Health Care Financial Terms Worksheet Essay

Understanding health care financial terms is a prerequisite for both academic and professional success. This assignment is intended to ensure you understand some of the basic terms used in this course. Complete the worksheet below according to the following guidelines: In the space provided, write each term’s definition as used in health care management. You must define the term in your own words. In the space provided after each term’s definition, summarize a health care management scenario that illustrates the importance of the skill, concept, procedure, or tool to which the term refers. In the scenario, you may wish to consider the following: Why is the skill, concept, procedure, or tool necessary for accurate record keeping, operational efficiency, excellent patient services, employee management, regulatory compliance, reducing costs, forecasting, and so forth? What successes are enabled by an adequate understanding or appropriate application of the skill, concept, procedure, or tool? What risks or failures are associated with an inadequate understanding or inappropriate application of the skill, concept, procedure, or tool? Save the completed worksheet as a Microsoft Word document with your name in the file name. Submit the file to your instructor. Worksheet Submitted By: Term Definition Scenario Capital expenditure budget A budget that can cover one year or multiple years and has a more futuristic view. If the economy is expected to go into a recession that may last several years a company may need a capital expenditure budget. One that may show a plan for the financial survival over the next few years. Things like plans to spend less on expensive or unnecessary supplies or switch to more generic brands are good examples of what could be taken into consideration when making a capital expenditure budget. Direct cost Cost that is directly related to the production of goods or services. Costs related to Materials used for production or labor costs are examples of direct costs because they are directly related to producing goods or services. Flexible budget Budget that is made by using budgeted revenue and cost amounts and can be adjusted according to expected outputs. If a business has had busy Summers in the past and may have another busy Summer they may want to plan for a higher workload and more staff. This requires them to have a flexible budget so they can adjust the budget according to the rising activity level or volume of business. Operating budget Budget that deals with short term revenues and expenses that are needed to keep an organization operating. When a business needs supplies to be able to provide services and needs to pay staff to provide services as well the money that is being spent on the wages of the staff and the supplies is part of the operating budget because those things are needed to operate the business. Responsibility center Center that is responsible for managing costs or costs and revenues. Cost centers are responsibility centers that are responsible for costs and profit centers are responsibility centers that are responsible for managing revenues and costs. Being responsible makes them â€Å"Responsibility† centers.

Puritanism in American Literature

Puritanism in American Literature The Puritans had a large influence in American literature and still influence moral judgment and religious beliefs in the United States to this day. Puritan writing was used to glorify God and to relate God more directly to our world. Puritan literature was commonly a realistic approach to life. â€Å"Puritanism as a historical phenomenon and as a living presence in American life has enriched American literature in ways far too numerous to detail here. † (G. Perkins B. Perkins Phillip Leininger 888) Puritanism is a collection of many different religious and political beliefs. Common styles of Puritan writing are protestant, Calvinist, purposiveness, and the writings also directly reflected the character of the readers who were literate and strongly religious. Pragmaticism and both political and religious Idealism are frequently themes in Puritan literature. Puritanism thus laid the basis for Americanism. It did so on the basis not of philosophical or legal argument, but of Christian belief based on the Bible. Gelernter 25)The Calvinist ideology, which was popular in Puritanism was based off of the Five Points, which are total depravity, unconditional election, limited atonement, irresistible grace, and the perseverance of the â€Å"saints. † Total depravity is the idea that all humans are born sinful. Unconditional election means that God chooses who he wants to save and also contains the concept of predestination, which is an ideology that God damns certain individuals for the salvation of others. This also ties in with limited atonement, the ideology that Jesus only died for a selected group of individuals, not for everyone. The ideology of irresistible grace is that â€Å"the saving and transfiguring power of God,† cannot be either earned or denied. Perseverance of the â€Å"saints† is the ideological belief that elected individuals have the power to interpret the will of God and to live in an upright fashion. The Puritans had secular concerns as well as religious. Puritans believed in working hard, and doing selfless things to help others. Puritans also believed in typology, the belief that God's intentions are present in human action and in natural phenomenon. Failures to understand these intentions are human limitations. (â€Å"American Puritanism: A Brief Introduction†) In 1620, William Bradford formed the Plymouth Plantation with a group of Europeans that came with him to America. In only a year, their number of survivors decreased by half. Bradford kept a journal that chronicled the first 30 years of Plymouth Colony. Plain speech was the high literary value of this society, as expressed by William Bradford, who enjoined â€Å"a plain style, with singular regard to the simple truth in all things. (â€Å"The Influence of Puritanism on American Literature†) In this journal, he exhibited diplomacy and integrity, the ability to assure the colony’s survival, and made a contribution in avoiding potential disasters. His principles established religious freedom and self-government that later shaped American colonial government. John Winthrop wrote A Modell of Christian Charity either before he crossed into America in 1630 or along his journey to the New World. In this book, the struggles that were to be faced in the New World are discussed along with Winthrop’s ideas and plan’s to overcome them. Winthrop was considered to be a contributor to the concept of American exceptionalism, the idea that the New World is unique to other countries by ideology based on laissez-faire and egalitarianism along with liberty. Winthrop has also portrayed that Puritans were neither visionaries nor self-conscious heroes. They were a part of society that believed in solid work such as building homes, trading, farming, and government. Anne Bradstreet was unique to authors of her time because her work had literary creativity and artistic merit and was written for literature. In contrast, works of Winthrop and Bradford were written for historical purposes and to express their positions and political beliefs on certain positions. In England in 1650, some of Bradstreet's poems compiled together by her brother-in-law who named them The Tenth Muse. The first of these poems was the Four Elements, which are fire, water, earth, and air. The Constitutions were the four temperaments of man kind as they were seen by medieval and Renaissance physiology, choleric, melancholic, phlegmatic, and sanguine. The four Ages of Man, which are child, teen, adult, and elder as Seasons of the Year which are Fall, Spring, Summer and Winter were described and explained. Bradstreet was better with her knowledge of literature rather than her own personal opinions directly. In some poems, Bradstreet displays deep affections of the patriarchal Puritan household and a sensuous response to nature. Bradstreet’s literature showed both sides of the spectrum by upholding puritan beliefs as well as creating artistic merit. The American writings of the seventeenth century possess as a whole no great artistic merit. They are valuable chiefly as a study in origins and as a complex mirror of early American experience. The world that they reflect is that of the Renaissance and Reformation, of Raleigh and Calvin and Cromwell, modified by its contact with the American wilderness. (â€Å"American Literature Lectures, Part I†) They are valuable in the sense as it is a study in origins of popular religious and political ideology of the early American experience that helped shape present day America. This experience was one that reflected the Renaissance and Reformation of individuals such as Calvin and Bradstreet. The branch of Reformation in Puritan ideology was one of the main topics of early American literature. In this Puritan literature, the mind of the a Puritan is shown through its consciousness of sin, Calvinistic beliefs, superstitions, contradicting beliefs of orthodoxy and nonconformity, and its preference to moral value over aesthetic value. Puritan tradition was a major influence in our nations government through establishments of principles such as the relationship between church and state and government’s popular sovereignty. Puritanism has contributed to the way our day-to-day lives are carried on. It has also contributed the way literature has transformed over the years. Many political and religious ideologies from Puritan literature are still upheld today. Works Cited Gelernter, David. â€Å"Puritanism lives. † The American Enterprise17. 4 (2006): 25+. Student Edition. Web. 18 Dec. 2011. â€Å"Puritans and Puritanism. † Benet's Reader's Encyclopedia of American Literature. George B. Perkins, Barbara Perkins, and Phillip Leininger. Vol. 1. New York: HarperCollins, 1991. 888. Student Edition. Web. 18 Dec. 2011. â€Å"PAL: American Puritanism: A Brief Introduction. † California State University Stanislaus | Home. N. p. , n. d. Web. 18 Dec. 2011. . Renaissance, the, the Reformation. â€Å"American Literature Lectures, Part I. † Texas. Net Lonestar. N. p. , n. d. Web. 18 Dec. 2011. < http://lonestar. texas. net/~mseifert/amlit1. html> Signet, Theodore Dreiser. New York:, and 1964. 815-28.. â€Å"The Influence of Puritanism on American Literature :: The Compulsive Reader :: A Haven for Book Lovers. † Compulsive Reader. N. p. , n. d. Web. 18 Dec. 2011. .

2 Discussions manage Essay Example | Topics and Well Written Essays - 250 words

2 Discussions manage - Essay Example There is a direct supervision of employees who work on projects determined by managers – there is little independence and individual performance is recognized and highly rewarded. Examples of how such a system helps to manage employees and their responsibilities include: provision of knowledge and skills, motivating employees to perform better, encouraging hard work, and building trust and loyalty. Workplace diversity is important to company’s culture and performance because it encourages teamwork. Secondly, it brings together different ideas, knowledge and skills that may be used to improve the performance and productivity of the company (Mondy et al, 2005). Thirdly, workplace diversity enables employees to share different beliefs and attitudes and learn to appreciate other people’s opinions and ideas. My coworker motivated me to perform better for the organization when he confessed to me one day that he had been trying to report to work earlier than me because I used to report to work earlier than anyone else. Therefore, the coworker inspired me by recognizing my efforts. From then on we were the first to report to work and we performed better than ever

Investment Appraisal Assignment - 2 Example | Topics and Well Written Essays - 2500 words

Investment Appraisal - 2 - Assignment Example The money accumulated is then invested in various investments, so that it generates further income. It is made sure that the income generated is enough to payout the pension benefits provided to the employees. The management of the funds is not necessarily separate from the management of the company. Usually these managers have expertise in investment techniques, in order to maximize the return upon the investments made. The fund portfolio is evaluated as how much percentage is invested in each portfolio. Also, it is taken into consideration how the return from each investment is accounted to the performance, of the fund as a whole. Based on the performance of the funds the investment appraisal is carried out. Fund Investment The pension fund is the accumulated fund, collected from the employers and employees. The earnings that this fund generates is accumulated within itself. The fund is managed by professionals with expertise in the related field of investment. The funds are to be utilized in fulfilling the financial needs of the company, which it has to bear in terms of constructive liability. The constructive liability being, to pay pension and other after retirement benefits to the employees. Pension fund are the accumulation of funds that are invested in various investments, where the returns are generated. ... The current portfolio is invested diversely in four divisions of investments, namely, UK Equities, Overseas Equities, UK Gilts and UK Property. A mere 5% of assets also exist in the form of cash. A) Review of Current Portfolio In the current portfolio of the assets, UK equities have a weightage of 50% of the fund. The assets held by the funds should not lose value and should be able to provide a handsome amount of return. Based on the risks associated with the assets of the fund, the main cause of concern is whether the fund performance is persistent and increasing or not (Christopher, et al., 1998). The portfolio of the funds consists of 25% of UK gilts investment which are the least risky of all the investments and also provide the least return. The appropriation of the funds in the current portfolio elaborates that 5% of cash is held. With the total fund size amounting to ? 1billion, this amounts to ? 50 million. This is an asset that is not invested and is losing value over the t ime. The cash that is retained in the portfolio is not considered to be healthy. Other liquid assets, such as equity stock, can easily be traded in the market. It should be considered as it will benefit the fund. This is because it shall be providing a return, thus minimizing the impact of inflation and reduction in the value of money. The majority of the portfolio consists of UK security and amounts to the ? 500 million. This amount is invested in the equity stock of the companies listed in the stock exchanges in United Kingdom. The performance of the fund is mainly concerned with the amount of return and the rate of return that it provides accounting for the risk associated with it too (Chan, et al., 1995). The performance of

