An Essay on the History of Pickles

Let us commence a journey into the much travelled topic of history of pickles. In depth analysis of history of pickles can be an enriching experience. While it is becoming a hot topic for debate, spasmodically it returns to create a new passion amongst those who study its history. Since it was first compared to antidisestablishmentarianism much has been said concerning history of pickles by socialists, obviously. In the light of this I will break down the issues in order to give each of them the thought that they fully deserve Social FactorsSociety is a simple word with a very complex definition. Back when Vealinger reamarked ‘the power struggle will continue while the great tale of humanity remains untold’ [1] he failed to understand that if one seriously intends to ‘not judge a book by its cover', then one must read a lot of books. Much has been said about the influence of the media on history of pickles. Observers claim it is crunchy on the outside but soft in t he middle. Did I mention how lovely history of pickles is? It is intrinsically linked to adolescent inner acclimatisation. Economic FactorsIs unemployment inherently bad for an economy? Yes. We will primarily be focusing on the Custard-Not-Mustard model, making allowances for recent changes in interest rates. Inflation history of pickles It is apparent from the graph that the influence of history of pickles is strong. What is the secret to its strength? Of course inflation, ultimately decided by politicians, will always be heavily influenced by history of pickles due to its consistently high profile in the portfolio of investors. Supply Side Economic Tax Cuts Tax deductions could turn out to be a risky tactic. Political FactorsPolitics has in some areas been seen to embrace an increasing ananiathesis of intergovernmentalism leading to neo-functionalism. Placing theory on the scales of justice and weighing it against practice can produce similar results to contrasting 0 In the words of that most brilliant mind Augstin Lionel Forbes Dickinson ‘political change changes politics, but where does it go? ‘ [2] This quotation leads me to suspect that he was not unaccustomed to history of pickles. It speaks volumes. If I may be as bold as to paraphrase, he was saying that ‘political ideals are built on the solid cornerstone of history of pickles. Where do we go from here? Only time will tell. Conclusion In conclusion, history of pickles plays a large part in the lives of all. It brings peace, puts out ‘fires', and figures show it's a winning formular. I'll leave you with this quote from Demi Lopez: ‘I wouldn't be where I am today without history of pickles. ‘ [3] [1] Vealinger – Turtle Power – 2003 ICJ [2] Dickinson – I Am The Dickinster – 1999 Hughs Books [3] Everything you always wanted to know about history of pickles, but were afraid to ask. – Issue 287 – QKS Publishing

Nell

Nell, a 26-year-old single lady ends up deserted by her beau in Paris one day. The hotel where she booked her room at, she finds that the room she has saved has been twofold reserved and ends up imparting the space to an American lady. Since Nell is an uncertain lady, she feels tentative about remaining in Paris and thinks about returning home, yet she chooses to remain when she discovers two tickets to a craftsmanship appear, left behind by an American lady. At the workmanship appear, Nell has a second experience with Fabian, a server and battling essayist whom she spilled her wine on the prior night. Discouraged over an ongoing separation and the loss of a large portion of his novel, that had been blown into the lanes of Paris the day preceding, Fabian winds up attracted to Nell when he recognizes her crying close to one of the canvases in the show. He approaches her out for an espresso, and she acknowledges. Here, the two associate sincerely and mentally, and Fabian requests that Nell go out with him that night to a bar where he is getting together with a couple of companions. Nell acknowledges. Before going out, Nell goes to a close-by shop and purchases another outfit since she needs to appear â€Å"Parisian.† At that point Fabian grabs Nell and takes her on a tornado voyage through Paris, and later they go to different bars, drinking and moving. They spend the whole night together, and they in the long run travel on the Seine, which is Fabian's dad's watercraft, the Rose de Paris. Fabian reveals to Nell that is father's business is enduring, and Nell recommends another strategy for success for the vessel, one outfitted towards giving sentimental, modified visits. Toward the beginning of the day, Fabian attempts to give Nell a kiss however, the two are hindered by the custodian of Nell's inn. Fabian asks Nell to supper. Meanwhile, Nell's companions back in England have found that Nell's beau, Peter, did not go on the outing since he needed to go out drinking with his companions. They constrain Peter on a plane that takes him to Paris. Nell spends her day strolling the boulevards of Paris with no specific arrangement, which is exceptionally bizarre, as she is generally extremely strict about making a motivation and adhering to it. Before coming back to the lodging she purchases the green dress. Later, Fabian picks her up and they begin strolling to a yard where Fabian has sitting tight for them a private supper with one of his companions dressed like a server. In transit, Nell got the telephone call that Peter is at the lodging. She pardons herself, and Fabian surmises that it is her boyfriend. At the hotel, Nell meets up with Peter, who is dressed carelessly and is hesitant to take Nell out to supper, expressing that he would want to have a snooze and room service. Nell is given a note by the attendant that clarifies that Peter had been constrained onto the plane by Nell's companions. After perusing this, Nell leaves Peter. Nell makes up for lost time with Fabian at a bar and the two rejoin and have an awesome time. Toward the night's end, they go to Fabian's condo, where Fabian peruses a few pages from a diary Nell has brought along, and Nell peruses pages of Fabian's novel. Fabian informs Nell regarding another original thought he has, which has a fundamental character fundamentally the same as Nell. Nell likes his thought then, they kiss, and Nell spends the night. Toward the beginning of the day Fabian strolls Nell home and they part without an arrangement to get together once more. A half year later, Nell gets an advancement at her activity. She is apathetic about it, and soon thereafter when she is giving an introduction to people keen on discovering work in her organization she closes the introduction by disclosing to them how dull corporate presence is. Later, Nell leaves the room, goes to the PC, and looks into Fabian's dad's watercraft. She finds that Fabian's dad had utilized her thought and that the vessel has become extremely famous. Nell considers her mom on the telephone and advises her mother to meet her at the movement office. Nell goes to Paris and sheets Fabian's dad's boat, yet Fabian isn't there. Nell discloses to Fabian's dad how she had succumbed to Fabian, and Fabian's dad calls Fabian. While orbiting the city, they discover Fabian looking out for one of Seine's scaffolds, and he hops into the pontoon. He reveals to Nell that he has a distributor for Fabian's new novel. Nell questions him on how it closures and he reveals to her he let the characters choose. The book closes with Nell revealing to Fabian the amount she constantly enjoyed cheerful endings.

Reflection Essay Example | Topics and Well Written Essays - 250 words

Reflection - Essay Example For students and teachers in academia, internet has become not only a boon but an indispensable part of life. Information retrieval from sites like sweetsearch, spezify, Google, Google scholar, wolfram alpha and itunes has become a child’s play. These are interesting but important search engines which can provide one with huge data of information of specific topic. If one starts to search for ‘delicious’ in these search engines, one would get from information from books, blogs, cooking, apple downloads to the smallest but repulsive creature which could be found delicious by some tribe! The wide scope of word ‘delicious’ defies imagination and would become most confusing if it is not affixed with some criteria like book, music or even a place. So one needs to use technology with great care and seek information that is specific. The internet has provided us with huge database of knowledge that can be accessed with the press of few buttons. The more one uses it, the more proficient one becomes so everyone in academia is advised to make the best of technology. (words: 277)

Chose a subject of popular culture and analyze this subject using Essay

Chose a subject of popular culture and analyze this subject using course concepts - Essay Example ra of Swing music, and thus this paper helps to give an insight about the musical genius’ life and subsequent contributions towards culture and also how the socio-economic, political and historical factors played a role in making significant changes towards the same. Bessie Smith’s inherent passion for music was discovered fortunately at a very young age as she and her brother took to the streets of their local neighbourhoods in Chattanoonga, as they sang and danced in order to earn money for their meals. However, her brother soon left her to join a professional troupe and she was left behind due to being very young. Soon enough, her brother arranged for a meeting and interview for Bessie for the Stokes Troupe and she was hired as a dancer but not as a singer, thus her true potential had yet not been realised. In 1915, the singer left and became a part of the Theater Owners Bookers Association, an African American performance group and this became the milestone in her career. The group helped her to gain popularity all over and become a recognised singer. Following this, offers began coming in for Bessie to be part of musicals and one of her firsts, titled ‘How Come?’ made its way to Broadway as well. Here, Bessie co starred with Sidney Bechet. Looking at her success and getting motivated by the same, Smith moved on to working in theatre, mostly Black theatres as they accepted her better, and in 1923 she landed with her first recording contract. Soon enough, Bessie became one of the highest paid black women in her field however, the money did not make much difference to her life then and she realised she wanted to sing all her life. Smith’s voice, mellifluous and harmonious, was something she was able to practice and develop on her own. She did not receive any formal training from anywhere, and with the practice she had had since her early years, she dedicated and devoted more time to get even better than what she was and all that she had

Why Sport Sponsorship is important for a company marketing strategy Dissertation

Why Sport Sponsorship is important for a company marketing strategy - Dissertation Example In addition to this, the research work also aims at understanding the influence of sports sponsorship on target audience. In this study, the researcher has selected a mixed research approach for this study, which includes both qualitative and quantitative research approaches. Following this approach, the study includes interview with manager of Nike and survey of Manchester United fans. The interview responses are analyzed on the basis of thematic analysis approach, whereas responses from survey are analysed statistically, which include descriptive and regression analysis of the responses. The study has concluded that sports sponsorship has a significant importance for business entities, particularly Nike, which has been considered in this study. The findings of the study have concluded marketers regard sponsorship as a significant marketing tool. In addition to this, an overall positive impact of sports sponsorship of Nike has been observed on its brand identity. In today’s b usiness world, marketers are in continuous search of new avenues which can be used to promote their products and services and therefore gain new customer bases or retain existing ones (Kotler & Armstrong, 2008; Farris et al., 2010). Sports sponsorship is a modern marketing tool, which is nowadays used extensively by a number of large business enterprises (Ferrand et al., 2007). Sports are today regarded as global events and when bearing sponsors they possess the potential to promote brands all over the world. Sponsorship is often viewed as an entirely different activity in comparison with promotion. This difference in viewing these two mediums of marketing is based on the fact that promotions are considered and used as a direct marketing tool which targets specific customer bases, whereas sponsorships are regarded as part of a company’s corporate social responsibility activities. As for instance, in sporting events sponsors pay significant amounts of money to help organizers to successfully arrange the event and entertain general public (Boyle & Haynes, 2009). However, notwithstanding the direct and indirect nature of promotions and sponsorships, corporate entities are always keen to gain from anything they do. Keeping aside the less direct nature of sponsorship, the underlying objectives are purely based on marketing principles. Building brand’s identity, equity, awareness, values, etc. is all what marketers seek through any channel of marketing (Ferrand et al., 2007). Moreover, with fierce competition all over the globe and increase in globalization and its effects, marketers have turned sports sponsorship activities into large scale marketing campaigns (Boyle & Haynes, 2009). 1.2. Research Aim The broad aim of this research work is to determine the

Short Report on Ancient Athens Essay Example | Topics and Well Written Essays - 500 words

Short Report on Ancient Athens - Essay Example Finally it concludes that the system was indeed democratic. The assembly, court, and council comprised the political institutions which governed ancient Athens. Throughout the history of Athens, the assembly remained the main avenue for political activity. It functioned to protect the integrity and security of the city state. It also had the power to negotiate or break treaties with foreign powers. The council was responsible for preparing the laws which would be passed by the assembly. The legal system was extensive and developed for that time period. The total population of Athens is reported to be around three hundred thousand people. Out of this population an estimate fifty thousand males were eligible for voting and participating in the political system. Pericles said in a speech that the Athenian system of government favored the majority of the citizens (â€Å"Pericles Funeral Oration†). One problem faced by the Athenian democracy was the clash between the court and assembly. A law was passed in 416 BC in which the courts could block or veto any law passed by the assembly. Any assembly member who had proposed the law could also be punished by the courts. This law restricted the power of the assembly. It also became a source of tension and frustration. Another problem faced by the city state was that ordinary citizens had too much power concentrated in running the affairs of the state. Pericles stated that the Athenian system provided â€Å"equal justice† for all of its citizens (â€Å"Pericles Funeral Oration†). The lack of professional civil servants, lawyers, judges, and politicians hindered the day to day affairs of the city state. It led to the inefficient allocation and use of resources as the citizens had direct power to pass or draft laws. An example of this would be the fact that amateur citizens could reduce taxes which might have been necessa ry for the survival of the government. The citizen initiator

