Program Evaluation by Berk and Rossi

Program Evaluation by Berk and Rossi Recognizing Issues and Formulating Questions for Program Evaluation Appropriate inquiry definition is the most significant viewpoint in program assessment as the inquiry expresses the measures as per which the program ought to be surveyed. Rossi et al (2004) guarantee that chiefs and partners should play the principle job in detailing questions. They are additionally certain that program assessment ought not rely decisively upon the perspective of partners due to their partial opinion.Advertising We will compose a custom exposition test on Program Evaluation by Berk and Rossi explicitly for you for just $16.05 $11/page Learn More The arrangement of the assessment question ought to rely upon the particular capacities the inquiry is planned for performing. Hence, the general rationale of assessment covers the accompanying perspectives, rules of legitimacy foundation, guidelines development, execution estimation and its examination with acknowledged principles. Detailing an inquiry for assessment program, it ought to relate to the accompanying trademark highlights, sensibility, suitability, it ought to be liable and pass on the exhibition rules (Rossi et al, 2004). Along these lines, there are numerous different issues and procedures for figuring inquiries for assessment programs. Alvesson and Sandberg (2011) offer the problematization method which is planned for coming up â€Å"with novel exploration inquiries through a persuasive cross examination of one’s own natural position, different positions, and the space of writing focused for suspicion challenging† (Alvesson and Sandberg, 2011, p. 252). Problematization strategy for planning question for assessment program is probably the best mean in various reasons. Above all else, it relates to the standards examined by Rossi et al (2004). Furthermore, it distinguishes a space writing, thinks about the suspicions inside recognizes area, assesses those presumptions, creates elective suppositions, relates those suspicions to the crowd lastly assesses presumptions with the reason to meet the necessities of the assessment program (Alvesson and Sandberg, 2011). Key Concepts in Evaluation Research Considering the key ideas in assessment examination, Berk and Rossi (1999) point at the accompanying perspectives, strategy concerns, partners, legitimacy, viability, and speculations. The thought of every one of these ideas may assist us with understanding the idea of the assessment research better. Strategy concerns depend on the data policymakers are anxious to give us with.Advertising Looking to exposition on open organization? We should check whether we can support you! Get your first paper with 15% OFF Learn More Thus, the assessment of the examination depends on the inquiries which show up in the focal point of policymakers (issues and approaches which remain the open space). The consideration of the assessment is normally pulled in by various individuals who are keen on the assessment research results which may fluctuate contingent upon the idea of the examination. Another key idea for assessment research program viability which in the event of dubious objectives of the program can gauge peripheral adequacy (intercession), relative viability (program/nonappearance of program differentiation) and cost viability (estimation of the expense per unit). Legitimacy idea surmises the estimation of the assessment research validity. Hypothesis might be a significant issue before creating different projects, planning assessment structure, or dissecting the information. Along these lines, this idea is significant for assessment research. There are more ideas which might be remembered for the assessments research. Program’s condition and program’s proposed and watched results ought to likewise be remembered for assessment research. Nature impacts incredibly all projects and procedures which happen in the general public. It is difficult to damage the social prope nsities which show up in nature. The correlation and difference of the program’s proposed and watched results ought to be utilized as the principle speculation for assessment. This data predicts assessment results and contrast those and the got ones for surveying the assessment believability (McDavid and Hawthorn, 2006). Limited Rationality and Evaluation Validity According to Herbert Simon, limited sanity is characterized as the constraint of the individuals by methods for the accompanying variables, inability to know it all and comprehend the future results accurately, inability to survey the value of things to come choices because of the powerlessness to gauge the viability and significance of the last mentioned, and inability to think about all the elective variations of the choice result. Every one of these disappointments are characterized as the powerlessness for an exploration to be sane, along these lines, the idea of limited objectivity is available (Simon, Egidi, a nd Viale, 2008). It ought to be referenced that assessment legitimacy relies upon the responsibility of the program evaluator, accordingly, it implies that the demeanor to the assessment is prejudiced.Advertising We will compose a custom exposition test on Program Evaluation by Berk and Rossi explicitly for you for just $16.05 $11/page Learn More Moreover, the exploration assessment is estimated by methods for the activities and thoughts, research questions and other explicit issues picked by the specialist. In this way, research legitimacy depends on the decision of the individual who conducts assessment. Regardless of how unbiased and reasonable an individual may attempt to be, the limited sanity is the idea which ought not be disregarded. Considering the key ideas talked about above and the issues for shaping an assessment question, a specialist assumes a prevailing job in the assessment result. Exploration assessment program can't be method of reasoning in its whole significance . There are consistently constraints and concerns which ought to be considered. An evaluator’s way to deal with conveying a comprehensive assessment with useful suggestions is a result of individual experience and practice due to the like limit sanity thought. An evaluator has a privilege to pick the assessment rule, expressive program of the examination and making decisions based on the thought about data (Gigerenzer and Selten, 2002, p. 117). Reference List Alvesson, Mats and Jã ¶rgen Sandberg. 2011. Producing research inquiries through problematization. Foundation Of Management Review 36(2): 247-271. Berk, Richard A. also, Peter Henry Rossi. 1999. Pondering system assessment. New York: SAGE. Gigerenzer, Gerd and Reinhard Selten. 2002. Limited discernment: the versatile tool stash. Cambridge: MIT Press. McDavid, C. James and Laura R. L. Hawthorn. 2006. Program assessment execution estimation: A prologue to rehearse. New York: SAGE.Advertising Searching for article on open organization? We should check whether we can support you! Get your first paper with 15% OFF Find out More Rossi, Peter. H., Lipsey, Mark. W., and Howard E. Freeman. 2004. Assessment: An orderly methodology. Thousand Oaks, CA: Sage Publications. Simon, Herbert Alexander, Egidi, Massimo, and Riccardo Viale. 2008. Financial aspects, limited levelheadedness and the intellectual unrest. New York: Edward Elgar Publishing.

The Resurrection of Jesus Assignment Example | Topics and Well Written Essays - 250 words

The Resurrection of Jesus - Assignment Example Mathew just notices Mary Magdalene and doesn't demonstrate the presence of different ladies (The Gospel as per Matthew, Chapter 28). They didn't locate the stone that was covering rather, two heavenly attendants appeared to them in sparkling articles of clothing and asked them for what reason they were looking for Jesus among the dead. In the book of Mathew, Jesus appeared to the pupils on their approach to enlightening the devotees regarding the risen Christ. The other three books don't represent this. He instructed them to remind the followers that they were to meet him in Galilee. As indicated by Luke, Peter, who didn't accept left for the vacant tomb to affirm what the ladies had said to them (The Gospel as indicated by Luke, Chapter 24). Different books don't depict these happenings. While on their approach to Emaus with an associate, Cleopas, Jesus appeared to them yet they didn't remember him until the time he fellowshipped. Jesus was not human he was completely of brilliant magnificence since he evaporated from them. They left promptly for Jerusalem where they met the eleven trains and educated them regarding the risen Christ and how he had appeared to Simon. As they described what befell them in transit, Jesus showed up in the midst of them and educated them to stay in harmony. They were so scared reasoning he was a soul. He demonstrated them of the scars on his feet and hands, however the pupils didn't trust him yet Jesus ate a seared fish t before them describing how a soul has neither substance nor bones (Bible, 2000). The various three books spread these happenings with the exception of the book of John. The books of Mark, John and Luke spread how Jesus uncovered to the pupils His dads endowments to them. He disclosed how they were to be observers of the abatement of sins and they were to lecture his name to all the countries. As he favored them, he was separated into the sky up to the sky. The various creators depicted the restoration of Jesus as they did on the grounds that there

What Do the A.P.A. Reflection Paper Tests Cover?

What Do the A.P.A. Reflection Paper Tests Cover?The A.P.A. (American Physical Therapy Association) reflection paper is a formalized set of physical examinations that any physical therapist must take before being qualified to practice as a physical therapist. They are not mandatory, but the testing is conducted by the physical therapist to determine whether the person in question has the skills and knowledge needed to help patients.In order to take the physical therapist's A.P.A. reflection paper, the person in question must complete a one-hour practice test. This test consists of one or more tests that will involve the physical therapist in question and has an entire different set of regulations and tests based on the trainee's specialty.There are multiple test formats and the physical therapist will take the test that most closely matches his or her training and education. These tests have been organized by the American Physical Therapy Association to assess their members' skills in a specific area of physical therapy.The main thing that all tests for the A.P.A. reflection paper must cover is how the physical therapist treats his or her patients.The first step is a post-treatment assessment. The therapist will look at the client and ask questions about his or her history. The questions will usually be along the lines of whether the patient requires more support or is able to do more. It is also important that the therapist knows about the condition of the patient in question, such as pain levels and whether the patient has developed any injuries or contraindications for a particular type of treatment.The next step in the process is a physical assessment, which will focus on the effects of the treatment. The patient will be asked questions about physical symptoms and signs that were present prior to the treatment and will then be asked if they are present after the treatment. It is very important that the therapist knows about the patient's feelings and emotion s while he or she is under the treatment. They will also be given questions about the client's reaction to the treatment.The next step is an evaluation, which will evaluate the effectiveness of the treatment. The client will be asked to perform a set of exercises and will be given feedback from the therapist. He or she will also be asked to do something that is not an exercise, such as sitting in a chair or drinking a beverage. They will also be asked to try on a new garment and perform a number of other activities that will help them get a feel for the physical therapist's expectations for their treatment.The final step is a review, which will simply ask the therapist for some feedback about how they performed their exam. They will be asked how the client felt after the treatment, what questions they would ask a new patient and other things like this. All of these tests are designed to gauge the ability of the therapist to treat their patients and make sure that they understand the ir patients' needs and can meet them.