Strategic and operations management Assignment Example | Topics and Well Written Essays - 2250 words

Strategic and operations management - Assignment Example This is one of the leading companies in the world with building materials. This company is however based in Ireland (Diana, 2013). It is important to highlight that CRH is quite focussed and takes into consideration every business hitch and utilizes it for the better. The company realized the factors that lead to the business and noted keenly with a lot of concern that for the company to excel, the price that is charged on the various commodities should be relatively cheap and affordable that favours a large number of people. It is also important to highlight the other factors that the company considered; the quality of services that are offered. This is the overall view, perception as well as experience that the customers get after consuming the products. The value that the customer attaches to the product offered and how the interact with the persons providing the service depicts the quality as either high or low quality (Diana, 2013). The company being ranked as one of the top leading companies in the world in terms of the provision of the building materials, it is important to highlight that the company had to strategize and develop ways to meet the large demand for the products that they offer. This therefore means that the company had to be more reliable and accountable in terms of productivity. This also led to the company establishing smaller markets and enterprises within due to the variations in the legal issues in different parts of the world. This was in the essence that the company had consequently known that micro-markets enhance the successful business performance (Diana, 2013). In the realization of the tight as well as the difficult market environment, it is important to highlight that CRH developed strategies for the successful operations. These strategies were with certain key elements as they are well explained and clearly discussed below: It is also important

Legal, security, or privacy issues within electronic commerce Assignment

Legal, security, or privacy issues within electronic commerce - Assignment Example These provisions relate to the issue of software updates. The law is controversial, although it aims at reducing malware and spyware, because it affects firms that produce legitimate software. It became illegal for companies, through their websites, to install software on the users’ computers automatically. This meant that such a process of software installation required explicit consent from the users. However, certain exemptions to the law include JavaScript, HTML, cookies related to the operating system, and bug fixes. In my personal opinion, the law is essential for the users’ online privacy and security. However, I feel that most companies and organizations are not prepared for the law and they may require more time to accept the change. The event influences my perception of the organizations in terms of their limitation in the resources that facilitate the adoption of the law. Firms and individuals have a hard time dealing with the temporal spam in the messages sent, in reaction to the anti-spam

Quiz 5 Essay Example | Topics and Well Written Essays - 250 words

Quiz 5 - Essay Example It makes no state gaining more power or strength against another. Imbalance in the powers results in joining of a weaker state to a stronger one from a significant external threat (Farrier 34) Interest group within the domestic policy plays major roles. Setting of government agenda and directing implementations become the main role. The groups also define opinions and effect decisions. The roles make the interest groups effective. The study by Burstein and Linton shows that the interest groups have impact on policy (Aggarwal 78) Utilization of task forces and study commissions enables president success. Complete investigation and research by the presidents enable utilization of their task force. The president also provide technical assistance to the peoples. Utilization is through ensuring that the presentations are balanced and informed. The presidents do not utilize the task force without focusing on economic growth, competiveness and job creation. Open mindedness in decision-making is one of the constituents of policy leadership. This is because it enables acceptance and evaluation of opinions from all the parties and work for the good of the whole. Another constituent is flexibility and adaptability. This component enables a leader to accept changes and situations and adjust to them (Kaiser 13). Additionally, good communication from a leader through listening, understanding the desires, problems and the needs of ones clients is important for any policy

Psychopharmacology Essay Example | Topics and Well Written Essays - 500 words

Psychopharmacology - Essay Example COX-2 inhibitors block the action of an enzyme used throughout the body to make a large and diverse family of compounds called prostanoids that are involved in regulating myriad physiological actions, including inflammation, blood clotting and protection of the stomach lining from the destructive effects of digestive acids (Brown, 2004). Congress is questioning why the FDA didn't force Merck to study Vioxx's heart risk sooner. Merck is facing hundreds of lawsuits and potentially billions of dollars in damages from Vioxx. Pfizer, the makers of Celebrex, which is a rival of Vioxx, have not yet pulled the popular painkiller off the market, although Celebrex also increases cardiovascular diseases. Celebrex, approved by the Food and Drug Administration in 1998 for arthritis pain, has been prescribed to 27 million Americans and is the world's most widely prescribed arthritis drug ("Pfizer cites", 2005). Zoloft, Prozac and Paxil, known as selective serotonin reuptake inhibitors or SSRIs, are antidepressants and act by enhancing the signals in nerves that transmit messages with serotonin, a neurotransmitter. , which are chemicals that are used to relay and modulate electrical signals between a neuron and another cell, are removed from the synaptic cleft by a process called reuptake. These drugs act on the neurotransmitter serotonin within the cell by delaying the reuptake process, thereby increasing the serotonergic effect. The regulators at the Food and Drug Administration ordered that all antidepressant drugs carry a prominent ‘black box’ warning to alert doctors that the medications increase the risk of suicidal thoughts and behavior among children and adolescents.

Human Papillomavirus (HPV) in Breast Tumors Coursework

Human Papillomavirus (HPV) in Breast Tumors - Coursework Example Thus, there is still an ongoing debate as to whether HPV causes breast cancer, and whether HPV vaccines can be used against it as well. Let’s look at two journal articles, published in year 2011, to exemplify such issue. Different Findings In the study of Antonsson et al. (2011), the prevalence of HPV in breast cancer tissue was determined through polymerase chain reaction (PCR) analysis and sequencing. Briefly, tissue samples were obtained from each of the fifty-four different fresh frozen breast cancer tissues obtained from surgeries at Wesley Hospital, Brisbane, Queensland, Australia between 2003 and 2007. The median age of these patients were 57 years old, with the age range of 31-88 years. 59% were post-menopausal, 63% were node-negative, and their mean tumour size was 24.3mm. According to the authors, this meant that HPV infection of breast cancer or HPV as an etiological agent decrease the metastatic potential of the tumour. To detect HPV, each sample was mixed with HPV general and type 18-specific primer pairs FAP59/FAP 64. After PCR, amplified products were analyzed using 1.5% agarose gel electrophoresis. 50% of the samples were found to be HPV-positive, specifically of HPV type 18, although the strains were different. Upon analyzing further, HPV-positive breast cancer patients (mean age = 50 y. o.) were found to be younger than the whole group, and HPV positive tumours were also found to be smaller than the others. Histologically, HPV positive samples (96.3%) were more likely to be ductal than HPV negative ones (85.2%). Aside from PCR, an in situ hybridization was also performed using INFORMÂ ® HPV III Family 16 Probe (B) (Roche Ventana Medical System, Tucson, Arizona) that can detect 16 different cancer-causing HPV types (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 73, and 82). However, no HPV were found in the samples using this method. The authors attributed this to the lower sensitivity of in situ hybridization as compared to PCR. Despite the results, the authors however recognized that their findings failed to determine whether the virus actually caused the breast cancer or it was just a chance passage for all 27 cases. As well, the potential mechanism behind the presence of HPV in the breast was still unanswered. A similar study was also conducted in India by Hedau et al. (2011). Breast tissue and blood samples from two hundred fifty two (252) breast cancer patients were analyzed through PCR using the general MY09/11, GP5+/GP6+ and type 16 specific E6/E7 as primers. The age of the participants were 51.5 Â ± 16.7, with a range of 25-80 years. 38% were postmenopausal. However, unlike that of Antonnson, the results of Hedau’s experiments showed absence of HPV DNA in breast cancer tissues. Social Implications In comparing the results of other similar studies conducted in different countries, Hedau et al. (2011) found that the breast tissue samples of a portion of breast cancer patients from Ital y, Sweden, China, Brazil, Austria, USA, Greece, Australia, Turkey, Japan, and Mexico were positive in HPV, with China and Mexico having more established results as more than one study have arrived at the same outcome of some breast cancer tissues being HPV-positive. On the other hand, studies in UK, India, Switzerland and France did not find HPV in breast

Global warming Essay Example for Free

Global warming Essay Global warming is the process by which several gases known ‘green-house gases’ (such as carbon dioxide, methane, water vapor, nitrous oxide, etc) are accumulating in the earth’s environment (as a result of human activity and pollution) and are trapping the sun’s energy resulting in a rise in the planet’s temperature. Some of the largest sources of green house gases include power plants, automobiles, etc. The hypothesis statement in this case is â€Å"Carbon Dioxide is not the only the largest contributor to Global warming, it is in fact the only contributor†. A recent study conducted By the US-DoE in the year 2000 clearly suggests that about 99. 5 % of the gases that cause global warming is carbon dioxide (NRDC, 2007, Eco Bridge, 2008, University of California, 2002). Carbon dioxide is emitted from several human activities. About 40 % of the carbon dioxide emitted in the US is from power-plants that emit the gas from burning coal. Even when LPG and natural gas is burnt, it produces huge quantities of carbon dioxide that contribute towards global warming. About 33% of the carbon dioxide is produced from vehicular emission. Vehicles that have poor mileage contribute larger quantities of carbon dioxide that ultimately result in global warming. About 3. 5 % of the carbon dioxide released in the atmosphere is from aero planes. The upper layers of the atmosphere are damaged as a result of air traffic. From building and domestic use, about 12 % of the total carbon dioxide content is contributed (NRDC, 2007, Eco Bridge, 2008, University of California, 2002). The other gases that can contribute towards global warming is methane (0. 47 %), nitrous oxide (less than 0. 1 %), water vapor and CFC’s (less than 0. 01 %). In actual fact, water vapor contributes towards 99. 99 % of the global warming. However, release of water vapor into the environment is by a natural phenomenon and hence it cannot be considered as a result of human activity. Several studies have demonstrated that effect of water vapor is increased by the presence of carbon dioxide in the atmosphere. Another group of thinking is that water vapor ultimately results in cloud formation, resulting of reflecting back the energy waves of the sun into the atmosphere. Besides, water vapor present in the atmosphere is released back onto the ground, thus helping to cool down the planet (NRDC, 2007, Eco Bridge, 2008, University of California, 2002, Hieb, 2003 University of California, 2002). Since the time of James Watt, the levels of carbon dioxide in the atmosphere has been rising. IN the US, an average the per capita emission of carbon is about 5 tons every year per head (one of the highest) and in Sweden it is about 2 tons (One of the lowest). Carbon dioxide molecules trap the heat rays that are radiating from the atmosphere and cause and increase in the air temperature. In cities and in areas having high levels of carbon dioxide at the ground level, it is found that the air temperature is comparatively higher. Whereas in forests, the air temperature is lower as the carbon dioxide is converted to oxygen. Over the last 100 years the temperature of the earth has risen by about 1. 5 to 5 degrees. The concentration of carbon dioxide in the atmosphere is increased from below 280 ppm to above 360 ppm (Hieb, 2003 University of California, 2002). By just doubling the levels of carbon dioxide in the air, the temperature has increased significantly. The levels of methane and other green house gases have fairly remained constant over the years, but global warming is becoming even more severe. Hence, it can be considered that carbon dioxide is not just the largest contribute to global warming; it may as well as be considered the only contributor (University of California, 2002). References: Eco Bridge. â€Å"Causes of Global Warming. † 2008. Eco Bridge. 6 Apr.2008. http://www. ecobridge. org/content/g_cse. htm Monte Hieb. â€Å"Water Vapor Rules the Greenhouse System. † 2003. Geo Craft. 6 Apr. 2008. http://www. geocraft. com/WVFossils/greenhouse_data. html Natural Resources Defense Council. â€Å"Global Warming Basics. † 2007. NRDC. 6 Apr. 2008. http://www. nrdc. org/globalWarming/f101. asp University of California. â€Å"GLOBAL WARMING: The Rise of CO2 Warming. † 2002. University of California. 6 Apr. 2008. http://earthguide. ucsd. edu/globalchange/global_warming/03. html