Questions # 9 Essay Example | Topics and Well Written Essays - 1000 words

Questions # 9 - Essay Example e burden of explaining of showing that she receives relatively lower pay than a male co-employee, for undertaking work substantially equivalent in skill, effort and responsibility under the prevailing identical working circumstances (Johnson & Everhart, 2011). This comparison ought to be made factor by factor with an existing opposite comparator. Therefore, the formation of the prima facie case under the Equal Pay Act fundamentally hinges on the underlying selection of a proper comparator (Twomey, 2010). For instance in this case, John would be a proper comparator to Jena under the Equal Pay Act. This is because Jena was employed in order to handle complex accounting problems which required similar skills and responsibilities. Moreover, Jevan had more responsibilities than John (Johnson & Everhart, 2011). Under these prevailing facts, the court will definitely observe that Jena meet her burden of depicting that she undertook work substantially equivalent in skill, effort and responsibility under the working conditions similar to the John’s. Indeed, Jena undertook more than that she and John are paid different salaries. Therefore, she can put forth an adequate prima facie case under the Equal Pay Act. The outcome of the case falls firmly in the Fourth Circuit’s mainly established jurisprudence with regard to Equal Pay Act (Snell & Bohlander, 2013). In such cases Fourth Circuit is analyzed an Equal Pay Act claim within the higher education context. The court has affirmed either a grant of summary judgment or corresponding dismissal of the action based on the plaintiff’s failure to establish a prima facie (Twomey, 2010). Similarly, in cases where the prevailing plaintiff has identified a specific comparator, but the comparison clearly is an unsuitable one thus the Fourth Circuit must immediately uphold the summary of the judgment. In case Jena fails to establish a prima facie claim under the Act then it would be cumbersome for a plaintiff in an Equal Pay Act

Commercial Law Assignment Case Study Example | Topics and Well Written Essays - 2000 words

Commercial Law Assignment - Case Study Example In fact, he speaks very little English. This means that Nathan may not be able to make an informed bargain or decision, if he engages in a contract where the other party speaks English due to the limitation in language. On the other hand, John works as a sales representative with a telephone company known as Dubious Connections Pty Ltd. He sells telephone contracts. John was aware that Nathan knew nothing about telephone contracts and that he did not understand most of the matters that are discussed in English. Nathan was influenced to enter into a contract by John, as the latter told the former that there was a special promotion just for that day and that if the former signed that day, he was entitled to a free iOS7.1 telephone. Therefore, Nathan was under undue influence to enter into this contract, given that he did not understand much English to have the capacity of making an informed decision. In addition, John explained the main features of the contract, but he knew that Nathan did not understand most of the details. John did not offer to get an interpreter to explain the terms and conditions of the contract to Nathan, who thought he could terminate the contract any time and simply return the phone. Nathan was not aware that the contract was to run for three years, and terminating the contract at any time during this period, Nathan would have to pay the full contract price of $3,120, plus $ 800, which is the price of the iOS7.1 telephone. However, after two months into the contract, Nathan found out that the additional expense of the monthly phone bill was difficult to manage, given that he received a meager allowance from Red Cross. Nathan now wants to terminate the contract and return the phone. From the aforementioned issues, a determination whether there was a valid contract between Nathan and Dubious Connections Pty Ltd is made. Also, the remedies available to Natha n are outlined and discussed. Unconscionable conduct

Informal Reading Assessment Case Study Example | Topics and Well Written Essays - 1000 words

Informal Reading Assessment - Case Study Example III. GENERAL OBSERVATION †¢ Interpersonal response to the clinician On the examination day, john entered the assessment room when he was so frightened. He seemed to be scared because I was new to him. Moreover, the class teacher did not brief him about the assessment. After I explained in details the purpose of our meeting, john was extremely inquisitive to know why I was assessing him. In fact, he asked me if their class teacher was not qualified enough to conduct the assessment. I explained to him that all the other students were to undergo the same test. As I was about to start the test, I realized that John was busy trying to find out what was in my laptop. I asked him what his favorite class program was, and he told me about a cartoon TV program that he always watches at home in the evening. I listen to him so that he would feel appreciated. John answered short answer questions extremely well. However, I kept quiet and looked at the laptop when I asked him to explain some q uestions. This was expected because at his age, a child does not like challenging things or questions. †¢ Perceptiveness of the task of reading From how he read the passage in one of the story books, it was so evident that John enjoyed reading short passages. He could struggle to pronouns some long words and those with silent syllables. †¢ Attention and concentration during assessment John’s attention during the assessment was commendable. However, he was often distracted by the laptop, that made me realized that he likes computers and video games. The student’s overall grades levels are as follows Independent grade level was 0 miscues in word recognition, 90% miscue in comprehension and 0 miscue in listening level. This come to an average of 99% Instructional Grade level were 2 miscues in word recognition, 3 miscues in comprehension and 2 miscues in listening level. This come to an average of 90% Frustration Grade level were 8 miscues in word recognition, 49 % miscues in comprehension and 4 miscues in listening level. This come to an average of 90%=49%. It is very evident that the student’s performance is good. However, a few improvements should be made, since the student has a potential of performing higher than this. IV. Discussion on the assessment Word recognition results and graded word list John did not have many problems on the word list. In fact, all the questions on the word list for grade three were not an issue to him. He was able to handle them with a lot of ease. His frustration manifested on instructional and partly independent level, where he could miss the pronunciation of words whose syllables are almost similar. The greatest problem is where he could say the words that are particularly common in the text books whenever he sees a similar word. For example, it was†¦. For any sentence that start with It. This also resulted to confusion of words whose last syllables changes. For instance, he said enabled instea d of enabling. Another problem was reading long words. He had a habit of skipping such word because they were hard to pronounce. In addition, he would interchange the pronunciation of some words. For instance, t instead of d. this is attributed to the influence of child’s first language. Goal The teacher needs to give more concentration on john’s points of weaknesses. The best way to improve on such areas is giving more assignments on the same and monitoring him closely. The books

Compare and contrast mongol rule Essay Example for Free

Compare and contrast mongol rule Essay During the 12th and 13th centuries the Mongols swept across Eurasia and conquered various peoples, including the Persians and Chinese. There are many slmllarltles and differences In the political and economic effects of Mongol rule on the Abbasid Empire In Persia and on the Yuan Dynasty In china. In both regions, the Mongols were relatively tolerant of all religions. However, they differed in that the Mongols allowed Persia to have native administrators but did not allow China to. When the Mongols ruled in Persia and China, they respected all the religions they encountered. In Persia, the Mongols were attracted to Islam and overtime they ssimilated to it. The Mongols were intrigued by Muslim society and by the year 1295, the Persian khanate had converted to Islam. They built mosques throughout the region and returned Islam toa privileged position of Persian society. The Mongols were also tolerant of the other religions in Persia including. Nestorian Christianity, Buddhism and Judaism. In China as well, the Mongols respected all cultural and religious traditions. They began to adopt some of Chinese culture, like ancestor worship. Khubilai Khan even built temples for his predecessors, so he could practice ancestor worship. The Mongols tolerated religions and belief systems such as, Confucianism, Daoism, Buddhism and Christianity. They allowed churches, temples and shrines to be built, because they wanted to maintain a good relationship with the people ot the region. Although the Mongols tolerated Confucianism, they did not allow It to have official support. The Mongols effects on rellglon In Persia and china were quite similar. The Mongols ways of governing In Persia differed from how they governed In China. In Persia, the Mongols ruled using ideas from Persian bureaucracy. They set up many district and appointed provincial governors. The highest government positions were held by Mongols, but Persians were allowed to be government offcers at lower levels. Persians served as state officials, ministers and provincial governors. The Mongols allowed the Persians to govern the ilkhanate because they knew the Persians had a successful government and would be able to maintain order. However, the Mongols required the Persians to deliver tax receipts as a way of limiting Persian power. The Mongols set up government in China very differently than they had in Persia. The Mongols pushed native Chinese people to the bottom of the hierarchy. The Mongols got rid of Civil Service Exams because they thought there was no need for them. They did not make use of Chinese administrative talent; instead they had foreign administrators govern China. The governing staff included Persians, Arabs and some Europeans. The Mongols didnt want Chinese people to rule because all they wanted from China was to generate revenue and have the people be cultivators. The Mongols governed and treated the Chinese and Persian people very differently. The Mongols political and economic control on Persia and China were alike In some ways and unalike in others. The treatment and tolerance of religions in China ere very similar to that In Persia. Yet, the administrative control in Persia differed than the administrative control In China. The Mongols had multiple methods of ruling conquered regions, none 0T wnlcn were very successTul. However, tnrougnout the Mongols rule, they facilitated trade and encouraged long distance communication throughout Eurasia, which led to cultural diffusion that can still be seen today. Additionally, the Mongols support of Islam helped establish its popularity and encouraged its spread, which has contributed to Islam being the fastest growing and second largest religion.