Causes of Bolshevik Success Using Voilence Essays

How far do you agree that the Bolsheviks consolidated their hold on power in the years after the October/November revolution mainly through the use of violence against their opponents? The Bolsheviks consolidated their power after October 1917 however they faced many severe problems which made keeping their power complex. For Lenin and the Bolsheviks winning political power was relatively easy compared with retaining it. The Bolsheviks may have had a temporary majority in the All-Russia soviet in October 1917, but they did not have a majority following in the country as a whole . Russia was in chaos, politically and economically, and normal government had broken down in large areas. . yet lenin was able to overcome these problems and†¦show more content†¦The Workers Decrees outlined measures for minimum wage, limitations on workers hours, and the running of factories by elected workers committees. This consolidated Bolshevik support amongst the working classes in the cities, where they had taken power, because it gave the workers a sense of democracy. However Lenin also had solutions to these problems through a more violent approach, this was repression. The cpnstituent assembly which had been promised by the provisional government took place as planned on 12 november 1917 and the result was that the social revolutionaries became the largest party in Russia. This made lenin fear was that the constituent assembly would challenge the newly Bolshevik rule so when the assembly rejected by 237 to 137 votes to be subservient to the decrees, Lenin took violent action by having armed troops and red guards threaten the assembly at gun point to close down. The Bolsheviks had been successful because the opposition was divided on what to do; half of the socialist revolutionaries supported the Bolsheviks and joined them in a coalition government; half followed the leader viktor chernov who called for peaceful

Factors Affecting The Financial Crisis - 2534 Words

1. Introduction Financial crisis is often related to a situation that the value of financial asset(s) or financial institution(s) drops rapidly. Financial crisis is not likely to occur suddenly. It must be a process from creating the bubble till the bubble bursting. As many factors can be attributed to financial turmoil, usually there are several reasons for a financial crisis. It may seem that nothing going wrong when various factors are simmering. Thus, when the bubbles burst, everything comes together rapidly with great impact. When the bubble in American sub-prime mortgage lending and mortgage backed securities (MBSs) burst, no one knew it would lead to such a pervasive global financial crisis. Those toxic assets such as†¦show more content†¦When many subprime mortgage holders found themselves not able to pay back the mortgage, lenders took their houses and released them in the market and thus the housing price dropped. The leading credit crisis deteriorated the economy of the United States. As long as the U.S. government made efforts to spread out the adverse impact brought by the credit crisis to revive its economy, the global market started to suffer in different levels. The close interconnection within the international market eventually spread the financial crisis out across markets. The global market has suffered an unprecedented financial depression. The more the market is open, the greater loss the market is suffering. Modernized convenient platforms for financial instrument trading are one of the great contributors. In general, there are two types of â€Å"places† for financial instrument trading. One is trading on an exchange and another is trading over the counter (OTC). When trading in an exchange, certain rules and regulations are implemented in order to facilitate the trading process and to protect the interests of all the involved parties in the trading. When the buyer and the seller reach agreement which the bid and the ask price are equal, the transaction will be executed and the agreed price will be communicated throughout the market. Once two parties agree at a matching price, the trade can be executed no

The Metamorphosis Analysis - 1682 Words

In The Metamorphosis, Kafka establishes, through his religious imagery and gospel-esque episodic narration, the character of Gregor Samsa simultaneously as a kind of inverse Messianic figure and a god-like artist, relating the two and thus turning the conventional concept of the literary hero on its ear. The structure of the novel reflects that of the Gospel of Mark in that it is narrated in individual events, and in this it is something of a Kà ¼nstlerroman - that is, the real metamorphosis is over the course of the novel, rather than just at the beginning, and that change is a heightened sensitivity to the world in an artistic sense. The motif of change is a rather theological one as well: we see it in a religious sense, in the form of†¦show more content†¦. . at the table quietly reading the paper or studying (Kafka 12-13). This imagery of Samsa as a studious carpenter characterizes him as humble and, in this, somewhat unlikable to the toughest audiences. Even imagery as simplistic as this conjures the image of Gregor as a bookish, studious milquetoast. At the same time, the carpenter characterization connotes Christ, and thus immediately hints at Samsas eventual heroism, even before anything significant has happened. So when the books first metamorphosis occurs in the first sentence, Gregors prior circumstances make him fertile ground in which a change in spirit can occur. Samsa even acknowledges the metaphysical change enacted in himself: when he tries to explain to his family and the head clerk why he cannot leave his room, his audience can no longer (understand) his words, even though they (are) clear enough to him, clearer than before even (15). It is as if he is in another dimension from them completely and therefore a sort of immortal at heart, before the knowledge is even imparted upon him in the form of his metamorphosis into an insect. Only as a vermin can Gregor, thoroughly isolated from the world, be truly human. In this alternative hum anity Kafka incorporates James Joyces assertion that an artist remains ... invisible, refined outShow MoreRelatedAnalysis Of The Metamorphosis1501 Words   |  7 PagesBeveridge, A. (2009). Metamorphosis by Franz Kafka. Advances in psychiatric treatment, 15(6), 459-461. This brief article is written from the psychiatric perspective, pointing out that Kafka has always been of great interest to the psychoanalytic community; this is because his writings have so skillfully depicted alienation, unresolved oedipal issues, and the schizoid personality disorder and The Metamorphosis is no exception to this rule. While this writer tends to think that psychiatrists shouldRead MoreAnalysis Of The Metamorphosis 854 Words   |  4 PagesAnalysis of the Metamorphosis The Metamorphosis can be analyzed in many different ways. One way that could be looked into is why exactly Gregor is turned into an insect. There are many things that he could have changed into, like a monkey or a bird for example. But Kafka makes it obvious that Gregor is a bug although he never says what kind. Bugs can be, more or less, controlled, considered useless, and gross. To call a person a bug means they can bend easily to another’s will and are expendableRead MoreMetamorphosis Analysis1503 Words   |  7 Pagesmost wickedest of men will do the most wickedest of things for the greatest good of everyone.† 20th century novelist, Franz Kafka would agree with such a statement as he strongly despised capitalism and its faults. In his celebrated short story, Metamorphosis, Kafka explores the cruelty and exploitations of capitalism through the eyes of Gregor Samsa. ironically, he also represents capitalism to further illustrate its barbarity. Kafka’s use of ir ony is significant for it leaves the readers confusedRead MoreThe Metamorphosis Analysis848 Words   |  4 PagesIn the short novel The Metamorphosis by Franz Kafka, the novel revolves around the transformation of the protagonist, Gregor Samsa. Gregor wakes up one morning to find himself transformed into an insect, and becomes the main conflict and driving force of the novel. Beyond being a driving force within the book, the transformation in which Gregor undergoes being a literal challenge in his life and his family’s, it serves as an allegorical narrative on isolation. Gregor spends the rest of his life inRead MoreAnalysis Of Metamorphosis826 Words   |  4 Pages Metamorphosis, written by Franz Kafka, is a novelette detailing the life of a young man named Gregor and his family, which include his sister, Grete, and his parents. Gregor is a traveling salesman who has an overbearing manager and extremely long hours. He is unhappy with his job due to these circumstances and the fact that he is not able to make any friends. One morning Gregor wakes up and is suddenly a beetle instead of a normal human. The life of everyone in the household is flipped upsideRead MoreEssay on Analysis of The Metamorphosis1033 Words   |  5 PagesAnalysis of The Metamorphosis This story The Metamorphosis is about Gregor, a workaholic, who is changed into an insect and must then deal with his present reality. The hardest part of being an insect for him was the alienation from his family, which eventually leads to his death. In reading the short story The Metamorphosis, (1971),one can realize how small the difference is between Magical Realism and Fantastic. This literature written by the Austrian, Franz Kafka, is often debated overRead MoreAnalysis Of The Metamorphosis Essay1390 Words   |  6 Pagesan attempt to distance oneself from an undesirable event or occurrence. It can also range from an overt set of actions as a person is changed, to willful ignorance, malicious or otherwise, of an individual’s dreams or goals. Franz Kafka’s â€Å"The Metamorphosis†, in which the main character, Gregor Samsa, awakens to find himself changed, contains several obvious examples of this dehumanization. He has become vermin of some kind, no longer even human. Deprived even of basic human form, and transfiguredRead MoreMetamorphosis Analysis1142 Words   |  5 PagesFranz Kafka’s â€Å"The Metamorphosis† is about the dehumanization of a man named Gregor, when he wastes his life monotonously repeating the same task every day to support his uncaring family. The lack of purpose in his life is an example of absurdist fiction, a genre of fictional narrative that uses satire and irrationality to explore the human experience of meaninglessness. Furthermore, â€Å"The Metamorphosis† uses aspects of magical realism, such as transformation of common, distortion of time and lossRead MoreLiterary Analysis Of The Metamorphosis 1422 Words   |  6 PagesElaina Faerber, Hannah Lindsey, Jake Sims Mrs. De Oro Hon, English 12A Pd 3 19 October 2015 Literary Analysis Essay-Rejection When individuals are rejected by family and society, they tend to feel abandoned and unloved. In Franz Kafka’s, The Metamorphosis, Gregor’s transformation into a â€Å"monstrous vermin† (Kafka 1) results in him being psychologically and even physically abused by his family. Rejection from his mother, sister, and father leave Gregor feeling unwanted and feeling as if he is a terribleRead MoreMetamorphosis Analysis1761 Words   |  8 PagesFranz Kafkas The Metamorphosis is so strikingly absurd that it has engendered countless essays dissecting every possible rational and irrational aspect of the book. One such essay is entitled Kafkas Obscurity by Ralph Freedman in which he delves down into the pages of The Metamorphosis and ferrets out the esoteric aspects of Kafkas writing. Freedman postulates that Gregor Samsa progresses through several transformations: a transformation of spatial relations, a transformation of time, and a