The Sociology of Mental Illness

The Sociology of Mental Illness Within this report I aim to outline the biomedical model, investigating whether it can be used to assess mental illness. I will compare both social realism and social constructionism with regards to mental illness and assess the role of the psychiatric profession from the viewpoint of functionalist theory. Firstly, the biomedical model is the scientific diagnosis of a condition which is reached by quantitative and qualitative measures, often disregarding psychological and sociological factors. That being said, can the biomedical model of health really measure a persons mental health? Many mental health issues often have un measurable (scientifically) factors and symptoms, often having blurred lines between a common set of factors; making it hard to distinguish between a select group of illness.   In 1952 the American psychiatric association published the D.S.M. (Diagnostic and Statistical Manual of Mental Disorders) which clearly outlined the symptoms and effects of a range of mental illness. Since its first publication, the D.S.M. has grown from featuring 22 mental disorders, to overviewing over 297 diagnosable issues. While there are no standardized medical laboratory tests to diagnose mental health issues (bar those classed as organic AND functional mental illness, which derive from brain impairment such as Alzheimers etc.), these will come into play during diagnosis to ensure there is no other causation for the patients symptoms. In theory these investigative measures can be argued to be the biomedical involvement for the diagnosis (in respect to solely functional mental illness such as depression etc.). The key players now would be the psychologist, psychiatrist and trained mental health professionals who are medically equipped to diagnose such issues. While the biomedical approach focuses itself on science and the causations being objective and measurable, the theory of lay opinion coverts the ideology of social construction, economical factors and social conformity. Lay opinion focuses on behavioural patterns and socio-economical input upon a persons life, and the subsequent impact these have upon their mental state. This theoretical approach can be seen as highly influential when determining a service users mental state, the practitioners diagnosis being based upon observations of an individuals behavioural characteristics which correlate to the D.S.M and I.C.D. (international classification of diseases). Again, despite the highly theoretical methodology which leads to diagnosis, within these methods we see standardized tests and assessments, which can in fact be construed as scientific as they set about to differentiate between normal and abnormal using a standardized set of questions and observational directives. There are arguments from either side as to the theoretical basis of psychiatry, on one hand Thomas Szasz famously quoted Its not science. Its politics and economics. Thats what psychiatry is: politics and economics. Behavior control, it is not science, it is not medicineà ¢Ã¢â€š ¬Ã‚ ¦ (cchrint.org, 2017) Szasz believed that the practice of psychiatry was wholly influenced by the state, creating a mass of quacks diagnosing with free reign. He argued that there were two radically different kinds of psychiatric practices, consensual and coerced, voluntarily sought and forcibly imposed. (Szasz.com, 2007) his concept was that psychiatry based itself upon the principle of interpretation and social conformity or a service users behaviour. As mentioned before questions of coercion and imposition upon a patient undergoing assessment take the forefront in Szasz arguments, giving his ideals a typically Marxist approach. More recently the newest edition of the D.S.M. came under fire from the ps ychiatric community with a number of high-profile articles by Professor Allen Francesà ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. (that) highlighted changes to the manual that he argued were examples of over-medicalisation of mental health. These changes included: Aspergers syndrome, Disruptive mood dysregulation disorder, Mild cognitive disorder, Generalised anxiety disorder and Major depressive disorder (NHS, 2013). While all arguments for the objective and subjective thesis of psychiatry have their merits, it can be argued that psychiatry as a whole can ONLY be deemed subjective as it uses no scientific model of approach to diagnosis, merely perception, opinion and guidance from the D.S.M and I.C.D. to decipher traits and categorize symptoms. The social realism perspective defines mental illness and the diagnosis of, as having a defined set of abnormal behavioural patterns which can be definitively seen across cultures and societies. Realists argue that despite the fact some illnesses are not recognized or share a common name, the symptoms and actual condition are very much real and observable. That being said, on the other hand we have the perspective of social construction, where by its theorists argue that mental illness is determined by social norms and values. For instance, the mental impairment of post-natal depression. Social realists would argue that the definitive set of symptoms being displayed by the suffering party, would be enough to determine effect. Constructionists however would argue that the individual could be presenting these symptoms due to their social environment and ideologies of social norms. Due to the nature of the illness, and its unpredictable effect on the individual either of these theories could be applied. Because of the set of diagnosable characteristics and cross society definition, realists could argue that despite its irregularity surrounding time frame, its cause and eventual effect can be clearly categorised without outside input. That being said, constructionists can argue that the illness is purely defined by social perception of norms. As the illness can take shape both instantaneously and over a prolonged period of time, the cause and effect could actually be influenced by sociological and environmental issues experienced by the individual, causing stress and ultimately the effects and symptoms of post-natal depression to take hold. The functionalist view of the psychiatric role is one of great social standing and status within the community and society as a whole. Due to their organizational position and social hierarchy, they, as a medical professional, hold great stature and ranking within the framework of functionalist society. Because functionalism bases itself on the premise that each key part (the church, institutions, the family) work together to keep society running smoothly, deriving its ideologies from social consensus; it is their view that the role of the psychiatrist is primarily motivated by the desire to heal the sick (Moore et al, 2010) Because functionalism focuses on categorising mental and physical illness as social deviances due to the upset of balance and roles, they put great importance on the timely rehabilitation and re conformation of individuals. They view the rehabilitation of individuals as necessary coercion so as not to upset social structure. As psychiatrists hold the key to diagnosis of mental health and subsequent re conformity of an individual to social norms, a great precedence is put upon their work. References   Ã‚   Jeffrey A. Schaler, Ph.D defining psychiatry, [2007] available at: http://www.szasz.com/freeman21.html accessed 20/1/17 Moore, S. et al sociology AS for OCR chapter 5 sociology of health page 172, Collins, London, [2010] NHS Choices news analysis: controversial mental health guide DSM-5, [2013] available at: http://www.nhs.uk/news/2013/08August/Pages/controversy-mental-health-diagnosis-and-treatment-dsm5.aspx accessed 20/1/17 Professor Thomas Szasz Psychiatry as a Human Rights Abuse, [2017]   avaliable at: https://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/quotes-on-psychiatry-as-a-human-rights-abuse/ accessed 20/1/17

Public vs. Private Education Essay -- Compare Contrast School Educatin

Public vs. Private Education   Ã‚  Ã‚  Ã‚  Ã‚  I have examined and compared public versus private education. Also, this collection of information should help you understand differences between public and private schools. Aspects of equality and achievement in private and public education will be dissected and evaluated. Observations I have evaluated and examined both public and private education instittutional systems. Public Education Public schools are in crisis, and not because of any shortages of public funds (more money is spent on public education than ever before, but with declining results). Many people like to think the problem with our schools is precisely that they are public: "Government schools" are run like the rest of the government, poorly and inefficiently. Teachers are not primarily to blame, because they are also victims of bad conditions of schools and their profession. The solution is to get government out of the business of education and to run education in a more businesslike way. However, education is not a business like other businesses; it does not turn out a product whose value can be expressed adequately in terms of market price. Education does impart business or workplace skills, of course, but the value of reading and writing well cannot be captured fully by a future salary. The love of learning and growing as a student mentally is what shapes each individual's identity in public life. Before much progress can be made, Americans will have to be persuaded that public schools are a public failure -- that they are turning out not just poorly educated students but bad or indifferent citizens. However statistics show that Americans have confidence in public education. In 1997 Phi Delta Kappa/Gallup Poll of the Public's Attitudes Toward the Public Schools was the first in which an effort was made to determine whether the public wants to place its confidence in the public schools or to start looking for an alternative system. In that poll, the public clearly indicated its preference for the public schools.. The results clearly affirm the public's belief that our national commitment to educating all our children through the public schools should be maintained. 71% of Americans indicate that the focus in education should be on reforming the existing system. This compares to 27% opting for finding an alternative system such as p... ... school also generally increased with family income. Children from the lowest income families (less than $15,000) were more likely than those from families with incomes over $30,000 to attend a chosen public school. However, the net result of the various types of choice was that children from families with incomes over $50,000 were much less likely than children from families in lower income categories to attend an assigned public school over which they had not exercised any choice. Reference The Condition of Education 1997, 182, based on NCES, Schools and Staffing Survey, 1993?94, and the Teacher Follow-up Survey, 1994?95. 14/ NCES, Schools and Staffing in the United States, 1993?94, 107. 15/ V.E. Lee and J.B. Smith, "High School Size: Which Works Best, and for Whom?," paper presented at the annual meeting of the American Educational Research Association, New York, 1996. 16/ F. Mosteller, R. Light, and J. Sachs, "Sustained Inquiry in Education: Lessons from Skill Grouping and Class Size," Harvard Educational Review 66 (4) (1996): 797?842. 17/ The Condition of Education 1997, 136, based on NCES, Schools and Staffing Survey, 1987?88, 1990?91, and 1993?94.

