Reformation Its Religious And Educational Impact Essays

Reformation: Its Religious And Educational Impact Alvarez 1 Carlos A. Alvarez Veroy Mr. and Mrs. Alvarez 10th Grade Research Project 6 June 2001 Reformation: Its Religious and Educational Impact Throughout the fourteenth and sixteenth centuries a movement called the Reformation took place in Europe. But merely being more than just another religious movement, the Reformation was the moment in history in which God showed His great power and Salvation to the world through the lives of men like John Wycliffe, John Huss, William Tyndale, Martin Luther and John Calvinmen which were determined to die if it was necessary for the Lords causea moment in which two distinct forcesthe desire of learning and the rebirth of the Word of Godmade it possible for people to believe in the Bible as the only absolute source of wisdom and truth, putting it as the final authority over man and church. As stated in World History and Cultures by George Thompson and Jerry Combee, the story of how the Protestant Reformation began is a story of how brave men in a world dominated by the Holy Roman Empire desperately searched for the truth about salvation and found it in the Bible and how they were willing to step out on the sole authority of Gods Word, even if it meant to stand alone for what is right(246). I think that Martin Luther clearly expressed this thought when he said, Alvarez 2 Unless I am refuted and convicted by testimonies of Scripture, my conscience is bound in the word of God: I cannot and will not recant anything. I cannot do otherwise. Here I stand. God help me, Amen. Before the printing press was invented, books and Bibles were very rare, and people thought that the Roman Catholic Church held the final authority concerning religion and God. The Catholic Church not only possessed the few Bibles available, moreover they were the only ones who could interpret them since they were written only in Latin and Hebrew and only monks and highly educated people could read those languages. They even set a law which prohibited to everyone but the church to have Bibles, and if anyone else wanted to translate it, he had to translate it from the Catholic manuscripts and not from the original Hebrew or Latin texts. As I said before, books were not very abundant and making one was not an easy task. Edith Simon writes, The making of a book was a slow, expensive process that had improved but little in a thousand years. The professional scribe might spend four or five months copying out a 200-page text; even more costly than his labors were the 25 sheepskins needed t o make enough parchment for a book of that length(134). Therefore, if you wanted to have a Bible of your own, you did not only had to pay a lot for it but had to know how to read Latin or Hebrew and since in those days education levels were so poor and Alvarez 3 expensive, only a small number of people could afford it, making it for anyone a great privilege to read and write. However, in 1450, Johann Gutenberg invented the printing press and by 1501, there were printing presses in 110 European towns and cities. This made literature available to all class levels, opening peoples minds and encouraging them to study and educate themselves in any field of education that they wanted. This invention became later one of the key tools God used to carry the Gospel to all parts of the world. Throughout all this time the Roman Catholic Church dominated almost every social aspect of the European life, including politics, economy, religion and education, but once men realized the great teachings the Bible possessed, there was nothing that could stop the truth from coming out. Some might say that the Reformation began many decades before Martin Luther lived but the thing is that none of them had so permanently influenced the world as he did. He was born in Eisleben in 1483 to a middle-class family. All through his life, he tried to live according to the churchs teachings but it seemed like nothing was sufficient to save him from eternal judgment. He tried to do everything in his