Antigone Analysis of Greek Ideals Essay Example For Students

Antigone Analysis of Greek Ideals Essay In Ancient Greece, new ideals surfaced as answers to lifes complicated questions. These new beliefs were centered around theexpanding field of science. Man was focused on more than the Gods or heavenly concerns. A government that was ruled by the people was suggested as opposed to a monarchy that had existed for many years. Freedom of religion was encouraged to be exercised in city-states. These new ideals, though good in intentions, often conflicted with each other creating complex moral dilemmas. Such was the case in Antigone a play written by Sophocles during this era of change. In the play, Antigone and Creon battle a philosophical war dealing with the controversy of the Greek ideals. They both based their actions on their beliefs of what is right and wrong. The conflict arose when the ideals that backed up their actions clashed with each other, making it contradiction between morals. Antigones side of the conflict held a much more heavenly approach, as opposed to the mundane road that Creon chose to follow. Antigone feels that Creon is disregarding the laws of heaven through his edict. After she is captured and brought to Creon, she tells him I do not think your edicts strong enough to overrule the unwritten unalterable laws of God and heaven, you being only a man. Antigones staunch opinion is one that supports the Gods and the laws of heaven. Her reasoning is set by her belief that if someone is not given a proper burial, that person would not be accepted into heaven. Antigone was a very religious person, and acceptance of her brother by the Gods was very important to her. She felt that It is against you and mehe has made this order. Yes, against me. Creons order was personal to Antigone. His edict invaded her family life as well as the Gods. An important ideal in Ancient Greece was the belief that the government was to have no control in matters concerning religiousbeliefs. In Antigones eyes, Creon betrayed that ideal by not allowing her to properly bury her brother, Polynices. She believed that the burial was a religious ceremony, and Creon did not have the power to deny Polynices that right. Antigones strong beliefs eventually led her to her death by the hand of Creon. Never, though, did she stop defending what she thought was right. As Creon ordered her to her death, Antigone exclaimed, I go, his prisoner, because I honoured those things in which honour truly belongs. She is directly humiliating Creon by calling his opinions and decisions weak and unjust. She also emphasizes his prisoner, which tells us that Creons decision to capture Antigone was his own, and was not backed up by the majority of the people. She feels that Creon is abusing his power as king and dealing with her task to a personal level. Creons actions are guided by the ideal that states Man is the measure of all things. The chorus emphasizes this point during the play by stating that There is nothing beyond (mans) power. Creon believes that the good of man comes before the gods. Setting the example using Polynices body left unburied is a symbol of Creons belief. No man who is his countrys enemy shall call himself my friend. This quote shows that leaving the body unburied is done to show respect for Thebes. After all, how could the ruler of a city-state honor a man who attempted to invade and conquer his city. From that perspective, Creons actions are completely just and supported by the ideals. .u1c4d2c0ef6e549f9cbbbc295d5d404c8 , .u1c4d2c0ef6e549f9cbbbc295d5d404c8 .postImageUrl , .u1c4d2c0ef6e549f9cbbbc295d5d404c8 .centered-text-area { min-height: 80px; position: relative; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8 , .u1c4d2c0ef6e549f9cbbbc295d5d404c8:hover , .u1c4d2c0ef6e549f9cbbbc295d5d404c8:visited , .u1c4d2c0ef6e549f9cbbbc295d5d404c8:active { border:0!important; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8 .clearfix:after { content: ""; display: table; clear: both; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8:active , .u1c4d2c0ef6e549f9cbbbc295d5d404c8:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8 .centered-text-area { width: 100%; position: relative ; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8:hover .ctaButton { background-color: #34495E!important; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8 .u1c4d2c0ef6e549f9cbbbc295d5d404c8-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u1c4d2c0ef6e549f9cbbbc295d5d404c8:after { content: ""; display: block; clear: both; } READ: Japanese immigrants and the following generations EssayThough most of Creons reasonings coincide with the Greek ideals, one ideal strongly contradicts his actions. The ideal states that the population would be granted freedom from political oppression and that freedom of religion would be carried out. Creon defied both of these. First, Antigone was his prisoner, not necessarily the publics. In fact, the general population supported Antigone, though they were too scared to say anything. Haemon, the son of Creon, knew of this, and told Creon, Has she not rather earned a crown of gold?- Such is the secret talk of the town. This proves that Creon was exercisingcomplete dominat ion

The Problem of Ocean Pollution in Modern World

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buy custom The Computer Types essay According to research, classification essay is an essay that requires the writer to take different types of information and create sensible information out of it by putting it properly as need be. There are a considerable of computer types ranging from the hybrid to the analog types. The day to day computers that a high number of people use to accomplish their tasks includes laptops, palmtops, and desktop computers (Kim, 2009). Because of the ever-increasing rate in technological advancement, there have been inventions of new computers that are able to meet the daily needs and demands of people of all ages. Laptop is the most familiar form of computers which is for personal usage. There are also other types of personal computers, and these include the desk top and the personal computer. Desk top is not portable meaning that it is in a certain location for it to be used. It, however, provides extra power, storage capability and versatility at a cheaper price than the others which are portable. Computers play a significant part in the daily lives of people such as acting as servers. For instance, they can be optimized in order to enable them offer services to other computers through a network. With such computers, they always have strong processors, large memory and bigger hard drives. Other types of computers such as the main frame enable a large group of individuals to accomplish their work on time with similar data. Therefore, because of the ever-increasing demands from the consumers, new advancements are in the process of developing new computers that meet different demands and purposes. Thus, it is vital that people keep on following each and every step the science department takes in order to be at the same level with the current knowledge concerning computers. Buy custom The Computer Types essay

Perform a Limited Risk Managment Study Coursework - 1

Perform a Limited Risk Managment Study - Coursework Example Privacy invasion: Using P2P networks or applications may give unauthorized users access to personal data either, by accessing personal directories or users give private information to whom they believe to be a trusted source or organization. When Medical or financial information, sensitive individual or corporate data is compromised, users are vulnerable to identity theft (Bidgoli, 2004). Vulnerability: Several P2P networks and applications ask users to open certain ports on the computers firewall to share files. Opening this ports provide attackers with channels to attack the user’s computer by utilizing any susceptibilities that may exist in the P2P connection. Service Denial: Downloading media files raise the capacity of traffic across the network. This may restrain the user’s internet access or inhibit the availability of certain applications in the user’s computer. The best ways to avoid these risks is by refraining from P2P networks and applications, but if a user insists on using them, they should have a proper and up to date antivirus program and they should have installed and enabled a firewall on their

Cover letter and Resume letter Assignment Example | Topics and Well Written Essays - 500 words

Cover letter and Resume letter - Assignment Example an Assistant Industrial Engineer and the experience provided me with a valuable insight into the real world of engineering where my knowledge was used in a real world work setting. I am also a member of Engineering Club in University which supplemented our expertise from knowledge from various aspect of engineering such as electrics engineering, avionics engineering making our perspective about engineering more complete. I have been a President of the club manifesting my leadership skills and ability to work with others. Writing a cover letter and a resume serves as a purview of my qualification to a certain job I am applying for. It is important to highlight my qualifications that includes academic preparation, experiences (if any) and internship related to the job. It would also help if to mention extracurricular activities that manifests leadership and ability to work with others. Personal information such as religious affiliation, weight, height and ethnicity are not important and can be omitted in the