Napster Dilemma :: essays research papers

A major business ethics issue has surfaced which has a dramatic impact on the recording industry and may affect additional industries. As this issue of our newsletter goes to press, the 9th Circuit Federal Court of Appeals in San Francisco, California should be close to rendering a decision in the Napster case. This case has been in the limelight for several months, and many people are following it with great interest since they have important stakes in its outcome. Many college and university students, faculty and administrators have been particularly tuned in to the case, since Napster is very popular on campuses. Regardless of its outcome, the case is expected to transcend the parties involved and have an immense impact on the future of cyberspace, the internet, and the information highway. In this article, I will bring the readers up to date on the case, including the court arguments presented in support of both sides. As one can imagine, the legal documents in the case are very voluminous, technical and complex. So to make it easier for the reader to follow, I am presenting the key points in layman's terms. What is Napster and how does it work? In early 1999, Shawn Fanning, a Northeastern University freshman, created Napster software. That summer he made it available for free through his Napster.com website. Napster is a peer-to-peer technology, which makes it possible for users to freely share their music files through the internet with other users all over the world. Specifically, this is how Napster works: A user sends a request for a song. Napster checks its database of music to see if the song is on the PC hard-drive of another Napster user whose computer is turned on (Note: No music is stored on Napster servers). Napster finds the song. Napster sends the song in MP3 format to the user who requested it. What is the controversy and status of the case? The record industry alleges that Napster is engaging in or assisting others in copying copyrighted music without payment or the express permission of the rights owner. The chronology of the case is, as follows: December 6, 1999: the record industry sued Napster in Federal District Court for copyright infringements, and petitioned that court to shut down Napster. July 26, 2000: the judge issued a temporary injunction to shut down Napster. July 27, 2000: Napster appealed the ruling before the U.

Importing nurses from overseas for the nursing shortage Essay

The Rapid growth in the aging baby boomers and the shortfall among the full- time equivalent nurses intensify the profound need for skilled nurses, thus, resulting to a massive importation of foreign registered nurse. To that end, several debates and questions sprung due to the governments considerable quick- fix in the shortage; imploring the legalities and the little attention given to the academic sector that strives to combat the problem. With the health care system being the beacon of a nation’s prosperity, addressing problems of statistics with just importation might be a problem itself. With the use of the nursing process, this paper examines the problem at hand, the actions taken and other solutions that may be use in the nursing deficit. Assessment According to the study by Brush, Sochalski, & Berger (2007); during the past 50 years, only 5 % of the United States nursing workforce was imported. It was only in the second half of 1990 that nearly 10,000 foreign nurses migrated. By the 20th century, as revealed by the American Hospital Association Survey of the Hospital Leaders (2007), difficulty in the hospital staffing of nurses garners 2nd or 44% over other hospital positions, with 49% dissatisfaction among nurses and issues of hospital capacity that garners 48% in all hospitals, acted as a bubble to the registered nurse shortage. This in time increases due to a decline in the graduates and the number of candidates taking the National Council Licensure Examination. Now with the increase in life expectancy, The American Hospital Association (2007) projected 75 million will be at the ages of 46 to 64 by 2010; Resulting to an increase in the needs and resources to match up with the future challenges of bedside care especially with chronic conditions in regards to old age Importing nurses from overseas for the nursing shortage p. 2 With a baseline of 2,347,000 demands for full-time equivalent nurses by 2010 as shown by the Health Resources and Services Administration (HRSA) it is projected by that only 83% of the total demand will be responded. Approximately there are 116,000 vacant positions for registered nurses or 8. 1 % national vacancy rate (HRSA, 2006). With a big shortage to relieve, the government pushes its efforts to create a more enticing and beneficial area for other nurses abroad to work in the country. Which therefore act as the driving force of the robust and lucrative business of recruitment agencies, that surges a worldwide manpower search resulting a turnover of foreign nurses in the hospital sector of about 71. 5 % as of 2000 alone (Brush et al.2007). In a 2004 survey by the Department of Health and Human Services, over 100,000 foreign born nurses, half of which are Filipinos, are already working in the U. S. (Savage, 2006); Thriving on the 42 % hiring rate of hospitals that have been reported by AHA Survey of Hospital Leaders (2007). As the nurse-patient ratio discrepancy is being filled up, problems with the local sector particularly with the academe tends to shake the grounds; Imploring on the little attention being given by the government to the local sector. As 42, 000 qualified applicants in 2006- 2007 were turned away by US nursing schools (Kuehn, 2007), the problem undermines an institutional problem due to lack of funds to train fresh graduates in relation to lesser clinical training placement, a growing faculty shortage, and a higher percentage of registered nurses that is not practicing as a full-term equivalent nurse in relation to a better shifting, work facility, and compensation on other fields. Importing nurses from overseas for the nursing shortage p. 3 The lack of support for a transition program for the foreign nurses and an increasing foreign recruitment cost for the hospitals also lingers on the sideline. As stated by Parkland Health & Hospital System executive Beth Mancini, MSN, RN, FAAN, in an interview by Heather Stringer last 2002 for Nurseweek. com â€Å"The costs of hiring foreign nurses have substantially increased. † And that several nurse executives said â€Å"It costs about $10,000 to recruit an international nurse today and can take between 18 and 24 months for the nurse to arrive. † With the shortage problem seemingly to increase every year, several nurse executives contends that importation might not just be a short-term solution, and not the best that is, resulting to an aggressive stand to ease the institutional inadequacies. Diagnoses Importation reliance related to limited manpower secondary to work dissatisfaction and or insufficient college programs The unprecedented migration of foreign nurses only resolves the short- term problem in the health care sector. Instead of concentrating on importation, the root of the problem should be taken into account, as well as the drawbacks of relying on importation. Which does not only hinders U. S. institutions growth, but decelerates foreign countries health services. Planning With a wide range of interplaying reasons of nurse deficit, a formulated component of nurses’ shortage is applicable to organize the core problems within the dwindling insufficiency among the heath care sector. Importing nurses from overseas for the nursing shortage p. 4 Components in the nurses’ shortage: †¢ Decline in the public perception of the attractiveness of the nursing profession. Contributed by an increase in professional opportunities for women outside nursing, unattractive salary and longer career advancement. †¢ Unfavorable working conditions. Precipitated by problems on working hours, increase in the nurse-patient ratio, safety and size of the hospital facility. †¢ Inadequate institutional resources. That resulted to a shortage among nursing educators, a shift or state migration to bigger hospitals and lesser clinical placement. Implementation To bolster a growth in the U.S nurses population, problems that arise should be tackled on its ground roots. Using the nurse shortage component list, a summary of programs will be emphasized to meet the underlying causes of the nurses’ shortage. To encourage an influx of students to take up nursing, favorability and a positive avenue for growth and development must be shown. With the studies and advancement made by the National Advisory Council on Nurse Education and Practice (NACNEP) in their third report to the Secretary of Health and Human Services and the Congress last April, 2003. Solutions to the formulated list will be guided by the requirements of the Public Health Service Act as amended by the Nurse Education and Practice Improvement Act of 1998. 1. Decline in the public perception of the attractiveness of the nursing profession. Concentration to provisions that support career enhancement, Importing nurses from overseas for the nursing shortage p. 5 and expansion of knowledge and skills such as the Nurse Reinvestment Act and Career Ladder Grant Program which facilitates and funds further study of nursing specializations and enough appropriations for nurses to become faculty members. 2. Unfavorable working conditions. Enhancing patient care delivery system via granting funds related to communication among heath professionals for continuity of care. Giving out an award that develops internship or residencies for motivation, setting up limits to working hours, and establishment of programs that set nurse staffing to the level of care needed by the patients. 3. Inadequate institutional resources. Reaching out to the young members of society by granting scholarship program in exchange for community service, loans, and monthly stipends. Aside from concentrating on the students, faculty turnover should be address by giving out funds to nurses in exchange to become full- time students that are geared as a future faculty. Evaluation The immense power of a nation to import should not be the sole solution to any inadequacies of a country, though importation is beneficial to fill in the gaps, foresight is much needed to give a better perspective of what is vital for a country to grow. Providing continued support to the local system most especially to the academic and medical institutions, fosters a bigger advantage to the local sector. It produces insurmountable avenues and resources with for further health care challenges. Such actions taken by the NACNEP brings about a wider range of possibilities for the profession to grow. References American Hospital Association. (2007, May 8). When I’m 64: How boomers will change health care. Retrieved November 1, 2007, from http://www. aha. org/aha/research-and-trends/index. html American Hospital Association. (2007, July). The 2007 State of Americas Hospital-taking the pulse. Retrieved November 1, 2007, from http://www. aha. org/aha/research-and-trends/index. html> Brush, B.L , & Sochalski, J. , & Berger, A. M. ( 2004, May/June). Imported care: recruiting foreign nurses to U. S. health care facilities. Health Affairs, volume 23 (3), p 81. Health Resources and Services Administration. (2003, November). National Advisory Council on Nurse Education and Practice: Third Report to the Secretary of Health and Human Services and the Congress. Health Resources and Services Administration. What is behind HRSA’s projected supply, demand and shortage of registered nurse? Retrieved November 1, 2007, from http://bhpr. hrsa. gov/healthworkforce/reports/behindrnprojections/6.htm Kuehn, B. M. (2007). No end in sight to nursing shortage: Bottleneck at nursing schools as a key factor. Journal of the American Medical Association, volume 298 (14) 1623-1625. Savage, L. (2006, April). Bandaids will not heal the nursing shortage. Hypercube Center for Science and Medical Journal. Boston University College of Communication. Stringer H. (2002, June 6). Foreign investments. Nurseweek. Retrieved on November 1, 2007 from http://www. nurseweek. com/news/features/02-06/international. asp WANTED: Imported Nurses Importing nurses from overseas for the nursing shortageÃ'Ž

Most Significant Event of My Life

In 2000, our family business was not doing well and our financial condition was very bad. My father was not in a position to finance my education. But because of these financial difficulties, at the age of 18, I got the opportunity to get a first-hand experience in business. For two years I was completely involved in business. It was a life-changing experience, which I think I could not have normally attained even in a five-year period. My father has a construction business, mainly doing irrigation projects and small bridges for the government. It is a small business with 100-120 employees. During that period, there was a huge delay in getting the bills passed, even after the work is completed. The interest on the loans became a huge burden because of this delay. My father had to spend a lot of time in getting the bills passed, but that affected the functioning of ongoing projects. I was doing my pre-bachelor degree then. I was not interested in business and was planning to go for engineering. But I had to put aside my dream and help my father, even before my exams were over. Initially my father had given me only the accounting tasks. I had to keep track of the employees and their salaries. I also had to monitor the stock of equipment. I learned many things within short time; preparation and submission of quotations, arrangement of funds, doing the complicated calculations involving kilograms of cement and cubic meters of sand and rubble, and keeping track of work completed and money spent. Gradually he gave me more important duties. After one year, I was responsible for managing employees and monitoring the work. I also began interacting with suppliers and government officials. Since I started taking care of many things, he got sufficient time to follow up and get the bills passed at the earliest. Gradually our business was on the track again. I still wanted to complete my formal education. After overcoming the financial difficulties, I joined for graduation. Even though I got less marks in my pre-degree, my attitude towards the business was completely changed by that time. I became a new person with added enthusiasm, confidence and experience. My decision to join MBA, to some extend, roots back to my experience in family business.