Correcting a Run-On Sentence With a Period or Semicolon

Correcting a Run-On Sentence With a Period or Semicolon The simplest way to correct a run-on sentence (also known as a fused sentence) is with a mark of punctuation- a period or semicolon. Correcting a Run-on Sentence With a Period To make two separate sentences out of a run-on, put a period at the end of the first main clause and begin the second main clause with a capital letter: Run-on SentenceMerdine is a skilled carpenter she single-handedly built a two-story log cabin.CorrectedMerdine is a skilled carpenter . She single-handedly built a two-story log cabin. Inserting a period at the end of the first main clause is often the best way to correct a long run-on sentence. Correcting a Run-on Sentence With a Semicolon Another way to separate two main clauses is with a semicolon: Run-on SentenceMerdine is a skilled carpenter she single-handedly built a two-story log cabin.CorrectedMerdine is a skilled carpenter ; she single-handedly built a two-story log cabin. Be careful not to overwork the semicolon. The mark is most often used between two main clauses that are closely related in meaning and grammatical form. Adding a Conjunctive Adverb Although a period or semicolon will correct a run-on sentence, a mark of punctuation alone wont explain how the second main clause relates to the first one. To make this relationship clear, you can follow the period or semicolon with a conjunctive adverbthat is, a transitional expression that introduces a main clause. The common conjunctive adverbs show that you are continuing a thought (furthermore, moreover), offering a contrast (however, nonetheless, still), or showing a result (accordingly, consequently, then, therefore, thus). Unlike coordinating conjunctions, conjunctive adverbs dont join main clauses; however, they do guide your readers by linking ideas: I loathed my job more than I loved the paycheck; consequently, I quit work and returned to college.After three days of rain, I was tempted to abandon the hike. Nevertheless, on the fourth day I took bearings from my compass and set out due west toward Cedar Bay. Remember that a conjunctive adverb between two main clauses should be preceded by a semicolon or period. It is usually followed by a comma. This exercise will give you practice in applying the guidelines on page one of  Correcting a Run-on Sentence With a Period or Semicolon. To view the exercise without ads, click on the printer icon near the top of this page. Instructions: Use either a period or a semicolon to correct each of the run-on sentences below. A jump rope is the ultimate aerobic exercise it provides a top-notch daily workout.My teacher never missed a day of school I think even the flu and the common cold were afraid of that lady.Experience is not what happens to you it is what you do with what happens to you.A low blood-sugar level signals  hunger a higher one tells the brain that you dont need to eat.A lobotomy is a fairly simple operation however amateurs should not attempt it.Fifty years ago, parents were apt to have several children nowadays children are apt to have several parents.Humor is a rubber sword it allows you to make a point without drawing blood.Black magic is meant to harm or destroy white magic is intended to benefit an individual or the community.Carefully open the can of soup empty the contents of the can into a saucepan and stir gently.Its not enough to hear opportunity knock you must let him in, make friends, and work together with him.Boy bands should be exploded from a great height theyre just pret ty people singing music written by others. Happiness is the key to success if you love what you are doing, you will be successful.It is not the strongest of the species that survives nor the most intelligent that survives it is the one that is the most adaptable to change.Courage is doing what youre afraid to do there can be no courage unless youre scared.During a boat trip in 1862, Charles Dodgson began telling a story about an adventure in a world full of peculiar creatures the place was called Wonderland. Answers A jump rope is the ultimate aerobic exercise. It  [or  ;  it] provides a top-notch daily workout.My teacher never missed a day of school. I  [or  ;  I] think even the flu and the common cold were afraid of that lady.Experience is not what happens to you. It  [or  ;  it] is what you do with what happens to you.A low blood-sugar level signals hunger.  A  [or  ;  A] higher one tells the brain that you dont need to eat.A lobotomy is a fairly simple operation. However,  [or  ;  however,] amateurs should not attempt it.Fifty years ago, parents were apt to have several children. Nowadays  [or  ;  nowadays] children are apt to have several parents.Humor is a rubber sword. It  [or  ;  it] allows you to make a point without drawing blood.Black magic is meant to harm or destroy. White  [or  ;  white] magic is intended to benefit an individual or the community.Carefully open the can of soup. Empty  [or  ;  empty] the contents of the can int o a saucepan and stir gently.Its not enough to hear opportunity knock. You  [or  ;  you] must let him in, make friends, and work together with him. Boy bands should be exploded from a great height. Theyre  [or  ;  theyre] just pretty people singing music written by others.Happiness is the key to success. If  [or  ;  if] you love what you are doing, you will be successful.It is not the strongest of the species that survives nor the most intelligent that survives. It  [or  ;  it] is the one that is the most adaptable to change.Courage is doing what youre afraid to do. There  [or  ;  there] can be no courage unless youre scared.During a boat trip in 1862, Charles Dodgson began telling a story about an adventure in a world full of peculiar creatures. The  [or  ;  the] place was called Wonderland.

The Private Finance Initiative Essay Example | Topics and Well Written Essays - 4000 words

The Private Finance Initiative - Essay Example The basic premise behind the concept was to involve private players in service provision hence lessening the burden on the government. It was also meant to bring a touch of professionalism that is common in the private sector in provision of public services. The entry of Britain in the European Union also played a significant role in the starting of this scheme. New EU laws put a cap on government expenditure resulting from both internal and external debt. These laws consequently put a major strain on government expenditure on public projects such as new schools, roads and hospitals. Technical experts therefore resulted to PFI in order to expedite the provision of essential public services. In some circles the scheme was also known as the Private-Public partnership or simply the PPP. While the scheme was designed to ensure efficient provision of public services and reduce government borrowing from the public sector, it drew some criticism in some quarters. Some economic experts and political scientist pointed holes at the idea saying that it was a blatant display of government inefficiency. There was also fear that providers of these public services may be motivated by profits and end up providing mediocre services. In public finance, the government provides public goods since unlike private players; it is not motivated by profits. ... As noted earlier the Private Finance Initiative was the brainchild of the conservative government then led by John Major. It was billed as the most cost effective means of service provision to the public. As expected this attracted the wrath of the then opposition labour party who accused the government of engaging in unplanned privatisation of key government services. Courtesy of some wheel dealing and backroom consultations the labour party warmed up to the idea and consequently the Private Finance Initiative was implemented. In spite of its initial opposition to the idea, the labour went ahead to adopt PFI when it eventually swept to power under the stewardship of the youthful leader Tony Blair. The chancellor Gordon Brown who was one of the most vocal opponents of the scheme beat a hasty turn around and became scheme's number one supporter. The chancellor praised the scheme pointing out that it was due to PFI that over 150 new schools were built, 40 new hospitals constructed and a dozen road and rail projects constructed within a very short span of time. Economists at the treasury also argued that it was due to PFI that the government had spent more on capital projects and there was less public borrowing by the state. PFI was well manifested in London as it was responsible for the building of the ultramodern London Underground system. Mayor Ken Livingstone was forced to eat humble pie and support the project after its success. Akintole et al (2003) points out that Private Finance Initiative was one of the thorny issues in the labour government. There was the usual criticism that public assets were managed by private individuals in a questionable manner for a very long period of time. It was also quietly pointed out that some highly important