Corticosteroids and Mental Disorder

Corticosteroids and Mental Disorder Abstract Corticosteroid medication is an essential treatment in almost all medical specialties. Psychiatric side effects of corticosteroids may be both common and severe and include psychosis, mania, depression, delirium and dependence. Only a small evidence base exists about susceptibility to and epidemiology of these conditions. Corticosteroid induced psychiatric disorder typically has an acute onset and is dose related. Manic symptoms predominate acutely however long term use may be associated with depression. Steroid dependence and withdrawal syndromes have been documented. Case reports suggest that a combination of mood stabilizers and antipsychotics may be useful in management severe acute effects. This article will give psychiatrists working in a general hospital a guide to the epidemiology, clinical presentation and management of corticosteroid induced psychiatric disorder. Introduction Corticosteroids were first introduced into medical practice in the late 1940s, since when they have been used by almost all medical specialists as effective treatment for autoimmune and inflammatory conditions. Over 5 million prescriptions are written for corticosteroids in the UK each year, at a cost of over  £100 million. (NHS Health Care Statistics 2005) About 1% of the general population and as many as 7% of hospitalized patients are receiving oral corticosteroid therapy at any given point in time. (NHS Health Care Statistics 2005) Whilst being renowned for important therapeutic actions they can have many adverse effects which must be considered in long term treatment. Physical effects such as osteoporosis, central obesity and immunosuppression are frequent in patients receiving corticosteroids. Psychiatric effects include alterations in mood, delirium, dementia and psychosis. As corticosteroids have a critical place in the management of chronic disease, psychiatrists should be equipped with the knowledge to recognize and manage corticosteroid induced mental disorder. This article describes the epidemiology, clinical presentation and management of these conditions. Indications and Pharmacology There are several forms of corticosteroid medication licensed in the UK, including: betamethasone, cortisone acetate, deflazacort, hydrocortisone, methylprednisolone (prednisolone) and triamcinolone. Each of these drugs has varying degrees of mineralocorticoid and glucocorticoid activity. All of the above preparations exist in oral or intramuscular form. Inhaled steroid preparations are also will not be discussed as there is little evidence that they can induce mental disorder. The main indications for these medications are: Suppression of inflammatory and allergic bowel disease; chronic or treatment resistant Asthma and COPD; Immunosuppression in Acute Lymphoblastic Leukemia, Hodgkins and non-Hodgkins disease, and Hormone sensitive breast cancer; Palliation of symptomatic end-stage malignant disease; Organ transplant rejection; Auto-immune (Rheumatic) disease such as Systemic Lupus Erythematosis and Wegners Granulomatosis. Corticosteroids are rapidly absorbed across the Gastro Intestinal  membrane following oral administration. Peak effects can be observed after 2 hours. The circulating drugs bind extensively to the plasma proteins Corticosteroid Binding Globulin (CBG), albumin and transcortin, with only the unbound portion of a dose active. Systemic prednisolone is quickly distributed into the kidneys, intestines, skin, liver and muscle. Corticosteroids also distribute into the breast milk and cross the placenta. Corticosteroids are predominantly metabolized by the liver to active metabolites then further metabolized to inactive compounds. These inactive metabolites, as well as a small portion of unchanged drug, undergo urinary excretion. The plasma elimination half-life is 1 hour whereas the biological half-life of prednisone is 18-36 hours. Corticosteroids act as glucocorticoid receptor agonists. On binding, the corticoreceptor-ligand complex translocates itself into the cell nucleus, where it binds to Glucocorticoid Response Elements (GRE) in the promoter region of target genes. Insert Figure 1 about here The DNA bound receptor then interacts with basic transcription factors, altering gene expression. There are high concentrations of CBG in specific brain areas such as the hippocampus and pre-frontal cortex and these can therefore be thought of as a potential mediator of corticosteroid induced psychiatric disorder. Chronic disease and corticosteroids In parallel to the psychiatric side effects of corticosteroid therapy, most chronic medical conditions may be associated with considerable psychiatric morbidity. A primary objective of the psychiatrist is to distinguish between the psychiatric effects of chronic illness and corticosteroids. The 1-year prevalence for ICD-10 depressive episode alone is 3 ·2% (95% CI 3 ·0-3 ·5) and an average of between about 9% and 23% of patients with one or more chronic physical diseases have co-morbid depression. In an international meta-analysis, patients with a variety of chronic physical diseases and co-morbid depression had significantly worse health scores than those with chronic disease alone. (Moussavi et al 2007) There are many potential reasons for this, including physical symptoms such as pain and secondary disability leading to loss of function. Studies of depression amongst the medically ill almost always fail however to account for possible corticosteroid effects. In patients with severe COPD given 30 mg of prednisolone for 14 days, when lung spirometry and mood state were measured, no changes in spirometry were detected until 7 days of active therapy. However, small but significant reductions in anxiety and depression were measured after 3 days of prednisolone and before any measurable improvement in lung function. This single study is a major part of a small evidence base suggesting that corticosteroids produce a mild sense of wellbeing rather than the wellbeing necessarily being a consequence of physical improvement. (Swinburn et al 1988) Classification, Epidemiology and Clinical Features Psychiatric side effects were first described and classified by Rome and Braceland in 1952 shortly after the initial introduction of corticosteroids into the pharmacopoeia. As can be noted in Table 1, the descriptions of symptoms in 1952 have an implicit hierarchy which places psychosis above ego disturbance of a neurotic nature and places these above euphoria. (Rome and Braceland 1952) Insert Table 1 about here Epidemiology The proportion of patients developing psychiatric symptoms during corticosteroid therapy has been reported to range from 3 to 75 percent, with a weighted average of about 28 percent. (Lewis and Smith 1983) Amongst the larger studies, the Boston Collaborative Drug Surveillance Program (Boston Collaborative Drug Surveillance Program 1972) monitored 718 hospitalized medical patients who received prednisolone, of whom just 21 (3%)had acute psychiatric reactions: in 6 of 463 (1%) patients receiving 40mg prednisolone, 8 of 175 (5%) patients receiving 41-80mg and 7 of those receiving above 80mg (18%). The dose-response trend was significant, but the study was conducted in 1972 and deals with relatively small numbers of affected subjects who underwent only a basic psychiatric screening. In terms of speed of onset, symptoms appear to develop rapidly. In groups of both patients and healthy subjects, psychiatric symptoms occurred between 3 days and one week. (Lewis and Smith 1983, Hall 1979, Naber 1996) Evidence shows that significantly more women than men (P =0.009) develop psychiatric symptoms as a function of corticosteroid treatment. (Nielsen et al 1963) Prednisolone is the medication most cited to cause psychiatric side effects. In case reports, prednisolone was responsible for 37 cases followed by methylprednisolone, dexamethasone betamethasone, and hydrocortisone. (Lewis and Smith 1983) When dose equivalences were calculated, ranging from 5 to 200mg prednisolone per day, a mean dose of 58.3mg per day or more was cited as substantially raising the risk of a psychiatric reaction. This does not mean that psychiatric reactions only occur at higher dosages. While dosage is not related to the risk of developing mental disturbances, dosage nor duration of treatment seems to impact upon the time of onset, duration, severity, or type of mental disturbances and it is unclear whether patients with a history of psychiatric disorder are predisposed to such disturbances. (Ling 1981) Affective Symptoms The most common psychiatric reaction during glucocorticoid therapy is mood change, which accounts for almost 90 percent of the psychiatric reactions (Hall 1979, Stiefel 1989) In a review of 56 case studies of psychiatric reactions to steroids, of those reporting mood symptoms (45 cases), mania was observed in 48%, depression in 25%, and a mixed state in 9%. (Flores and Kenna) Reversible mood change can be seen in healthy control subjects after administration of prednisone and dexamethasone. One study showed that 8/12 healthy controls experienced this, with manic symptoms predominating. (Brown 1998) A further study which looked at methylprednisone in ophthalmology patients, all of whom were free of psychiatric disorder, found that 36% developed mania or depression during high dose steroid treatment. (Naber 1996) Studies examining the consequences of low dose steroid treatment have found little or no affective symptomatology (Swinburn 1988). With regard to steroid induced mania, patients typically report sudden euphoric mood, excessive energy, indefatigability and some grandiosity. In addition to the rapid development of mood symptoms, suicidality can be associated with steroid treatment. (Flores and Kenna). In addition to mood symptoms patients have been reported to experience sleep disturbances and weight gain. Recurrent affective disorder A further important consideration is whether any such affective disturbance involves one isolated episode or leads on to recurrent disorder. Nine patients whose initial clinical presentation met DSM-IV criteria for a steroid-induced mood disorder were shown in the long term to have a clinical course of bipolar disorder. (Wada 2001) Seven patients initially developed a manic or hypomanic state with sub-acute onset ranging from 1 to 3 months and six patients had manic episodes accompanied by psychotic features. The proportion of manic episodes relative to total mood episodes of the 9 patients was 66%, suggesting manic predominance. Seven patients had future mood episodes that had no direct relationship to corticosteroid therapy and were preceded by various psychosocial stressors. Four of 5 patients who received future steroids rapidly became manic or hypomanic. Recurrent cases of corticosteroid-induced mood disorder therefore appear to have clinical features such as sub-acute onset, fr equent accompanying psychotic features, and similar recurrent episodes in association with psychosocial stressors and corticosteroid use. Psychotic Symptoms In a review of 55 case reports of steroid induced psychiatric disorder, 58% of cases demonstrated psychotic symptoms. (Ling 1981) In 72% of the cases with psychotic symptoms, they were combined with an affective disorder. Similarly, in a review of 79 case reports there was a 71% incidence of psychotic symptoms with affective symptoms reported in over 75% of these. Hallucinations occurred in 58% of the cases and delusions in 74% .