Animal Farm: Snowball Essay

He was a great leader, a devious leader, but caring at the same time. You may have thought I was talking about a man, but I was talking about a very powerful pig on a farm. I read a book called Animal Farm by George Orwell. The animals in this story represented humans in the Russian revolution. It was a very interesting book and I related most to a character named Snowball. The character that I feel represented me the most is an eloquent, passionate, and intelligent pig named Snowball. In the beginning of the novel, Snowball was the leader of Animal Farm. He and Napoleon often competed against each other. Even though Snowball believed in Animalism and felt that pigs were more superior to the other animals on the farm everyone still agreed with everything that he said. He created the slogan â€Å"Four legs good, two legs bad.† Snowball had always won the animal’s side against Napoleon. Later on, Snowball led a battle against Mr. Jones and the other farmers. The crusade was called the Battle of the Cowshed. After the animals won, Snowball had even more power than he had ever had before. He had an idea that they should build a windmill to power the farm and provide better service for the animals. Napoleon realized that Snowball had to leave the farm. He got Snowball to leave the farm by having dogs chase him away and he never came back after that. The author of Animal Farm named George Orwell, represented Snowball as Leon Trotsky. I think that Orwell did a very good job comparing a pig to a tremendous war leader from the Russian revolution. Snowball and Trotsky shared many characteristics. Some of them are that they were both clever leaders, they both wanted to make life better for their comrades and that they were both admirable, good speakers. In my opinion, it seems like it would be very difficult to represent important, influential people from the Russian revolution to animals. Orwell did a very nice job of comparing the two. Not only does Snowball compare to Trotsky, he also can represent me too. The competent pig, Snowball can represent me in some ways too. We are both smart, nice, caring, and responsible. Another way that we are alike is that we both compete against people. Snowball competes against Napoleon, and I compete against other girls at dance competitions. As you know, Snowball was a devious but caring leader. He led the Battle of the Cowshed, had conflicts with Napoleon, and got chased out of the farm by vicious dogs that Napoleon sent to attack him. I believe that Snowball was a better leader than Napoleon because he cared more about the animals, but at the same time Snowball treated the pigs better than the rest of the animals on the farm. Snowball may have gotten chased out of the manor farm, but he will always be my favorite and most representable leader from the book. Works Cited: http://www.sparknotes.com/lit/animalfarm/characters.html. n.d. Orwell, George. Animal Farm. Harcourt Brace & Company, 1946.

Early Death Penalty Laws Essay

The death penalty laws were started way back in the eighteenth century B. C. under the Code of King Hammaurabi of Babylon which covered the death penalty for approximately 25 different offenses or crimes. In the Fourteenth Century B. C. of the Hittite Code, the Fifth Century B. C of Roman law of the Twelve Tablets and the Seventh Century B. C. of the Draconian Code of Athens used death penalty as a part of their laws and made capital punishment as the sole punishment for every crime committed. During those times, death penalties were executed through drowning, beating to death, crucifixion, burning alive and impalement. Moreover, during the Tenth Century A. D. in Britain, the common method of executing the accused was through hanging. A century later, William the Conqueror would not like to see and permit any convict to be hanged or else executed for any offense except during times of war. But this trend did not last because during the reign of Henry VIII in the Sixteenth Century, there were approximately 72,000 convicts that were executed. The methods used in the execution during his reign were burning at the stake, hanging, boiling, beheading, quartering and drowning. In addition, in the following two centuries, the rate of capital offenses continued to go up in Britain. During the 17th century, there were about 222 crimes were sentenced by death penalty in Britain which included cutting down a tree, stealing and stealing a rabbit warren. And due to drastic punishment of death, several juries would not easily convict a defendant if the case committed was not really serious. This action had brought changed in the death penalty of Britain. Since 1823 up to 1837, the capital punishment was abolished for over 100 of the 222 offenses sentenced to death. Furthermore, Britain had influenced the United States of America to practice death penalty compared to any other country. As the time European colonizers arrived in the new world, they brought with them the practice of death penalty. The first man ever recorded and received such punishment in 1603 under the new colonies was Captain George Kendall in the Jamestown colony of Virginia. Captain George Kendall was sentenced to death because he was a spy of Spain. Four years later, Sir Thomas Dale (a governor from Virginia) decreed the Devine, Moral and Martial Laws which used death penalty even for minor crimes like killing chickens, trading with Indians and stealing grapes. Laws which regard to capital punishment depend from colony to colony. The first execution in the Massachusetts Bay Colony happened in 1630 although the Capital Laws of New York Colony instituted the Laws of Duke of 1665. In these laws mentioned, crimes like denying the â€Å"true God† and striking individual’s father or mother were sentenced to death (see â€Å"Early Death Penalty Laws†. History of the Death Penalty, p. 1). In addition, the chart below records the practice of death penalty in United States of America in the past four centuries. The chart emphasizes the gradual rate growth of death penalty during seventeenth, eighteenth and nineteenth centuries. In the middle of 1930s, there were approximately 200 executions happened every year and between 1967 and 1977, there was succeeding regression in practice and a suspension on executions. The statistics utilized in the chart were compiled from M. Watt Espy and John Ortiz Smylka’s database â€Å"Executions in the U. S. 1608-1987: The Espy File. † (See â€Å"Executions in the U. S. 1608-1978: The Espy File. DPIC, 2006). C. Different methods used to execute people There are many ways on how to execute death penalty as mentioned in the earlier discussion. But then again, there are seven principal methods of execution that are presently use globally and these are the hanging, firing squad, lethal injection, stoning, poison gas, guillotine, and electric chair. c. 1 Hanging If this method handled properly, this would be considered as humane method. The neck is intentionally broken and then, death quickly comes. Nonetheless, if the fall is insufficient, the convict will slowly choke to death. If it is excessively great, the rope has the tendency to slit the convict’s head (see â€Å"Methods used to execute people†. Facts about capital punishment: Part 1: Data and Trends. Religious Tolerance. org). c. 2 Firing Squad The convict is tied and shot in the heart using several marksmen. Death is expectedly to be fast and of all of the states in the United States of America, only the Utah practiced such method. In March 15, 2004, the method was abolished by other states and chose to have lethal injection instead, but with the exception of the four convicted murderers on death rows that were sentenced to death through firing squad (see â€Å"Methods used to execute people†. Facts about capital punishment: Part 1: Data and Trends. Religious Tolerance. org). c. 3 Lethal Injection This kind of method is the most â€Å"convenient† execution of death penalty. While the convict is lying on the table, the lethal drugs are injected to him/her. Normally, sodium pentothal is injected to cause unconsciousness to the convict. After that, pancuronium bromide is injected. This drug stops breathing and paralyzes the convict. Then lastly, potassium chloride is injected to end the circulation of the heart. If this method is properly performed, the convict easily becomes unconscious. But if the dosage is extremely slow, the person may possibly experience paralysis. This kind of method is practiced by most states in the United States of America (see â€Å"Methods used to execute people†. Facts about capital punishment: Part 1: Data and Trends. Religious Tolerance. org). c. 4 Stoning The convict is frequently buried up to his neck and bombarded with rocks till the convict will finally die. Rocks are used for this method because they are big enough to initiate fatal injury to the convict but even one rock can already cause death to the convict. This method is absolutely not practiced in all states of United States of America but is actually practiced in several Muslim countries as a punishment for adultery, murder, blasphemy and other offenses (see â€Å"Methods used to execute people†. Facts about capital punishment: Part 1: Data and Trends. Religious Tolerance. org). c. 5 Poison Gas Cyanide is dropped into acid which produce Hydrogen Cyanide. It is a deadly gas. It would take several minutes of anguish and pain before the convict dies (see â€Å"Methods used to execute people†. Facts about capital punishment: Part 1: Data and Trends. Religious Tolerance. org). c. 6 Guillotine This was recognized and eminent French invention and not practiced in North America. It cuts the neck and death comes very fast (see â€Å"Methods used to execute people†. Facts about capital punishment: Part 1: Data and Trends. Religious Tolerance. org). c. 7 Electric chair This is the only method of death execution that not a single person knows how fast the convict dies from the electric shock or what the individual is experiencing. The ACLU explains two incidents where convicts obviously lived for 4 up to 10 minutes before they will die (see â€Å"Methods used to execute people†. Facts about capital punishment: Part 1: Data and Trends. Religious Tolerance. org).

