, underlying assumptions, qualitative characteristics, recognition and measurement of elements of the financial statements, and the concepts of capital management. Though there are other ways measuring the elements of the financial statements, â€Å"historical cost† is the most commonly used by entities. This basis renders accounting information of less value in the prediction of future performances of the entities. Before the introduction of a conceptual framework, the accounting system could be said to have been â€Å"rule based†, governed by rules on how to treat each and every transaction. Such a system was inflexible and rigid but it promoted excellent comparison of financial performances. Contrastingly, the introduction of a conceptual framework which is â€Å"principle based† has led to the development of accounting standards from a generally accepted conceptual basis with clear and specific objectives. It could be argued that the conceptual framework ensures that the information in the financial statements present a â€Å"true and fair view† financial position of the entity. This means that based on the management estimates and judgment, the financial information presented is fairly accurate. It could also be taken to mean that the financial information does not have material errors, and the users of such information can used it to make meaningful decisions. It is also worth

Employee Empowerment in the Workplace Essay Example | Topics and Well Written Essays - 2500 words

Employee Empowerment in the Workplace - Essay Example Empowerment is seen as a process that results in individual employee enjoying autonomy while performing their jobs. This also ensures accountability on their part and thus develops a sense of ownership and increases the sense of fulfillment, while achieving shared organizational goals. Employee Empowerment has grown in importance in public administration. Early concern for employees as human resources and for the social aspects of work grew into the Quality of Work Life movement and such other efforts (e.g., McGregor 1960; Peters and Pierre 2000). The new public administration and the reinventing government movements have emphasized empowering employees (Marini 1971; Osborne and Gaebler 1992; DeWitt et al. 1994). Empowerment has become "one of the buzzwords of the hour" (Clark 1999, 5) (Lacerda Ramos Eduardo 1995). There were instances of efforts in stimulating employee empowerment in the history "Since World War II, the movement for worker empowerment has steadily gained momentum, c ertain countries have attempted (and in some cases sustained) experiments in various cooperative form of empowerment. With state support, the communal kibbutzim of Israel and Palestine have existed for over eight decades. In Latin America, major national trials in workers' ownership were initiated by the government in both Chile and Peru. In Europe, workers' firms came to constitute a major portion of Italian cottage industry, as well as French small- to medium-sized firms - especially in professional services such as printing, architecture, and engineering" (Lacerda Ramos Eduardo 1995). The present project work is an attempt to describe the importance of employee empowerment for employees as well as the organization. It takes an descriptive approach to illustrate the direct relationship between employee empowerment and their contentment and improved performance. Employee Empowerment- Meaning In common parlance, the term 'empowerment' refers to the process of enabling or authorizing an individual to think, behave, take action, and control work and decision making in autonomous ways. It is the state of feeling self-empowered to take control of one's own destiny. In the organizational context, this term is used with the term 'workers' to denote a changed work atmosphere where employees are at liberty to take decisions on their work and given the responsibility for the performance or otherwise at work place. In other words, employee empowerment is the process of granting the authority to employees with non-managerial capabilities to take decision in an autonomous way. Employee involvement and participative management are similar concepts used in the context of empowerment, but are not interchangeable. In fact, empowerment is the act of strengthening an individual's beliefs in his or her sense of effectiveness. In essence, then, empowerment is not simply a set of external act ions; it is a process of changing the internal beliefs of people (Conger and Kanungo, 1988). Individuals believe themselves powerful when they feel they can adequately cope with environmental demands-that is, situations, events, and people they confront. They feel powerless when they are unable to cope with these demands. Conger and Kanungo (1988) were among the first to define psychological empowerment. They described empowerment as

Acute Inflammation, Appendicitis In Young Adult

Acute Inflammation, Appendicitis In Young Adult Case Thomas is a 23-year-old graduate student that has been admitted to the emergency room with severe abdominal pain in his lower right abdomen. He has been experiencing the pain the last 2 days. Initially he experienced moderate tenderness in a general area around his lower abdomen. He has also been experiencing low appetite and nausea. Etiology The cause of appendicitis usually occurs as a result of the blockage of the opening of the appendix into the cecum. The blockage of the opening can lead to build up of mucus that may cause a variety of problems within the appendix such as swelling of the lymphatic tissue, thrombosis of vessels and increased internal pressure of the walls of the appendix. Bacteria that are normally found in the appendix may start to leak out of the appendix due to blockage. The bacteria can trigger a response from the body known as acute inflammation. Pathogenesis The obstruction of the appendix leads to increased intraluminal pressure. This causes constriction of surrounding vessels which results in decreased blood and oxygen supply to the appendix. This may result in necrosis of the appendix. The combination of increased intraluminal pressure and weakening of the walls of the appendix may cause may cause leakage of bacteria that is normally found within the appendix. The bacteria will trigger an acute inflammatory response of the body. The inflammatory response starts with the release of chemical mediators and emigration of neutrophils to the site of infection. Chemical mediators such as histamine, prostaglandin, leukotrienes, bradykinin, interleukin are released to mediate the inflammatory process. Histamine and bradykinin promotes vasodilation and increased permeability. Prostaglandins and leukotrienes can result in spasm and edema. This leads to swelling and pain of the appendix found in the right lower quadrant of the abdomen. Interleukin-1 is also released to increase the number of white blood cells. Neutrophils will attempt to recognize the infection and destroy it by ingestion. Ingested and destroyed bacteria will lead to pus formation (exudate). If not resolved, appendicitis can lead to further complications such as rupture of the appendix, which may lead to peritonitis (spread of infection to lining of abdomen and pelvis). Infection may also enter the blood and travel throughout the body which can be life threatening. Diagnosis Patients with appendicitis often have elevated body temperatures and pain and tenderness when palpated in the lower right abdomen. These symptoms can be found through physical examination. Further tests must then be done to verify any findings. An X-ray of the abdomen can be done to detect any obstruction that may be causing appendicitis. A swollen or enlarged appendix can be seen through ultrasound, however the absence of the appendix through ultrasound does not omit the diagnosis of appendicitis because it may not be revealed. CT scan can also be used when available and is usually more accurate in diagnosing appendicitis than ultrasound. Clinical Manifestations In early cases, decreased bowel function, decreased appetite may be an indication of appendicitis. Abdominal pain may not be localized and is dispersed throughout the lower abdomen. As appendicitis progresses it usually manifests in abdominal pain in the right lower quadrant. Nausea and vomiting may also occur due to obstruction. Treatment Surgical removal of the appendix (appendicetomy) is usually done. Antiobiotics may be given to reduce the spread of infection and pain medication may be used to manage pain. Prognosis Recovery from surgical removal is usually between 10 to 28 days. Appendicitis may also resolve spontaneously from inflammatory response. References G. B. Ryan, G. Majno. Acute inflammation. A review. Am J Pathol.1977 January; 86(1): 183-276. J R Johnson. Pathogenesis of acute appendicitis. Br Med J.1978 February 4; 1(6108): 305. Chronic Inflammation Rheumatoid Arthritis Case Betty is a 46-year-old woman who has been experiencing increasing pain in the joints of her wrists and fingers over the past year. Her symptoms have worsened and increased in frequency. She now experiences stiffness and swelling of the joints in her hand and also in her knees. She has since been diagnosed with early rheumatoid arthritis. Etiology Rheumatoid arthritis is a chronic inflammatory disorder that mainly affects synovial joints. The cause of RA is unknown. However it is known to be some form of autoimmunity in which unknown factors trigger the immune system of the body to attack its own tissues through inflammatory response. Pathogenesis There are many cell mediators that are activated in the body in a patient with RA. Changes initially occur at the synovial lining of joints. Symptoms arise mononuclear cells increase in number and accumulate around the synovium. This causes swelling of the joint. As RA progresses, its characteristics develop similarly to an acute inflammatory process. Many inflammatory mediators are found in the synovial fluid and progressively cause the destruction of the cartilage. A large number of neutrophils can be found which are mainly responsible for acute inflammatory response. Histamine, Cytokines and chemokines can also be found aiding in the inflammatory response. T lymphocytes also play an important role in RA by increasing production of antibodies that damage the synovium. These antibodies activate the bodys complement system which plays an important role in immunity and inflammation by destroying cells in ways such as cell membrane destruction, leukocyte activate, adhesion and phagocyt osis. Because the disease is autoimmune, inflammatory response occurs intermittently through life with no resolution (chronic). Diagnosis Diagnosis of RA is dependent on a set of criteria. At least 4 of the following criteria must be present: Morning stiffness that last about 1 hour, Arthritis of 3 or more joint areas (finger, wrist, elbow, knee, ankle, toes), symmetric arthritis, rheumatoid nodules, erosion of bone and reduced calcium in bones, and positive rheumatoid factor blood test. Clinical Manifestations RA generally manifests in symptoms involving the joints such as pain, swelling, tenderness, and stiffness. Rheumatoid nodules can also occur near the joints. RA can progressively lead to deformities of the joints such as the fingers and toes. Treatment Currently there is no cure for RA. Treatment is aimed at decreasing pain and inflammation and protecting the joints from further degradation and maintain function. Treatments can vary greatly due to the complex nature of the disease. This can involve rest to prevent inflammation and exercise to strengthen the joints and muscles. Medical treatments for RA are also available and include NSAIDs (non-steroidal anti-inflammatory drugs), steroids, DMARDs (disease modifying anti-rheumatic drugs), biological agents, immunosuppressive drugs and supplements. NSAIDs and steroids are mainly used as anti-inflammatory drugs and do not affect the progression of the disease. DMARDs are used to reduce the progression of RA but are not able to halt its progression. Biological agents are used to reduce destruction of the joints. Prognosis Progression of RA can vary from patient to patient. In most, the disease has a life long progression which eventually leads to some level of functional disability.