Law Project Essay Example | Topics and Well Written Essays - 1000 words

Law Project - Essay Example Additionally, the law protects the employers from irresponsible employees (Gulf News. 2013). In this case, this research indents to find out the relationship between employee rights to be informed prior to being fired and the authority of employers to terminate employees’ responsibilities without notice. To analyze the situation of employer termination procedures, a case study on ABC v. XYZ (pseudo named as a classified case) in which the claimant, ABC, accuses the defendant, XYZ, to pay the periodical allowance (Small Claims Tribunal, 2012). This research makes use of article 61 and article 102(1-7), which deal with employee work termination. This research makes use of secondary data through the use of a case study. Case studies are accounts relating to a topic of interest about a specific entity. In this case, a case study is used in the analysis of recorded data regarding a real life situation. Since information is already published, a case study is considered a secondary source unless a live coverage through the use of primary data collection method, observation, is used. In order to access information relating to UAE labor law, the internet will be utilized since it provides relevant and recent information sources unlike print materials (Gulf News. 2013). The rationale of using the case study method in this case is to ensure that various other sources on the background of the case can be provided. In the analysis of legal data, this research makes use of FIRAC analysis method where facts, issue, rule, analysis, and conclusion are the legal analysis variables considered in this case. The nature of the data presented in the case study is in literature, descriptive format, and descriptive analysis is selected as the most appropriate method of analysis. The chosen case study to support the objectives of the research project include ABC v. XYZ case as well as two articles from the UAE

About Pesticides Essay Example | Topics and Well Written Essays - 250 words

About Pesticides - Essay Example Use of chemicals therefore results to minimum tillage a practice that reduces soil erosion. This prevents water bodies’ siltation which causes imbalance in the aquatic environment (Matthews 2006, p.21) One of the major effects of pesticides to the environment is destruction of aqua system. When pesticides are washed away by rainfall, they are taken into the water bodies. When consumed by aquatic animals it causes complications in their bodies leading to death (Matthews 2006, p.13) Human being is also affected by these chemicals when they are released in the environment. The release of these chemicals causes body complications such as breathing complications. Some of these diseases cause human death. In addition to this, when plants are sprayed by pesticides, they may end up accumulating in the body of human being through ingestion causing body disorders and diseases such as cancer (Matthews 2006) In conclusion, pesticides fumes are cited as great contributors of global warming and therefore, use of pesticides should be highly discouraged and instead uphold organic farming. On the other hand reduced tillage as a result of use of pesticides gives farmers time to participate in other social activities that involve