(Lewis and Smith 1983) In a more recent review of 56 case reports, psychotic symptoms were reported in 65% of cases. In eight of these, the development of psychotic symptoms was more clearly associated with the withdrawal, rather than with the administration, of steroids. (Flores and Kenna) Interestingly, but perhaps coincidentally, seven of these eight cases occurred in female patients. All eight cases included mood disturbance; 2 with depression, 4 with mania, and 2 with a mixed state. Cognitive effects The cognitive effects of corticosteroid therapy have been seen in patients receiving short term or long-term corticosteroids, and relate primarily to declarative or verbal memory. (Flores and Kenna) In one study, patients on corticosteroids had poorer performance on the Rey Auditory Verbal Learning Test (RAVLT), (a measure of declarative memory), the Stroop Color Word Test (a measure of working memory) performance, smaller hippocampal volumes and lower levels of N-acetyl aspartate (a putative marker of neuronal viability in the temporal lobe region). (Brown 2001) Deficits in declarative memory have been observed in subjects receiving as low as 4 to 5 days of dexamethasone or prednisone. (Newcomer 1999) A dose-dependent impairment in declarative memory has been reported with high dose (160 mg/day), but not low dose (40 mg/day) hydrocortisone. It appears that these cognitive impairments may be reversed with the reduction or withdrawal of corticosteroids. Similar results for declarative memory deficits are found in persons with Cushings disease. Such findings are consistent with reductions in hippocampal volume which are correlated with cortisol levels. (Starkman 1992) Steroid Dependence and withdrawal Several case reports suggest that corticosteroids may be abused for their euphoric effects. (34) Typically this will involve higher doses of oral systemic steroids although there is one report of dependence secondary to a nasal spray. (35) In a case review, 8 patients out of 11 cases of steroid dependency had a previous psychiatric history (predominantly depressive symptomatology), and 4 had a history of drug or alcohol mis-use or dependence. It has been suggested that patients who may request higher steroid doses or who resist dose reduction despite their improving health should be carefully monitored. (Stoudemire 1994) In the more recent review of case studies (Flores and Kenna), the development of psychiatric symptoms was also associated with the withdrawal of steroids. Corticosteroid withdrawal symptoms generally include depression and fatigue but mania and delirium have also been reported during dose reduction or discontinuation. Psychiatric symptoms during steroid withdrawal generally improve or resolve when corticosteroids are re introduced. Cushings disease and psychiatric disorder Cushings syndrome relates to the multi-organ over exposure of iatrogenic or endogenous corticosteroid and is associated with a variety of psychiatric and psychological disturbances. In one study examining 43 patients before and after treatment for Cushings psychopathology was observed in a considerable number. Only 8 patients of 43 with active Cushings syndrome (19%) were without psychiatric symptoms. Psychiatric diagnoses included: neurotic depression in 20 (46%), possible neurotic depression in 1 (2%), reactive depression in 6 (14%), and non-specific neurotic symptoms in 8 (19%). Psychoses were suspected in 3 of the patients who were depressed, but none of the 43 patients with active Cushings syndrome had a definite diagnosis of Schizophrenia, Mania, Obsessive Compulsive Disorder or Generalised Anxiety Disorder. After treatment in 25 patients, when cortisol levels had been substantially reduced (to within normal limits in 88% of them), the percentage rated as psychiatrically asymptomatic increased from 19% to 68%. Scores for depression and anxiety showed significant improvements after treatment for Cushings syndrome and Eysenck Personality Inventory assessments showed a significant improvement in neuroticism score. (Kelly 1996) Treatment of Corticosteroid induced psychiatric disorder There is a very limited literature on the treatment of corticosteroid induced mental disorder, although it can be noted from the forgoing that psychiatric symptoms generally resolve with discontinuation of the medication. In one review of the literature, tapering the dose of steroids alone appears to be effective up to 90% cases. (Flores and Kenna) Case studies also suggest that switching steroids may be of value. (Okishiro et al 2009) The primary objective in managing these conditions is to balance the relative risk of psychiatric disturbance against the medical consequences of withdrawing the steroid. The management of corticosteroid induced psychiatric disorder can otherwise be largely divided into managing an acute psychotic/manic episode versus managing long term depressive symptoms and dependency. Although little evidence exists either way, it can be assumed that severe behavioral disturbance should be managed as it usually is symptomatically with appropriate doses of benzodiazepines and antipsychotics. In terms of managing acute psychotic/manic episodes one study found that of 27 patients treated with lithium carbonate prophylactically none developed severe mood symptoms while receiving corticosteroids. However, six out of 44 patients (14%) not receiving lithium developed mania or depression. (Falk 1979) Antipsychotics, specifically haloperidol, risperidone and olanzapine, are noted from case reports to be useful in mania, mixed affective states, psychosis and delirium. A further case report suggested the successful use of low-dose olanzapine (2.5 mg/day) for severe mood swings and suicidal ideation in a patient with asthma on chronic prednisolone therapy. With regard to depressive symptoms, several case reports have demonstrated some evidence with lithium following the onset of depressive symptoms. Carbemazepine has been reported to be useful in managing both manic and depressive symptoms secondary to corticosteroids. (Wada 2001) There appears to be little benefit from the use of tricyclic antidepressants and in fact, a worsening of neuropsychiatric symptoms has been reported. (Hall 1978) Case reports have been published describing the successful treatment of steroid-induced depression with sertraline, fluvoxamine, and fluoxetine. One such report supports the use of a combination of an antidepressant and antipsychotic in the treatment of steroid-induced psychotic depression (Ismail 2002). Case reports are noted to suggest the effectiveness of benzodiazepines, in the management of specific steroid-induced symptoms as insomnia and anxiety Conclusions Above all, it is clear that the literature on the psychiatric adverse effects of corticosteroids is limited and larger studies on medically ill populations need to be carried out. Clinical practice continues to be informed by case reports despite over 50 years of awareness of these problems. There exists a great opportunity for future research to find predictors of steroid response including their genetic and neuroimaging antecedents and it is clear that the literature could be enhanced with prospective studies and clinical trials. The ICD 10 codes steroid induced psychiatric disorder under F55.5 Abuse of non-dependence-producing substances Steroids or Hormones. No distinction is made about type or chronicity of symptoms. Arguably it may be more useful to classify steroids induced psychiatric disorder under F19.-Mental and behavioral disorders due to multiple drug use and use of other psychoactive substances. Corticosteroid induced psychiatric disorder can pragmatically be classified at present as described in table 2. Insert Table 2 about here With regard to the acute corticosteroid syndrome, the clinical presentation can be diverse but the severity of the symptoms appears to be dose dependent and they tend to occur within the first week of steroid administration. Affective symptoms are most common and a hypomanic/manic presentation is most likely. Some patients appear to have sub clinical hypomanic symptoms which they do not report. Symptoms resolve in most cases on discontinuation of the steroid. Cases are best treated with a mixture of a mood stabilizer (possibly prophylactically) and antipsychotic. With regards to chronic steroid syndrome, the merits of continuation of the steroid must be considered and a small literature suggests that depression in this group can be managed with an SSRI and not a tricyclic antidepressant. In patients who are on long term steroids, a dependence and withdrawal syndrome may be seen. No evidence exists as to how this should be managed but again negotiation should occur between the clinicians and the patient on the need for steroids and a gradual tapering of dose should be considered. Presently it is not known whether individuals have idiosyncratic reaction to steroids or that, given a high enough dose everyone would suffer some mental disturbance. There is a suggestion that those with a previous affective disorder or a family history may be more susceptible to the adverse effects of steroids. If as many as 27% of those on high dose steroids suffer psychiatric symptoms, it is surprising that millions of patients do not present to psychiatric services. Case vignette: Steroid-induced psychosis A 40-year-old woman was admitted to a GI ward for corticosteroid treatment as a result of a flare-up of her inflammatory bowel disease (IBD). Her previous psychiatric history included recurrent depression, for which she had been successfully prescribed fluoxetine by her GP for several years. She was treated for 5 days with prednisolone 40mg IV which was then switched to oral prednisolone prior to her discharge home. Over the next week she progressively became increasingly irritable, experiencing hyperacusis, preferring to stay up all night doing housework and decorating, and suffered from marked lability of mood, fluctuating from euphoria to extreme despair and tearfulness, and anxiety. She began to experience command hallucinations of her late father, who had suffered from schizophrenia, telling her to kill herself, as he had in fact done a number of years earlier. She experienced delusions of being unclean and malodorous. She was visibly seen to be responding to unseen stimuli. She was unable to leave her home for fear that people wished to harm her. On day 5 post-discharge her family sought help from her GP who recommended that she stop her steroids, after noting that 18 years earlier she had experienced a similar episode in response to steroid treatment for her Crohns disease. Her GP prescribed Chlorpromazine but unfortunately the patient developed a marked pill-rolling tremor and akathisia. Next day the patient attended a GI outpatient clinic and due to her distress and anxiety a psychiatric opinion was immediately sought. She was informally admitted and commenced on olanzepine and diazepam with a significant diminution of her psychosis and anxiety such that after a few days she was able to be discharged home. Over the next several weeks she was closely followed-up by liaison psychiatry as an outpatient. Her psychotic symptoms had completely resolved with olanzapine treatment. She did, however, continued to experience low mood and anxiety as a result of on going stress associated with her IBD and required further treatment with antidepressant medications.