Leukemia Essay -- Cancer Health Medical Leukemia Essays

Leukemia Leukemia is a cancer that has had a significant effect on our society and with the developments of new drugs it may become treatable. Leukemia originates in the blood-forming organs which may include the lymph tissue and bone cells. In a person with leukemia the rate and the number of cells produced is altered. This altering can become fatal, or with proper treatment it can be subdued. There are two main types of leukemia which include "total" and "differential." These are mainly characterized by the appearance of white blood cells. When leukemia attacks the blood cells, the bone marrow (where blood cells are made), the spleen, and the lymph nodes are extremely weakened (Reagan 90). The classification of leukemia is based on what organ it is attacking. Leukemia can be in acute or chronic form, which means it can happen rapidly, or be prolonged and severe (Bourne 996). To diagnose leukemia doctors have to insert a needle into the bone marrow to extract it and then then view it under a microscope to see if it has any abnormalities that relate to that of leukemia. Some of the symptoms that are involved with leukemia include: lack of energy, fever, susceptibility to infection (because of lack of white blood cells), excessive or repetitive bleeding, easy bruising, and also enlargement of the liver, spleen and lymph nodes (997). This disease has been known to cause about "10% of all cancer deaths, about 50% of all cancer deaths in children and adult...

Case Digests And Political Law Essay

Facts: Petitioner was charged with violation of Section 2 (4) of the revised securities act. Respondent filed to cancel the passport of the petitioner and to issue a hold departure order. The RTC ordered the DFA to cancel petitioner’s passport, based on the finding that the petitioner has not been arraigned and there was evidence to show that the accused has left the country with out the knowledge and the permission of the court. Issue: Whether or Not the right to travel may be impaired by order of the court. Held: The bail bond posted by petitioner has been cancelled and warrant of arrest has been issued by reason that he failed to appear at his arraignments. There is a valid restriction on the right to travel, it is imposed that the accused must make himself available whenever the court requires his presence. A person facing criminal charges may be restrained by the Court from leaving the country or, if abroad, compelled to return (Constitutional Law, Cruz, Isagani A., 1987 Edition, p. 138). So it is also that â€Å"An accused released on bail may be re-arrested without the necessity of a warrant if he attempts to depart from the Philippines without prior permission of the Court where the case is pending (ibid., Sec. 20 [2nd par. ]). Article III, Section 6 of the 1987 Constitution should be interpreted to mean that while the liberty of travel may be impaired even without Court Order, the appropriate executive officers or administrative authorities are not armed with arbitrary discretion to impose limitations. They can impose limits only on the basis of â€Å"national security, public safety, or public health† and â€Å"as may be provided by law,† a limitive phrase which did not appear in the 1973 text (The Constitution, Bernas, Joaquin G.,S.J., Vol. I, First Edition, 1987, p. 263). Apparently, the phraseology in the 1987 Constitution was a reaction to the ban on international travel imposed under the previous regime when there was a Travel Processing Center, which issued certificates of eligibility to travel upon application of an interested party (See Salonga vs. Hermoso & Travel Processing Center, No. 53622, 25 April 1980, 97 SCRA 121). Holding an accused in a criminal case within the reach of the Courts by preventing his departure from the Philippines must be considered as a valid restriction on his right to travel so that he may be dealt with in accordance with law. The offended party in any criminal proceeding is the People of the Philippines. It is to their best interest that criminal prosecutions should run their course and proceed to finality without undue delay, with an accused holding himself amenable at all times to Court Orders and processes

American Parties Essay

The Republican secession affected the vote in some of the Western States but the Democratic â€Å"bolt† was more significant. It took two forms: one, the nomination of separate candidates for President and Vice President known as gold Democrats, and the other votes given directly to McKinley as the surest means of beating Bryan. There is no question that business was much depressed publicans had hoped to charge this condition to the Democratic administration and to the Tariff bill of 1894, and therefore McKinley, who represented protection more than any other man in the country, was the logical candidate. He was the â€Å"advance agent of prosperity† and promised the â€Å"full dinner pail†; prosperity was to be secured by a return to the protective tariff of the Republican party. A few Gold Democrats made a vigorous campaign, especially in the border states where the vote was likely to be close, but in general the party suffered from the closeness of the contest. A rumor on election eve that labor was swinging heavily to Bryan led many thousands of Democrats to shift their votes from Palmer to McKinley. Cleveland advised Gold Democrats to support Republican electors in doubtful states; and Palmer declared publicly that he did not consider it â€Å"any very great fault† if his hearers voted for McKinley. The result was a pitiful 131,000 votes for Palmer, less than 1 per cent of the total and 10,000 fewer than the Prohibition party polled. Even so, many Gold Democrats were well satisfied. Atkinson claimed it as an acknowledged fact that McKinley had been elected by the Gold Democrats. Wheeler insisted that they had polled enough votes in Indiana, Kentucky, and Maryland to give those states and a majority in the electoral college to McKinley, though others have doubted whether this was true in any state but Kentucky. Certainly a nucleus of â€Å"true† Democracy had been preserved for 1900. Leaders like Atkinson were sanguine. â€Å"Heretofore,† he wrote, â€Å"both the old political parties have truckled to the ilver states; hereafter, the National Democratic party will, like the old Free Soil party, hold the balance of power, and although small in number, they will in a forceful manner control events. † In the campaign of 1884, the Republicans again vigorously advocated the doctrine of Protection, protesting against indiscriminate horizontal reduction, but pledging themselves to correct the irregularities of the Tariff and reduce the surplus â€Å"without injuring the laborer or the great productive interests of the country. † The Democrats carefully avoided their blunder of 1880, when they flatly favored a tariff for revenue only. They devoted a long paragraph to the customary abuse of the opposing party and then explained that they meant to reduce taxation so that it â€Å"shall not exceed the needs of the Government economically administered,† and that this â€Å"can and must be effected without depriving American labor of the ability to compete successfully with foreign labor. † McKinley carried the New England States, New York, New Jersey and Pennsylvania by large majorities. The Middle Western States gave him their electoral votes. He invaded the solid South, carrying Delaware, Kentucky, West Virginia and Maryland, Maryland by an imposing plurality. Bryan carried Kansas and Nebraska, all the mining States except California, and also Washington, while Oregon voted for McKinley. North Dakota did likewise, while South Dakota gave her electoral vote to Bryan by a small plurality. Ohio, the State of McKinley and Hanna, was a disappointment to the Republicans. While they never regarded seriously the boasts of the Bryanites that they would carry the State, yet her plurality, being less than that of Michigan and about one third that of Illinois, showed that Ohio was somewhat uncertain. For, in the August forecast, Michigan was set down as very doubtful and, while Illinois was considered less doubtful, she was not regarded, like Ohio, as safe beyond peradventure for McKinley. Bibliography Binning, William C. 1999. Encyclopedia of American Parties, Campaigns and Elections. Greenwood Press: Westport, CT. Boller, Paul. 1984. Presidential Campaigns. New York: Oxford University Press. Felt, Thomas E. 1960. â€Å"The Rise of Mark Hanna†, Unpublished Ph. D. Dissertation, Michigan State University. Kelly, Patrick J. 2003. The Election of 1896 and the Restructuring of Civil War Memory. Civil War History 49 (3).

The Jim Crow Era

The Jim Crow Era The Jim Crow Era in United States history began towards the end of the Reconstruction Period and lasted until 1965 with the passage of the Voting Rights Act. The Jim Crow Era was more than a body of legislative acts on the federal, state and local levels that barred African-Americans from being full American citizens. It was also a way of life that allowed de jure racial segregation to exist in the South and de facto segregation to thrive in the North. Origin of the Term "Jim Crow" In 1832,  Thomas D. Rice, a white actor, performed in blackface to a routine known as â€Å"Jump Jim Crow.†Ã‚   By the end of the 19th Century, as southern states passed legislation that segregated African-Americans, the term Jim Crow was used to define these laws In 1904, the phrase Jim Crow Law was appearing in American newspapers. Establishment of a Jim Crow Society In 1865, African-Americans were emancipated from enslavement with the thirteenth amendment. By 1870, the fourteenth and fifteenth amendments are also passed, granting citizenship to African-Americans and allowing African-American the right to vote. By the end of the Reconstruction period, African-Americans were losing federal support in the South. As a result, white legislators on state and local levels passed a series of laws that separated African-Americans and whites in public facilities such as schools, parks, cemeteries, theaters, and restaurants. In addition to barring African-Americans and whites from being in integrated public areas, laws were established prohibiting African-American men from participating in the election process. By enacting poll taxes, literacy tests and grandfather clauses, state and local governments were able to exclude African-American from voting.   The Jim Crow Era was not just laws passed to separate blacks from whites. It was also a way of life. White intimidation from organizations such as the Ku Klux Klan kept African-Americans from rebelling against these laws and becoming too successful in southern society.  For instance, when  writer Ida B. Wells began exposing the practice of lynching and other forms of terrorism through her newspaper, Free Speech and Headlight, her printing office was burned to the ground by white vigilantes.   Impact on American Society In response to Jim Crow Era laws and lynchings, African-Americans in the South began participating in the Great Migration. African-Americans moved to cities and industrial towns in the North and West hoping to escape the de jure segregation of the South. However, they were unable to elude de facto segregation, which barred African-Americans in the North from joining specific unions or being hired in particular industries, purchasing homes in some communities, and attending choice schools. In 1896, a group of African-American women established the National Association of Colored Women to support women’s suffrage and fight against other forms of social injustice. By 1905, W.E.B. Du Bois and William Monroe Trotter developed the Niagara Movement, assembling more than 100 African-American men throughout the United States to aggressively fight against racial inequality.  Four years later, the Niagara Movement morphed into the National Association for the Advancement of Colored People (NAACP) to fight against social and racial inequality through legislation, court cases, and protests. The African-American press exposed the horrors of Jim Crow to readers throughout the country. Publications such as the Chicago Defender provided readers in southern states with news about urban environments- listing train schedules and job opportunities. An End to the Jim Crow Era During World War II the wall of Jim Crow began to slowly crumble. On the federal level, Franklin D. Roosevelt  established the Fair Employment Act or Executive Order 8802 in 1941 which desegregated employment in war industries after civil rights leader A. Philip Randolph threatened a March on Washington in protest to racial discrimination in the war industries.   Thirteen years later, in 1954, Brown v. Board of Education ruling found the separate but equal laws unconstitutional and desegregated public schools. In 1955, a seamstress and NAACP secretary named Rosa Parks refused to give up her seat on a public bus. Her refusal led to the Montgomery Bus Boycott, which lasted over a year and began the modern Civil Rights Movement. By 1960s, college students were working with organizations such as CORE and SNCC, traveling to the South to spearhead voter registration drives.  Men such as Martin Luther King Jr. were speaking not only throughout the United State but the world, about the horrors of segregation. Finally, with the passage of the Civil Rights Act of 1964 and the Voting Rights Act of 1965, the Jim Crow Era was buried for good.