Health Essays Myocardial Infarction Mortality

Health Essays Myocardial Infarction Mortality Myocardial Infarction Mortality 1.0 Introduction In the UK, about 838,000 men and 394,000 women have had a myocardial infarction (MI) at some point in their lives, (NICE clinical guideline 48, 2007). The latest statistics from the British Heart Foundation state that approximately 227,000 people suffer from an acute MI (heart attack) each year (British Heart Foundation Statistics Website). To put this figure in to perspective this equates to one person every 2 minutes. Mortality is at approximately 30% which is 68,100 deaths in the UK per year. The National Service Framework (NSF) for Coronary Heart disease (CHD) is a 10-year programme published by the Department of Health in 2000 and has set key standards for the prevention and treatment of CHD. Access to the right treatment for those who suffer from an AMI, is essential to reduce morbidity and mortality and improve clinical outcomes. People with diabetes mellitus constitute a group of patients who have a higher risk of having an MI and also a poorer prognosis post infarction. The higher death and complication rates appear to be multifactorial but a significant finding in the Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) Trial showed to reduce one year mortality by 30% (Malberg et al., 1995). It’s recommended 1.1 Primary Objective To determine the relationship between HbA1c and prognosis of patients in East Lancashire having a myocardial infarction. 1.2 Secondary Objectives To assess the prognosis of patients below the glucose cut off threshold for DIGAMI treatment and whether or not this borderline category falls in to the highest risk group in terms of mortality and morbidity. To determine if there is both a clinical and analytical case to use fluoride oxalate tubes for plasma glucose and HbA1c collection and analysis in East Lancashire. To ascertain the effect of a previous DIGAMI audit conducted in 2006 by the Clinical Audit Team and reflect on any improvements of conformance to the protocol two years later. If there is a significant relationship between HbA1c and prognosis then a risk stratification chart and a more clinically and analytically robust inclusion criteria on to the intensive treatment protocol (DIGAMI Regime) can be determined. This could lead to a better prognosis for a group of patients that fall into a borderline category that are not currently treated under the current protocol who potentially should be depending on the results of this study. 1.3 Cardiovascular Disease 1.3.1 Incidence of CHD The incidence of CHD follows different trends across the UK depending on various factors including regional, socio-economic and ethnic differences. There is a definite North-South gradient, and mortality rates are at the highest in Scotland and the North of England. Social class inequalities in mortality rates show that male manual workers are 58% more likely to suffer premature death from CHD than non-manual workers. Statistics also show that South Asians (Indians, Pakistanis, Bangladeshis and Sri Lankans), are more likely to suffer premature death with figures of 46% for men and 51% for women. This ethnic grouping the highest risk (Figure 1.). The East Lancashire NHS Trust provides a service for over half a million people offering care across four hospital sites. The population of East Lancashire falls into one of the higher risk areas in the UK with local authority statistics for reflecting this fact. Age-standardised death rates per 100.000 in Blackburn with Darwen, Burnley, Rossendale, Nelson and Pendle show that these areas fall into the upper fifth quintile for men and upper fourth and fifth quintile for women (Coronary Heart Disease Statistics 2005). In the Lancashire NUTS-2 area, which includes Blackburn with Darwen Unitary Authorities 93.4% of the 1.41 million residents classified their ethnic group as white British, Irish or other white background. A further 5.3% gave their ethnic group as Asian or British Asian. This figure is 1.3% above the national average. Even more pronounced is when the East Lancashire population is singled out, where the percentage rises to 10.8%. (Appendix ). The sub region of East Lancashire contains the highest proportion of ethnic minorities which is a contributing factor to the high incidence of CHD in addition to the socio-economic differences compared with other regions. Myocardial Infarction 1.4.3 Risk Factors Pathophysiology 1.4.2 Morbidity and Mortality 1.4 Diabetes Although there have been significant advances in the care of many of the extrapancreatic manifestations of diabetes, acute myocardial infarction continues to be a major cause of morbidity and mortality in diabetic patients. Factors unique to diabetes increase atherosclerotic plaque formation and thrombosis, thereby contributing to myocardial infarction. Autonomic neuropathy may predispose to infarction and result in atypical presenting symptoms in the diabetic patient, making diagnosis difficult and delaying treatment. The clinical course of myocardial infarction is frequently complicated and carries a higher mortality rate in the diabetic than in the nondiabetic patient. Although the course and pathophysiology of myocardial infarction differ to some degree in diabetic patients from those in patients without diabetes, much more remains to be known to formulate more effective treatment strategies in this high risk subgroup. J Am Coll Cardiol, 1992; 20:736-744 Acute myocardial infarction in the diabetic patient: pathophysiology, clinical course and prognosis RM Jacoby and RW Nesto Myocardial function is further impaired in diabetic patients by the metabolic changes that occur in the early stages of myocardial infarction: insulin resistance and hyperglycaemia are induced by release of catecholamines, cortisol, glucagon, and growth hormone.10 At the same time, secretion of insulin by the pancreatic islets is reduced,11 which impairs the ability to compensate for this state of insulin resistance. The combination of low insulin concentrations and elevated catecholamine concentrations increases release of non-esterified fatty acids, which augment myocardial oxygen requirements and depress mechanical performance. 12 BMJ 1996;313:639-640 (14  September) Editorials Insulin infusion in diabetic patients with acute myocardial infarction 1.4.1 Pathophysiology Mention stress hyperglycaemia 1.5 Glycated Haemoglobin Glycation is a nonenzymatic process of adding a sugar residue to amino groups of proteins. Normal adult haemoglobin usually consists of Hb A (97%), Hb A2 (2.5%), and HB F (0.5%). HbA1c is one of a group of a minor haemoglobins separated from the major constituent Hb A. It has become the dominant measure of glycated haemoglobin because of improved analytical techniques and ease of routine separation and quantification. HbA1c is formed by the condensation of glucose with the N-terminal valine residue of the haemoglobin ÃŽ ²-chain to form an unstable Schiff base followed by dissociation or a Amadori rearrangement to form the stable ketoamine (Figure ). The glycation of haemoglobin is essentially irreversible and its level depends on the lifespan of a patient’s red blood cell and the blood glucose concentration. Tietz p791 HbA1c is primarily used as an indicator of glycaemic control and used in diabetic monitoring. The feasibility study of the DCCT trial (diabetes control and complications) published in 1993 provided evidence for the much hypothesised opinion that better glycaemic control would decrease long term complications of diabetes mellitus and that the HbA1c test can be used as a measure of this. The UKPDS (U.K. Prospective Diabetes Study) followed on from these findings and conducted the largest clinical research study of diabetes focussing on reducing life-threatening complications by appropriate treatment including maintaining a HbA1c result of 7.0% or below (see section 1.5.1). 1.4.1 Utility of HbA1c Type 2 diabetes can be diagnosed using two different criteria, the fasting plasma glucose (FPG) and the 2 hour glucose value of the oral glucose tolerance test (OGTT) which is the ‘gold standard’. The FDG cut-off value of 7.0 mmol/L has been calculated to roughly correlate to the OGTT 2 hour diagnostic value of 11.1 mmol/L and provides greater reproducibility. A major disadvantage to the patient is the requirement to fast prior to both of these protocols. Glycated haemoglobin concentration is an indicator of the average blood glucose level over approximately 90 days. Though the lifespan of a red blood cell is normally 120 days, the contribution of the plasma glucose concentration to glycated haemoglobin differs depending on the time interval, with the largest influence on the HbA1c value being the most recent. It provides a retrospective index of integrated plasma glucose levels and has been suggested to have a role to play in the screening and diagnosis of diabetes in addition to its primary role of monitoring diabetic control. The debate of whether an HbA1c result could be used for diagnosis continues despite the generally accepted argument that the test as a single entity is not sensitive enough to provide definitive cut-off values and determine reference ranges because the values of the two populations; non-diabetics and diabetes overlap. An HbA1c result above the upper reference limit however is specific for glucose intolerance. Another concern is the limitations of the HbA1c result in individuals with abnormal haemoglobinopathies and anaemias, especially when the latter is secondary to haemolysis or iron deficiency (Kilpatrick, 2005). Glycation depends on the lifespan of a patient’s erythrocyte and the blood glucose concentration so in these groups the results will not be accurately representative of metabolic control in comparison to reference ranges based on the general population. 