Employment and Social Care Worker Essay

All employees receive a contract of employment within several weeks or before starting a new post. A contract of employment discloses information witch together make up the terms and conditions of the individuals employment, such information includes names of the employer and employee, the scale, rate and frequency of wages, hours of work and any conditions relating to these, job tittle and disruption, place of work and the length of notice to terminate employment. For example within the contract of employment it will state how many hours of work per week the employee will undertake, if the employee fails to comply with these conditions it could lead to disciplinary action or termination of the contract by the employer. Describe the information shown on own payslip. Information that is show on a payslip includes: Payments, Deductions, National Insurance number, Bank Account details, Tax code, Annual salary/ hourly rate, Payroll reference and Pay date. Payment and deductions are shown on a payslip so the individual can see how much they have earned since their last payslip and how much of that pay has been deducted, it is also shown so that if there is a mistake in the amount that has been paid or deducted from them the individual can resolve the problem through the appropriate means. By law every employee has a certain amount deducted from their wages; this covers National insurance and income tax and any other deduction that have been agreed with the employer such as pension contributions. Identify two changes to personal information that must be kept up to date with the employer. Information on employees that must be kept up to date includes, the employee’s home address, Work, home and mobile number and all emergency/ next of Kin contact details. Details such as the employees work home and mobile number must be kept up to date with the employer, if such detail are not kept up to date, and there is an emergency that requires the employees to attend, other employees and the employer will not be able to get hold of the individual as quickly as is needed witch may result in disciplinary action if there was a fatality. It is the employee’s responsibility to update and change any of their own personal information and to inform the manager/employer about such changes. Describe the procedure to follow in the event of a grievance. According to the OCC (Oxfordshire County Council) Resolving Grievances policy the procedure to follow in the event of a grievance is as follows; Employees should aim to resolve most if not all grievances informally. This is done by the employee talking to their line manager or person concerned, such as a service user. The employee should explain clearly what the problem/concern is, and with little disruption the employee should also aim to resolve disputes through discussion and seek to understand the views and perspective of those involved. It is the responsibility of all employees and managers to try and resolve disputes and problems as quickly as possible. If a grievance can not be resolved informally then there is a formal grievance procedure to follow. This involves filling out a grievance form, a ‘written statement for the purpose of the grievance meeting and any investigation. This form is then sent to the employee’s line manager and a copied to the HR management advice team, who will send a letter of conformation of the receipt of the grievance. After this a formal grievance meeting will be arranged, this will involve the employee who filled out the grievance form, the grievance manager and a HR advisor. It is the job of the grievance manager to decide what actions to take at the end of the meeting, this may be that the grievance manager adjourns the meeting to conduct an investigation to obtain more information or they may decide to put in place actions to resolve the matter. Explain agreed ways of working with the employer in the following areas: -Data Protection At ADTS (Abingdon Daytime Support) there are procedures to follow when writing in individuals support notes, to keep their confidentiality. When writing support notes, staff at ADTS make sure that the information they are writing is relevant to that individual, and if other service users need to be mentioned staff are to use their initials and not their full names. -Grievance At ADTS, staffs use an OCC ‘resolving grievances’ policy to resolve any grievance or complaints they may have. This policy states that staffs are to, at first try and resolve the grievance informally, by talking to the individual(s) involved and try to understand each individual’s perspective and put in place actions, such as control measure, to resolve the grievance. If the grievance cannot be resolved informally, staffs are to resolve the grievance formally by arranging a grievance meeting and following actions, stated in the policy to resolve the grievance as quickly as possible and with little distress to those involved. -Conflict Management -Anti-discriminatory practice Staffs, at ADTS, follow OCC policies such as, ‘equality and diversity’ to provide a seamless service which includes all individuals not matter how demanding their needs may be. Staffs at ADTS are encouraged to adapted games and activities for each individual, so that they can join in every activity possible. For example, Staff at ADTS take GE (a service user who attends the day service) Bowling with a small group of more abled service users, GE users a wheelchair to mobilise and has little mobility control over his limbs. -Health and safety At ADTS, staffs follow a local heath and safety policy as well as the OCC Health and Safety policy parts 1, 2 and 3. Part 1 is the general heath and safety policy, part 2 is health and safety for management and part 3 is health and safety for day services. -Confidentiality At ADTS staffs follow the Data protection Act and the OCC ‘confidentiality statement’ to comply legally and respectfully to individuals confidentiality. The confidentiality statement and Data protection Act state that Information should only be shared on a need to know basis, For example if a support worker needed to disclose any information to an individuals GP then the support worker must ensure that the information they give is relevant and only necessary information is given. If staff disclosed information that the GP did not need to know, then that staff member has broken the individuals confidentiality and may face disciplinary actions. -Whistle blowing Explain how own work role contributes to the overall delivery of the service provided. As a social care worker, what you do within the workplace affects the overall service. For example if social care workers put in place a good working practice then the effect on the service overall is a positive one, this is because a good working practices means that the social care worker works with person centred approaches, to make sure the service provided is a inclusive and friendly, leaving service users felling positive and valued as a person. Alternatively as a social care worker, what you do within the workplace can have a negative affect on the overall service provided. For example if a social care worker does not follow a good working practice or doesn’t comply with a policy or procedure then there is a negative affect on the overall service, this may be through negligence, failure to follow a procedure may leave an individual without the appropriate support they need, leading to their need not being met and leaving the individual themselves feeling undervalued and disrespected.

Is the UK economy out of recession Essay Example | Topics and Well Written Essays - 2000 words - 2

Is the UK economy out of recession - Essay Example But this hope was to prove a mirage as the trend reversed in subsequent months. Though the UK took a little while to catch up with the crisis in the United States, at the beginning of the second quarter of 2008, the region’s economy was in acute recession. It has been close to two years since the onset of recession in the UK and the economic condition of the region remains weak and vulnerable. While some economists assert that the turnaround is already underway, others take a more pessimistic view. This essay will try to answer this important question, by way of perusing scholarly and news media resources. (Lynch, 2009) The recession that began in early 2008 gave no signs of recovery even after one full year. As the industry data for third quarter 2009 revealed, the economy shrank a further 0.4 % in during this period, which completed the sixth consecutive quarter in decline. As per the Office for National Statistics, by this time â€Å"output has slumped 5.9% since the onset of recession - almost as bad as the 6% slump seen in the early 1980s. The lingering decline came despite interest rates at a record low of 0.5% since March, additional Government spending and an unprecedented pounds 175 billion boost to the money supply through quantitative easing† (Lynch, 2009). But even as the UK was enduring this economic decline, neighbouring countries such as France and Germany have already shown early signs of recovery. While neighbouring countries in Europe were already into recovery, it was only during the heralding of year 2010 that the UK economy showed clear signs of recovery. Financial experts have declared that technically the UK economy has emerged from recession, but concerns still remain about the stability and strength of the pound against the dollar and the euro. Due to the internal economic turmoil, there is a strong possibility for deflation of currency during

Market Plan and Strategy Coursework Example | Topics and Well Written Essays - 500 words

Market Plan and Strategy - Coursework Example Goal: The objective of this business is to reduce the fright or anxiety of individuals regarding their surgery or any sort of medical treatment by providing them personal, professional, friendly and confidential consultation. Customers see the services of different providers as similar and do not care about providers as compare to the price. The solution of this price competition is to create differentiation. â€Å"Medical tourism† will give its customers proper services they do not need to worry about their reports’ result as the company will not just guide them, but the company would also resolve their translation issue of reports. Company will set complementary product pricing. This strategy would allow the company to charge a high price for its complementary services. The basic services of â€Å"Medical Tourism† is to guide customers and make appointments with required or suitable physician. Additional price will be charged for translating and interpreting services (Rao, 2009). There are many questions of patients and their relatives regarding health. Therefore; there is an identified need for medical consulting firms. The consulting business would consult patients for surgical decisions or medical diagnosis. The promotion of services is a challenge in comparison to the products because people cannot touch or feel these services until they buy them (Lovelock, and Wirtz, 2011). Therefore, promotion will be done through the distribution of brochures at different places. For promotion, medical tourism would work with local businesses such as hospitals, doctors’ offices, churches, taxi-cab services and bus stations. Medical tourism would distribute its brochures to all places including homes boxes. Website of the company would provide all information related to the services and it will help in educating people. The most important promotion tool for such businesses is â€Å"word of mouth†. Company will hire experienced people who will give the complete

Financial Regulation and Supervision Essay Example | Topics and Well Written Essays - 2500 words

Financial Regulation and Supervision - Essay Example The paper tells that Andrews Pick & Mix should seek to put in place relevant PCI DSS compliance measure according to its level of operations, and accept to offer credit and debit card payments, which would go a long way in enhancing its online retail business. Credit and debit card services are advantageous in that, they enable the business to verify and accept payments from a variety of major debit cards, credit cards, traditional checks, and electronic checks. The business is also able to accept payments from anywhere, since transactions are processed online at any remote location all over the world given internet connectivity. Moreover, the services will enable entry of information manually incase sales and purchases are done in physical retail outlets. Andrews Pick & Mix would also be able to get protection from fraudulent activities that are rampant in transactions made over the internet. Credit and debit card services consequently offer security protection through modern encryp tion utilities to give customers assurance and confidence when transacting and processing their personal credit and debit card information. The service security measures focus on the use of VeriSign SSL Certificate that does not require individuals to separately purchase certificates, as well as Address Verification Service that would help them in protecting fraudulent credit card application. When deciding on whether to accept the bank’s offer, Andrews Pick & Mix retailers need to analyze which card of credit and debit card payment solutions are relevant with respect to the merchant account they had with the company. If need be, the company may process alternative merchant accounts with the bank with regards to what is convenient to them, since the online income was only a small part of their turnover, although it provided a wider access to their portfolio of products. These particular aspects are critical for decision making on the kind of credit and debit payment solutions they will put in place. Moreover, Andrews Pick & Mix retailers had their own web servers hosted and managed by a design agency that had developed and customized their online payment application, which was integrated with a third-party provider of credit and debit card transaction processing facilities. However, Andrews Pick & Mix were not completely aware of the level of charges for different types of transaction and the precise contractual obligations they had adopted, as well as the potential risks involved. Their services had client’s payment card details being entered on the retailer's website, while other orders were being accepted by fax, telephone, and physical shop where payments could be made with a point-of-sale card terminal. The retailer needs to comprehensively put into consideration a broad range of aspects such as the average approval rating, cost per month, customer service, account set up time, point of sale options, start up costs, and internet based featur es (Segel, 2008). Average approval rating evaluates percentage of applicants approved, the application fees, and speed of processing the application. Ideal service provisions seek to target high rates of approval at no fee with

The humpty dumpty falls scale Essay Example | Topics and Well Written Essays - 1000 words

The humpty dumpty falls scale - Essay Example This paper critically analyses the paper ‘The Humpty Dumpty Falls Scale: A Case–Control Study’ which reports the findings of the aforementioned research study and a critique of the various components of this paper is presented in the discussion that follows. Research Problem/Purpose or Question Hypothesis   The authors have clearly stated the purpose of the study as being an assessment of the efficacy of the newly developed Humpty Dumpty Falls Scale (HDFS) in predicting the risk of falls in pediatric hospitalized patients, in a separate section entitled ‘purpose’ (Hill-Rodriguez, et al., 2009). Moreover, in the same section, the choice of the study design, i.e. case control study has been justified and the authors have explicitly mentioned that the research question was to elucidate whether the risk of falls predicted by the screening tool in question was in conjunction with the actual risk of falls. This gives the readers a clear picture of the aim s and objectives of this study and the rationale behind the conduction of this study. Review of Literature   An adequate review of the existing literature has been provided. The authors have quoted statistics to emphasize the magnitude of the burden that the problem in question poses. As pointed out by the authors, there is ample literature on the issue of falls occurring in the elderly population, but there is a paucity of existing data on the pediatric population in this regard (Hill-Rodriguez, et al., 2009). The importance of the development and implementation of screening and preventive strategies in the pediatric population is underscored by authors in this section. Moreover, the authors have also identified the gaps in the existing literature and have thus provided the rationale of conducting this study in order to build upon the existing research findings and fill in the gaps which were identified. Theoretical/Conceptual Framework   No theoretical or conceptual framework for this study has been provided by the authors. However, the study design is such that it does not warrant the need for a theoretical/conceptual framework. Research Design   The study design employed in this study was a matched case control design (Hill-Rodriguez, et al., 2009). The cases and controls were matched in various regards such as This design is best suited for the research question identified by the authors, as case-control studies have been found to be a suitable study design to evaluate the effectiveness and usefulness of screening tools (Rothman, Greenland, & Lash, 2008). Sampling Method/Data Collection   The data was collected from five different in-patient and two ICU pediatric units from a single center. (Hill-Rodriguez, et al., 2009) The sampling method is not mentioned clearly but it can be extrapolated from the given information that purposive convenient sampling methodology was employed. Although no specific inclusion criteria or cut-offs for age are mentio ned, the exclusion criteria are defined and presented in the paper by the authors. The data collection tool used was the Humpty Dumpty Falls Scale (HDFS), which consisted of seven different assessment items. This tool was designed after input from various skilled and expert nurses and other medical personnel (Hill-Rodriguez,