Fake profits Essay

Fake profits Essay Fake profits Essay PROFITS ARE WHAT businesses are supposed to be about. Shareholders start, build and continue to own businesses, in order to make profits. But all companies are not equal. Profit margins differ among industries and to a lesser extent among companies in the same industry. If margins are too low, the company is reliant on debt to expand. If margins are too high, it attracts competition. Importantly, if the profits are real, the company can pay cash dividends. While some shareholders may prefer that a company reinvest its earnings to create future wealth for shareholders, the sad reality, as noted by Benjamin Graham in The Intelligent Investor, is that few companies are able to reinvest such profits to earn the same rate of return as the existing business. Besides assuring shareholders of a minimum return on their investment, a cash dividend also serves as useful, albeit partial, proof that the company’s reported earnings are real. If the profits are real, the margins will also be similar to that of competitors – after all, with the same capital inputs, the same workforce, the same customers, and the same selling price, the profits must also be the same. Few companies are so unique that they have no competitors and can set any price they wish. So what happens if the profits are fake? Generally, if the profits are fake, it is because the reported profit margin is too high. This can be detected in a peer comparison with the company’s direct competitors, or similar businesses operating elsewhere in the world. Given today’s globalized economy, very few companies will leave a region alone if it is seen that a peer is making good profits there. Thus, excess profits are unlikely to persist, and over time profit margins go back to normal i.e. there is reversion to the mean. Because profits and losses from the income statement are reflected in the balance sheet, fake profits will also show up on the balance sheet, often in the form of imaginary cash balances. The problem here is that cash is a transparent and easily auditable item, which makes it a prime focus of auditors. Blatant fraudsters may of course collude with bank officials to produce fake statements to fool the auditors. However, even if the auditors are fooled, as cash apparently builds up on the balance sheet, it becomes increasingly more difficult to fend off minority shareholder demands for cash dividends, or at least a repayment of outstanding debt. One way to avoid having to show the cash to the auditors is to not collect it in the first place. This then causes the trade receivables account to swell. This topic was discussed 3 years ago in the June 2009 newsletter, so it will not be discussed further here. If one does pretend to collect the cash, then the logical progression is to use up the fake cash on items which are harder to evaluate than cash. Popular choices include inventory, machinery, supplier prepayments, intangible assets and even other companies. Inventory, specifically finished goods, can be a useful place to dump fake earnings, as finished goods comprise a mix of different costs such as raw materials, capital and labour. This creates more work for auditors, who are not interested in dissecting the business to figure out the true cost of finished goods. In a retail business, the stock is also scattered across hundreds if not thousands of stores. So a retail company can dump fake earnings here and be fairly confident that the auditors are not going to do a thorough stock-take. For example, Ports Design, a luxury apparel brand, has reported very high profit margins for the past 10 years. One would expect that Ports would then be sitting on a huge cash hoard. Instead, Ports has opted to plow much of its earnings back into inventory, to the extent that since the end of 2009, its inventory holdings have represented more than 18 months of sales. But apparel, by its nature, goes in and out of fashion. Therefore, stock

Guide and Tips to Write a Definition Essay

Guide and Tips to Write a Definition Essay A Complete Guide on How to Write a Definition Essay What can be better for a student than writing tons of essays every week? Aren’t you one of those writing addicts? Then you may find the academic process rather boring and difficult. With so many academic assignments. Many students simply fail to complete the course due to a lack of writing skills. However, becoming an advanced writer is easier than it may seem. Our complete essay-writing guide will put an ease on the writing process as well as make your college life simpler. Tips on writing a definition essay Our complete guide includes a systematic instruction on how to write a definition essay. All you need is to follow each step as well as add some creative work to make your paper look outstanding. You will certainly get the A grade effortlessly. Describe your idea Choose a word that will perfectly describe your concept or paper idea. This word is supposed to become a fundamental issue. It will let you broaden the view of the topic itself. â€Å"Love†, â€Å"Hate†, â€Å"Truth† – look for the definition in the dictionary and pick a proper word for your essay. Avoid complicated objects Avoiding complicated objects and specific things is the best way to stay away from writing troubles. Never choose too mundane objects that are hard to define. Avoid too simple words like â€Å"table† or â€Å"chair. They will narrow down the process of creative thinking. Select a term ft. several definitions A good idea is to choose a word featuring multiple definitions and meanings. However, make sure that you do know the word and have a clear understanding of all the available meanings. It will provide more opportunities to write about different aspects of the word. Look the word up in a dictionary The first step is to find the official definition of a chosen word. Look it up in a dictionary. Memorize it and create a structure for the definition to reveal possible writing paths. The idea here is to find out as much about the word origin as you can. Use all available sources ranging from encyclopedias, original dictionaries, online resources, etc. Ask your friends, relatives, and teachers about the word. Summarize the information Get all the facts you know about one place and summarize the info. The main idea at this stage is to create your own vision of the word as well as your own definition. How to build an outline for the definition essay? Building an outline for the definition essay is the same as working out a clear plan. It should contain all vital aspects of the major work arranged in a reader-friendly manner. The main mission here is to establish a comprehensive coherence between each paragraph. The draft should include the following points: Introduction – introduce the main idea of your paper. Let readers know what you are going to speak about; Thesis Statement – make a strong statement describing the word or term you are going to define. Avoid writing too much in a thesis statement. Make it brief but clear; Body Paragraph – body paragraphs come as the major part of your paper. Make sure they are well organized and contain sections that are logically connected; Conclusion – right a short summary of your paper highlighting the core ideas related to the word. You need to make the ending of your paper interesting and impressive. Include some arguments and points to hammer the key ideas of the essay. It will certainly make an impact resulting in A grade for your work.

Organizational Behavior Essay Example | Topics and Well Written Essays - 500 words - 3

Organizational Behavior - Essay Example The resistance could be severe as well when trade unions and the like protest their anger and shut down on work in a swift manner, thus halting the organizational domains in an excessive manner. The need is to deal with resistance in such a manner that will make both the parties happy. (Berkowitz, 2003) The employees as well as the organizational top heads must reach a consensus as to what exactly could be summed up as a compromising situation. Culture is manageable to the extents that it does not hinder the employees’ working space and it is changeable if all the above mentioned parties in unison agree with the notion that the organization’s success is more important than their individual preferences. Organizations can prevent resistance to change if they pre-empt the moves that the employees and stakeholders will take in the event of a changing scenario looming large in their face. The organizations can find out how the people concerned would react when change is put upon them and how they would show their pleasure or the lack of it within the contexts of their personal lives and more importantly at the workplace. This is significant since organizations pose a number of problems for the employees both on the domestic as well as official fronts and change in any such situation could work towards creating problems for them, no matter within the short term or in the longer scheme of things. The cultural change aspect needs to be embedded in a clear and concise manner within the realms of an organization so as to extract the best possible results, both in the short term as well as in the long run. Organization structure impacts the manner in which work is basically carried out. More than anything else it adheres to the different purposes of the discrete services and the related achievements with the passage of time. This brings to

Social Contract Theory of John Locke Research Paper

Social Contract Theory of John Locke - Research Paper Example The US constitution includes the Bill of rights, which protects the freedom, liberty, and other rights of the individuals; at the same time, the constitution specifies the scope of authority of the President, the Judiciary, and the Congress. Thus, the constitution in its true sense in indeed a contract between the individuals and the state, whereby the natural laws of the individuals are intact and the state authority has been specified as well. Moreover, the criminal justice system also follows the principals of Locke`s social contract theory, as the system ensures that the rights and the belongings of individuals are protected, and, by collective submissiveness to law, all citizens empower the system to take punitive action against the violators. In this context, one can conclude that freedom leads to complete independence and liberation; however, as per the social contract, one also has to fulfill the duties and comply with ethical standards to obtain one`s own rights. Social cont ract is an intellectual, even political theoretical paradigm, which focuses on the origins of the society and the legitimacy of the state authority over the individuals of the state. The basic tenet of this theory implies that the individuals of the state have permitted the state to exercise power over them to protect their rights and freedoms; in other words, there is a social contract between the state and the individuals – the people will give authority to the government and, in turn, seek the protection of their natural laws. Different theorists have come up with their own versions of the theory, with the same basic assumptions but, however, with minute differences in the perspectives. Hugo Grotius (1625) gave the idea of the natural laws and argued that all individuals should comply with the moral and religious values to ensure that everyone receives their due share of rights. Thomas Hobbes has an important contribution to the development of the theory, as he suggested t hat a social contract resulted between individuals and the state due to the anarchy, which was the reason behind poor living conditions of the individuals. Rousseau, on the other hand, gave a different version of the theory, as he believed that the general will of the people should be considered for the social contract, as every person has the right to express his or her will – thus he aimed at attaining social contract not by collective will but rather by the general will of the individuals. However, Pierre-Joseph’s version of the social contract implies that the contract is a result of the individuals trying to avoid coercion from other individuals; he argued that the contract is a result of â€Å"†¦ An agreement with a man to a man...† (Morris, 1990). However, Locke`s form of social contract theory implies that the individuals would willingly form a state in an effort to protect their natural rights by virtue of the state, which would further be discusse d in detail. (Morris, 1990) John Locke is of the view that the natural law transcends all other man-made laws, and thus, to protect these natural laws, the individuals themselves willingly give authority to

Professional Capstone Project Essay Example | Topics and Well Written Essays - 4500 words

Professional Capstone Project - Essay Example To address this issue further clinical trials are essential and preventive health strategies addressing the established causative agents should be implemented. Lung cancer often results from the abnormal growth of the cells lining the passageway of the lungs. They can be dangerous as they can spread and invade other tissues of the body. Because of this it is one of the most common causes of cancer death worldwide. The disease has a very low prognosis, with less than 15% of the diagnosed patients surviving 5 years after diagnosis. The clinical signs and symptoms are often vague and non-specific Radiologic tests such as x-ray and CT scan often provides the usual indication of lung cancer. PET scan has been shown to be important in cancer staging. The role of diagnosis on the staging, treatment and management of lung cancer cannot be overemphasized, thus it is essential to understand the contributions and limitations of each diagnostic procedure. The signs and symptoms of lung cancer are often covert or if not, they mimic other respiratory infections. Radiologic techniques, especially X-ray and CT (computerized axial tomography) scan are the most preferred techniques for initial diagnosis, and yet both offer some advantages and drawbacks. X-ray could not determine small tumors, if detected the patient may be in the late stages thus making treatment more difficult and even impossible. CT scan is more sensitive, having the ability to determine even the smaller tumors and yet lacks the ability to resolve whether the tumor is benign or just an inflammation as a result of respiratory infection. Furthermore, CT scan has not reduced the mortality rate of lung cancer. Furthermore, CAT scans have not decreased the incidence of the disease (Spiro, 2007). Proper screening and diagnosis of any type of cancer is important in the staging and treatment.