The Blood Clotting Cascade Biology Essay

The Blood Clotting Cascade Biology Essay von Willebrand Factor is a large multimeric clotting protein which plays a significant role in the process of blood coagulation. It is mainly secreted by the vascular endothelial cells and also by megakaryocytes in the bone marrow. The vWF performs two important functions in the process of blood coagulation, and thats why it is very important. First, it is responsible in bringing together the elements to form the primary hemostatic plug. It serves as an anchor for platelets at the site of injury in the blood vessel. Second, it acts as a protective chaperone for Factor VIII, to avoid lysis by proteolytic agents in the blood. The Factor VIII also released by vWF at the site of injury, whereby it brings about the completion of the Intrinsic Pathway of blood coagulation, and seals the site of injury with Fibrin. von Willebrand Disease (vWD) is the most common inherited bleeding disorder in human beings the world over. Although, mutations in the vWF gene are responsible for the type of vWD in a patient, the transmission of vWD to the next generation is not solely linked to the vWF gene, but involves linkages with other genes such as the ABO blood type genes. The gene that encodes von Willebrand Factor is present on the short chromatid of chromosome 12, and is 178kb long with 52 exons or coding sites. Most of the exons are small, some as small as 41 base pairs (Schneppenheim, 2011). Exon 28, which has 1379 base pairs, is the largest. Mutations in the genes encoding vWF are primarily responsible for most vWD cases. Mutations can cause qualitative or quantitative deficiencies of vWF. Mutations in the vWF gene and the vWD that is attributed to the mutations are shown in Figure 1. C:UsersTj WorkDropboxTjBlood SensorThesisvWF Domains rot.jpg Figure : Upper panel: vWF Exons coding for the domains; Lower panel: Locations of mutations and their corrseponding vWD types The multimeric von Willebrand Factor contains identical subunits of 250kDa each. These subunits dimerize (into 500 kilo Daltons subunits) and then multimerize into clusters greater than 10 mega Daltons in weight (Sadler JE, 2006). The vWF performs two functions serve as an anchor for binding platelets to the site of injury and bind to and stabilize Factor VIII from degradation by proteases in the blood and presenting it only at the site of injury. A vWF monomer has a repeated domain structure S D1 D2 D D3 A1 A2 A3 D4 B1 B2 B3 C1 C2 CK (Figure 1). The monomer is 2813 amino acids long. At the N-terminal is the 22 amino acid long signal peptide. Domains D and D3 are specific to Factor VIII binding. Platelets bind to vWF at its A1domain with their Glycoprotein (GP)-1b surface receptors. The A3 domain is specific to collagen, predominantly type III (J. Siekmann, 1998). Thus, domains A1 and A3 are necessary and must be fully functional to form the primary hemostatic plug in the process of coagulation. Figure 2: Domains of vWF protein, (U.S. Department of Health and Human Services, 2007) Overview of the clotting cascade A brief overview of the blood clotting cascade is necessary to understand the function of vWF in the process of clotting. The process of blood coagulation involves platelets and clotting proteins. At the site of injury in a blood vessel, the subendothelial collagen (types I and III) in the extracellular matrix of the blood vessel is exposed to blood. vWF that is present in the blood binds to the exposed collagen with its A3 domain. The flow of blood causes the multimers of the anchored vWF to unfold and expose the sites of platelet binding on the A1 domain (Figure 2). The platelets bind to this domain with their Gp-Ib receptor proteins present on the platelet cell surface. The binding of platelets to vWF activates them and a chemical messenger Thromboxane A2 is released by the platelets. Thromboxane A2 at the site of injury attracts more platelets in the blood, and aids in platelet aggregation. Platelets flowing in the blood stream bind to the activated platelets with a surface prot ein Gp IIb/IIIa. Fibrinogen (Factor I) is present in between the GP-IIb/IIIa receptors of two platelets. Thus, a primary hemostatic plug, though weak in strength, is formed. Figure 3: Sequence of events of blood coagulation due to vWF (U.S. Department of Health and Human Services, 2007) The unfolding of the multimers of vWF also releases Factor VIII at the site of injury. In the Intrinsic pathway of coagulation, Factor VIII is essential in catalyzing the conversion of Factor IX to Factor X, and eventually, prothrombin is catalyzed to from thrombin. Thrombin catalyzes the conversion of Fibrinogen (Factor I) into Fibrin. The fibrin forms a thick proteinaceous mesh, which seals the loss of blood from the blood vessel, this completing the process of hemostasis. Tissue repair and wound healing ensues. von Willebrand Disease von Willebrand Disease (vWD) is a deficiency of von Willebrand Factor. Based on the quantitative and qualitative deficiency, it is classified into subtypes. Combinations of assays are done to detect vWF levels in human plasma. Results of these tests report vWF levels in International Units per deciliter (IU/dL). The plasma concentration of vWF in healthy individuals is reported to be at around 10Â µg/mL (Mannucci, 1998), and the corresponding IU measurement is 100 IU/dL. The classification of the vWD types is based on the criteria developed by the vWF Subcommittee of the International Society of Thrombosis and Haemostasis at Carrboro, North Carolina, USA in 1994. Annual meetings are held by ISTH to review diagnosis and management guidelines for vWD by experts all over the world. The standard guidelines for the diagnosis and treatment of vWD in the USA is based on the vWF Report by the National Heart, Lung and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services, which was released in 2007 by the expert panel on vWF, chaired by Dr. William L. Nichols, Jr., M.D. The ISTH holds annual meetings all over the world to discuss updates on vWD. The first vWD classification by the ISTH in 1994 was based on information about mutations on the vWF gene. However, because it was appropriate to only a small population of the human race, it was overruled in 2006 and was replaced by the new method based on response to treatment with DDAVP or other blood based therapeutics. vWD is classified based on qualitative and quantitative deficiencies. Partial quantitative deficiency is type 1 vWD and total quantitative deficiency is type 3. Qualitative deficiency is type 2, and is subdivided into types 2A, 2B, 2M and 2N based on the functions of the vWF which are affected. Quantitative deficiencies of vWF are discussed first types 1 and 3 vWD. The main laboratory tests to analyze vWF in patient samples are vWF:Antigen activity (vWF:Ag), Factor VIII: Coagulation activity (FVIII:C) and vWF: Ristocetin Cofactor activity (vWF:RCo). Type 1 vWD A patient with partial quantitative deficiency of vWD is diagnosed as type 1 vWD. The level of vWF in the plasma, though low, can still carry out the formation of the primary hemostatic plug, and also protect Factor VIII. In most type 1 vWD cases, Factor VIII levels are very mildly affected. It is hard to accurately diagnose type 1 vWD because, the vWF levels also depend on the ABO blood grouping. The average vWF level in healthy individuals with blood type O is about 75 IU/dL. It is reasonable to classify the condition of a patient with less than 20 IU/dL vWF level as type 1 vWD because this indicates a probable hereditary mutation. The vWF:Ag and vWF:RCo tests show similar reductions in vWF activity for type 1 vWD patients compared to the reference plasma by ISTH (U.S. Department of Health and Human Services, 2007). Type 3 vWD When the vWF activity of a plasma sample is less than 10 IU/dL, it is classified as type 3 vWD.84-86 Major mutations such as frameshifts, large deletions, splice-site mutations, and missense mutations can be causes for type 3 vWD (U.S. Department of Health and Human Services, 2007). Sometimes, clearance of vWF from the blood stream due to autoimmune disorders can decrease vWF quantity in the blood to type 3 levels of vWD. This is also one of the causes of of Acquired von Willebrand Syndrome AVWS. Type 2 vWD Type 2 vWD is a qualitative deficiency of vWF, where, although the vWF may be produced in normal quantities, fails to perform its tasks effectively. Based on the defect in the von Willebrand Factor, it is mainly classified into types 2A, 2B, 2M and 2N. In type 2A vWD, the vWF platelet binding activity is decreased due to the absence or deficiency of high molecular weight multimers of vWF. There is a sharp fall in the vWF:RCo activity, but not much decrease in vWF:Ag and FVIII:C activity. This is because the vWF is still able to bind to Factor VIII. (Ruggeri ZM, 1980) The high molecular weight multimers are either degraded by proteolytic enzymes in the blood or have not been produced due to mutations in the exons of the vWF gene that code for the A2 and/or the D3 domain. (Schneppenheim R, 2001), (Sutherland JJ, 2004) . Type 2B VWD is characterized by an abnormal increase in the vWF-platelet binding affinity, which leads to depletion of large, functional VWF multimers, and also a fall in platelet numbers (Zimmerman TS, 1986) The platelets circulating in the blood stream are blocked with the mutant vWF, due to which, there is a great difficulty in the formation of the primary hemostatic plug. Thus, thrombocytopenia ensues, along with increased Ristocetin Induced Platelet Aggregation (RIPA) even at low concentrations of Ristocetin. Mutations in the A1 domain are responsible for type 2B vWD (Huizinga EG, 2002). In type 2M vWD the vWF platelet binding activity is reduced. But unlike the type 2A vWD, there is no decrease in the quantities of high molecular weight multimers. This phenomenon is only due to a decreased affinity to the Gp-1b receptors on the platelets (Ginsburg D, 1993), (Schneppenheim R, 2001), (Meyer D, 2001), (Rabinowitz I, 1992) (Mazurier C, 2001). The vWF:Ag, vWF:RCo and FVIII:C activities in types 2A and 2M vWD are similar. They can only be diagnosed based on high resolution gel electrophoresis images. (Meyer D, 2001). Another phenotype of type 2M vWD is the failure of vWF to bind to collagen in the extracellular matrix of the vascular sub-endothelium. vWD type 2N is due to the absence of vWF-Factor VIII binding. This is due to mutations in the D and D3 domains of the vWF protein (Ginsburg D, 1993), (Mazurier C, 2001). The laboratory tests for this type of vWD indicate normal levels for vWF:Ag and vWF:RCo tests, but the FVIII:C activity is only about 10% of normal levels. Acquired von Willebrand Syndrome Acquired von Willebrand Syndrome (AVWS) is type of vWD which is not genetically linked. There are three mechanisms by which it is manifested: Autoimmune reactions against vWF, Increased proteolysis of vWF by a protease ADAMTS13 (A Disintegrin And Metalloproteinase with a ThromboSpondin type 1 motif, member 13), or abnormal increase in the binding affinity of vWF to platelets or other cell surface receptors (U.S. Department of Health and Human Services, 2007). Diagnosis of vWD The diagnosis of von Willebrand Disease and its sub-type is made based on an initial review of previous health conditions and familial history of bleeding disorders, which is done in the clinic, and then obtaining plasma samples of the patient for laboratory tests.

Problems With The Death Penalty Essay -- legal issues, death penalty

Who has the right to take away someone’s life? No one really, but the bitter truth is that the government does. The way they see it is an eye for an eye. Protecting the rest of the world from what is considered to be a monstrous human being filled with only hatred and violence, with no chance of changing or improving their horrific behaviors. The death penalty is racially and economically biased, rarely reversed for the wrongly accused, and the government should not have that power. What is the death penalty some might ask? According to WiseGreek â€Å"It is a punishment that involves executing someone after being found guilty of a capital crime. It is considered to be an act of retribution, making sure that the person cannot and will not repeat these offenses. Depending on where you live the death penalty differs. In the United States that honor is reserved for those who commit murder in the first degree, espionage, or treason. A typical sentence would be a decade or more just waiting for execution; where they will die from lethal injection. Until then prisoners on death row spend majority of their time suffering in isolation. Unlike the other prisoners those on death row are held to different standards. Unable to enjoy their last moments of their lives, living in unbearable and harsh living conditions. The 8ft by 8ft cells they are placed in can only hold a bed and toilet. During visiting hours inmates are separated by glass and closely watched. Janis Barkda le once stated in a recent interview with Aja Beech and myself that when she went to visit her fiancà © that in addition to the glass separating them and the guards Robert Lark was also wearing hand and ankle cuffs. Not to mention that when they are allowed to go outside for a... ...E ON DEATH ROW.† Web blog post. Death Penalty Information Center. Michigan Law Review, 2005, June 2008. Web. 13 Jan 2014. Donohue, John J., and Justin J. Wolfers. â€Å"Uses and abuses of empirical evidence in the death penalty debate.† Stanford law review 58.1 (2006): 791-846. â€Å"Death Penalty Appeals Process/ Capital Punishment in context†. Death Penalty Appeals Process/ Capital Punishment in Context. N.P., n.d. Web. 20 Jan. 2014. . "Does the Death Penalty Violate the 8th Amendment?" The Premier Online Debate Website. N.p., n.d. Web. 22 Jan. 2014. Equal Justice imitative.† Racial Bias. N.p., n.d. Web. 16. Jan 2014. . â€Å"Has DNA Testing Led to Significant Improvements in the Criminal Justice Statem?† ProCon.Org. 19 Aug. 2008. Web. 15 Dec.2013