Any arguement with a moral or causal claim Essay

Any arguement with a moral or causal claim - Essay Example Indubitably, such religious decrees have made man what he is today, where God and His guidelines have been argued to have paved the way of human development. Astonishingly, there is no specific definition for God. Yet, man loves Him and fears Him from the ancient period. Nevertheless, humans, either in their conscious or unconscious thoughts, have faced the questions asking for the existence of God. Certainly, if God exists, and as argued in the religious verses, acts in the good of mankind then why does not He share His presence in the earthly world or even support His followers with firm evidences to proof that He exists? Thesis Statement This thesis will aim at assessing the cosmological claim of God’s existence which states that if the universe exists, it is for a cause which is none other than God and thus, it can be considered as a truth that God exists. Based on this cosmological thought and the modern day connotations, the thesis will further intend to argue regarding the causal claim to come across a rational explanation to the theological question that whether God exists, and if He does then why. Discussion Since the evolution of scientific theories, ancient human beliefs have been contradicted on various grounds, whether it is Galileo Galilei’s discovery of earth’s rotation around the sun or Albert Einstein’s theory on gravity. Although these revolutionary concepts were accepted in the human society with passing time and relatively at a much rapid pace, a few of these still remain widely debated topics amid philosophers and scientists. The arguments regarding God’s existence have been one of the most disputable issues to create a parallel distinction between atheists and theists. Certainly, due to the unavailability of requisite proof on the basis of scientific rationale and also because of the reluctance deciphered by the theists to accept the logic argued by atheists, this particular issue has contributed in moder n philosophy as a cosmological thought which has attracted critics from around the world and apparently, from every doctrine (Palmquist, 2009). Arguments raised on this ground have often pointed that if God’s existence is questioned, the historic notional views, based on which the human society has been built, shall fumble and alas, might be destroyed (Hans & Helge, 2011). The cosmological view explained with reference to kalam argument on the existence of God further affirms that, â€Å"Everything that exists or begins to exist has a cause (Premise 1: EP); The universe exists and began to exist (Premise 2: EP); The universe must have a cause (Premise 3: IP); The cause of the universe is God (Conclusion: IC)†. However, this particular argument has been strongly criticized by atheists acclaiming the view to be a paradoxical notion (Morriston, 2000). In response to these questions and arguments, various studies were conducted to prove that God exists on the basis of comp lex theoretical philosophical underpinnings. Explaining the cosmological arguments on the existence of God, Craig (2010) explained that things exist either for an external cause or because of its necessity in the world as connoted in the Premise 1 of the kalam argument. For instance, mathematics exists because of necessity while physical objects exist for a particular cause. Therefore, if the universe is regarded as a physical object, it

Interview Essay Example | Topics and Well Written Essays - 1250 words - 1

Interview - Essay Example Violence is often attributed to alcohol use and alcohol-related fatalities remain an important concern in the United States. The following is an excerpt from an interview I undertook with Dr. Daniel Smith1, a clinical psychologist from the Alcohol and Family Violence section of St. Mary’s Clinic. His specialization is on the linkages between alcohol and family violence and the following is a concise transcript of our discussion (Agarwal and Steitz 40-55). A: Well, the psychological and biological consequences of excessive alcohol intake can have a direct impact on the lives of individual drinkers. The effects of alcohol abuse include distortion of cognition and perception, disinhibition, bad judgment and attention deficit. All of these factors can lead to conflict with other individuals, especially after an alcohol user has drank. With the progression of time, alcohol abuse if compounded and alcoholics face a variety of social as well heath ramifications associated with their behaviour. From a health perspective, alcoholics face health complications including liver damage, heart failure, and an overall decreased life expectancy. Alcoholics are also more likely to engage in other detrimental behaviors such as smoking cigarettes or taking illicit substances such as illegal drugs. They are also more prone to aggression and violent behavior, especially within the family unit. A: Alcoholism may lead to conflicts within the family unit, particularly with the respect to the relationship between parents and children. Alcoholic parents are unfortunately not uncommon and alcohol abuse has been proven to lessen the ability of a parent to act as a proper caregiver to children in need. Another component of alcohol abuse on the family is marriage instability, increased tension in spousal relationships and violence between an alcoholic parent and

Discrimination At the Work Place Essay Example | Topics and Well Written Essays - 2000 words

Discrimination At the Work Place - Essay Example This paper stresses that the utilitarianism approach has various limitations that make it difficult to achieve ethical standards in the organisation. One of the limitations is that most people are taught to focus on self-development, and they do not care about the actions that they may take and influence other people around them. Thus, it is hard for most of the people to practice utilitarianism. Additionally, what may create pleasure to an individual may not create pleasure to someone else. Thus, it is difficult to determine what will make someone happy in a specific condition or situation. This report makes a conclusion that utilitarianism approach offers a method for deciding the morally upright situation in any course of action as discussed in the essay above. Thus, individuals should identify the courses of action before they perform any action. Additionally, they should also determine the harms and the benefits that can result from performing a certain action. Afterwards, they should choose an action that benefits the stakeholders in an organisation. Any discrimination will be done away with if the parties involved consider the consequences of their action. Discrimination causes more harm than good in an organisation. Thus, utilitarianism approach is beneficial in determining the ethical concerns in the organisation. Other models that can be used include the common good approach, justice approach, and virtue approach.

Visual Art education and Graphic Design Essay Example for Free

Visual Art education and Graphic Design Essay Computer technology has added a new aspect to all people desiring to broaden their horizons by furthering their education. Over time the traditional methods of learning have evolved with the advancements in technology. In todays society modern technology makes anything possible, even earning a degree online. This is especially popular for those considering a career path in graphics design. However does this mean that a traditional fine arts education is no longer needed for those who are in pursuit of a degree in graphic design? Typically online colleges advertise visual arts degrees under the idea that graphics design is nothing more than computer knowledge and creativity. As a result, students graduate lacking the necessary skills and knowledge to be successful in the graphics design world. All students looking to earn a degree in graphics design should pursue a traditional art degree. Even though anyone is able to achieve a graphics degree online, completing a traditional arts degree teaches you the skills that help you to achieve the highest level of success. Online education in many instances has too often replaced the core curriculum of art with technology. Many traditional art professors, even in graphics design put technological skills last on the their lecture list. Instead, concepts of how art and design function and how to express creativity in the art studio environment are emphasized as being the key concepts of a graphics designer education. Over time, knowledge is gained through a series of art drawings, paintings, photography classes, critical thinking exercises, peer evaluations and problem solving; resulting in students becoming more aware of the variety of ways to go about turning creative ideas into innovative designs. Unfortunately, students who are taught online are not able to grasp the importance of skill beyond technology. As a result the lack of knowledge to express creativity inevitably becomes a liability instead of an asset to a graphics design company. Design is a combination of skill and finding ways to create a visual message to your target audience. The main role of a designer is to communicate a message in the most effective way. Computer programs cannot create the knowledge of the reason behind the image, only the designer can. You cannot  have technical skills only and expect a program to do the creative work. The computer has revolutionized the design studio, but it will never run it. Traditional art education gives students the opportunity to learn these skills and to execute effective designs through hours of instruction in classes like illustration and typography. Online education simply does not offer students this opportunity and will never be able to substitute these skills with numerous amounts of technology. The last benefit of a traditional arts education is the communication skills you learn and the face-to-face interactions you experience by attending an actual university. Social skills are harder to learn when you do not attend school. There is no curriculum for showing students the importance of social interaction in the career of an artist or designer. Sure you may think that having a discussion board is important but it doesnt compare to face-to-face interactions. In a traditional learning environment you attend classes that create situations where students can and must collaborate with one another. Through these environments, the students witness that original design is rarely done alone. Its great groundwork for the reality of the working graphic designer. In the end, knowledge is the measure of success and the more enriched you are in your career field the better communicator you become. Therefore earning an education through a traditional college or university provides students with a variety of skills and knowledge would only be beneficial to those looking to be successful in the graphics design. This is why students looking to earn a degree in graphics design should receive a traditional arts educationWorks CitedSome of the web sites that I viewed while writing this paper are listed below. Most of my knowledge comes from my educational arts background and my previous job, which involved working at publishing company in the art department assisting the graphic designers. 1. American Art Institute Online http://www.aionline.edu/microsite/programs/?keyword=art%20institute%20onlinepublisherSite=DSYahooDS_KWID=p30168552. AllgraphicsDesign:http://www.allgraphicdesign.com/graphicsblog/2007/05/22/gra