Concert Review Essay Example | Topics and Well Written Essays - 1000 words - 3

Concert Review - Essay Example Notably, the performers were a combination of instrumentalists and vocalists. Indeed, Mateusz Wolski played the Violin; Inon Barnatan played the Piano, and Julian Schwarz played the cello while Mid-Columbia Mastersingers provided the vocals under the leadership of Jeremy Briggs Roberts. The first to perform was Jeremy Briggs Roberts conducted the live performance while the Mid-Columbia Mastersingers provided the vocals. The performance of Piazzolla’s â€Å"Four Seasons of Buenos Aires† was fascinating and soul fulfilling courtesy of a calm tone, harmonious melody, and smooth texture presented by the vocalists. According to their general expressions, the band appeared prepared to entertain the audience. Although the melody of the set was highly syncopated, I managed to count the 12 bars. The sweet rhythm provided by Mateusz Wolski, the violinist, complemented the melody. The pianist harmonized the performance with a moderate tempo, cool tone, and harmonious melody that rhymed well with the cello played by Julian Schwarz. The performance marked the climax of the concert with high tones, sweet melodies, and precise rhymes. Notably, the live performance corresponds to the classical stylistic period learnt in class. The second performance on stage featured Mateusz Wolski the violinist. The following piece was included in the performance: â€Å"Maracanzo† and â€Å"Four Seasons of Buenos Aires.† Indeed, the combination of the vocalists and instrumentalists in the performance of â€Å"Maracanzo† and â€Å"Four Seasons of Buenos Aires† was so fascinating and entertaining. The form employed was AABB. Specifically, I enjoyed the part played by Mateusz Wolski the violinist since it was melodious, high-pitched, had a moderate tempo, and was so clear and coordinated. Moreover, as a football fan, I identified with the terrific performance of â€Å"Maracanzo† that created a stadium feeling. The performance depicted the memorable 1950

Objectives of Reconstruction in the years immediately after the Civil Essay

Objectives of Reconstruction in the years immediately after the Civil War - Essay Example the strongest desire to secure to the freedmen the full enjoyment of their freedom and their property and their interdependence and equality in making contracts for their labor† (Johnston, teachingamericanhistory.org). This is the thinking and suggestion of Andrew Johnson. At the same time, Abraham Lincoln had a similar opinion concerning the freedom of men after the civil rights, â€Å"with malice toward none, with charity for all, with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation’s wounds† (Lincoln, teachingamericanhistory.org). According to my view, these three great individuals had similar views in regard to the slaves and the freedmen, though the kind of approach that they had taken was different. Lincoln agitates for peace, while Andrew Johnson rejected a bill passed by the senate and approved by the house of congress. In his explanation, it is quite clear that the details of the bill were not consistent with the people’s welfare; he therefore had to reject it. Given the effort and steps taken by Andrew Johnson towards the establishment of measures that could oversee that the freedmen and the slave got justice, he has been greatly attacked by Sumner Charles, whereby he describes him with many attributes, â€Å"original partisan of slavery North; habitual compromisers of great principles; maligners of the declaration of independence† (â€Å"Charles Sumner opinion,† rug.nl). This description depicts a negative image of the one known for his understanding and good will for the people. Though all these individuals had the same aim, to deliver the slaves from the bondage of suffering, they had different approaches. Abraham Lincoln has described the origin of the civil war and has greatly included God’s involvement in his issues. He eventually urges the people to come together so as to ensure that all slaves get their rights. Andrew Johnson on the other hand is one person

Report outlining the major stages & variables of Business Relationship Literature review

Report outlining the major stages & variables of Business Relationship development (BRD) - Literature review Example Any organization specialising in the production of a particular goods has a number of supplier who supplies raw materials and equipments to the company. Thus, stages for widening supplier relationships are the focus of the current study. This report gives insights into the essential steps and ideas required in attaining an effective supply chain management strategy in the concerned DIY furniture company. The concept of business relationship management deals with linking the organization with various stakeholders in order to fulfil business requirements as efficiently as possible (Krause et al. 2007). In order to develop a new supplier relationship, organizations like DIY furniture provider, can implement the supplier relationship model. The Supplier Relationship Model (SRM) consists of planning and maintaining a constructive relationship with the suppliers who supply materials and goods to the business (Hakansson, 1982). SRM is a part of supply chain management that provides major focus on developing and nourishing a strong relationship with the organizational suppliers. As per the model, when a business communicates with its suppliers, it needs to manage its entire supply chain in an efficient manner. Buying SRM software is a good option to start. Apart from that, there are four other stages that can be taken into account to build a good partnership with the suppliers and increase an overall organizational performance. In order to develop a good supplier relationship, business organizer can purchase Supply Chain Management Software (SCMS) that contains features of SRM or apps (Wilson, 1995). This type of software includes invaluable features to perform a task of building a good relationship, such as deifying and accommodating new suppliers, monitoring supplier’s performance, providing all suppliers’s updated business profile etc. This software helps to keep

Objectives of Reconstruction in the years immediately after the Civil Essay

Objectives of Reconstruction in the years immediately after the Civil War - Essay Example the strongest desire to secure to the freedmen the full enjoyment of their freedom and their property and their interdependence and equality in making contracts for their labor† (Johnston, teachingamericanhistory.org). This is the thinking and suggestion of Andrew Johnson. At the same time, Abraham Lincoln had a similar opinion concerning the freedom of men after the civil rights, â€Å"with malice toward none, with charity for all, with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation’s wounds† (Lincoln, teachingamericanhistory.org). According to my view, these three great individuals had similar views in regard to the slaves and the freedmen, though the kind of approach that they had taken was different. Lincoln agitates for peace, while Andrew Johnson rejected a bill passed by the senate and approved by the house of congress. In his explanation, it is quite clear that the details of the bill were not consistent with the people’s welfare; he therefore had to reject it. Given the effort and steps taken by Andrew Johnson towards the establishment of measures that could oversee that the freedmen and the slave got justice, he has been greatly attacked by Sumner Charles, whereby he describes him with many attributes, â€Å"original partisan of slavery North; habitual compromisers of great principles; maligners of the declaration of independence† (â€Å"Charles Sumner opinion,† rug.nl). This description depicts a negative image of the one known for his understanding and good will for the people. Though all these individuals had the same aim, to deliver the slaves from the bondage of suffering, they had different approaches. Abraham Lincoln has described the origin of the civil war and has greatly included God’s involvement in his issues. He eventually urges the people to come together so as to ensure that all slaves get their rights. Andrew Johnson on the other hand is one person