Economics of Market Failure :: Government Intervention

Market failure has become an increasingly important topic for students. In simple terms, market failure occurs when markets do not bring about economic efficiency. There is a clear economic case for government intervention in markets where some form of market failure is taking place. Government can justify this by saying that intervention is in the public interest. Government intervention occurs when markets are not working optimally i.e. there is a Pareto sub-optimal allocation of resources in a market/industry. In simple terms, the market may not always allocate scarce resources efficiently in a way that achieves the highest total social welfare. There are plenty of reasons why the normal operation of market forces may not lead to economic efficiency. Public Goods Public Goods not provided by the free market because of their two main characteristics  · Non-excludabilitywhere it is not possible to provide a good or service to one person without it thereby being available for others to enjoy  · Non-rivalrywhere the consumption of a good or service by one person will not prevent others from enjoying it Examples: Streetlighting / Lighthouse Protection, Police services, Air defense systems, Roads / motorways, Terrestrial television, Flood defense systems, Public parks & beaches Because of their nature the private sector is unlikely to be willing and able to provide public goods. The government therefore provides them for collective consumption and finances them through general taxation. Merit Goods Merit Goods are those goods and services that the government feels that people left to themselves will under-consume and which therefore ought to be subsidized or provided free at the point of use. Both the public and private sector of the economy can provide merit goods & services. Consumption of merit goods is thought to generate positive externality effects where the social benefit from consumption exceeds the private benefit. Examples:Health services, Education, Work Training, Public Libraries, Citizen's Advice, Innoculations Monopoly Few modern markets meet the stringent conditions required for a perfectly competitive market. The existence of monopoly power is often thought to create the potential for market failure and a need for intervention to correct for some of the welfare consequences of monopoly power. The classical economic case against monopoly is that  · Price is higher and output is lower under monopoly than in a competitive market  · This causes a net economic welfare loss of both consumer and producer surplus  · Price> marginal cost - leading to allocative inefficiency and a pareto sub-optimal equilibrium. See also the study page on economic efficiency  · Rent seeking behaviour by the monopolist might add to the standard

Required classes for college students Essay -- essays research papers

"Open Your Eyes" Open your eyes, clean out your ears, sit down and listen, straighten your back, keep your head forward and be ready to have an open mind? Having an open mind is a good quality to have while experiencing different situations that you may encounter. People have many different opinions and ideas which they are expressing in today's society. College is another step along the journey of life that a select few will experience. College should be first priority on everybody's agenda in order to be successful in this struggling world. People need education outside of their own studies to broaden their horizons. People are sometimes stuck in their own "little world" and do not realize the important factors of life. Hopefully, college students will realize the importance of the classes which they are taking in college courses, and that the classes have meaning. Students may not understand the meaning of these required classes at the time which they are required, but someday t! hey may understand. College students may think basic required classes is just busy work, wasted time, and a waste of their money. There is another intention to why these classes are required. Imagine that you are the Vice President of a well known company while sitting there in a meeting with the President of the same company and all of your coworkers. Somebody says to you Mr. VP, what do you think about the Checks and Balances of our American Government? What is Mr. VP ...

Persuasive memo Essay

My name is Darrell Pace and I am requesting to continue research for the implementation of a Spanish curriculum in the Professional Academy Day School. The proposed research will greatly impact our students, parents, and faculty because the world is becoming increasingly interconnected. Parents are turning to language immersion programs for their toddlers and preschoolers. Some are motivated by the desire to preserve family heritage and culture. Others see early language instruction as a way to provide their children with the academic and cognitive advantages. It is very important for the Professional Academy Day School to accommodate the interest of our parents who entrust their children to us, to teach them skills that are beneficial now and in the future. When we offer the children in our day school the very best curriculum, it enhances our credibility among our competition and the community. According to the article by Stephanie Meade, â€Å"7 benefits of Raising Bilingual Kids†, it shows that bilingual children have the following advantages over that of monolingual students: Bilingual children have a better ability to focus and ignore distractions in the environment Bilingual kids can switch from one activity to another faster and are better at multitasking. Bilinguals have increased mental flexibility and creativity. Bilingual children in dual-immersion schools have been shown in one study to score higher on both verbal and math standardized test conducted in English Bilingual children display stronger logic skills and are better equipped at solving mental puzzles Being bilingual carries over throughout life as it alters brain chemistry and starving off the onset of Alzheimer’s. After learning two languages, it makes it more apt for learning a third language The advantages of a child being immersed into a school that offers dual languages cannot be ignored nor taken lightly when the demographics toward Spanish speaking cultures have more than doubled over the last ten years here in our state of Texas. Our school will be behind the curve if we don’t react now and research the necessary curriculum that will be the most effective among our students in the classroom. In the article, â€Å"Preschool Curriculum: What’s in it for Children and Teachers† written by The Albert Shanker Institute, children learn language when it is presented in meaningful contexts. A strong curriculum teaches vocabulary during studies of interesting content. This strategy which we have found through our research provides repeated exposure to new words and teaches children the words they need to represent the new ideas and concepts that they are learning. Our research will prove that the proper Spanish curriculum produces success in math, science, literacy, social studies and the arts. Language is the foundation for children’s learning, and the pre-k years are a crucial time for Spanish language development. The research on Spanish curriculum in Pre-k and kindergarten classes is timely and it is of substantial importance to the future of learning at the Professional Academy Day School.

Planetary Comparison Essay

Man first came to live by finding ways to sustain his life. He could think, decide, create an opinion and work with his bare hands. After many years of survival, he became more curious at the things around him. He saw the moon, the sun and the stars. It was when the man was curious that human life was considered intelligent life. Without man’s curiosity, he wouldn’t care about the planet that he is hosting his life. Without his brain, he wouldn’t know that other planets and other heavenly bodies exist aside from the planet Earth. The properties of planet Earth include its shape, density, reflection of light and age. The shape of the Earth resembles that of a sphere. It is a spherical planet because of gravity. What makes the Earth spherical is the bulging characteristic it has on the equator. The bulges exist on this part of the planet because of rotation. Properties of the Earth Density – As of the Earth’s density, it refers to the â€Å"mass per unit volume† of the planet. The density of the Earth can be better imagined if compared to the density of iron, rock or water. The density of is 8 grams per cubic centimeter, 2. 5 grams per cubic centimeter for a rock. With water, it is just a gram per cubic centimeter. Deep down the planet is surely a dense section of the Earth (Newman, 2000, p. 267). † Reflection of Light – Another property is reflection of light. The Earth has 37% albedo, which means that it has 37% of light that it is capable of reflecting. Again, to get the clearer picture, the reflection of light of the Earth can be compared to that of dirt, clouds and ice. Dirt can only reflect around 10%, while water and clouds have just enough albedo. When albedo is moderate, it means that the reflection of light ranges from 40 to 60 percent. Meanwhile, ice has a high albedo because its reflection of light is almost a solid one hundred percent (Hamilton, 2001). Age of the Earth – The age of the Earth is also another property of the planet. Planet Earth is as old as billions of years. With the help of radioactive dating of stones, scientists and geologists discovered that the Earth existed 3. to 4. 5 billion years ago (Hamilton, 2001). The Earth’s Interior The Earth’s interior is characterized by explosions, earthquakes and seismic waves. There are waves that travel in both solid and liquid parts of the Earth. There are also waves that run only on solid ground (Hamilton, 2001). Inside the Earth’s interior, one can find nickel, iron and solid in the inner core. In the Earth’s outer core are nickel, iron and liquid. It s mantle are oxygen and silicon, which, when combined, form silicate rocks. The temperature inside the Earth’s core is hotter than the surface of the sun because of radioactivity and collisions. During the early years of history, the Earth is molded by numerous collisions and the heat from this activity contributed to the 6500K temperature of the planet’s core (Hamilton, 2001). Surface Changes It is a fact that the surface of the Earth changes constantly. One activity that contributes in the surface change of the planet is continental drift. Continental drift, as its name implies, refers to the drifting apart of the Earth’s continents. The continents move over time, and such movements were better understood and explained as the Plate Tectonics Theory came out, describing the lithosphere of the planet (Hamilton, 2001). If the lithosphere breaks, tectonic plates are built. In this planet, there are plenty of minor tectonic plates. With major tectonic plates, there are only seven. There is movement among these plates at different kinds of boundaries which include transform boundaries, spreading or divergent boundaries and collision or convergent boundaries. These boundaries pave way to the formation of oceanic trenches, mountains, volcanic activities and even earthquakes. Imagine two pieces of large lands collide (Hamilton, 2001). The tension caused by the collision alters the shape of the pieces of land. This is what happens to planet Earth. Whatever type of activity there is, the surface of the Earth will always be affected (Hamilton, 2001). Even erosion affects the surface of the Earth. Erosion happens when particles like rock, soil and sediments are displaced or moved to other places. What cause the displacement are agents like water, living organisms and wind. Ice is also another cause of displacement because of the downward slope (Hamilton, 2001). The Earth and the Other Nine It cannot be denied that the Earth is special because compared to other planets in the solar system; it is only the Earth that is capable of sustaining life. It has an atmosphere. It has displacement of lands. It has plate tectonics. It has water. It has humans. The one thing that separates the Earth from the other planets is the human being and human life. There may be signs of the existence of life in Mars, and that there are other forms of life in the moon of Saturn, but only Earth is capable of supporting and maintaining life (Moskowitz, 2008). Intelligent Life – Even if it may be proven in the future that there are indeed organisms living in Mars, it is still safe to say that the Earth is home to intelligent life. Other planets may be able to host life, but only the planet Earth is capable of hosting the intelligent kind (Moskowitz, 2008). Life on other planets would not even be possible without the planet Earth, according to Gregory Laughlin. Laughlin is a planet hunter and an astrophysicist at the prestigious University of California, Santa Cruz. Gregory was able to say this because the Earth delicately transferred some of its materials to the other planets. These tiny materials can be found in the planet’s crust (Moskowitz, 2008). Water – Another feature of the Earth which cannot be found in other planets is water. The planet is indeed a place conducive for evolution because it has water in it, in that amount. The amount of water on Earth is almost magical. The amount of water present in this planet is just enough to keep a desert alive. There is not too much water to drown the Earth’s mountains (Moskowitz, 2008). Water on Earth is different from the water in the other planets because the water in the other planets either fry or freeze. This can be explained through the distance between the planet earth and the sun (Moskowitz, 2008). Distance – Distance, of course, is a unique feature of the planet. The Earth indeed has the best location in the solar system because if we depend on too much sun, then the distance between the planet and then sun is just right enough to match the Earth’s geological timescales (Moskowitz, 2008). It is the temperature we get from the sun that regulates the Earth’s atmosphere. It is the distance between the Earth and the sun that keeps the temperature of the Earth’s surface around the temperature of the waters (Moskowitz, 2008). Size – The size of the Earth is also another unique feature of the planet. A smaller Earth will not leave space for the planet to hold on to the atmosphere. A bigger Earth may be a hotter Earth for humans. Hotter in this sense means the kind of warmness which humans will not be able to tolerate (Moskowitz, 2008). Getting More Detailed Mercury is the nearest planet to the Sun. Among all the other planets, it is the eighth largest. It has two moons namely Titan and Ganymede. While these moons are smaller than Mercury, they are more massive than the planet. Mercury, compared to the Earth, is closer to the sun (Arnett, 2008). Venus, on the other hand, is the sixth largest planet in the solar system. It is also nearer to the sun compared to the Earth. It is an inferior planet with phases easily seen through a telescope from the Earth (Arnett, 2008). Aside from the Earth, Mars stands out to be a popular planet since the early times. Today, there are observatories that are ground-based just to study Mars. The size of Mars is a barrier in studying it, but the planet still shows features that can host life (Arnett, 2008). The biggest planet in the solar system is Jupiter. When it comes to mass, this planet is doubly massive compared to the Earth and to the other planets as well. In fact, when compared to the Earth’s mass, Jupiter has 318 times more (Arnett, 2008). Saturn is a popular planet since the prehistoric years because there was Galileo in 1610, holding a telescope, observing this planet with rings. Galileo knew that Saturn looked different and he thought that the Earth passes through the rings after some years on a regular basis (Arnett, 2008). If the Earth is spherical, then the planet Uranus is ecliptic. Unlike the Earth, Uranus’ poles are hotter than its equator. The poles of this planet are more receptive to the sun’s energy than the equator (Arnett, 2008). Neptune is far from the sun, but its core measures the same as that of the mass of the Earth. Its core is made of rocks. It does not have a unique internal layering like that of Saturn and Jupiter, but the composition is nonetheless distinct. Whatever heat it receives from the sun is nothing compared to the heat it can generate itself through its core (Arnett, 2008). Pluto is the smallest planet in the solar system. It has an eccentric orbit, which makes it closer to the sun at times than Neptune. Unlike the Earth and all the other planets, this heavenly body rotates in the opposite direction (Arnett, 2008). Above all these, it is still the Earth that stands out. All these pieces of information would not be known without the human mind, made possible with life, sustained by the Earth.