The Mortuary Complex of King Zoser :: essays papers

The Mortuary Complex of King Zoser Around 2680 BC, a precedence was set for future Egyptian architecture, as well as over all architectural design. Only a short distance to the south of the previous burial mastabas of the first and second Egyptian dynasties, the Mortuary Complex of King Zoser was constructed. Lying atop a stretch of high ground at Saqqara overlooking the city of Memphis, this complex is believed to be the first of its time to utilize new techniques in Egyptian construction, and was by far the largest and most elaborate of any tombs built before it. Just as the burial sites before, King Zoser’s complex was built facing the Nile River to the east. A large rock wall surrounded the complex, measuring 550 by 275 meters, with the only noticeable entrance being at the southern part of the east face. When one enters the complex they then head north through the entry corridor. This hyperstyle hall is lined with two rows of half columns engaged to spur walls. These columns carry a stone ceiling cut to resemble rounded logs. After passing through a doubled number of columns at the end of the hall, one comes into a large court. This court is known as the Heb-sed court, and was presumably used for ceremonies. At the southwest corner of this court is a building of solid masonry, and to the north, in another separate court, is two temple buildings with columns carved to imitate the lotus and the papyrus plants. Just to the west of this court lay the stepped pyramid under which King Zoser’s body lay in a granite sarcophag us. This sarcophagus was originally topped with a simple stone mastaba, but was then enlarged three times. This stepped pyramid was then enlarged to the north and the west, making its final size consisting of six stages standing at 204 feet tall. The stepped pyramid concealing the burial chamber was consistent with previous burial sites however, none before had been as extravagant and contained as many additional structures as King Zoser’s complex. The man regarded with designing this structure, Imhotep, is also considered the first known architect. The evidence found at Zoser’s complex suggests that architects held a higher place in society among the wealthy and educated Egyptians. This differed from early Mesopotamian society where the kings took credit for their burial site constructions, hence the reason for no evidence of who designed the previous structures.

Gastritis and Its Consequence

Gastritis is an inflammation of the lining of the stomach, and has many possible causes. [1]The main acute causes are excessive alcohol consumption or prolonged use ofnonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria, primarily Helicobacter pylori, chronic bile reflux, and stress; certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain. Other symptoms are indigestion, abdominal bloating, nausea, and vomiting andpernicious anemia. Some may have a feeling of fullness or burning in the upper abdomen. A gastroscopy, blood test, complete blood count test, or a stool test may be used to diagnose gastritis. Treatment includes taking antacids or other medicines, such as proton pump inhibitors or antibiotics, and avoiding hot or spicy foods. For those with pernicious anemia, B12 injections are given, but more often oral B12 supplements are recommended. Many people with gastritis experience no symptoms at all. However, upper central abdominal pain is the most common symptom; the pain may be dull, vague, burning, aching, gnawing, sore, or sharp. Pain is usually located in the upper central portion of the abdomen, but it may occur anywhere from the upper left portion of the abdomen around to the back. Other signs and symptoms may include: †¢ Nausea Vomiting (if present, may be clear, green or yellow, blood-streaked, or completely bloody, depending on the severity of the stomach inflammation) †¢ Belching (if present, usually does not relieve the pain much) †¢ Bloating †¢ Early satiety Loss of appetite †¢ Unexplained weight loss Acute Erosive gastritis is a gastric mucosal erosion caused by damage to mucosal defenses. Alcohol consumption does not cause chronic gastritis. It does, however, erode the mu cosal lining of the stomach; low doses of alcohol stimulate hydrochloric acid secretion. High doses of alcohol do not stimulate secretion of acid. NSAIDs inhibit cyclooxygenase-1, or COX-1, an enzyme responsible for the biosynthesis of eicosanoids in the stomach, which increases the possibility of peptic ulcers forming.. Also, NSAIDs, such as aspirin, reduce a substance that protects the stomach called prostaglandin. These drugs used in a short period are not typically dangerous. However, regular use can lead to gastritis. Chronic Chronic gastritis refers to a wide range of problems of the gastric tissues. The immune system makes proteins and antibodies that fight infections in the body to maintain a homeostatic condition. In some disorders the body targets the stomach as if it were a foreign protein or pathogen; it makes antibodies against, severely damages, and may even destroy the stomach or its lining. In some cases bile, normally used to aid digestion in the small intestine, will enter through the pyloric valve of the stomach if it has been removed during surgery or does not work properly, also leading to gastritis. Gastritis may also be caused by other medical conditions, including HIV/AIDS, Crohn's disease, certain connective tissue disorders, and liver or kidney failure. [10] Diagnosis Often, a diagnosis can be made based on the patient's description of his or her symptoms, but other methods which may be used to verify gastritis include: †¢ Blood tests: †¢ Blood cell count †¢ Presence of H. pylori †¢ Pregnancy †¢ Liver, kidney, gallbladder, or pancreas functions †¢ Urinalysis †¢ Stool sample, to look for blood in the stool †¢ X-rays †¢ ECGs †¢ Endoscopy, to check for stomach lining inflammation and mucous erosion †¢ Stomach biopsy, to test for gastritis and other conditions Treatement Over-the-counter antacids in liquid or tablet form are a common treatment for mild gastritis. Antacids neutralize stomach acid and can provide fast pain relief. When antacids do not provide enough relief, medications such as cimetidine, ranitidine, nizatidine orfamotidine that help reduce the amount of acid the stomach produces are often prescribed. [15] An even more effective way to limit stomach acid production is to shut down the acid â€Å"pumps† within acid-secreting stomach cells. Proton pump inhibitors reduce acid by blocking the action of these small pumps. [15] This class of medications includes omeprazole, lansoprazole, rabeprazole, andesomeprazole. Proton pump inhibitors also appear to inhibit H. pylori activity. Cytoprotective agents are designed to help protect the tissues that line the stomach and small intestine. They include the medications sucralfate and misoprostol. If NSAIDs are being taken regularly, one of these medications to protect the stomach may also be taken. Another cytoprotective agent is bismuth subsalicylate. Many people also drink milk to relieve symptoms, however the high calcium levels actually stimulate release of gastric acid from parietal cells, ultimately worsening symptoms. In addition to protecting the lining of stomach and intestines, bismuth preparations appear to inhibit H. pylori activity as well. Several regimens are used to treat H. pylori infection. Most use a combination of two antibiotics and a proton pump inhibitor. Sometimes bismuth is also added to the regimen. The antibiotic aids in destroying the bacteria, and the acid blocker or proton pump inhibitor relieves pain and nausea, heals inflammation, and may increase the antibiotic's effectiveness.

Summary European Imperialism Dbq - 1278 Words

Courtney Sloan 3/4/13 1st European Imperialism DBQ Part A 1. According to the author, the colonies received benefits from the â€Å"modern progressive nations† such as being able to yield tropical produce, receiving foodstuffs and manufactures they need, and having their territory developed by the addition of roads, railways, canals, and telegraphs. They also have the benefit of having schools and newspapers established, as well as the blessing of civilization, which according to the author, would not be attainable without the help of the progressive nations. 2. This political cartoon reveals that colonization for the native people meant enslavement. This is established through the caption â€Å"Learning civilized ways is hard work†, hard work meaning slavery. This idea of enslavement can also be detected in the picture as you can see an Asian man and an African man pulling a British man on a rickshaw. 3. There are five types of empire builders according to the author in this passage. There are the exporters and manufacturers who are the makers of cotton and iron used in the colonies, the bankers who are the most powerful of all business groups, the military and naval leaders who believe strongly in the expansion of the white man’s superiority, the missionaries who were preachers and builders of the earthy empires, and the politicians. 4. According

The Alcoholics Anonymous 12 Step Recovery Program Guide...