The employee caries out this specific job role Essay Example for Free

The employee caries out this specific job role Essay Job roles are appointed to each individual employee in McDonalds and it is important the employee caries out this specific job role to the best of his/her ability. It is also important to carry out these roles to ensure McDonalds run smoothly and efficiently. Working arrangements is the time and location and terms an individual employee must work. These working arrangements will vary to each individual as some employees may do part time work while others do full time work. Job roles vary to different employees. Some employees have more power than others and so have more responsibilities. This level of power in McDonalds can be shown in a hierarchal. McDonalds Pyramid Structure The pyramid structure of McDonalds is a diagram (pyramid) showing the different levels of power each employee has within McDonalds. McDonalds use a pyramid structure to show the powers of different members of staff. The pyramid shows the flow of information from top to bottom. The person with the highest power within McDonalds is placed at the top of the pyramid and the person with the lowest level of power is placed at the bottom of the pyramid. There are two types of pyramids these are tall and flat pyramids. A tall pyramid is used by larger organisations such as McDonalds. A tall pyramid consists of more levels and more power as you go higher up. A flat pyramid is used by smaller organisations, and consists of less levels and the amount of power the top person has is considerably less than the amount of power that the top person has in a tall pyramid. Important decisions are usually made by the person at the top of the pyramid. This information is passed down to the employees. It is also important to know that the level of authority increases as you go up the pyramid. The pyramid structure also shows that the higher you are in the pyramid the higher your wages are. The five key points to know about McDonalds pyramid structure are A pyramid structure shows the levels of power of an employee. A pyramid structure is either tall or flat. A pyramid structure can be used to show the flow of information from top to bottom. A pyramid structure can be used to represent the importance of a particular person within McDonalds. (The higher in the pyramid you are, the more important you are.) A pyramid increases in size as you go down because there are more people carrying out that particular job. This is why the structure is a pyramid shape. Organisation charts are charts that show the main people of McDonalds and their level of power. A normal organisation chart would show a high managers picture at the top with a description and name and below this person would be other employees who work just under the high manager. However McDonalds is far too big a business to have this so it is likely that McDonalds have an organisation chart which shows the more important departments. The role of the organisation chart is to show power structure and the line of communication within McDonalds. In an organisation charts you will be able to see. Chain of command Line manager Depth of control Span of control The chain of command shows a direct level of power from top to bottom. For example a managing director would be at the top and a crew member would be at the bottom. The chain also shows the path of communication within McDonalds. And also from a chain of command you can see where your instructions are coming from. A chain of command will change in lengths. This is dependant of the different types of employees and job roles within a department in McDonalds. This is what an organisation chart may look like for McDonalds. The line manager is the person who an employee will receive an immediate instruction from. From the diagram above you can see the levels of power and responsibility increase as you go up the chain. It is likely that a floor manager will receive his/her instructions from the manager. The depth of control can also be seen from the above chart. The depth of control is the number of levels a person controls or is higher than. For example a floor manager has a depth control of two were as the manager has a depth control of 3. A span of control has a different style of presentation as it shows how one person has immediate authority over another person or how someone is under the authority of another. For example there maybe seven crew members. One of these crew members may be manager of the other crew members so the manager has direct authority over the other crew members. This is what the chart would look like. Job Roles Managers Managers are mainly found in medium or large organisations. McDonalds is a large organisation and so has many managers. Each managing level will have different responsibilities. For example a floor manager will have different responsibilities to a supervising manager. The managers have a role to take care of a section of McDonalds and to perform duties given to them by the director. Their tasks may include helping with customer service, registering complaints, analyzing the profit and loss accounts, etc. Managers have a very good level of job security, as managers will always be needed and also there are fewer managers in a restaurant than crew members. And a manager has specific qualities and skills. The skills needed maybe the ability to calculate profits and loss, ability to analyse assets. It is likely that you would need a qualification maths. Managers of McDonalds are paid well for the work they do. Supervisors Supervisors work a level below the managers. Supervisors have a role to lead a group (crew members). They have day to day responsibilities these include monitoring progress of employees, Check profits are coming in, help in customer service, serve customers and so on. Supervisors also have good job security as there are less of them (almost always one in every group) and also it is likely that supervisors will be promoted to be a manager. They are usually looked on to solve small problems such as disputes between employees and to handle customers with complaints. People who have become supervisors have usually been working in McDonalds as a lower position for a period of time so a quality a supervisor would need is experience. Skills to be a supervisor could be to be able to calm customers down, know how to solve disputes, etc. Supervisors have a pay which is good for the job they do, however the pay is very little. Operatives Operatives are people who work on the shop floor of McDonalds. They carry out activities such as cleaning and serving. They have a responsibility to provide customers with a high standard of food along with a high standard of service. The job security for an operative can be low as there are so many and the jobs they carry out are tedious. Some of their duties can be replaced by machines witch means that they can loose their job at any time. An operative at McDonalds must have good communication skills, they must be quick and efficient at their job, and they must also be able to do different jobs within the team. The qualifications expected by an operative are minimal. The pay for an operative is quite low as the jobs carried out are simple. Crew Member A crew member has several responsibilities they must serve customers, provide excellent customer service, perform general kitchen duties and take part in annual stock take. The job description of an employee is one that is very simple. They must process customer orders for payment, collect and pack customer orders and provide customers with information and advice about products within McDonalds. There are two types of contracts these are permanent and temporary. The level of job security is dependant on the type of contract the employee has agreed to. A temporary job has a finishing date of work. So the amount of time the employee can work for is fixed. This offers minimum job security, however a permanent job offers a greater level of job security as the date that the employee finishes working is not fixed. The only way in which the employee can loose his or her job is by either getting sacked or by resigning. A crew member plays a minimum role in decision making as the only decision the crew member makes is how to pack a customers order. The skills and qualifications a crew member is expected to have is to have G.C.S.Es in English and maths. The crew member is also expected to have good customer service skills along with having commitment to hard work and being a team worker. Previous work experience is not necessary. A crew member can be expected to have an Hourly pay of à ¯Ã‚ ¿Ã‚ ½3.45 à ¯Ã‚ ¿Ã‚ ½5.05 per hour. Good performance by employees are rewarded with bonuses. Annual paid leave is provided along with employee discounts in regards to McDonalds products. Restaurant Manager A restaurant manager has many responsibilities. The restaurant manager is responsible for the restaurants overall performance and profitability. The restaurant manager also has the duty of reporting performance to head office and area managers. The restaurant manager is also responsible for management of staff along with taking responsibility that the McDonalds restaurant food is cooked properly and that only in-date stock used in the food used to provide their customers. The restaurant manager must also make sure that health and safety regulations are followed carefully and to absolute precision. He/she must also monitor the training and development of their staff. The restaurant manager also has the responsibility of having to be able to deal with customer queries, complaints along with ensuring high level customer service. The job description of a restaurant manager would include the roles the restaurant manger must play. These are provision of standardised food and customer service, setting performance targets to monitor staff performance against targets, manage section managers, recruit staff, communicate regularly with staff and to keep restaurant costs within budget. The restaurant manager has a high level of job security as the contract he/she is employed on is a permanent contract. In order for the restaurant manager to keep his/her job security high he/she must complete the objectives told in his/her job description. Decisions made by the restaurant manager include the recruitment of section managers, store layout and range of goods kept in store. The qualifications expected of a restaurant manager is that he/she must have a degree, HND or work experience with NVQ. The restaurant manager is also expected to have good leadership skills along with good communication skills. Good organisational skills and excellent customer service skills. The salary of a restaurant manager usually increases over time, when a restaurant manger starts off he/she would be paid between à ¯Ã‚ ¿Ã‚ ½17,000 and à ¯Ã‚ ¿Ã‚ ½22,000 yearly. After time the restaurant managers yearly salary should increase to about à ¯Ã‚ ¿Ã‚ ½35,000-à ¯Ã‚ ¿Ã‚ ½55,000. Completion of achieving set aims of McDonalds is rewarded by performance bonuses. Franchising opportunities are given to the restaurant managers, and are paid annual leave of (5 weeks). The restaurant manager also gets staff discounts and stakeholder Pension scheme. Working arrangements at McDonalds An employment contract is a very important document as it states what is expected for the employee and what the employee can expect of the employer. Such expectations of the employee can be the time he/she reaches for work and leaves. The attitude taken towards customers, the jobs expected to do. If the employment contract is broken either by the employer or the employee their jobs will be at risk. Below are the key points of information shown on an employment contract. * Job title. * Hours of work * Place of work * Terms and conditions of employment * Pay and benefits * Date of commencement of employment * Name of employer * Employees name There are five types of working arrangements. This is to say five different ways of taking work. These are. *Permanent employment * Temporary employment *Full time workers *Part time workers *Flexible hours * Shift work * Flexitime workers * Overtime Permanent employment is when you are given set hours to work and you have no decided end to your job. The only way your job can end is if you retire or are sacked. The advantage of permanent employment is that you have high job security and that you can claim benefits such as having paid leave. A disadvantage of permanent employment is that you can be sacked. Temporary employment is when you work for a set number of hours however you have an end to the job. A disadvantage to this is that you cant claim benefits from McDonalds (such as paid leave). The advantage of temporary employment is that you dont have to work very long and that you get paid. Full time workers are permanent employees that work standard hours. Standard hours would cover the hours of between (9.00 am- 5.00 pm.) The disadvantage to this is that you have to work long hours for almost all work. The advantage to this however is that there is more pay in working full time. Part time workers are employees that work less hours through agreement. The advantage to this is that you can work hours that suit your schedule. The disadvantage to this is that you do not get paid as much as full time work. Shift work is when you work for a period of time over twenty four hours. The advantage to this is that you work shorter hours that suit your needs. The disadvantage to this is however you dont get as much pay as full time work. Flexitime workers are employees that decide when to start and finish work however by completing the standard working hours. The advantage to this is that you can take care of jobs you must do before you work such as (drop children off to school, etc). The disadvantage is that you would end up finishing work at a later time as you would still have to complete the working hours set. Overtime is a working arrangement where employees work for longer than the standard hours. The disadvantage is that you would have to work for a longer time, however the advantage is that you would get paid more. It is expected that an employee of McDonalds is expected to work seven hours a day (not including part time workers). These working hours are shown in the employment contract witch the employee has signed showing that he/she has agreed to complete those hours. Your place of work can sometimes vary depending on what you work as. An operative of McDonalds will almost always be located in the restaurant this is a fixed place of work. This is also included on your employment contract. Your payment is included in your employment contract. It will also state of the pay is annual or hourly. Holidays are given to employees and they can be taken at any time, however their holiday time is limited as when the employees are on holiday they are still getting paid. Any days taken off after your holiday will not be paid for. Different employees will have different benefits. If an employee works far away from their place of work they are given a company car. Medical and life insurance are very likely to be covered by McDonalds. Flexible hours are important to McDonalds. This is because it keeps there employees less stressed and so are more happy to work and that adds to a happier working environment. When an employee is able to come in at a later time and so get other jobs out of the way such as dropping off children to school they are a lot happier and so are able to get on with their jobs better. Family Flexi Working Family flexi working is when there are two or members of a family working in McDonalds, and the agreement allows them to cover each others shifts. The advantage to this is that family members can take time off when needed, however the disadvantage to this is that it does not always work as both family members may have to take time off work at the same time.