Private Versus Public Warehouse Essay

Nowadays, manufacturing and services firms face growing challenges to increase profit margins amidst increasingly fiercer competition. Under such circumstances, industry analysts and supply chain experts suggest manufacturers and service providers to promote more effective supply and demand planning, management, and execution as the means to unlocking significant gains in margins. According to Search CIO (2007), SCM refers to management of information, materials, and finances along a chain of process from suppliers to manufacturers and then from manufacturers to customers. The interests in the discussion of supply chain management occur since it relates to costs reduction in all aspects of business process especially regarding the inventory reduction that suggests manufacturer produce goods when needed. In this situation, the selection of type of warehouses play significant role since it determines the SCM strategy for a company. In general, there are two types of warehouses: private and public warehouses. 2. Private Warehouse By definition, private warehouse is type of warehouse that directly maintained and operated by the owner of products or goods that are stored in it. Meanwhile, the warehouse facility itself could be happened to be privately owned or leased (Seaboard Warehouse Terminals, 2004) 3. Public Warehouse The other type of warehouses is public warehouse. Unlike private warehousing, public warehousing provides greater efficiency for a company since one warehouse is designed to design multiple logistics. Figure 1 shows typical design for warehousing needs in which the selection of public and private warehousing depends on the needs. Figure 1 Warehouses Needs Classifications 4. Public Warehouse versus Private Warehouse: Consideration Like outsourcing decision, the selection of type of warehousing that is suitable for a company. And according to comparison based on several factors, the public warehousing is considered beneficial than private warehouses as following: 4. 1. Costs Reduction †¢ Public warehousing does not require a company to have dedicated human resources/personal to operate the warehouses facility †¢ The handling and storage fee is predictable †¢ the warehouse costs can be translated into the storage costs to volume that would help marketing department to include this costs in the pricing scheme of the products   

Low Inflation Rate Of Australia

Inflation is a rise in the general level of prices of commodities. Inflation is a major economic issue in Australia, and is one which requires stable management for durable and long-term improvements. Low inflation and steady economic growth; have emerged as outstanding economic achievements this decade. Along with unemployment, economic growth and external viability; inflation acts a major economic indicator, illustrating the strength and stability of our economy. It is for this reason that inflation management has played such a great role in domestic economic policy over the last decade. Inflation at present is the focal point of the Australian economy. Inflation is at an unprecedented low, which has acted to keep the Australian economy competitive. Economic policy in Australia has acted to keep inflation low, which has been a traditional problem for decades. At present Australia's, underlying inflation rate is less than 1. 3%, which has opened up a stronger, more competitive export market. With such a pleasing outcome for inflation, Australia can reap the rewards through lower interest rates as well as economic growth, and job increases. Low inflation does more than simply slow price increases; it acts as an expansionary booster to the economy and a stimulus for other economic objectives. In recent times, low inflation levels have characterised the Australian economy. The underlying inflation rate was only 1. 1% to June 1999, and this has meant further stability of prices and continued growth. This result has come on the back of Australia's â€Å"Inflation Target†, set by the Reserve Bank (RBA) in 1993. This has acted as a guide to spending and domestic monetary policy, over the course of the economic cycle. The RBA has set an underlying inflation target of 2-3% per year, and this has contributed to our steady inflation performance. In the late 1990s, Australia has operated at the lower level of this target, and this has pleased the government and the RBA through their initiative. Inflation figures of fewer than 2% annually are testament to this. Recent trends have given Australia one of lowest underlying inflation rates in the OECD group, which includes many highly industrialised nations. Over this century Australia, has seen both high and low inflation. In the 1950s, 1960s and early 1970s we experienced periods like today. Yet we faced high levels in the 1970s and 1980s. These were due to the great peaks and falls in the economic cycle, brought on by recessions and boom periods. The Australian economy has developed by adapting to changes in the economic cycle, and flattening out the large â€Å"bumps†. Causes of inflation are varied in both their diversity and severity. They include excess demand, where high aggregate demand for commodities forces prices upwards. There is also cost-push inflation, where an increase in the cost of production promotes an increase in the price of goods for consumers. Inflation can also be brought about through inflationary expectations, hence the quote â€Å"Inflation breeds inflation†, as well as currency depreciation, which also damages exports. The numerous causes of inflation give testament to the fact that it is a difficult problem to combat. Increased levels of inflation also cause many changes in the economy. There are essentially three main negative aspects of high inflation. It acts by reallocating resources in the economy, usually by encouraging speculative investment. It also causes redistribution of wealth from those who hold cash funds, as opposed to property or capital. Thirdly, it causes decreased levels of international competitiveness. Conversely, there are many positive aspects of low inflation. Australia has gained through lower interest rates, high but steady economic growth and the promise of job creation in the future. Low inflation has bred a more confident economy, one which is wiser for the adversity it has faced through recessions of the past. Low inflation creates a more externally viable economy, and allows competitive export growth. Australia's current low level of inflation can be attributed to an array of factors. These have included the lagging effects of the recession earlier this decade, as well as the implementation of a number of recent economic policies. Current low levels of inflation are the product, of three main policy initiatives. First and foremost, Monetary policy has helped our inflation by keeping spending in check. Through interest rates, and the adoption of an inflation target, the RBA has been able to artificially control the level of economic activity in Australia. Monetary policy has been a favoured government option, and it has proven a success. Secondly, micro-economic reform has played a major role in keeping inflation low. It is essentially based on efficiency and productivity in the Australian industries, where it has aimed to help firms lower costs, thereby creating a stable economy based upon strong and efficient production, healthy exports and generally more economically sound industries. This decade it has included moves for a national competition policy, deregulation of industries as well as general moves for efficiency. Fiscal policy is the third policy option. It surrounds government spending and taxation initiatives. In recent times it has acted in a contractionary manner, including budget surpluses and the repayment of foreign debt, which have allowed for more expansionary monetary policy. Some feel that currency policies aren't doing all they could. While drives for efficiency are a step in the right direction, it is clear that monetary policy could be eased to benefit other economic objectives. Being below the RBA target for inflation should allow Australia to lower interest rates. These could help economic growth and achieve greater job expansion. This could easily be achieved if the government would diversify its one-eyed monetary policy. The coalition must begin to realise that low inflation is coming at the expense of other, equally important economic objectives. While tight fiscal policy may be paying off foreign debt, we are still faced with high unemployment and unfavorable CAD terms. It is clear that while inflation is at a low level now, we must turn more attention to other pressing economic objectives. Inflation is a major economic management issue, and is one which requires great vigilance and perseverance for durable improvements. Though through the efforts of the RBA and the current government, inflation has fell to an unprecedented low, via much agony and policy deliberation. At present inflation has been brought back to earth through monetary and micro-economic policy essentially. Yet the pressing issue is not how far we can go with inflation, but how much can it's current level benefit our other major management issues.

Controversy Analysis Research Paper Example | Topics and Well Written Essays - 1750 words

Controversy Analysis - Research Paper Example This is a contentious subject since it grants an individual user unrestricted freedom in terms of quantity and mode of marijuana usage. Arizona currently enjoys the license for medicinal purposes. It is arguable that legalization of marijuana for recreational purposes is feasible in Arizona. There are notable social costs of marijuana prohibition. For instance, FBI reports indicate that 658, 000 arrests, in 2012, occurred due to marijuana use as compared to 256, 000 for heroine and related drugs (The New York Times 1). This is coupled with a jammed judicial system that cannot manage the many cases reported daily. In addition, jailing of marijuana users impose huge costs on state governments. Many reports indicate that such arrests are racially inclined as they fall disproportionately on the black and Latino population. A social crisis sets in such populations as young people spend their productive time in jails. This limits their chances at later economic success thereby creating a generation of low-income earners. Scientists have uncovered mild problems with marijuana in terms of addiction and dependence thereby proving as less harmful as alcohol. In addition, research has found out that there is limited correlation between violent crime and marijuana usage. This is un like the popular opinion that marijuana usage increases the risk of harmful activities such as marriage violence (Costa 1). It is crucial to underscore the fact that marijuana usage is common in the American states in spite of the typical government detestation of the drug. The animosity towards cannabis sativa has always existed alongside its common use in the US. For instance, the glorification of marijuana in American music videos attests to the fact that in spite of an abhorrent government, marijuana usage remains a common feature of the American landscape. Legalization of marijuana in

Analysis Of Pete Thamels Writing Style Essay Example | Topics and Well Written Essays - 500 words

Analysis Of Pete Thamels Writing Style - Essay Example Thamel makes use of the proper grammar and syntax to make his writings more logical and comprehensible. The general ethos evident in Thamel’s writings points out that he is knowledgeable about his field and knows what he is talking about. He tends to use an informal sentence structure to reach out to a maximum number of people which shows his consideration towards his audience. He does not mess with fancy words and difficult sentences, rather he writes in a way to get his message through to his audience. The sentence structure he chooses to display in his column is the loose sentence form mainly. Thamel uses a relaxed and casual tone in his writings mixed with a playful but serious take on the issues he is addressing. Thamel’s writing style does not demonstrate much of pathos. He has however often shown distress over the issues he discusses in an offhanded way.  He has made use of informal diction in all of his columns. Thamel’s literary techniques include fram ing, imagery, irony, and a narrative hook. Students can and do share their writings, projects, and assignments through such medium. Another Californian high school teacher states that the students are more willing to share with each other rather than with their teachers which are yet another step towards learning and sharing. If organizations such as the CTA have their way and get the school boards to lift the ban from social networking, this may yet be the greatest revolution the world would ever see. It would change the meaning of education.

Romanticism Art Movement Essay Example | Topics and Well Written Essays - 500 words

Romanticism Art Movement - Essay Example The artists of Romanticism considered imagination as a gateway to transcendent experience and spiritual truth and these qualities were evident in their artistic creations. . It is significant to note that the Romantic Movement in art was a product of the movement in literature and philosophy which accentuated emotional, spontaneous and imaginative approaches. â€Å"In the visual arts, Romanticism came to signify the departure from classical forms and an emphasis on emotional and spiritual themes. Caused by the sudden social changes that occurred during the French Revolution and the Napoleonic era, Romanticism was formed as a revolt against Neoclassicism and its emphasis on order, harmony, balance, idealization, and rationality.† (Romanticism) Thus, the movement stressed freedom, emotion, and imagination of individuals and was subjective in character. The artists of this group emphasized spontaneity and freedom and considered imagination as greater to reason and beauty. Therefo re, they depended greatly on personal spirit and creativity as against formal training. â€Å"Romantic techniques were developed to produce associations in the mind of the viewer. These foundations of the Romantic Movement were influential in the development of Symbolism and later Expressionism and Surrealism.† In conclusion, Romanticism has been a significant movement in the history of art and literature which tremendously influenced the artists of the period as well as the other movements of the time and the following age.