Management of Post-Traumatic Piriformis Syndrome: Case Study

Management of Post-Traumatic Piriformis Syndrome: Case Study Diagnosis and Chiropractic Management of Post-Traumatic Piriformis Syndrome: A Case Study Chief complaint A 37-year-old male patient presented himself at a local chiropractic clinic with a chief complaint of persistent low back pain that was radiating into his left buttock, all along the posterolateral aspect of his left thigh and calf, and to the lateral aspect of the foot. History of the patient illness The pain initiated 2 years ago. The patient reported a blunt trauma of his left buttock in a motorcycle accident 8 months before his symptoms were first noticed. The patient was presented with low back pain, radiating from sacrum and gluteal region to the lateral aspect of the foot, all along the posterolateral aspect of his left thigh and calf. The pain was occasionally accompanied by paresthaesia and burning sensation. When asked to rate his pain with a numeric rating scale (NRS), he noted his low back pain to be 3/10 at best and 7/10 at worst. Prolonged sitting and car driving aggravated his symptoms. And standing up and walking a few steps for a moment would make the pain partially relieved. The patient also noted that prolonged external rotation of the affected hip (sitting posture) made the symptoms more intense. He avoided sitting in a cross-leg posture due to the pain. The patient had a transient relief of his pain after treatment of physiotherapy. However, the pain came back after a few days. Other than the traumatic fall on his left hip in a motorcycle accident, the patient’s medical history was not remarkable. Relative family history, social and environment history Both of the patient’s parents were diagnosed with disc herniation of the lumbar spine in their 50s. The patient went to gym 4 times per week, doing cardiovascular and weight bearing training. And he used to play soccer once a week. However he had to stop playing since his low back pain and leg pain started to bother him. The patient was an attorney and his job required him to sit in front of his desk for more than 6 hours per day. He reported that he had to stand up and walk a few steps in the office every 30 minutes due to the pain. Relevant medications The patient’s symptoms were partially relieved by taking Panadols. He was not taking any other prescribed or non-prescribed medications. List of possible diagnoses from the patient history Lumbar disc herniation The patient was presented with symptoms and signs of radiculopathy including sensation disturbance of the lower limb, pain shooting to the foot, and pain worsened by sitting and relieved by walking. According to the dermatome, the nerve roots of L5, S1 or S2 were possibly affected. Considering that both of the patient’s parents are diagnosed with lumbar disc herniation, it should be on top of the differential diagnosis list, for recent studies have suggested that lumbar disc herniation may be attributed more to genetic factors than to environmental and constitutional risk factors. The patient’s occupation which kept him sitting for a prolonged time increases the chance of lumbar disc herniation. The history of blunt trauma could also be a factor of developing lumbar disc herniation. Sciatic nerve irritation of other origins The patient’s altered sensation on the lower extremity is in the distribution of sciatic nerve. Sciatica should be taken into consideration. However, the underlying cause of compression or irritation of sciatic nerve should be revealed with further examination and investigation. Piriformis syndrome Piriformis syndrome is an uncommon form of sciatica in which the sciatic nerve is compressed and irritated by piriformis muscle. It usually occurs in people who are middle-aged (mean age 38 years old). Robinson described 5 significant manifestations of piriformis syndrome in 1947, including: (1) history of trauma in the gluteal region; (2) pain in the sciatic nerve distribution; (3) symptoms relieved by traction and aggravated by sitting or stooping; (4) palpable tenderness or mass over piriformis muscle; (5) positive straight leg raise test. This patient was presented with the first 3 features of piriformis syndrome, whereas the 4th and 5th need further examination. Sacroiliac joint syndrome Sacroiliac joint syndrome is the dysfunction of sacroiliac joint that is attributed to either hypermobility or hypomobility, causing low back pain, buttock pain and sciatic lower limb pain. Lower abdomen, groin and medial thigh are occasionally affected as well. The symptoms of sacroiliac joint syndrome and sciatica are often similar. Hamstring syndrome Another possible differential diagnosis is hamstring syndrome. Hamstring syndrome is caused by entrapment of the proximal sciatic nerve by the hamstring tendons (1). It usually occurs associated with trauma such as hamstring tears or strain (2). However, in many cases, not significant history of trauma is noted (1, 2). Patients with hamstring syndrome present with lower gluteal pain and radiate down to posterior thigh and knee (2). The symptoms are similar to sciatica of other origins. Results of the neurological exams Observation, static palpation and range of motion Observation and static palpation are performed to look for any degree of antalgic posturing, any deviation from a normal spinal curve, pelvic position, and muscle spasm or bulks. Characteristic findings of each differential diagnosis are listed below. Lumbar disc herniation Possible hyper-lordosis of lumbar spine in an antalgic posture; Significant decrease in lumbar active and passive range of motion, especially in lumbar flexion and unilateral lateral flexion; Possible limited hip range of active motion due to muscle weakness; Possible palpable restricted lumbar vertebral segments; Hypertonic or tender lumbar muscles on static palpation, especially erector spinae (ES) muscles; Piriformis syndrome Possible limping or walking with the assistance with crutches due to pain and lower extremity muscle weakness; Possible hip external rotation on the affected side due to excessive piriformis muscle contraction, which is also known as â€Å"piriformis sign† (3); Significant decrease in hip active and passive range of motion, especially in hip internal rotation and adduction; Ipsilateral short leg (3); Tenderness at the sciatic notch on palpation; Possible hypertonic gluteal muscles (3); Sciatica Findings depend on the causes of sciatica such as lumbar disc herniation, piriformis syndrome and hamstring syndrome. Sacroiliac syndrome The posterior superior iliac spines (PSIS) on both sides are not at the same horizontal level; Possible redness and swelling at the affected sacroiliac joint; Possible leg length discrepancy; Significant decrease in sacroiliac joint mobility; Possible local tenderness on static palpation; Hamstring syndrome The pain is more localized, but possibly radiating; Tenderness of hamstring tendons or over ischial tuberosity on static in palpation; Significant decrease in hip active range of motion, especially in hip extension; On observation, static palpation and range of motion assessment, the patient was noticed for: Positive piriformis sign (hip external rotation) on the ipsilateral (left) side; A relatively shorter left leg compared with the right leg; Tenderness over contralateral (right) sacroiliac joint; A palpable â€Å"sausage-shaped† mass in the ipsilateral (left) gluteal region (3); Hypertonic left hamstrings; Tenderness over left sciatic notch on static palpation; Limited hip active and passive range of motion, especially internal rotation; Decrease in sacroiliac joint mobility; Other findings were not remarkable. The results of the assessment suggested that piriformis syndrome and sacroiliac syndrome were most possible diagnoses. Coordination and gait analysis Coordination and gait should be examined before other assessments are done, for this test provides us a big picture of the patient’s lower extremity function including motor function, joint integrity and coordination. Any gait dysfunction or antalgic gait should be recognized and further tests should be performed to look for the causes. No abnormal movement or disturbance of the patient’s gait was observed. He also reported a partial relief of symptoms when he was walking. The insignificant findings made lumbar disc herniation less likely, however, there was still a possibility. Sensory exam Sensory exams of peripheral nerves were performed to look for any sensation change on the symptomatic lower limb, which would lead to localization of the lesion. Assessments included fine touch, pain, temperature, and proprioception. Decrease in two-point discrimination and light touch was noticed over the lateral aspect of the left leg and foot. Motor exam Lower extremity muscle strength was tested to identify which nerve roots were affected according to myotomes. On examination, no significant findings were noticed. deep tendon Reflex Abnormal deep tendon reflex may be seen in lesions of muscles, sensory neurons, lower/upper motor neurons, neuromuscular junction and mechanical factors such as joint disease. On examination, the patient’s Achilles reflexes were normal (+2) on both sides. An abnormal Achilles reflex suggests a tibial nerve lesion (S1-2). Neurodynamic assessment Straight leg raise The test is designed to look for any impingement of the dura and spinal cord or nerve roots of the lower lumbar spine, especially in sciatic nerve (L4, L5, S1). The patient’s result was negative (70 °), suggesting less possible lumbar disc herniation. Bonnet’s test Bonnet’s test is a variant of straight leg raise and used to test for entrapment of sciatic nerve by piriformis muscle. The patient’s result was positive, indicating possible piriformis syndrome. Bowstring test Bowstring test is another variant of straight leg raise and used to test for entrapment of sciatic nerve by hamstrings. The patient’s result was negative, suggesting less possible hamstring syndrome. Orthopaedic examinations Valsalva maneuver Valsalva maneuver was done to look for any disc herniation causing radiculopathy. This would increase intrathecal pressure which may reproduce the patient’s symptoms. The patient’s result was negative, indicating less possible lumbar disc herniation. Lumbar compression-distraction test This test is also designed to look for disc herniation. When the compressive force is applied, it increases the intrathecal pressure and replicates symptoms if the patient has disc herniation. And the symptoms are relieved by distraction. The patient’s result was negative, suggesting it was less likely to be disc herniation. Gaenslen’s test Gaenslen’s test is to assess sacroiliac joint involvement. The patient’s result is negative. Yeoman’s test Yeoman’s test is designed to assess the integrity of the sacroiliac joint. The patient’s result is negative. Squat test Squat test is designed for quick screening of lower limb pathologies including joint disease, motor and sensory neuron lesions. The patient’s result was positive. Supported belt test Supported belt test helps to determine whether the pain is of lumbar origin or pelvic origin. The patient was noticed for having pain only without supported belt, suggesting his symptoms were caused by pelvic dysfunction. List of possible diagnoses from the neurological exam Piriformis syndrome Sacroiliac syndrome Further blood and radiological tests At this stage, no further imaging or other tests are needed, for the diagnosis can be made based on the patient’s history and results of neurological and orthopaedic examinations. It is recommended that the patient should be treated for piriformis syndrome at the start. A conservative treatment plan should be designed to reduce pain intensity, stretch hypertonic muscles and increase lumbar and sacroiliac joint mobility. However, if the patient does not respond to the treatment or the symptoms are worsened after the treatment, further investigations should be done. Considering a large extent of soft tissue and nerve involvement, magnetic resonance imaging (MRI) would be the most effective imaging method. A lumbopelvic view should be taken. This does not only demonstrate possible hypertrophied piriformis muscle and sciatic nerve entrapment, but also helps to rule out other differential diagnoses such as lumbar disc herniation. Nevertheless, many studies failed to show consistence of radiographic abnormalities in piriformis syndrome. Therefore, no significant findings on MRI do not necessarily exclude piriformis syndrome. CT and ultrasound are also used to look for abnormality of piriformis muscle, but they are not as sensitive as MRI. EMG is an investigation to assess abnormal spontaneous activity of muscles which are innervated by sciatic nerve, thus differentiating sciatica and lumbosacral radiculopathy; however, EMG findings are often normal in piriformis syndrome. Local injection of anaesthetics or steroid can be applied for both diagnostic and therapeutic purposes (4). This technique is widely used after initial evaluation. However, the specificity and efficacy is not well determined by clinical trials (4). A certain portion of patients with piriformis syndrome do not respond to piriformis muscle injection (5). Final diagnosis Based on the patient’s history, the results of neurologic and orthopaedic examinations, and likely radiographic findings, piriformis syndrome is the most likely diagnosis. Chiropractic management Conservative treatment is recommended at this stage, for 79% of patients with piriformis syndrome showed a significant improvement with use of non-steroid anti-inflammatory drugs (NSAIDs), muscle relaxants, thermo-therapy and rest (fishman, osteopathic approach). The aim of the chiropractic treatment is to reduce the intensity of pain, relax piriformis muscle, increase the range of motion of the hip joint, and increase mobility of lumbar and sacroiliac joint. The tone and length of the left piriformis muscle and other affected muscles (hamstrings, other lateral rotators, gluteus muscles) should be assessed with chiropractic muscle test and static palpation. Any trigger point, tenderness, hypertonia are noted. Stretching exercise and muscle release are introduced first to help the patient relax the hypertonic piriformis muscle. The patient needs to receive the muscle release training daily for 2 weeks until the muscle tone is assessed again and any improvement of his symptoms is seen. Stretching of other affected hypertonic muscles is also required. The mobility of the patient’s lumbar spine and sacroiliac joint should be assessed with orthopaedic examinations and chiropractic motion palpation. Any restricted segment is adjusted with high-velocity low-amplitude (HVLA) spinal manipulation. Chiropractic adjustments help to relieve pain, increase joint mobility and re-establish biomechanical stability of the body. References 1.Saikku K. Entrapment of the proximal sciatic nerve by the hamstring tendons. Acta orthopaedica belgica. 2010 06;76(3):321-4. 2.Puranen J. The hamstring syndrome. A new diagnosis of gluteal sciatic pain. The American journal of sports medicine. 1988;16(5):517-21. 3.Boyajian-ONeill LA. Diagnosis and management of piriformis syndrome: an osteopathic approach. The Journal of the American Osteopathic Association. 2008 11;108(11):657-64. 4.Jankovic D. Brief review: Piriformis syndrome: etiology, diagnosis, and management Article de synthà ¨se court: Le syndrome du muscle piriforme – à ©tiologie, diagnostic et prise en charge. Canadian journal of anesthesia. 2013 10;60(10):1003-12. 5.Martin HD, Martin H. Diagnostic accuracy of clinical tests for sciatic nerve entrapment in the gluteal region. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2014 04;22(4):882-8.