Factors Influencing Calprotectin Levels

Factors Influencing Calprotectin Levels Several factors have been reported to affect faecal calprotectin levels. Some of these factors have been investigated in this study through the survey. Referring to Figure 3.1, 34% participant are aged between 50-59 years. From this study, a correlation between age and calprotectin level is positive, meaning that, as age of participant increases, calprotectin level increases (p Socioeconomic status is another factor which is thought to impact on calprotectin level. Figure 3.2 shows that 48.86% participants were from medium socioeconomic status. From Table 3.7, the correlation between socioeconomic status and calprotectin level was statistically significant (p The health status of participants was divided in 3 subcategories: healthy, unhealthy, and quite healthy. From Figure 3.3, 66% participants stated that they are healthy while 20% were unhealthy. Referring to Table 3.8, no positive correlation exists between health status and calprotectin level (p>0.05). This implies that health status of the individual does not affect calprotectin level. 47 % participants judged that they were moderately stressed (Figure 3.6). Stress has long been implicated in the pathogenesis of several GI conditions. Stress profile is known to contribute to GI inflammation. From this study, a statistically significant correlation does not exist between calprotectin and stress level (p>0.05) (Table 3.10). This demonstrates that as stress level rises; calprotectin does not increase accordingly, implying that according to the test, GI inflammation is not observed accordingly. This is refuted by findings of another study, reporting that stress is a potent modulator of the inflammatory response in the gut [104]. Among other lifestyle factors which can affect calprotectin level and thus GI inflammation is undoubtedly alcohol consumption. Excessive alcohol consumption often results in intestinal damage, mediated by inflammatory processes [105]. Figure 3.7 shows that only 4.55% participants consumed alcohol regularly. Statistical analysis demonstrates no correlation between alcohol consumption and calprotectin level (p> 0.05; Table 3.11). Another study also reported that faecal calprotectin level in active-drinking alcoholics are not significantly different, compared with controls. These results may suggest the absence of a subclinical intestinal inflammation involving neutrophils in the alcoholics [105]. Cigarette smoking is another factor likely to cause GI inflammation and thus, affecting calprotectin level. With reference to Figure 3.8, 20.45% participants smoke. Table 3.12 shows that the correlation coefficient is 0.073, however, it is not significant (p>0.05). There is no linear relationship between smoking and calprotectin level. However, literature suggests that smoking modifies pro/anti-inflammatory cytokines, which can contribute to inflammation [78]. Cigarette smoke and nicotine can aggravate colon and stomach inflammation [79]. However, this study concludes that no correlation exists between cigarette smoking and calprotectin level. Genetic influences can also alter the probability of suffering from GI inflammation. The study reveals that 40.91% participants (Figure 3.9) have family history of GI inflammation. Using the Mann Whitney test, a statistically significant correlation is seen between calprotectin level and family history of GI inflammation (p Literature suggests that GI surgery may have a protective or detrimental effect on GI inflammation. From Figure 3.11, 12.50% participants had undergone different types of GI surgery. The R2 value for GI surgery and calprotectin level is 0.037 (Table 3.16), implying that no linear relationship exists between calprotectin level and GI surgery. There is only 3.7% chance of having a linear relationship between calprotectin concentration and GI surgery. With reference to Table 3.15, it can be depicted that the correlation between calprotectin concentration and GI surgery is not statistically significant (p>0.05). Consumption of different types of food may have different types of outcome on the GIT. Some food can have a protective role on the GIT while others have detrimental effects. Table 3.2 shows that 62.5% participants consume fruits vegetables daily while 50% consume meat dairy products every day. A correlation between consumption of fruit vegetables and calprotectin level is statistically significant (R=0.236, p Referring to Figure 3.12, it can be seen that 65.91% participants took antibiotics in the last 6 months while 34.09% did not. The Mann Whitney test suggests that there is no correlation between antibiotic intake and calprotectin level (p>0.05) (Table 3.18). 4.2 Central obesity and GI inflammation One aim of this study is to determine whether centrally obese males are more susceptible to GI inflammation or not. 44 participants (50%) were centrally obese while 44 (50%) had a normal waistline (Figure 3.4). The BMI of participants was also assessed. From Figure 3.5, it can be concluded that 56.82% participants had normal BMI (18.5-24.9 kg/m2), 36.36% were overweight (25.0à ¢Ã¢â‚¬ °Ã‚ ¤BMIà ¢Ã¢â‚¬ °Ã‚ ¤29.9) and 6.82% participants were obese (BMIà ¢Ã¢â‚¬ °Ã‚ ¥30.0). It should be noted that an individual with central obesity does not necessarily mean that he is obese. Centrally obese participants can have normal BMI as well. Using the Spearmans correlation, a statistically significant correlation between central obesity and calprotectin level was not found (p> 0.05) (Table 3.9). Moreover, there is no statistically significant correlation between BMI and GI inflammation (Table 3.9). Calprotectin is described as a novel marker of obesity [106]. Literature suggests that central obesity correlates more strongly with disease states compared with total body fat [7]. Another study reported that faecal calprotectin level is normally elevated in individuals with increased BMI [107]. In addition, obesity-relaed systemic changes can create conditions predisposing to gut inflammation [108]. One study reported that though patients have high faecal calprotectin level, which is characteristic of GI inflammation, they may not necessarily have associated symptoms [7]. This provides evidence that there can be increased inflammatory activity in normal subjects associated with obesity. 4.3 Drug use and GI inflammation The main objective of this study is to investigate drug use and GI inflammation. Referring to Table 3.21, a statistically significant correlation was not noted between drug use and calprotectin level (p>0.05). It should be noted that in this study, none of the participants had calprotectin levels higher than 620 pg/ mL, which is the cut off point for this ELISA kit. This implies that no participant suffered from GI inflammation. With reference to Table 3.5, the maximum calprotectin level recorded is 300pg/mL. The mean calprotectin level is 97.3 pg/mL. Referring to Table 3.4, 10.2% participants consume hypoglycaemic drugs while 9.1% use both hypoglycaemic and antihypertensive drugs. Yet, no correlation was found between drug use and GI inflammation (Table 3.21). With reference to Figure 3.19, 39.77% participants use drugs daily. However, no statistically significant correlation was noted between duration of therapy and calprotectin level (p > 0.05) (Table 3.22). This suggests that duration of drug therapy does not influence calprotectin level and hence GI inflammation. Other factors such as frequency of therapy with a given drug or whether the drug is brand or generic also do not affect calprotectin levels (Table 3.22). One study reported that low-dose aspirin treatment does not increase faecal calprotectin levels, although the use of NSAIDs might cause a rise in calprotectin concentrations due to NSAID-induced enteropathy in patients without IBD [39]. This study shows that aspirin does not increase calprotectin level; however, it also demonstrates that NSAIDs do not increase calprotectin level as no participant taking NSAIDs had calprotectin level above the cut off value. 4.4 Signs and symptoms of GI inflammation and calprotectin level With reference to Figure 3.13, 37.50% of the participants stated that they have suffered from GI inflammation in the past. Among those who have suffered from inflammation in the past, 17.05% suffered from gastritis while 11.36% suffered from inflammation of the intestine (Figure 3.14). Some participants have recently suffered from signs and symptoms of GI inflammation such as abdominal pain. Referring to Table 3.3, it can be seen that 27.3% participants suffered from no signs and symptoms of GI inflammation. Another 27.3% stated that they suffered from diarrhoea, abdominal pain and flatulence recently. These are clinical symptoms of GI inflammation. However, despite this fact, no statistically significant correlation was noted between signs symptoms of GI inflammation and calprotectin level (p>0.05) (Table 3.20). Despite this fact that participants clinically suffered from signs and symptoms of GI inflammation, no calprotectin level above the cut-off point of 620 g/mL (Table 3.5) was detected. Although clinical signs symptoms of GI inflammation were present, the calprotectin level might not have risen to a concentration high enough to be detected by the ELISA kit. This may account for calprotectin levels below the cut-off value. In addition, among those suffering from signs and symptoms of GI inflammation, 29.55% of them ultimately took drugs to alleviate these symptoms (Figure 3.15). Furthermore, Figure 3.16 depicts that among those suffering from signs symptoms of GI inflammation, in 57.95% cases, they were acute while in 13.64% cases, these signs and symptoms were chronic. These two factors might have contributed to the fact that no correlation is seen between calprotectin level and signs of GI inflammation as these drugs might have attenuated the inflammation, if ever present, which could have resulted in calprotectin levels below the cut-off point. Moreover, since the inflammation they suffered from was mostly acute, this might imply that the calprotectin level might not have reached a concentration high enough to be detected by the ELISA kit. 4.5 Calprotectin level With reference to Table 3.5, it can be seen that the minimum calprotectin level recorded was 20pg/mL while the maximum level recorded is 300pg/mL. The table also demonstrates that 15.9% of participants had calprotectin level of 80pg/mL. However, we can conclude that none of the participants suffered from GI inflammation because in no case, the calprotectin level exceeded 620pg/mL, which is the cut-off point for this ELISA kit. Only values above 620pg/mL indicate that GI inflammation is detected. Otherwise for all values below 620pg/mL, it suggests that GI inflammation is absent. Another study reported that the normal range for calprotectin is 52.8-352.9 ÃŽÂ ¼g/mL, meaning that levels of calprotectin above 352.9 ÃŽÂ ¼g/ mL should be considered positive for GI inflammation [109]. This shows that there is inter-kit variation for cut-off points for calprotectin level.

The Sans-Cullotes During the French Revolution :: History

The Sans-Cullotes During the French Revolution 1793 was an important year during the French Revolution, king Louis XVI was executed for his perjury, amongst other crimes. A month later, France declared war on Great Britain, causing food riots in Paris. There were also various "Federalist" revolts that erupted in many important provincial centres against Paris domination. The source is a public document, due to the fact that it was published in a newspaper, "Le Pà ¨re Duchesne". "Pà ¨re Duchesne" was a name given to certain pamphleteers, who became the voice of the "sans-culottes", pro-revolutionary town folk that didn't wear breeches, but wore workmen's trousers as a political gesture amongst the working class civilians. "Le Pà ¨re Duchesne" was written and published by Jacques-Renà © Hà ©bert, a French journalist and revolutionary, he gained the support of the working classes through his newspaper and was prominent in the Cordeliers. Hà ©bert was obviously interested in gaining political power through the general public with his pro-revolutionary views, however, eventually he was sentenced to death by the tribunal on the charge of formenting insurrection. Jacques-Renà © Hà ©bert provides useful information in the extract taken from "Le Pà ¨re Duchesne", on the "sans-culottes". He gives fairly detailed descriptions on who the "sans-culottes" really were: "The sans-culotte is useful because he knows how to plough a field, to forge iron, use a saw, to file, to roof a house, to make shoes-and to spill his blood to the last drop for the safety of the Republic" In the first paragraph of the extract, "the cream of sans-culotterie", is used to describe the finest of the working class "sans-culottes". This phrase is immediatly followed by, "the garrets of the working-men", in this case the word "garrets", means the attics or rooms in a roof. At the bottom of the first paragraph the author, mentions "l'Ami des Lois", this was a French theatrical comedy at the time, followed by "Chaste Suzanne", which was a popular operetta. "The citizenesses in the gallery", is used in the second paragraph to describe the women that the upper-class men would seek to win approval of. In the final paragraph, "the sans-culotte always has his sword with the edge sharpened, ready to cut off the ears of all opponents of the Revolution", is symbolic for uprising and anger of the pro-revolutionary "sans-culottes". In the extract, the testimony that the author, Jacques-Renà © Hà ©bert, wishes to convey is that, although the "sans-culottes", are lower, working-class citizens, they are still important and essential to the French Republic.