College Physics Research Paper Example | Topics and Well Written Essays - 1000 words

College Physics - Research Paper Example According to the electromagnetic theory, a charged particle in accelerated motion must radiate energy in the form of electromagnetic radiation. So an electron revolving around the nucleus must also radiate energy and finally fall into the nucleus following a spiral path. 5. Although these quarks can not be isolated individually, but in combination with the others it can give existence to subatomic particles as electrons and protons. An electron is made up of one up-quark and two down-quarks (u, d, d) and a proton is made up of two up-quarks and one down-quark (u, u, d). Water or moisture on the earth absorbs heat from the sun and the surroundings. When enough heat has been absorbed, some of the liquid molecules have enough energy to escape from the liquid and begin to rise into the atmosphere as a vapor. As the vapor rises higher, the temperature of the surrounding air becomes lower. Eventually, the vapor loses enough heat to the surrounding air to allow it to turn back into a liquid. Earth's gravitational pull then causes the liquid to "fall" back down to the earth, thereby completing the cycle. It should be noted that if the temperatures in the surrounding air are low enough, the vapor can condense and then freeze into snow or sleet. Once again, gravity will claim the frozen forms and they will return to the earth. Like giant capacitors in the sky, these clouds get charged up. The upper portion of the cloud is positive

Philosophy Essay Example | Topics and Well Written Essays - 500 words - 2

Philosophy - Essay Example Therefore, we are certainly not planning to take the legislation lying down. There are also those who will manage to pay the extra tuition fee one way or the other, and will not be forced to leave college. But they too realize that this increase will result in wastage of talent and violation of merit. It will also reduce opportunities for young people and promote economic inequality in a society which is already haunted by its ill-effects (such as unsettling urban crime rates). Protests can be very effective as they can demonstrate clearly to lawmakers the unpopularity of certain legislation. They can perchance sway them, and force them to reconsider their allegiances. Protests and acts of civil disobedience are sure to swiftly put the issue in media spotlight, which will get it the attention that it deserves. Protests can provide an effective means of mobilizing public opinion for a particular cause, and can help earn support from a wide range of people. Nonviolent protests and acts of civil disobedience have been carried out for worthy causes in the past. I intend to participate in such activities to make myself heard, and draw attention to this pressing concern. Part 2 The realm of ethics (not unlike other branches of knowledge) is fraught with conundrums and complications. But ethical decision-making is a necessity.

Cosmetic retailing project Research Proposal Example | Topics and Well Written Essays - 500 words

Cosmetic retailing project - Research Proposal Example Cosmetics in Japan have traditionally been sold through keiretsu stores that emphasized personalized, individual attention. In the mid-1990s, the rise of serufu-sabisu (self-service) products showed that customers were willing to sacrifice service for price. This led to a separation between high-end quality brands and the inexpensive utilitarian products. Shiseido once relied upon taimen hanbai (face-to-face, personal selling), as the core of its marketing strategy. The company believed consumers needed counseling before purchasing cosmetics. In June 1994, Shiseido made a radical shift, moving forty-one brands into the self-service category, followed by another sixty-five products in the fall. By 1995, about 42 percent of the companys products were sold through self service. Akira Tsuruma, managing director of Shiseido, estimates that half of the companys sales will come from the serufu category in the future (Shiseido Home Page 2008). The image of Shiseido is based on red colors which symbolizes a rising sun, and its national identity. Thus, the main colors of its project â€Å"Pureness† are white and blue (see Appendix 1). Shiseido spun off new brands such as Ipsa and Ayura. Sadao Abe, senior executive director of Shiseido, noted that they introduced these brands not only for their own sake but also for protecting the purity of the Shiseido brand umbrella. With a rapidly increasing elderly population, many Japanese ads feature seniors. For example, a Shiseido ad shows a gray-haired woman in a kimono. A series of ads for a skincare product were targeted toward women in their fifties, an audience that is typically ignored in cosmetics ads. The company has begun to sharpen its brand identity through the image of â€Å"successful aging.† It weeded out outliers from its line and launched new individual brands such as Ayura and Ipsa with different identities

Macroeconomic Data Analysis and Report Essay Example | Topics and Well Written Essays - 750 words - 2

Macroeconomic Data Analysis and Report - Essay Example It is important to note that the population growth rate is an important factor in gauging the economic performance of a state and by taking the case of these two countries it will be easy to establish their economic trends. If this is presented in a table form or graphically the trend will give an insight into the economic characteristics of the two countries. Exchange rate is vital in comparing the strength of the currency between the countries and this is an index of measuring level of economic growth holding other factors constant. Purchasing power parity is important in measuring the inflation rate between the two states under case study. The ratio of gross national product to gross domestic product is important in providing a ground for estimating the amount of income that is repatriated to other countries. Bigger ratio means unfavorable productivity of the country and overdependence on foreign capital and skilled manpower. To explain the economic growth and development parity b etween these two states needs to be presented in graphs. The figure one above shows that the exchange rates between the two states have a wide gap and this is consistent across the three years. It is important to note that UK is more developed and economically stable as reflected by its comparatively lower exchange rate than Saudi Arabia. Considering the figures of exchange rate across the years shows some changes for United Kingdom while Saudi Arabia has a constant exchange rate which hints stable currency and consistent economic growth than in UK (Sarno & Taylor, 2005, 98). United Kingdom has a high population which presents a strain on the existing resources but considering the geographical size of the state. The point of concern in this case is the trend in population growth. The rate of population increase is high for Saudi Arabia than UK and this present expansionary threat to Saudi Arabia as the population will put steady

Turbines Case Essay Example for Free

Turbines Case Essay Definition and historical background Claude Burdin (1788–1873) was the very first person to use the word turbine. The word came from the Latin term turbo/turbines, which means a â€Å"whirling† or a â€Å"vortex.† Burdin used the term to describe the subject matter of an engineering competition being held during that time for a water power source. It would be an oversimplification to describe turbine as a rotating machine that is used to derive power or electricity from the water; a common water wheel may not immediately or necessarily be a turbine, but it definitely is a rotating machine. A more precise definition of a turbine is that it is a machine â€Å"in which the water moves relatively to the surfaces of the machine, as distinguished from machines in which such motion is secondary, as with a cylinder and piston† (Daugherty and Franzini 1965, 213–214). More broadly, to include other types of turbine, it is one of those devices or machines that is being used to channel or convert energy from a stream of fluid (liquid or gas) into mechanical energy which would eventually be used to generate electrical energy, or to support or augment another utility/device. This is done as the stream passes through a system of fixed and moving fanlike blades which causes the latter to rotate. This device (turbine) looks like a large (and sometimes small) wheel with small radiating blades around its rim. The four general classes of turbines are water or hydraulic, wind, steam, and gas turbines. Water or hydraulic, wind, and steam turbines are generally used for the generation of electricity; while the remaining one, gas turbines, is mostly being used in aircrafts (Britannica Concise Encyclopedia 2006). The principal components of simple turbines are the rotor, which in most if not all cases has blades projecting radially from the center to its periphery; the nozzles, where the working jet of fluid is directed and expanded; and blades, where the conversion of kinetic to mechanical energy takes place. Theoretical and operating principles Potential and kinetic energy both exist in a working fluid, which could be compressible or incompressible. Turbines collect this available energy by utilizing any or both of these physical principles: impulse turbines and reaction turbines. Impulse turbines change the direction of flow of a given high velocity fluid jet. The impulse, as a result of this, causes the turbine to spin or rotate, diminishing the kinetic energy of the fluid flow as this is absorbed by the device. In the case of flowing water, it comes available in purely mechanical form (water in nature is one of the most useful and efficient sources of kinetic energy). Scientific calculations show that 1 cubic meter of water can actually produce 9.8 kilojoules of pure mechanical energy for every meter that the volume of water descends. In the same way, a flow of the same volume of water for every second in a fall of 1 meter can provide 9.8 kilowatts, or 13 horsepower. Hydraulic turbines efficiency is estimated at approximately 1, meaning, almost all energy is available or utilized. This kinetic/mechanical energy can be converted to electrical energy with an efficiency of more than 95.0% (Calvert 2004). To get this much power from water, it should be extracted as it is lowered in elevation. The current in a stream, of course, is obvious. This flow comes from the open-channel movement or flow of water as influenced by gravitational forces. Simply put, holding a paddle-wheel in the stream of water will result to the paddle-wheel being rotated and from this outcome, power can be extracted (mechanical energy or electrical energy). This is an example of elementary impulse turbine, a machine acted upon by the impulse or force of moving or flowing water (Calvert 2004). In the case of reaction turbines, torque is developed as a result of fluids pressure or weight. The fluids pressure changes as it goes through the rotor blades of the turbine. There should be a pressure casement so as to contain and maintain the energy of the working fluid as it acts on the turbine stage(s). If there would be no pressure casement, the turbine must be immersed in the fluid flow, such as in the case of wind turbines. It is the casing that directs and contains the working fluid. In the case of water turbines, it maintains the suction which is imparted by the draft tube (Calvert 2004). A simple but very good example for this principle is the lawn sprinkler. In contrast to the impulse turbine, where the pressure change took place in the nozzle, the pressure change in reaction turbines occurs in the runner itself. This happens at the time that the force is exerted, hence, a reaction. Looking at the example of sprinkler, its duty is to spread water coming from it; the resulting energy from the turbine serves to move (rotate) the sprinkler head. Water flows from the center of the sprinkler going radially outward. Water under pressure comes from the center, and then jets of water that can possibly cover the area go out to the ends of the arms of the sprinkler at zero gauge pressure. The significant decrease in pressure takes place in the sprinklers arms. The water is projected at a certain angle to the radius, but it should be noted that the water from a working sprinkler actually moves along a defined radius. The jets of water do not impinge on a runner; but rather, they leave the runner, and this momentum is not converted into force, as opposed to an impulse turbine. The force residing on the runner reacts to the creation of the momentum, hence, the principle itself, reaction turbine (Calvert 2004). In any case, there is no restriction, as far as laws of physics are concerned, for any machine to utilize both principles. Many machines or devices use both of these principles as it is more efficient for the machine to be that way. Different kinds of turbines There are different kinds of turbines used in modern period: the water or hydraulic, steam, gas, and wind turbines. There are other types but these four are the most common and are usually the bases of any other turbines. Hydroelectric power stations utilize water, or hydraulic, turbine to drive their electric generators. Wisconsin, in 1882, witnessed the first of this kind of turbines. The processes taking place in a hydraulic turbine is simple: falling water hits a set of buckets or blades connected to a shaft. This impact will cause the shaft to rotate and move the rotors of the generator. The most common kinds of hydraulic turbine are the Francis turbine, Pelton wheel, and the Kaplan turbine. Two engineers, Sir Charles A. Parsons and Carl G. P. de Laval (of Great Britain and Sweden, respectively), pioneered the building of hydraulic turbines during the late 19th century. Continual developments and improvements of basic machines made hydraulic turbines to be the main power sources utilized to drive most large electric generators (Reynolds 1970). Another kind of turbine is the steam turbine. This is typically consist of conical steel shell that encloses a central shaft wherein a set of bladed disks are placed like washers. These blades are bent and extend outward (radially) from the edge of each disk. Some steam turbines have shafts that are surrounded by a drum wherein the rows of blades are attached. In between each pair of disks, there is a row of stationary vanes that are attached to the steel shell. These extend radially inward. Each set of vanes together with the bladed disk immediately situated/placed beside it constitutes one stage of the steam turbine. Most steam turbines have multistage engines (Columbia Electronic Encyclopedia [Online edition], 2007). Steam turbines are used mostly for electricity generation in thermal power plants, (i.e., plants using fuel oil or coal, or nuclear power). Steam turbines were once used to drive mechanical devices such as in the case of ships propellers. However, most such applications now utilize an intermediate electrical step or reduction gears. Gas turbines are now used mostly for aircraft engines. But there are still some gas turbines being used to drive electric generators (i.e., in an electric–gas turbine locomotive) as well as high-speed tools. The essential components of a gas turbine are (a) compressor, (b) combustion chamber, and (c) turbine that somehow resembles that of a steam turbine (refer to the description in the previous paragraph). The compressor is driven by the turbine, and then provides high-pressure air into the combustion chamber. In this chamber, the high-pressure air is mixed with a fuel and then burned. This makes the high-pressure gas(es) drive the turbine, with the same gas(es) expanding until their pressure decreases and reaches atmospheric pressure (Columbia Electronic Encyclopedia [Online edition], 2007). The last kind of turbine is the wind turbine, which as the name suggests converts the kinetic energy coming from the wind into mechanical and/or electrical energy. If the resulting mechanical energy is directly used by a nearby or even attached machinery (e.g., pump or grinding stones), the turbine device is usually referred to as a windmill. But if this mechanical energy is used to generate electricity, then, the device is called a wind turbine, wind generator, or wind energy converter (WEC; Reynolds 1970). Wind turbines can be three-bladed, two-bladed, or even one-bladed (counterbalanced). Computer-controlled motors point them to the direction of the winds. Danish turbine manufacturers have utilized the three-bladed turbine type. This type of wind turbine has high tip speeds (even reaching up to 6 times the speed of the wind), low torque ripple, and high efficiency, which contributes to the overall good reliability. This type of turbine is the one that is being commercially used to generate electricity. In many cases, the blades are colored in such a way that it blends with the clouds. The length of these blades usually ranges from 20 to 40 meters (or about 70 to 100 feet) or more, while the height is about 200 to 295 feet. Contemporary wind turbine models rotate at a speed of 16.6 rpm (revolution per minute). As a safety precaution to avoid overspeed damage, most wind turbines are equipped with automatic shutdown features during strong winds (Reynolds 1970; Wikipedia, The Free Encyclopedia 2007). There are other kinds of turbines, albeit fewer and smaller ones, in existence. These are the transonic turbines, contra-rotating turbines, statorless turbines, ceramic turbines, and shroudless turbine. Other uses of turbines Almost all electrical energy being used on Earth is generated with any one of the turbines discussed. Turbines with high efficiency can harness approximately 40% of the produced thermal energy, with the rest of the output exhausted as waste heat. Turbines are being utilized by most jet engines to provide mechanical energy from their fuel and working fluid as do most, if not all, power plants and nuclear ships. Reciprocating piston engines (like those found in aircraft engines) can utilize a turbine to drive an intake-air compressor. This configuration is known as the turbocharger (or turbine supercharger) or more colloquially known as â€Å"turbo.† Most turbines are capable of having very high power density the ratio of power to volume, or power to weight. This is due to their ability to function at extremely high speeds (Wikipedia, The Free Encyclopedia 2007). As of yet, no one has established any limitation for this invention of humankind. And with enough research and development, the present capability of these machines can even yield astonishing achievements. Woks Cited Calvert, J. B. â€Å"Turbines.† Date accessed: November 29, 2007 (http://mysite.du.edu/~jcalvert/tech/fluids/turbine.htm). Daugherty, R. L., and J. B. Franzini. Fluid Mechanics. 6th ed. New York: McGraw-Hill, 1965. Reynolds, J. Windmills and Watermills. New York: Praeger, 1970. Strandh, S. A History of the Machine. New York: AW Publishers, 1979. â€Å"Turbine.† Britannica Concise Encyclopedia. Encyclopedia Britannica, Inc., 2006. Date accessed: November 29, 2007 (http://www.answers.com/topic/turbine). â€Å"Turbine.† The Columbia Electronic Encyclopedia. 6th ed. Columbia University Press, 2003. Date accessed: November 29, 2007 (http://www.answers.com/topic/turbine). â€Å"Wind turbine.† Wikipedia, The Free Encyclopedia. Wikimedia Foundation, Inc. Date accessed: November 29, 2007 (http://en.wikipedia.org/w/index.php?title=Wind_turbineoldid=173495357).