1.4.2 Reason for the Study It is highly unlikely that the HbA1c test will replace routine glucose testing for the diagnosis of type 2 diabetes but it may still have an invaluable role in this area. HbA1c levels may be less influenced by acute stress induced by an ischemic event compared with plasma glucose and therefore could be useful as a tool for differentiating patients with diabetes, and identifying undiagnosed cases in the inpatient setting. Although the increased risk of CHD with type 2 diabetes is universally accepted, a study conducted by Khaw et al. of the general population showed that medically diagnosed diabetes only accounted for 20% of all CVD fatalities. The majority of fatal events came from apparently healthy individuals with a glycated haemoglobin > 6% in the absence of diabetes and this relationship was independent of other risk factors (Khaw et al., 2002). Minor glycometabolic dysregulation may be associated with an increased risk yet this route of research has been poorly explored. If a strong correlation exists then HbA1c could be used as a routine test in the primary prevention of CHD, and patients with suspected acute coronary syndromes can be diagnosed with dysglycemia. In this identified group of individuals, intensive treatment could improve the long term prognosis of the patient. 1.5 Previous Studies DIGAMI 1 and 2 DCCT VA Cooperative Study UKPDS 1.6 Current Situation at the RBH East Lancashire Hospitals NHS Trust provides a range of health care and acute services to the Boroughs of Blackburn, Burnley, Hyndburn, Pendle, Ribble Valley and Rossendale with a population of approximately 515,000 falling into its catchment area. The primary purpose of the Pathology Department at Blackburn Royal Infirmary is to provide a high quality testing service for the diagnostic, screening and monitoring of patient samples. Recent drivers for change revolve around The Pathology Modernisation Programme which was launched in 1999. This aims at improving the quality and efficiency of NHS pathology services and encourages the introduction of new technologies and practices to deliver high quality patient care and matching capacity with increased demand. England’s National Health Service has embarked on an ambitious program of system reform. The Labour Government has committed to increase NHS spending to implement changes of streamlining services and improving quality of service. One of East Lancashire Hospitals NHS Trusts Key Objectives is to streamline diagnostic services and to reduce overheads as part of a Trust wide cost improvement programme. The aim is to work ‘smarter’ rather than ‘harder’ to balance activity with demand. However, current capacity to meet demand is almost at saturation point and we have reached the inevitable point in which processes have to change. 1.6.1 Post MI Management DIGAMI 1.6.2 Laboratory Service to Users The decision of treatment for some patients with a suspected MI can rely on the venous glucose result. It is therefore paramount that the result validated is accurate and precise. 1.6.2.1 Glucose Stability The MI patients treated as per DIGAMI protocol are diabetic patients or non-diabetics with a glucose of >11.1mmol/L. An area of contention is the fact that for inpatients, serum glucose is collected in Startedt S-Monovette ® gel tubes containing no preservative and analysed on the VITROS 5,1 FS chemistry system. The manufacturers’ guidelines state the stability of glucose decreases by approximately 8% for every half an hour prior to separation of the serum from the cells (VITROS datasheet ). Though samples from A+E are dealt with urgently this is a short timeframe from collection to result. Some bloods are taken via a paramedic collection on route to the accident and emergency department and therefore are delayed even longer prior to analysis. The stability of serum glucose is a well known problem hindering the accuracy of results this is the reason that samples arriving from GP surgeries are processed routinely on the Thermo Konelab analyzer using blood collected in tubes containing a fluoride oxalate preservative. It has been discussed to also use such tubes for ward samples, with all glucoses being run on the VITROS analyzer. Up to now the stability issue of hospital samples has not been thought of as a clinical hindrance because they are prioritised and processed sooner than the GP samples and therefore there has been a ‘medically allowed tolerance’ The importance of the admission blood glucose result has come to light as it can be a deciding factor for the inclusion of MI patients on to the intensive DIGAMI treatment protocol, and as a direct consequence, will have a clinical impact on the prognosis of a patient. Due to the glucose being metabolised by the cells and giving a falsely lower result, a group of borderline patients may not meet the inclusion criterion for DIGAMI as a result and have a worse prognosis than they should have. Therefore this is an issue of great clinical importance. This project should indicate to what extent the stability is a problem and approximately how many patients it affects. If the HbA1c result could be utilised as a complimentary test to be used in conjunction with known diabetic status and admission plasma glucose then the inclusion criteria would be both more clinically and analytically reliable. Historically HbA1c analysis is performed by the haematology department on EDTA blood samples for logistical reasons. If analytical stability and comparison studies show that fluoride oxalate tubes can be used accurately and precisely for glucose and HbA1c analysis then one biochemistry tube would be sufficient for both tests. Laboratory practice for diabetic diagnosis and monitoring could then be a leaner process for cascade HbA1c testing in terms of archiving, retrieval and storage of samples. 1.7 Clinical Audit Clinical audit is a quality improvement process which is a component of clinical governance within the NHS introduced to improve patient care through a systematic review against explicit criteria and the implementation of change. Participation is recognized by the General Medical Council as an integral part of good practice and the results should be used to improve the quality of care. The Myocardial Infarction National Audit Project (MINAP) is funded by the National Institute of Clinical Excellence (NICE) and is carried out by the Royal College of Physicians (RCP). It was established in 1999 as a method of clinical audit to examine the quality of management of myocardial infarction and shows how hospitals in England and Wales are performing against targets in the NSF for CHD. 1.7.1 Summary of 2006 DIGAMI Audit In 2006, the clinical audit team conducted an audit with one of its’ main objectives being to assess whether the DIGAMI protocol was being adhered to. This was a retrospective study in which the casenotes of 46 patients were viewed and information extracted. These patients were either known diabetics or had a plasma glucose of >11.1mmol, and had presented with cardiac pain. A summary of the baseline characteristics was that over half of the patients were of Asian descent, there was a slight female prevalence and the majority included were known diabetics. They also concluded that the DIGAMI regime was only initiated in 24% of the cases, whereas all 46 patients should have been treated as per current protocol. Another non-conformance to the protocol was the fact that approximately 50% of the patients did not have a venous blood glucose checked by the biochemistry laboratory (Bharucha et al., 2006). The results of this audit will be re-addressed in this study to ascertain the effectiveness of the recommendations and the impact of the results two years on. Reasons for undertaking this project According to estimates there are as many as a third of undiagnosed diabetics (as cited in Greci et al., 2003). The DIGAMI regime is an intensive treatment protocol for the management of myocardial infarction in patients known to have diabetes mellitus or in patients with hyperglycaemia on admission. At East Lancashire NHS Trust, intensive treatment with intravenous dextrose and insulin reduce and control blood glucose levels to between 4-9 mmol/L. Currently, there is a standardised inclusion criterion and treatment protocol rather than a treatment programme which is graded in intensity, and tailored to individual glycometabolic status. Hospital glucoses are analysed using serum collected in Starsedt Monovet 4.2 ml gel tubes. The manufacturers’ guidelines state the stability of glucose could decrease by 7% every half an hour prior to separation of the serum from the cells. Although samples from A+E are dealt with urgently this is a short timeframe. Paramedic collection of samples on route mean even longer time delays before separation.