Otto Van Bismarck And State So :: essays research papers

Bismarck used the media to his advantage. He used it only when it suited him, and never realized that the implications he were presenting were wrong. When world depression in 1875 hit, and assassination attempts were made on the Kaiser, Bismarck engineered an outpouring loyalty from the nation to the Kaiser ~ anyone who opposed him or the Kaiser was characterized as a traitor, and disloyal. In 1878, an election proved Bismarck’s ideologies to be used truly to his advantage. Because emotions ran high during the assassination attempts, Bismarck was able to put together a coalition of conservative deputies that gave him a large majority and put the Reichstag in his “ultimate plan';. Because of his control on the media, and the way he took advantage of his situations, he was able to put off his masterful plans in the government, without being caught. He was walking a very thin line, and it is this trait that led him to his downfall. Many times, Bismarck used foreign policy to insure German security. It is especially clear, when we read that history on the three emperors and the dual alliance. Because Germany was in the center of Europe, it had powerful neighbors along its borders. Germany did not want to fight against Russia and France at the same time, and fights two battlefronts could lead to the destruction of Germany. France alone had no immediate threat, but if, by chance, it formed an alliance, Germany would be in grave danger. To prevent this, Bismarck sought out two other countries ~ Germany, Russia and Austria-Hungary, to make the three emperor’s league. As well, the dual alliance made in 1879 proved to be another point where Bismarck used foreign policy to his benefit. To start his defense strategy, Germany called upon Austria-Hungary to come to each other’s defense in case of war and attack from another power. As a result of this strategy, it led to the renewal of the three emperors league in 1881. Again, Bismarck continued in his treaties, and signed in 1887 the Reinsurance treaty. This treaty involved Russia. Although these alliances may seem deceitful, it protected Germany and made Europe peaceful, which was Bismarck’s goal from the start. Bismarck clearly used state socialism in the building of the German nation. He recognized the needs of the working classes, and brought forward a series of welfare concepts initiated at the support of the workers away from unions. Otto Van Bismarck And State So :: essays research papers Bismarck used the media to his advantage. He used it only when it suited him, and never realized that the implications he were presenting were wrong. When world depression in 1875 hit, and assassination attempts were made on the Kaiser, Bismarck engineered an outpouring loyalty from the nation to the Kaiser ~ anyone who opposed him or the Kaiser was characterized as a traitor, and disloyal. In 1878, an election proved Bismarck’s ideologies to be used truly to his advantage. Because emotions ran high during the assassination attempts, Bismarck was able to put together a coalition of conservative deputies that gave him a large majority and put the Reichstag in his “ultimate plan';. Because of his control on the media, and the way he took advantage of his situations, he was able to put off his masterful plans in the government, without being caught. He was walking a very thin line, and it is this trait that led him to his downfall. Many times, Bismarck used foreign policy to insure German security. It is especially clear, when we read that history on the three emperors and the dual alliance. Because Germany was in the center of Europe, it had powerful neighbors along its borders. Germany did not want to fight against Russia and France at the same time, and fights two battlefronts could lead to the destruction of Germany. France alone had no immediate threat, but if, by chance, it formed an alliance, Germany would be in grave danger. To prevent this, Bismarck sought out two other countries ~ Germany, Russia and Austria-Hungary, to make the three emperor’s league. As well, the dual alliance made in 1879 proved to be another point where Bismarck used foreign policy to his benefit. To start his defense strategy, Germany called upon Austria-Hungary to come to each other’s defense in case of war and attack from another power. As a result of this strategy, it led to the renewal of the three emperors league in 1881. Again, Bismarck continued in his treaties, and signed in 1887 the Reinsurance treaty. This treaty involved Russia. Although these alliances may seem deceitful, it protected Germany and made Europe peaceful, which was Bismarck’s goal from the start. Bismarck clearly used state socialism in the building of the German nation. He recognized the needs of the working classes, and brought forward a series of welfare concepts initiated at the support of the workers away from unions.

Marketing Anti-Depressants: Prozac and Paxil Essay

The expiration of Prozac’s patent necessitates swift, defensive action from all companies in the SSRI industry. As generics enter the market, demand for more expensive, branded medications will fall as price sensitive consumers switch to the cheaper alternatives. Additionally, incident prices on consumers themselves, in the form of copayments, will rise as insurance companies pressure their constituents to switch to more cost-effective offerings. To overcome these obstacles, we recommend the following to both GSK and Lily: 1. A decisive repositioning of the brand to emphasize its advantages over market substitutes. 2. The rapid deployment of new inclinations to support previous point while simultaneously addressing the issue of competition. Background: Prozac’s early success stemmed from its value proposition of effectiveness and relative safety, compared to the current brands on the market. Prozac involved minimal side effects and was easy to self-administer, in contrast to the dangers associated with the Tricyclics and MAOIs on the market at the time. Prozac first segmented and targeted psychiatrists who were the main prescribers of anti-depressant medications then. After Prozac’s reputation grew, they targeted the general practitioners who were comfortable prescribing such a safe drug requiring minimal doctor supervision, thereby eliminating the need to send patients to costly specialists. Once the FDA relaxed rules on advertising prescription drugs, Prozac targeted the general public with a series of advertising campaigns. Furthermore, Prozac initially positioned itself simply as an anti-depressant treatment but soon expanded to a cure-all drug, treating issues ranging from OCD to compulsive gambling. Originally positioned as an alternative to Prozac, an SSRI called â€Å"Paxil† was introduced in 1993. Like Prozac, Paxil was effective for various illnesses, could be taken once a day, and had comparable side effects. However, an opportunity to market and develop an unknown emerged in 1999 when Paxil became the â€Å"first and only† medication to receive FDA approval in treating social anxiety disorder (SAD). SmithKline Beecham changed its marketing plan, with a new focus on heightening SAD public awareness. An aggressive campaign was launched and supplemented by direct-to-consumer advertising, focused almost entirely on the disorder, rather than the drug. The next year, SmithKline Beecham merged with Glaxo Wellcome to position themselves as one of the world’s largest pharmaceutical companies, known as GlaxoSmithKline (GSK), enabling a significant increase in their DTC advertising budget which in turn triggered roughly $1. 6 billion in sales. Recommendations: Although Paxil’s patent does not expire for several years, it will be significantly and similarly affected by the expiration of Prozac’s patent. Therefore, its reactive strategy to the nullification of Prozac’s exclusivity should be very similar, on a conceptual level, to what we are proposing to Lily. The foremost concern for both Paxil and Prozac will be repositioning. Paxil has the advantage of remaining an exclusive brand and thus does not face the immediate concern of losing existing customers to a direct generic replacement. However, Paxil must stress its unique benefits to new customers to stay competitive with other brands and generic forms of Prozac. Towards this end, we recommend that Paxil reorient its DTC marketing strategy to target those who suffer from illnesses uniquely treatable by Paxil, specifically SAD and Generalized Anxiety Disorder (GAD). In addition, GSK should heavily emphasize the advantages of its newly approved controlled release variant, particularly decreased side effects. Finally, practitioner advertising should be increased and similarly targeted. These measures will ensure that potential customers suffering from SAD or GAD will be more likely to both recognize their illness and purchase the GSK product. Even more, consumers may be drawn from other brands attributable to the promise of decreased side effects. Similarly, Lily should put heavy emphasis on their new, weekly variant of Prozac. Additionally, following the introduction of generics, Prozac should focus its marketing strategy around PMMD. Basis for Recommendation: The population of people suffering from the two adds up to 9. 3 million Americans (minus overlap for people who suffer from both), about 6. 5% of the adult population in America (Exhibit 5). With the incredible versatility Paxil has had treating various conditions, these two aforementioned conditions, both relatively new, have not gotten the attention from GSK that it really should garner given the fact that no other company can attract people in this state. GSK must look to re-position itself as a figure-head, a trailblazer in the field of SAD and GAD to build a strong market share now and develop brand loyalty to off-set, as best they can, the impending downturn brought on by future generics for the product. Based on the regression we conducted using data from Exibit 12 , we believe that DTC advertising presents an effective way to increase both company’s bottom lines. Looking at the data for prescription drugs, a $1 million investment will, on average, yield a $14. million increase in sales for the product alone. That is a pretty sizeable increase and the model proves that there is a strong correlation between DTC advertising and sales. This does seem reasonable, especially given the companies’ proclivity toward airing late-night infomercials (a form of DTC) when a large group of depressed patients are watching, leading them to go into the doctor’s office the next time, recall the product they were exposed to by t he ad, and request to have it prescribed. Paxil gets about $19. 6 million dollars return on a $1 million investment in DTC advertising. Similarly, Prozac should run a similar type of advertising campaign. Since they do not show up in the statistics in Exhibit 12, they should be slightly more hesitant to go all-in on the investment but should incrementally invest and see which direction it takes sales; all signs point to a solid return for Prozac which already has a solid brand image and loyalty. Lastly, with the advent of the generic, both Paxil and Prozac have to seriously consider lowering their prices to a competitive level to keep pace somewhat with the much cheaper generic, Prozac needing to do so more because of its $14 higher price-tag of $79. 20 to Paxil’s $65. 70. With this market penetration pricing, and within a reasonable interval, consumers will be willing to pay that extra bit because they are comfortable with the brand and value its credibility and integrity. Plus, once consumers see a decrease in price, even with a cheaper generic option, those who are price-sensitive but satisfied users of Paxil or Prozac will see discount  and feel like they did not have to change their buying patterns but saved money. The fact is Prozac and Paxil may completely lose out on their market share in the fields the generic has access to unless the respective companies make calculated, practical price cuts. Although Lilly and GSK’s hands are forced, they still stand to benefit greatly for this market penetration pricing strategy.