Running head: 12-Step Meeting Reaction Paper 12-Step Meeting Reaction Paper Carissa Hardy ADRE 6703 Abstract The Alcoholics Anonymous 12-Step recovery program guides alcoholics through a series of behavioral, emotional, cognitive, spiritual and social actions towards sobriety and wellness. According to the Centers for Disease Control and Prevention, excessive drinking has lead to approximately 88,000 deaths in the United States each year and accounts for 1 in 10 deaths in working age adults, aged 20-64. Alcoholics Anonymous, a spiritual fellowship of men and women focused on a common goal of stopping drinking, has helped over 2 million people get sober and stay sober. The 12 steps of Alcoholics Anonymous are designed to promote†¦show more content†¦I also enjoyed the prayer at the end. I didn’t like when everyone had to admit aloud that they were alcoholic (I get that it’s part of the 12 steps but it seemed like they had already admitted it to themselves because they were there). I did like that the meeting was held in a church. The atmosphere was relaxed, calm and no n judgmental. Even in a room full of what could’ve been total first timers or strangers, they had an amazing and supportive energy that just filled the room. I loved watching the people connect, grow, and heal over a tragedy that took over their life. It was also amazing and empowering to see them make the step to give themselves and the people they love a better future. I feel the 12-Step program is successful because others who can empathize, offer advice, and understand exactly what the other is going through are there for support and encouragement. By the time you decide to enter the meeting you are usually self-aware that there is a problem and you want to help yourself; to me that can and will make all the difference in determining your success in the program. I really like that 12-Step Programs are faith based, I think believing in something bigger than yourself is crucial to the process. 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AA is a worldwide fellowship of alcoholic men and women who are banded together to solve their common problems and to help fellow sufferers in recovery from alcoholism. These particular Alcoholics Anonymous meeting opened with a serenity prayer, a reading of the AA preamble, aRead MoreEssay on Alcoholics Anonymous: 12-Step Program2169 Words   |  9 Pagesï » ¿ Alcoholics Anonymous (AA) is the largest and most commonly known self-help group in the world. Since the creation of AA in 1935, there have been many programs modeled after it, which are also based on the 12-Step Program. Some of these include Narcotics Anonymous (NA) and Chemically Dependent Anonymous, as well as programs for specific drugs, such as Cocaine Anonymous (CA) and Crystal Meth Anonymous (NIDA, 2012). Attendance and participation for self-help groups are open for anyone to attendRead MoreCounseling For Alcohol And Drug Abuse2108 Words   |  9 Pagesentering into recovery or actively in recovery, the clinician must take their time with introducing the 12 Steps. T he individual may not be open to the 12 Step philosophies at the onset. Addiction is very complex and actively affects the person on a daily basis; therefore, it is so important to start from the beginning of counseling to create a structured program. Alcoholics Anonymous has given a wonderful platform of structure for the addicted ones to create a safe, solid, 12 Step guideline to

What Is ObamaCare - 772 Words

â€Å"Obama Care† is the republican nickname for the new health care reform law passed by President Barack Hussein Obama, called the Patient Protection and Affordable Care Act, based on a law passed in Massachusetts by Governor Mitt Romney. Despite controversy regarding this new law, it will inevitably positively benefit the people of the United States of America. The law introduces reforms such as: lower health insurance premiums by expanding Medicare and Medicaid, which ensures that the poor and sick have insurance. This is because the law requires that everyone in the United States obtain health insurance, either through government plans, a private insurance plan, their employer, or the new health care marketplace. â€Å"Obama Care† betters the people of the United States and is a completely utilitarian Idea- it benefits the greater part of the Community. There are currently 44 million Americans who were unable to obtain health insurance before the reforms because th ey could not afford the premiums or because they had a pre-existing condition. â€Å"Obama Care† is a tax funded government program which helps these individuals obtain insurance by expanding Medicare and Medicaid and offering cost assistance through health insurance market places. It also provides reforms to the health care industry iin order to cut health care costs and provide affordable health insurance to all. The Patient Protection and Affordable Care Act (or PPACA) originated as a Massachusetts law signed into effectShow MoreRelatedWhat is Obamacare?716 Words   |  3 PagesWhat is Obamacare? â€Å"Obamacare is the Patient Protection and Affordable Care Act of 2010. The name was created by critics of President Obamas efforts to reform health care, but it stuck. Even President Obama likes it, because he says it shows he does care.† (Amadeo, N.d) In short, the Patient Protection and Affordable Care Act is a policy in which you are required to obtain medical insur ance if you do not already have any, or be subject to a tax. The most easily argued aspect of the bill is constitutionalityRead MoreWhat Will The Second Year Of Obamacare Bring?1358 Words   |  6 PagesWhat Will the Second Year of Obamacare Bring? It has been one year since the implementation of the Patient Protection and Affordable Care Act, also known as Obamacare. Despite countless Republican attempts to repeal all or part of the new law, it is still with us and shows no sure signs of disintegration. The rollout of the government’s health care exchanges experienced significant growing pains right from the beginning. Time has fixed many of these technical glitches, but has done little to quellRead MoreEssay about What ´s Obamacare?812 Words   |  4 Pagesdirectly into an increase in government health care spending. If Republicans want to control the cost of the government, they will have to change their thinking from â€Å"cut government budgets† to â€Å"reform health care delivery† (The Real Problems with Obamacare). The main disadvantage of Obama Care is that it can increase the health care costs in a very short time period. It targets individuals and businesses that are going to be paying higher taxes. Taxes will be increased on those who make more than $200Read MoreHealth Care Controversy958 Words   |  4 Pages Health Care Controversy Essay ObamaCare, also known as the Patient Protection and Affordable Care Act, is a Health care reform law that was signed on March 23, 2010. ObamaCare’s goal is to provide more Americans with affordable health care insurance. ObamaCare also hopes to improve the quality of healthcare and health insurance in America, regulate the healthcare industry, and reduce the cost of healthcare in the United States. ObamaCare is made up of ten titles; I: Quality, AffordableRead MoreThe Healthcare Debate On Healthcare1312 Words   |  6 Pagesexpenses along with there own. While every American politician can agree, Healthcare is a huge problem in America, the Democratic and Republican parties have very different approaches to solving the issue. Upon considering the facts of both proposals, Obamacare should be abolished in favor of the Healthcare reforms proposed by the Republican party. The cost of healthcare in America is out of control. As the medical costs continue to rise, many Americans, especially those considered low income, have decidedRead MoreObamacare : Reasons For Obamacare1377 Words   |  6 PagesRepealing Obamacare: The Reasons Why Over five million individuals have lost their health insurance since Obamacare has been approved and put into action. The policy of Obamacare states that employers who are providing health insurance to their employees must tack on additional benefits that the companies cannot afford to do. This in turn causes the eventual cancellation of coverage for the employees, leaving them with no options besides signing up for Obamacare. It is the scheme of all schemes.Read MoreThe Debate Over ObamaCare Essay example1391 Words   |  6 Pages â€Å"ObamaCare contains many benefits, especially for low and middle income families and business† (â€Å"ObamaCare: Pros and Cons†). Many people have been having concerns on the cost of the insurance because it has raised in cost. There is a new law out there that President Barack Obama passed called ObamaCare. ObamaCare is also known to be The Affordable Care Act (ACA). The goal of this act was to make sure every American had health insurance by January 2014. ObamaCare went from being something goodRead MoreMajor Health Insurance in the United States: The Obamacare Essay1291 Words   |  6 Pages44th president of the United States of America, President Barack Obama, Obamacare is a type of health care system that is outrageously expensive and money consuming, putting Americans into serious debt. It had once been seen as a plan to help Americans in their health problems and unexpected accidents, but it went the opposite way of that goal, with the prices to keep you enrolled in it, raised to unexpected heights. Obamacare has been a bad outcome to America’s new health care systems because payingRead MoreIs Obamacare Really For The Best Of Its People?1451 Words   |  6 PagesAngela Qian Professor Young English 103 21 April 2015 Is Obamacare Really for the Best of its People? The American government’s main purpose is to ensure that its citizens’ individual rights are fully protected. However, earning the trust of residents will not always be an effortless task to take on as government have many complicated yet sometimes conflicting rules and policies they need to establish to prevent further conflict from arising. Social programs/policies have been enacted by the governmentRead MoreObamacare And The Uninsured Elderly1719 Words   |  7 Pagesâ€Å"OBAMACARE† AND THE UNINSURED â€Å"ObamaCare† and Insurance Coverage of the Uninsured in the United States Problem: Brief Description of, and Justification for Choosing the Health Policy Issue I’m sure you have heard many debates, discussions, and opinions about the law ObamaCare. Do you know what this law was implemented for? Do you know why some could support it or want it repealed? Do you realize how much money one could leave the taxpayers to pay for their unpaid medical bills because they could

Penny Byrne free essay sample

Penny Byrne is an Australian born artist. She was born in Mildura, Victoria, Australia. She lives in Melbourne and owns her own studio. She is interested in ceramics and works as a ceramics conservator. She did a bachelor of fine arts ceramics in Melbourne in 1987 and graduated from west Dean College in the UK after doing ceramics and glass conservation and restoration. She also did a bachelor of laws at La Trobe uni in Melbourne and uses her knowledge of political and social issues in her art. Penny Byrne uses her knowledge of ceramics and knowledge of world issues combined with simplicity and in your face messages in her artwork ‘how much can a polar bear #2’ (2008, sculpture, ceramic, 9. 5x7x11cm). Her artwork makes a public comment on the melting polar ice caps due to global warming and the effect that this is having on the polar bears. Byrne uses her knowledge of ceramics in this sculpture as she appropriates this ready-made ceramic polar bear figure. We will write a custom essay sample on Penny Byrne or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page She has taken a polar bear figure and put scuba diving gear on it to make it innocent and helpless. She uses relevant choices of material as she isn’t creating more waste, putting across this environmentally friendly message. The message she is putting across is made obvious through her use of scuba diving gear and the title of the work. She wants people to think about the polar bears and the environment she cares so much about and she achieves this through simplicity and easy understanding. The overall meaning of this artwork is that the polar bears are struggling, to find food sources, to adapt to new climate and that we aren’t helping, in fact we are making it worse. This is obviously a topic that Byrne feels strongly about. I find that she works well to channel her personal interests into the work and her uses of materials are appropriate to her knowledge, and the message she is putting across. Overall with the simplicity of the message and the use of appropriate materials are effective and work well with the knowledge and personal interest shown in her work. She uses this in many of her of her other works such as ‘the four horse men of the 21st century apocalypse’.