My Writing Profile :: Free Essay Writer

During my school years, I have been assigned lots of writing to do. At the start, I found great difficulty in putting my thoughts on paper, yet by practice, one gets to improve his abilities. One never stops learning as long as he lives. Moreover, practice results in perfection. In my past school years I have received many writing tasks, in addition, I gradually improved in each of them. There are various differences between my work in each stage of my life, example, the work I have done in the past, work in the present and what I intend to do as a writer in my future. As for my past, I had various writing assignments that my teachers asked me to do, such as character analysis essays, persuasive essays, and compare and contrast essays. Many of these essays I have truly enjoyed, such as the persuasive essay, however others, I really struggled at, such as the character analysis. Furthermore, I had others that I was at standard level at them, yet, they needed a lot of improvement in many ways. Last year, as for memorable things that teachers told me, was that I had a lot of trouble in the thesis statement structure, which however, affected the rest of the writing. Knowing all my mistakes now, moreover getting more advice this year, I hope that I will make huge progress. As for the present, during writing an essay I usually jot down my ideas on a piece of paper, next I prepare a peaceful environment, which I could easily get out my concentration, which is usually on a suitable desk in my room. The surrounding that I must have to write, is a well lighted room, where I am all alone without any distracting noise. I start off buy having a scrap paper where I do all my jotting notes at and mainly the first and second draft of the essay. Yet, that is easier for me as I could simply correct any mistake and use reference guides such as the dictionaries which also helps me in spelling mistakes and thesaurus for developing good word choice, lastly I write it on the keyboard neatly. When I think of going for advice, the first thing that comes on my mind is asking the teachers, as they are the number one choice to help you out.