Reasons for Studying English Translation Essay

Translation studies, in recent years, have become more prominent among different fields of study. Each year with more journals and essays being published concerning this major, more attention is focused on it and more students are attracted towards it. There are different reasons for people to focus on this field of study. Reasons such as field of interest, communication aims, job opportunities, etc are some of them which are explained in what follows. The firs reason for most translation students is that this major is included in their field of interest. This is an innate ability in some people to learn different languages easier and faster and therefore to make use of them to convey their messages and ideas to other people with different languages from theirs. In other words they enjoy communicating with people in two or more languages, so they might follow their interests and choose this major. The next is that the need for communication among people and governments increases day by day. People of different nations need to know about sciences and technologies newly discovered. To keep them informed about these new events, governments need translators to convey their scientists’ findings to the languages of other nations. This is also true about different cultures of different countries. All in all translation studies has made the communication between cultures and nation easier and more purposeful. Moreover, since this is a major involved in different majors and people need translators to translate contents of other sciences to other languages, there often seems to be many job opportunities for those interested in this subject matter. In short, it should be taken into consideration that different people have different reasons for choosing this major. But whatever the reasons might be translation studies has found its way among different majors and will progress to make communication even better and easier.

Healthcare Management Essay

Executive Summary There are over 850,000 physicians practicing in the United States today, covering every imaginable specialty and sub-specialty (Young, Chaudhry, Rhyne, & Dugan, 2011). According to the World Health Organization (2000), even though our country spends more money per capita than any other country in the world, the USA ranks 37 out of the top 191 countries in the world in terms of overall health system performance. Although there are many reasons for this poor performance, several experts cite the lack of emphasis on primary care and true preventative medicine in the US (The Commonwealth Fund Commission on a High Performance Health System, 2011). This is a proposal to create a community ambulatory health center in a suburban community that would provide the setting for training family medicine residents. The establishment of such a center would allow a hospital to provide better primary care services to the uninsured and underinsured patients in its community. It may also help reduce unnecessary emergency room visits as well as hospital readmissions by providing quality care to these patients. A training program would also improve the hospital’s ability to recruit and retain actively admitting primary care physicians. The proposal discusses the process for choosing the center’s location, funding models, administrative structures, as well as staffing and architectural requirements. Strategy of Service Lines and Location As mentioned in the executive summary, it is well known that many communities in the US could benefit from increased access to primary care services (Commonwealth Fund Commission, 2011). Even within suburban communities that may appear seemingly affluent, there are often significant socioeconomically challenged populations. The parent hospital would have to conduct a SWOT analysis, to identify its strengths, weaknesses, opportunities, and threats (Longest & Darr, 2008). In this case, the presence of a family medicine residency program is a great strength, both in clinical and economic ways. Family medicine residents (and their faculty) are well versed in current, best standards of care. Graduate medical education often provides significant revenue streams, as described below. Up to four residents can work under the supervision of a single faculty  physician; often the number of patients seen in a residency clinic far exceeds that of a private office. Weaknesses include the presence of other residency clinics in the region, as well as difficulties recruiting quality residents to a new training program that has no established reputation. It can also be difficult to recruit and retain skilled and motivated faculty physicians for progams, as the compensation for such academic positions is often less than that of purely clinical posts. Threats to this proposal include changes in GME funding (external environment) and the possibility of the residency program losing its accreditation (internal and external environment). In scanning the external environment of the organization, it is possible to identify specific geographic locations that have significant numbers of uninsured/underinsured patients (but still within the hospital’s catchment area). It would also have to be convenient to public transportation, such as bus stops, subway stations, or railroad stations. Analysis of the various economic, political, demographic, and regulatory sectors would also identify the best time and location to create such a clinic. Significant forecasting would also have to confirm that the current external environment would not change in a way that would significantly worsen the chances for the clinic’s success. The creation of this new community health center would fall under the hospital’s directional strategy, as most hospital’s mission and vision statements include caring for the needy in their communities (Longest & Darr, 2008). Management and Personnel Structure Being a hospital-owned facility, a hospital administrator would be the senior manager / liaison; this would most likely be the Vice President for Ambulatory Affairs or Chief Medical Officer. The organization itself would have two chief administrators reporting to the hospital liaison; an Administrative Director (who would be the middle manager responsible for the overall management and vision of the center) and a Medical Director (who would be responsible for clinical activities, supervision, and initiatives). The Medical Director might well be the hospital’s department Chair of Family Medicine. The family medicine residency program would require a full-time physician serving as both Director of Medical Education and residency Program Director. The residency itself would have 24 residents.  In order to maintain an appropriate ratio of preceptors to trainees, there would need to be at least 4 full-time faculty attending physicians (American Osteopathic Association, 2011) An office supervisor (first-level manager) would be responsible for the day-to-day operations in the front (reception) and back (finance) portions of the office. In the front office, the practice would need 3 receptionists who would register patients upon their arrival and answer telephone calls. They would also verify patients’ insurance status. The back office would require 2 coders who would be responsible for verifying correct coding for practice visits, submit claims, and process payments from both patients and third-party payors. Another clerical staff member would be needed to process pre-authorizations and referrals (both incoming and outgoing). Finally, a charting person would be needed (even in an electronic medical record-equipped practice) to accommodate incoming paper / faxed documents. The middle (clinical) part of the office, would require 2 medical assistants who would be responsible for bringing patients from the waiting room into the appropriate area (exam room, laboratory, or procedure room) and triage them (taking and recording vital signs, documenting the chief complaint, and verifying medications and allergies). A registered nurse and licensed practical nurse would be needed to administer vaccinations and medications. Finally, a phlebotomist / lab assistant would be needed to perform venipuncture’s, prepare specimens, and perform CLIA-waived tests. The registered nurse would also serve as the Clinical Supervisor (first-level manager) for the clinical support staff. Funding Model Medicare is the primary formal financier of graduate medical education programs, contributing 72 percent of all tax-financed support. Other federal payors include Medicaid (11 percent), the U.S. Department of Veterans Affairs (10 percent), the U.S. Department of Defense (3 percent), and the Bureau of Health Professions (3 percent) (Young & Coffman, 1998). A teaching hospital will receive direct medical education (DME) payments cover the cost of resident and faculty stipends and benefits, and overhead costs that are directly related to the teaching programs, such as ambulatory  office space. Hospitals also receive funding for indirect medical education (IME) costs because teaching hospitals have more complex case mixes, more uninsured patients, and provided services that were costly but not necessarily well reimbursed, such as trauma centers and transplants units (Cymet & Chow, 2011). These payments are, on average, total $100,000 per resident per year. However, over the last 20 years, the federal government has either frozen GME funding or in some cases, reduced it significantly (especially under the Balanced Budget Act of 1997) (Phillips, et al., 2004). Currently, the family medicine residents in this proposal do result in a net gain for the hospital. With an average salary of $45,000 plus $20,000 in benefits, the hospital stands to net $35,000 per resident. For a program of 24 residents (8 in each year), the hospital would have a net income of $840,000 from Medicare GME funding. Each of the faculty physicians would have their own clinical practice (about 0.25 FTE), so they would bill Medicare and third-party payors for their services. They would have a productivity plan whereby each month they would receive 25% of their revenue after fulfilling their monthly salary/benefit costs. Physical Characteristics / Layout of the Facility Because of the educational nature of the practice (i.e. a residency teaching clinic), the physical layout of the facility has specific needs. In the front portion of the office, the waiting room needs to have ample seating to allow for extended wait times associated with teaching clinics. The waiting room would also have to be child-friendly, with easily disinfected toys (i.e. no stuffed animals). Because many potential patients will have to apply for Medicaid or hospital-based charity programs, it would be ideal to have an office (or at least a kiosk) where a financial coordinator could meet with patients in a private area. Since this would be a multi-specialty practice with dozens of residents and attending physicians, there would need to be a large number of exam rooms, perhaps 18, all with exam tables equipped with stirrups to accommodate pelvic exams, Pap smears, and STD testing. There would also need to be a large procedure room to accommodate the need for various gynecological (colposcopy, endometrial biopsy, IUD placement/removal, etc.) and other types of procedures (suturing, biopsies. etc.). The center would also have a spacious area dedicated to residents for  charting and research, as well as two precepting rooms where clinical cases can be discussed with faculty physicians. There would be a conference room equipped with a computer and LCD projector for presentations and discussions. Numerous computer workstations throughout the clinic would allow access to an electronic medical records system. One exam room could be equipped for videotaping that is used (with the patient’s permission) to observe residents as they demonstrate the core competencies while providing patient care. The center would need a laboratory for the collection and processing of blood and other specimens. In order to avoid the same stringent regulations and testing associate with a hospital or reference laboratory, the center would only perform CLIA-waived tests such as finger-stick blood glucose testing, throat cultures, and urine dipstick analysis (CDC and CMS, 2006). The building would al so ideally have offices for each of the faculty attending physicians, as well as for administrative and support staff. Clinical Practice As mentioned previously, this community health center would offer multiple specialties. The main service would be primary care. Family medicine residents, under the supervision of faculty preceptors, would provide general internal medical, pediatric, obstetric (pre- and post-natal), and gynecologic care to patients of all ages. Additionally, other specialty physicians would be available for special â€Å"clinics†: obstetrics (perinatal) and advanced gynecology twice a week, dermatology once a week, and general surgery, gastroenterology, pulmonology, cardiology, and urology once a month. These specialty services are essential in serving the needs of the target population: uninsured and underinsured (i.e. Medicaid) patients who are unable to see these specialists in private practice. Credentialing The Chair of Family Medicine is responsible for maintaining records of each attending physician’s credentials. These would include a New York State Medical License (with updated registration), DEA registration (to prescribe controlled substances), copies of medical school and residency diplomas, proof of board certification (and maintenance), records of continuing  medical education, and CPR/Advanced Cardiac Life Support training cards. The Director of Medical Education / Residency Program Director is responsible for maintaining records for each resident physician such as their medical school diplomas/transcripts, licensing examination transcripts, ACLS training, and signed residency contracts. Local zoning and legal concerns Consideration must be given as to the choice of commercial property for this ambulatory health center. The ideal location would be a pre-existing medical office building that has already been zoned for a medical practice, and has the required number of parking spaces (especially handicapped) and adequate access in and out of the building. A multi-level building must have elevators that are compliant with ADA (Americans with Disabilities Act) regulations. In County, a Certificate of Need must be granted before a new healthcare facility can be built. There are also village and town zoning ordinances that must be considered when modifying or creating a medical office building . The center would fall under the jurisdiction of the same regulatory bodies as that of its parent hospital, and would be setup as a not-for-profit organization, since a significant portion of its care would be uncompensated.