Role of the nurse Essay Example for Free

Role of the nurse Essay The nurses in the Capulets household is the superior to that of a normal servant. Juliet seems to have taken the place of the daughter she once had and everything she does, she does for Juliets benefit. She is bossy with the other servants, knowing she has a special place in the family. She is a simple soul who is an easy target for Mercutios lewd ribbing. She is long-winded as well as rather rude and bawdy, but she seems sincere and makes the audience laugh with her rather than at her. As the story develops she becomes more and more a part of the conventional world that opposes and fails to understand the passion of Romeo and Juliet for each other. In the play, the Nurse serves as a mother figure to Juliet. She is a confidant, advisor and helper to Juliet. It is her relationship with Juliet that gives importance to her role in the play. The Nurse was the one who revealed to both Romeo and Juliet the identities of each other i.e. that Romeo was a Montague and Juliet a Capulet. She was also the go-between for Juliet and Romeo, delivering messages and notes from one to another. Thus, she played a key role in bringing about their marriage and its consummation. Not only does she contribute heavily the plot, the Nurse is also vital in the area of characterization. Her vulgarity and pragmatic views of love and marriage are in stark contrast to Juliets purity and passion. This emphasizes the pure and sacrificial love between Romeo and Juliet. The Nurses advise to marry Paris and give up Romeo also showed us the change in Juliet when she held fast to her love for Romeo and called the Nurse a wicked fiend for her hypocritical behaviour. The Nurse is a complex character with many sides to her personality. She displays both attractive and repulsive qualities at the same time. Firstly, it is obvious that she is genuinely fond of Juliet. This can be seen from her loving reminisces of Juliets childhood and her affectionate  calling of Juliet by names such as lamb and child. Also, she teasingly finds excuses to increase Juliets impatience for news of Romeo by talking about her various aches and pains. She acts as a go-between for Romeo and Juliet, carrying messages back and forth for the two lovers and does what they ask her to do for them. For example, she helps Juliet find out news about Romeo, and she helps Romeo procure a rope ladder. She also refuses to accept Romeos gift of money for these services at first, indicating her willingness to serve her mistress. This love for her young mistress naturally leads her to become protective of Juliet. She warns Romeo not to lead Juliet into a fools paradise, for that would be a gross kind of behaviour. Also, she wishes that she could see Juliet marry well. [Act I Scene III] When Capulet scolds Juliet for refusing to marry Paris, the Nurse speaks up for Juliet, saying that Capulet is to blame for rating her so, and that he should not scold her so badly. The Nurse sometimes speaks so much that even Lady Capulet has to tell her to keep quiet. This shows that she can be irritating at times and is also a gossip. She is also boastful, and claims all credit for Juliets upbringing. Her views of love and marriage differ greatly from Juliets. She advises Juliet that it best you married with the County because she thinks that Juliet will be happier in her second match. Your first is dead, or t were as good he were, As living here, and you no use of him Thus revealing that she does not believe in faithful and romantic love. She is also rather bossy with the other servants, ordering Peter around, because of her close association with Juliet and her parents. My fan, Peter. Ah, wheres my man? Give me some aqua-vitae. The Nurse is also fickle. Once she hears of Romeos banishment, she advises Juliet to marry Paris, comparing Romeo to him and pointing out his flaws. O, hes a lovely gentleman! Romeos a dishclout to him Although this could be viewed as practical, yet it is a violent contrast to her earlier praising of Romeo and comes across as being rather hypocritical, as Juliet observed in the lines, O most wicked fiend! To dispraise my lord with that same tongue Which she hath praised him with above compare So many thousand times! The Nurse does not seem to have got too carried away with the situation, but is eager for Juliet to marry. She offers no advice or caution to what Juliet should be doing, although she clearly knows that Juliet is young and inexperienced. She also makes no effort to suggest that this will be a problem. Like Friar Laurence, she goes behind her employers backs, acting as Romeo and Juliets messenger, such as when she is asked by Juliet to discover Romeos identity. At first the Nurse admires Romeo, Why hes a man of wax (Act 1 Scene 3), but warns him not to lead Juliet into a fools paradise (Act 2 Scene 4), probably mostly because Juliet is still very young and naà ¯ve. After Tybalts death, the nurse turns against Romeo Will you speak well of  him that killed your cousin (Act 3 Scene 2), Shame come to Romeo (Act 3 Scene 2). Finally, when Juliet needs the Nurse most Comfort me, council me when her parents tell her that she must marry Paris, the Nurse disappoints her by simply telling her that it would be better to marry someone to support her. Why does the Nurse fail as an advisor to Juliet? Although the Nurse genuinely loves and cares for Juliet, yet she does not understand the love and passion Juliet has for Romeo. The Nurse, unlike Juliet, is vulgar in nature and views of love and hence cannot comprehend why Juliet prefers Romeo to Paris. The Nurse advises Juliet to marry Paris, a very eligible and wealthy bachelor, as she does not believe in loyal and faithful love. Thus, she loses Juliets love and trust and Juliet does not confide in her Friar Lawrences plan to drink the potion. Hence, the Nurse is unsuccessful in protecting and caring for Juliet due to her lack of understanding, indirectly bringing about the final tragedy of her death. Romeo and Juliet, is a story of two young lovers whose love was destined for destruction. They did not imagine that their love would lead to the tragedies that it did. These two young people did nothing wrong except fall in love. Three aspects of their destruction included the feud between the two families, the nurse and her betrayal of Juliet and the most important aspect of all is fate.