The change strategy

Recent researches have confirmed that change is an important factor that an organization cannot afford to ignore if it expects to succeed in the current competitive market. Developing a change strategy that works is one of the most important factors that would determine success or failure of a firm in the market (Reiß, 2012). In this study, the researcher focuses on the small wins that come with development of an effective change strategy.Advertising We will write a custom essay sample on The change strategy specifically for you for only $16.05 $11/page Learn More The change strategy in this case would be simple and straightforward when it comes to its implementation. It will involve use video conferences by top management of the firm as a way of encouraging virtual conferences within this firm. In this strategy, there will be a shift from traditional style of having conferences in large offices in order to formulate policies for the organization. Top management will use this new strategy in order to ensure that they are able to discuss their strategies and challenges more frequently in order to find solutions and improve performance of the firm. In this strategy, an IT expert will be stationed in an office to coordinate the communication of the managers whenever they want to meet irrespective of their location on the globe. Each manager will be having all the instruments needed to make the conference a reality. The IT expert will have the responsibility of alerting the concerned officers when there is an online meeting to be held. This officer will inform these managers of the required time they should meet and the agenda of the meeting. The officer will get this information from the relevant office in the top management. When the meeting starts, the IT expert will ensure that the communication process proceeds without any interruptions as long as the gadgets used by individual conference members are in good condition. This wil l bring a ‘small win’ to the organization in several ways. Most managers always spend more time trying to come up with the best approach of how their operational units can perform better. In some of the cases, they are forced to make travels out of their offices in order to facilitate improved services offered by the units they manage. It is therefore, time consuming to leave their offices and travel to the headquarters for the meetings. Other officers also end up wasting their time waiting for other officers who arrive late at such meetings. This strategy is geared at eliminating this wastage and making this process more efficient and effective to the officers involved.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More This win will benefit this organization in various ways. The first benefit that will be generated from this change of strategy will be reduced time wastage. With this new approach to holding conference, officers will not have to move out of their offices when there is a conference needed. This means that if there is any delay in the meeting, other officers can continue with other tasks in their officers other than idling in the conference hall. This strategy will also eliminate cases of absenteeism from such meetings by some of the members. This is because there will be limited excuse as long as there is goodwill from these members. This will improve the overall performance of the organization because it will be possible to share new ideas as soon as they are hatched. The departments that are facing difficulties can also share their experience with other departments in case there can be any form of help needed. It is also important to note that there will be no need for a hall where the conference can be held. With the increasingly reduced space being experienced in organizations currently, the current conference hall can be put under a usef ul project for the organization. The win in this new strategy will not only be of value to the concerned officers who would use the facilities developed. There will be a shared value to various stakeholders when this strategy is implemented. It is a fact that this strategy will reduce time taken to make decisions. This means that the management will be able to operate more efficiently. This would mean that employees would have the needed attention from their supervisors because of their increased availability. This would enhance positive relationship between the management and the junior employees of this firm. To the shareholders, it is true that when efficiency is improved, there will be increased productivity, which would translate into increased profitability. This will increase the returns that the shareholders will have on their investment. It will also help in expanding the investment of these stakeholders within this firm (Spiro, 2011). The customers served by this firm will also share the value of this new strategy. When this firm decides to use this new technology, it would mean that the management would have more time to determine the needs of the customers and discuss among them how best they can create more value to their customers. They will also be able to direct junior employees on the best approach to take when delivering value to customers in order to make the experience to be of more value. It is important to give data in support of the strategy to be implemented. In this case, time will be considered. It can take 30 minutes for a physical conference to be arranged and started if all the officers are in the same building. It will take the officers about 15 minutes to settle back in their officers.Advertising We will write a custom essay sample on The change strategy specifically for you for only $16.05 $11/page Learn More If they are 10 officers, the total time wasted will be 450 minutes, which is 7.5 hours. If six such meetings are held in a month, time wasted will be about 45 hours in a month or 540 hours in a year. This is a massive time that can be used in developing the firm. In order to make this win a reality, it shall be publicized using direct memos to the relevant officers within the firm. The memos will be physically delivered to their offices to ensure that they get to read it. This will be followed by direct phone call from the enforcing authority. The next step for making continuous progress will be to purchase the necessary equipments that would be needed to make this project a reality. Then these officers will be trained on how to use these gadgets. Finally, a team of technicians will be responsible for their maintenance. In conclusion, it is apparent that this new strategy will have a radical shift from the traditional way of having conference. When all the responsible stakeholders commit themselves to this new approach, the overall performance of the organization will be improved. References Reiß, M. (2012). Change management: A balanced and blended approach. Norderstedt: Books on Demand. Spiro, J. (2011). Leading change step-by-step: Tactics, tools, and tales. San Francisco: Jossey-Bass. This essay on The change strategy was written and submitted by user Kiara Fowler to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

How to Prevent a Shark Attack

How to Prevent a Shark Attack Even though youre more likely to die from a lightning strike, alligator attack or on a bicycle than from a shark attack, sharks do sometimes bite humans. In this article, you can learn about the actual risk of a shark attack, and how to avoid one.​ The International Shark Attack File The International Shark Attack  File  was developed in the late 1950s to compile information on shark attacks. Sharks attacks may be provoked or unprovoked. According to the International Shark Attack File, provoked attacks are those that happen when a person initiates contact with a shark (e.g., bites occurring to a fisherman removing a shark from a hook, a bite to a diver that has touched a shark). Unprovoked attacks are those that occur in the sharks natural habitat when a human has not initiated contact. Some of these may be if the shark mistakes a human for prey. Over the years, records of unprovoked attacks have increased - in 2015, there were 98 unprovoked shark attacks (6 fatal), which is the highest on record. This doesnt mean sharks are attacking more often. It  is more a function of increased human population and activity in the water (visiting the beach, increase in participation in scuba, paddle boarding, surfing activities, etc.), and the ease of reporting shark bites. Given the large increase in human population and ocean use over the years, the rate of shark attacks is decreasing. The top 3 attacking shark species were the white, tiger and bull sharks. Where Do Shark Attacks Occur? Just because youre swimming in the ocean doesnt mean you may be attacked by a shark. In many areas, large sharks dont come close to shore. The regions with the highest percentage of shark attacks were Florida, Australia, South Africa, Brazil, Hawaii, and California. These are also regions where lots of people visit the beaches and participate in water activities. According to  The Shark Handbook, most shark bites occur to swimmers, followed by surfers and divers, but the majority of these bites are minor flesh wounds or abrasions. Ways to Prevent Shark Attacks There are many ways (most of them common-sense) that you can avoid a shark attack. Below is a list of what not to do if youll be swimming in waters where sharks might be present, and techniques for getting away alive if a shark attack really does happen. How to Avoid a Shark Attack: Dont swim alone.Dont swim during dark or twilight hours.Dont swim with shiny jewelry.Dont swim if you have an open wound.Dont swim too far offshore.Ladies: dont swim if youre menstruating.Dont splash excessively or make erratic movements.Keep pets out of the water.Dont swim in areas where there are sewage (for other obvious reasons!) or pinnipeds that are hauled-out. Both areas can attract sharks.Dont swim in areas being used by fishermen, as their bait could attract sharks.Dont push your luck - never harass a shark. Get out of the water if one is spotted and never attempt to grab or touch it. What to Do If Youre Attacked: Lets hope youve followed safety advice and successfully avoided an attack. But what do you do if you suspect a sharks in the area or you are being attacked? If you feel something brush against you, get out of the water. According to an article from National Geographic, many shark bite victims dont feel any pain. And sharks may strike more than once.If you are attacked, the number one rule  is do whatever it takes to get away. Possibilities include yelling underwater, blowing bubbles, and punching the sharks nose, eye or gills and then leaving the area before the shark strikes again. Protecting Sharks Although shark attacks are a horrific topic, in reality, many more sharks are killed by humans each year. Healthy shark populations are crucial to maintaining balance in the ocean, and sharks need our protection. References and Additional Information: Burgess, George H. 2011. ISAF Statistics on Attacking Species of Shark. (Online). FL Museum of Natural History. Accessed January 30, 2012.Burgess, George H. 2009. ISAF 2008 Worldwide Shark Attack Summary (Online). FL Museum of Natural History. Accessed February 5, 2010.Burgess, George H. 1998. Just for Kids: How to Avoid a Shark Attack Reprinted with permission from The Kids How to Do (Almost) Everything Guide, Monday Morning Books, Palo Alto, California. Accessed February 5, 2010.ISAF. 2009. International Shark Attack File. (Online). FL Museum of Natural History. Accessed February 5, 2010.Skomal, G. 2008. The Shark Handbook. Cider Mill Press Book Publishers: Kennebunkport, ME. 278pp.