Bullet-Trains

Also they are designed for long distance traveling, and have not been implemented in the United States. They have many competitive advantages such as higher speeds, which leads to a quicker means of transportation. This is a huge advantage because in todays society time is one the most important sources for competitive advantage. They have a much more modern look which includes comfortable seating, and high end dining, which these are also core competencies. This leads to quality, consumers are willing to spend the extra money for quality, which they will receive on the bullet trains. Also the technology is so advanced there wouldn’t be competition directly to Siemens if they were to start in the US market. will be competing against.Customers want to be able to have a relaxed experience when traveling, since traveling is hectic as it is. Bullet trains will fill those needs of the consumer, and with all of the surveys that have been done more than 60% of people do not enjoy the chaos that comes with traveling. Whether they are traveling through the air or in a car it is not very comfortable, this is a huge competitive advantage for bullet trains which also makes them â€Å"order winners†. Order Winners are features that basically win a customer over to your product or service they have made these trains based on consumer needs and wants, because of these trains being produced for such a long period of time. â€Å"The Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA) established a process for designating U.S. high-speed rail (HSR) corridors.† This started the testing of high speed trains which can go up to 90-120 mph.Bullet trains are almost twice as fast as these. This technology is very advanced though and the US government does not believe in funding at the moment. This is because the cost of production is very high, which is very important. If the government were to help with the funding this be a huge importance for Siemen s. Although they are a huge corporation without government funding, it is very expensive to produce the bullet trains. So at the moment they are coming up with different strategic methods on how to lower production costs, as well as how to relate the trains to a more specific market segment.The importance of the research that is being done will either make or break the opportunity for the trains to come to the  states. They need the governments support and the abilitity to come up with a new strategy on how to present the idea to Government. The contributions these trains will make are un-imaginable. They not only make the US a more innovative country, but it could help in increasing the US economy, which could very much use this boost. It will give citizens a lot quicker mean of transportation, while also lowering the costs of different industries such as: air travel, car travel, and slower and less convenient train travel. This could contribute to lowering gas prices, plane tick et prices, and push the US in a new direction for the future.This leads to the Value chain effect, Siemens is already way ahead of society’s technology today. They are a very futuristic organization and they already have on site research testing. They also produce a lot of their parts that would be needed for the trains which is a benefit of the value chain process. I would advise for the trains to come to the us because it would be a huge advancement for our society.

Mental health Essay

â€Å"Research suggests that burnout and low job satisfaction are significant problems among mental health workers and may be especially so among those working with clients with serious mental illness.†(Purdue) Many people suffer from mental illness and addiction, and many of these people end up in a community health center where social workers/case managers help them to cope with their issues and be the problem solvers for them. The ratio of patient to case worker is extremely off balanced and many case workers become overwhelmed and experience burn out. â€Å"Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed and unable to meet constant demands. As the stress continues, you begin to lose the interest or motivation that led you to take on a certain role in the first place.†(helpguide) When a case worker experiences burnout they put their patients at risk because they are supposed to be the solid ground for the patient to stand on and if the case manager is not motivated to help anymore they will do the patient no good in helping them move forward. Burnout is a dangerous state of mind for a case worker to have since they are supposed to be responsible, motivated and in a positive state of mind to help others. When burnout is present there is a greater chance of a case being mishandled and that can cause many different problems, not just for the person being helped, but for the case worker and their facility. The signs of burnout come in many different forms, such as physical, emotional and behavioral. Physical signs of burnout are feeling tired and drained most of the time, headaches and muscle aches and feeling sick all of the time. Emotional signs of burnout are loss of motivation, sense of failure, feeling helpless, trapped and defeated, always having a negative attitude; feeling detached from the world and decreased sense of accomplishment. Behavioral signs of burnout are withdrawing from responsibilities, using food, drugs or alcohol to cope, isolating yourself from others, taking out frustrations on others, procrastinating getting things done, skipping work and neglecting other responsibilities. The signs of burnout are a very serious matter, especially to a caseworker who should be in a positive state of mind when helping others. If a caseworker is not working to the best of their abilities the outcome of an individual’s case may not turn out positively and they may suffer even more to have to go through the process more than once. It also makes the client not trust others, making it harder for the next person who may be the case manager who may be dedicated to the case, but be ‘punished’ for the mistakes made by a previous case worker. The client has to trust their caseworker in order for them to work together and successfully work through their problems, a case manager must be able to provide their full support and attention. In order to prevent burn out an individual needs a positive support system whenever they feel burned out or have an overload of stress that can cause an eventual burnout. An individual should always know their limits and know when enough is enough and not push themselves over the edge. There should be a shared responsibility amongst caregivers/case managers and the load of work should be rationed evenly, as not to overwhelm any particular person. Caregivers should be able to ask for help when they are in need, because they are always helping other people and can possibly forget to take care of themselves. It is important to know that in order to help others, you must first help yourself and take care of your mental and physical wellness to be at your best for other people. There are caregiver support groups available also, which can help emotionally because everyone is sharing their experiences and it can show you that there are others out there who feel the same way you do and are going through the same things. Support groups can also help individuals share their ‘tricks’ they’ve learned with coping with stress and maybe give information for other helpful outputs that are beneficial to use as a caregiver. Caregivers are the most important people in the community; they are selfless and help those in need, oftentimes putting themselves last. Unfortunately burn out is a common trend in the caregiver service because of all the effort put into each individual case, it can become extremely overwhelming to deal with. The turnover rate among social workers, caregivers and case managers is very high because of burn out. These jobs are very demanding and it takes a special kind of person to be able to cope with these duties and continue to help others without ‘losing themselves’ and suffering a burn out.