Nebulized L-epinephrine in Post -Bronchoscopy Croup

Nebulized L-epinephrine in Post -Bronchoscopy Croup Safety and Efficacy of Nebulized L-epinephrine in Post -Bronchoscopy Croup in Children, Anesthesia Consideration Dr Asma Aref Idamat, Pharmacist Dr Hussein Khraysha, Senior Specialist Anesthetist Dr Najeh Alomari, Consultant Pediatric Surgeon Amman-Jordan ABSTRACT OBJECTIVE: To assess the value of bronchodilator effect of nebulized epinephrine post bronchoscopy in children and to compare the effectiveness and side effects of nebulized L-epinephrine (NLE) 1/1000 at a dose of 0.1 mL/kg versus 0.5 mL/kg in the treatment of post-bronchoscopy croup and upper airway obstruction . MATERIAL AND METHOD: Between April1998 and April 2002, 120 children, who developed signs and symptoms of upper airway obstruction (UAO) after bronchoscopy, were randomized to receive either 0.1 mL/kg or 0.5 mL/kg of nebulized L-epinephrine (NLE). Age group ranged from 4months to 14 years, mean of 4.6 years, male /female ratio 4:1. UAO scores, vital signs (VS) ,oxygen saturation (O2 Sat)and side effects if present were recorded before ,at 15 minutes , 35 minutes and 45 minutes after the treatment. The treatment was accomplished in the recovery room under the care of the anesthetist and pediatric surgeon. All patients were reviewed carefully prior to discharge from recovery room. RESULTS: Sixty children were allocated to the 0.1mL/kg (NLE) and sixty children to the 0.5 mL/kg (NLE).. The (NLE) was mixed with 2ml of normal saline. Both groups showed improvements in UAO scores and Oxygen saturation over time. There were no significant differences in UAO scores and VS between the groups at all time points. There were no side effects of epinephrine during the observation. CONCLUSION: The administration of nebulized L-epinephrine is safe and effective in reliving croup and upper airway obstruction (UAO) post-bronchoscopy in children. NLE at the dose of 0.1 mL/kg results in similar improvements in the UAO scores, compared with the dose of 0.5 mL/kg. No complications were seen in either dose and we recommend the routine use of 0.1ml/kg (NLE) post –bronchoscopy in children. Key words: Bronchoscopy, Bronchodilators, L-adrenaline, croup, children Introduction Croup or subglottic edema post bronchoscopy and post intubation is a well known entity. Children are more vulnerable to develop croup after such procedures than adults due to well known differences in the anatomy of upper airway and tracheo-bronchial tree with narrower laryngeal and tracheal lumens with the result of obstruction more readily by to mucosal edema due to different causes, like viral and bacterial infections as well as allergic manifestations. The narrowest part of upper airway is that at the level of cricoid cartilage which makes the internal tracheal injury by endo tracheal tube or bronchoscope sheath more prone at the narrow subglottic area even after easily passage through the vocal cords. Bronchoscopic removal of aspirated foreign bodies in children is a common procedure in Jordan and many other countries worldwide. The procedure is performed under general anesthesia using rigid bronchoscopic device through which the ventilation is maintained. Foreign bodies are usu ally successfully removed using forceps, wash out with saline and suction tube. In many cases repeated bronchoscopic intubation may be necessary to assure complete removal of foreign bodies with the result of significant irritation and edema to the tracheo-bronchial tree with the sequel of croup, wheezy chest and features of upper airway obstruction (UAO) which may lead to significant morbidity and prolonged hospitalization. The incidence of post intubation croup in children was reported to be between 1 to 6 % (1,2). The medical treatment of postintubation croup is the same as that for infectious croup, including corticosteroids and nebulized epinephrine. The vasoconstrictive effect of epinephrine decreases the degree of subglottic edema, resulting in clinical improvement. Traditionally recemic epinephrine has been used as a non-selective adrenergic agonist of choice in children due to its supposedly fewer side effects than the more active and more readily available natural laevorot atory form of epinephrine. However, there seems to be no pharmacological basis for this belief (3-5) and subsequent trials have shown the L-epinephrine which we use for resuscitation, to be safe and effective in both infectious and postintubation croup(6,7). In addition, L-epinephrine is readily available in all countries while racemic epinephrine is not. Even in countries where both forms are available the racemic form is much more expensive(8 ).It was noted that the doses of L-epinephrine used in those trials were 2.5 and 5 mL of 1:1000 solution for all recruited children, regardless of weight. As a result, the dose of L-epinephrine in the treatment of croup has been suggested to be 0.5 mL/kg, with a maximum dose of 2.5 mL and 5 mL for children younger and older than 4 years, respectively (9). So far there have been very few reports that have studied the efficacy L- epinephrine in the management of post bronchoscpy croup and (UAO) in children. This study was designed for tow purpo ses of: (a) ascertaining the effectiveness of L-epinephrine in the management of croup and weezy chest post bronchoscpy in children or not; and (b) comparing the efficacy of a nebulized L-epinephrine at the dose of 0.1ml/kg versus 0.5ml/kg for the treatment of the above conditions and finally to recommend the routine use of L-epinephrine at the dose of 0.1ml/kg as protocole for the management croup and (UAO) post bronchoscopy in Children Material and Methods Between April1998 and April 2002, 120 children, who developed signs and symptoms of upper airway obstruction (UAO) after bronchoscopy such as severe irritative cough, wheezy chest, stridor and hoarseness of voice were randomized to receive either 0.1 mL/kg or 0.5 mL/kg of nebulized L-epinephrine (NLE) with maximum of 2mL for patients below 5 years of age and 4mL for patients above 5 years of age. Two mL of normal saline were added to the dose of L-epinephrine. Age group ranged from 4months to 14 years, mean of 4.6 years, male /female ratio 4:1. We used L-epinephrine because racemic epinephrine in not available in our hospital and it is expensive. The treatment was accomplished in the recovery room under the care of the anesthetist and pediatric surgeon using facemask with 100% oxygen at 6 liters/minute. The main parameter that evaluated was the change of the (UAO) scores (Table 1) and the other parameters that evaluated were changes in the respiratory rate, heart rate, blood pressure and oxygen saturation observed by pulse oxymeter. All parameters were evaluated at 15 minutes, 35 minutes and 45 minutes after the treatment, side effects of nebulized epinephrine, if present such as tremor, arrhythmia, and pallor were recorded at the same time. The management was repeated after 2 hours whenever clinically indicated if the results were not satisfactory. All patients were reviewed carefully prior to discharge from recovery room. RESULTS One hundred and twenty children post bronchoscopy for foreign body aspiration (FBA) were enrolled in this study. Sixty children were allocated to the 0.1mg/kg (NLE) and sixty children to the 0.5 mL/kg (NLE). The (NLE) was mixed with 2ml of normal saline. Both groups had the same baseline characteristics (Table 2) and both groups had initially moderate upper airway obstruction. Both groups showed clinically significant improvements and reduction in UAO scores and Oxygen saturation at 15, 35 and 45 minutes(Table 3) compared to that prior to (NLE) at time 0. There were no significant differences in UAO scores and VS between the groups at all time points and none required immediate intubation or re-bronchoscopy. Side effects of epinephrine including pallor, arrhythmia and tremor were not observed. Table 1: Upper airway obstruction score (15)** Score 0 1 2 Cough Stridor Retraction Inspiratory breath sounds Cyanosis* None None None Normal None Hoarse cry Inspiratory Suprasternal Harsh with rhonchi In room air Bark Inspiratory +expiratory Suprasternal+ substernal +intercostal Delayed In 40% oxygen *Cyanosis was modified and defined as oxygen saturation ** Downes JJ, Raphaely RC. Pediatric intensive care. Anesthesiology 1975; 43: 238-50. Table 2: Patient characteristics of our study groups 0.1mL/kg 0.5mL/kg Number of patients 60 60 Mean age (years) 3.4 5.8 Gender (M/F ratio) 4:1 4:1 UAO score immediately after bronchoscopy ( Mild ( Moderate 4-7) n, % (Severe > 7) n, % 12 (20%) 42 (70%) 6 (10%) 15 (25%) 38 (63.33%) 7 (11.66%) Table 3: The outcome variables in our study groups Time Time 0 15 Minutes 35 Minutes Nebulized L-epinephrine / Dose Number of patients 0.1mL/kg 0.5mL/kg 60 60 0.1mL/kg 0.5mL/kg 60 60 0.1mL/kg 0.5mL/kg 60 60 Upper airway obstruction score (Mean) 5 (1-8) 5 (1-7) 3 (1-6) 2 (0-5) 2 (0-5) 1.4 (0-5) Respiratory rate/minute (Mean) 28 30 32 33 29 28 Heart rate /minute (Mean) 126 128 130 128 125 123 Systolic blood pressure :mmHg (Mean) 95 100 102 106 97 103 Diastolic blood pressure: mmHg (Mean) 55 61 58 63 56 62 Oxygen saturation % (Mean) 93 94 96 97 98 98 Discussion Post bronchoscopy croup and respiratory distress is know entity in pediatric age group, especially when there is a need for repeated bronchoscopic trials for retrieval of long standing foreign bodies. In such conditions, severe inflammatory process of tracheo-bronchial tree is almost present from certain foreign bodies like peanut and other seeds that elaborate severe irritative substances leading to infection and granulation of bronchial tree that aggravate the respiratory distress, bronchospasm and croup post bronchoscopy. The main aim of the clinician in such conditions is to provide relief of respiratory distress by decreasing upper airway irritation and improving air entry. The present study has attempted to verify the safety and efficacy of bronchodilator effect of (NLE) and to prove that a dose of 0.1mL/kg is at least as effective as the dose of 0.5mL/kg in the treatment of croup and (UAO) post bronchoscopy in children. Many studies have tested the value of racemic epinephrine compared to placebo (10) and to nebulized salbutamol (11-13) and the results showed superior value of racemic epinephrine in the treatment of bronchiolitis. It seems no pharmacological basis for the belief that racemic epinephrine is safer than L-epinephrine (3-5) and racemic epinephrine is not available in Jordan and is thus difficult to obtain and expensive, making L-epinephrine a more viable option. Sumboonnanonda (14) used (NLE) at the dose 0.05mL/kg (maximum 0.5mL) in the treatment of infectious croup. They found a clinically significant improvement in (UAO) scores at 24 and 48 hours after admission, even in the placebo group without dexamethasone treatment .The present study found similar results at average 30 minutes in children with post-bronchoscopy croup and wheezy chest. The maximum dose of (NLE) in this study was 2mL for patients less than 5 years of age and 4mL for patients more than 5 years. In our study we confirmed the safety and efficacy of (NLE) in the treatment o f post intubation croup (6) and infectious croup (7), when Nutman (6) used 0.25mL of 1% L-epinephrine (2.5mg) regardless the weight, for children post-intubation croup and found significant reduction of stridor score within 20 minutes, the same we observed in our study which continued at least over the next 4 hours post –bronchoscopy. Waisman (7) used 5mL of 1/1000 L-epinephrine (5mg), regardless the weight, in children with infectious croup when he found a significant reduction of croup score, reaching its maximum at 30 minutes. The majority of our patients required one section of (NLE) to achieve these results and in very few of them who had long standing foreign bodies and repeated trials of bronchoscopy and bronchial wash out, another session of (NLE) required over 24 hours on 6 hourly interval. The present results suggest that nebulized L-epinephrine, at a minimal dose of 0.1 mL/kg, is at least as effective as the dose of 0.5 mL/kg in the treatment of post-bronchoscopy c roup. Both doses temporarily alleviated airway obstruction without undesirable side effects. The dose of 0.1 mL/kg is much less expensive. We would suggest that the dose of 0.1 mL/kg is also efficacious in the treatment of children with post-bronchoscopy croup. This dose may be adequate to diminish mucosal edema of the upper airway by stimulating alpha-adrenergic receptors and producing vasoconstriction (4). In conclusion, the presented data suggest that administration (NLE), at the dose of 0.1 mL/kg is safe and effective and results in a similar reduction in upper airway obstruction scores, compared with the dose of 0.5 mL/kg, in children with post-bronchoscopy croup. Neither dose was associated with any adverse side effects and we recommend the routine use of 0.1mL/kg (NLE) post –bronchoscopy in children. Taking in consideration the comparable efficacy of both doses, the use of a small dose in clinical practice would save the medication expense and, theoretically, have a lower risk of developing side effects that are mostly dose dependent. Future studies should consider the use of (NLE) at the dose of 0.1 mL/kg in children with post bronchoscopy croup, which has a pathophysiology resembling infectious croup. Further studies examining the optimal dose and frequency of (NLE) in children with croup due to different pathologies including post-bronchoscopy croup seem warranted. Acknowledgment to DR Mohamad Al-Sukar, Chair of Anesthesia Department –Royal Medical Services,Dr Kassem Khamaeseh,MD, Anesthesia Intensive care for their support and review of this manuscript. References 1. Borland LM, Colligan J, Brandom B.W. J Clin Anesthesia Koba BV, Jeon IS, Andre JM, MacKay I, Smith RM. Postintubation croup in children. Anesth Analg 1977; 56:501-5 Holbrook PR, Issues in airway management -1988. 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The Harriet Lane Handbook 15th Edition .St Louis : Mosby-Year book,2000:705-6 Kristjansson S, Lodrup KC, Wennegren G, Strannegard I-L, Carlsen KH. Nebulized racemic adrenaline in the treatment of acute bronchiolitis in infants and toddlers. Arch Dis Child 1993;69:650-54 Wennegren G, Holmgren D, Engstrom I, Sten G, Bjure J. Using transcutaneous blood gases to evaluate treatment effects on acute asthma in young children. Scand J Clin Lab Invest 1988;48(supp 189:41-44 Sanchez I, Dekoster J, Powell RE, Walstein R, Chernik V, Effect of racemic epinephrine and salbutamol on clinical score and pulmonary mechanics in infant with bronchiolitis . J Pediatr 1993;122:145-151 Reijonen T, Korpi M, Pitkakangas S, Tehhola S, Kyllikki R. The clinical efficacy of nebulized racemic epinephrine and albuterol in acute bronchiolitis. Arch Pediatr Adolosc Med 1995;149:686-692 Sumboonnanonda A, Suwanjutha S, Sirinavin S. Randomized controlled trial of dexamethasone in infectious croup. 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