The History Of The Yo Yo essays

The History Of The Yo Yo essays It spins! It sleeps! It flips! It turns! It's the amazing yo-yo! So many people have busted a few moves with a yo-yo, or at least tried to, sometime in their lives. It's seems that it's been a toy that's been around forever. But, of course, it is a man-made object, therefore it must have an inventor, time, and place it came from. Now I will speak on the history of the yo-yo. You will discover aspects about it's origins, all the way up to becoming one of the world's most popular toys. Although you might see this study and research as pointless, you will be amazed at the immense history this simply stringed gadget has. Being a toy created in the ancient era, the yo-yo is one of the world's oldest toys, second only to the doll. Some people believe that the yo-yo was developed in ancient China. But, the oldest surviving yo-yo dates back to 500 BC, and is Greek. Proof of this, a Greek vase from the BC period shows a young boy playing with his yo-yo. Among other materials that could have been used to make these ancient toys, (such as wood, metal, and stone) historians have found that many were made of terra-cotta. Terra-cotta is a fragile, clay-like material. A yo-yo made of this material would break easily. Many of these were found on temple sights. Thus, archaeologists believe that Greek children gave their toy to the gods as a coming of age offering, rather than using it during their afternoon playtime. In Africa, images of young people yo-yoing adorn the walls of ancient Egyptian temples. A wooden box found in India depicted a scene of a girl playing with a yo-yo. On a more serious note, hunters i n the Philippines used a yo-yo like device to hunt animals from the treetops. In some cases, the yo-yo was thought to have been used as a weapon during skirmishes between the local tribes. Through time, the yo-yo survived and shifted from nation to nation, lasting through culture changes, wars, shifts of power, and many other historical ha ...

Gulf War III - How successful was Operation Desert Storm Could it have Essay

Gulf War III - How successful was Operation Desert Storm Could it have achieved more How joint was it - Essay Example Moreover it was the case that Iraq stated that they would bombard Israel with rockets should there be any military incursions into the nation of Iraq. So if based upon the parameters of liberating Kuwait, protecting the Kingdom of Saudi Arabia and protecting Israel than the operation would have been considered a complete success. However, one could argue that there were a number of ancillary objectives such as overthrowing Saddam Hussein, or the liberation of Kurdistan. And taken from this perspective the military incursion would have not been considered an overall success. As a final point, one could also make the argument that one additional objective as argued by Gordon & Trainor (1995) was for the US to demonstrate their military muscle in the middle east. Effectively showcasing their new military technology and superior leadership by Schwarzkopf and Powell. As a result of this action a significant military power in the Middle East had their entire military industrial complex nea rly annihilated. If viewed as a stand alone engagement, it could have been argued that the military engagement could have achieved more insofar as the United States later engaged in hostile action with the nation of Iraq during the second gulf war.

Marketing project Essay Example | Topics and Well Written Essays - 500 words - 1

Marketing project - Essay Example Netherlands has a population of 16,652,800 people and about 15,500,000 bicycles (Shahan, 2014). This translates to about 1.11 bicycles per Dutch. Research also shows that about 27% of all trips are made by bicycle. On average, each Dutch covers about 2.5 km per day on a bicycle. However, since safety is paramount, we intend to introduce state-of-the-art bright bicycle lights, which would be placed on the front of the bicycle to enhance vision and red lights at the back. At the backdrop of the continued growth of bicycle use in the Netherlands, we have decided to take advantage of the high demand for bicycle lights in the country by entering into the market. Although there are a variety of entry methods that ‘A company can use to enter the Dutch market, we have opted to use joint venture as the best entry method, considering the Dutch legal requirements and the advantages of joint venture. The company has already identified a company with which to form a joint venture in Netherlands. The company is called Royal Dutch Gazelle, which is the leading bicycle manufacturer in Netherlands today. We chose to form a joint venture with Royal Dutch Gazelle because of a variety of reasons. Firstly, Royal Dutch Gazelle is a well-established brand in Netherlands and , therefore, forming a joint venture with it will enable our bicycle lights receive a warm reception among the Dutch. Secondly, a joint venture with the Dutch company will help the company share the risk of entry (Brady, 2010). Company A will also benefit from the joint venture with Royal Dutch Gazelle because it will result in sharing of knowledge and expertise, thereby helping in the development of the company in Netherlands. Additionally, because of the strict Dutch laws regarding the entry of foreign companies, it became appropriate that we form a joint venture with a Dutch company to enable the company A