The Ghetto Made Me Do It

024 ENG October 18, 2012 â€Å"The Ghetto Made Me Do It† Violent behavior is a direct result of heredity, environment, and parenting. The author of â€Å"Seeking The Roots Of Violence† believed that genetic heredity has to do with violent behaviors. I believe in her hypothesis, but also believe that environmental factors play a big role as well. How you are raised and people you are most closest to have a greater chance of influencing you in many ways. There is a saying my parents used to tell me when I was younger â€Å"show me your friends, nd ill show you your future†. The people you surround yourself with on a daily basis do illegal drugs, eventually you will too. Friends and family carry a great impact on a person’s life, especially when he or she is young. For example, in the essay â€Å"The Ghetto Made Me Do It† Lisa Morgan was brought up in a violent home. Lisa Morgan’s mother once had set her father on fire. Environment isn’t the only thing that has an impact on violence, it also has to do with ones heredity. Our DNA and our genes make us who we are.Our DNA controls our height, weight, how we look, as well as how we act. In the essay â€Å"seeking the roots on violence† Anastasia Toufexis stated that â€Å"for one thing, genes help control production of behavior relating chemicals. One suspect substance is the neurotransmitter serotonin. † Someone that has a chemical imbalance in the brain can cause depression and violence. Serotonin is chemical in our brain that controls ones mood. When a person is clinically classified as depressed he or she is prescribed to take serotonin to balance out the chemical mbalance that is causing these irrational mood swings. If we were to evaluate criminals for there behaviors and give them these drugs, it could potentially help control there violent thoughts. Not only is this a possibility, but if we study this it could lower a lot of violence throughout the world. At the same time it is very expensive and in my opinion the government needs to have a present of the population behind bars so they can gain profits. After reading these two articles it personally shined some light on this subject.

Macbeth Essay

The medieval and renaissance view of the world saw a relationship between order on earth, the so-called microcosm, and order on the larger scale of the universe, or macrocosm. Thus, when Lennox and the Old Man talk of the terrifying alteration in the natural order of the universe † tempests, earthquakes, darkness at noon, and so on † these are all reflections of the breakage of the natural order that Macbeth has brought about in his own microcosmic world. Macbeth is set in a society in which the notion of honor to one’s word and loyalty to one’s superiors is absolute. At the top of this hierarchy is the king, God’s representative on Earth. Other relationships also depend on loyalty: comradeship in warfare, hospitality of host towards guest, and the loyalty between husband and wife. In this play, all these basic societal relationships are perverted or broken. Lady Macbeth’s domination over her husband, Macbeth’s reacherous act of regicide, and his destruction of comradely and family bonds, all go against the natural order of things. Clearly, gender is out of its traditional order. This disruption of gender roles is also presented through Lady Macbeth’s usurpation of the dominate role in the Macbeth’s marriage; on many occasions, she rules her husband and dictates his actions. Macbeth is very rational, contemplating the consequences and implications of his actions. He recognizes the political, ethical, and religious reason why he should not commit regicide. In addition to Jeopardizing his afterlife, Macbeth notes that regicide is a violation of Duncan’s â€Å"double trust† that stems from Macbeth’s bonds as a kinsman and as a subject. On the other hand, Lady Macbeth has a more passionate way of examining the pros and cons of killing Duncan. She is motivated by her feelings and uses emotional arguments to persuade her husband to commit the evil act. Macbeth Essay The play Macbeth was written in the start of the 1600s by William Shakespeare, if you ever get a chance to read this play in both script and graphic novel you will discover that there are many signs of imagery and symbolism. Some of the many examples have been shown in nature with trees and birds acting as something’s are going on in the back, some in the way that the people, kings, and nobles dress in the play and also some in the way that blood is used throughout the play. As Lady Macbeth and Macbeth make plans to kill King Duncan so that Macbeth can become king as what the witches’ prophecy states, they know Banquo was there talking to the witches with Macbeth. The first example shows how the weather and nature acts when Macbeth and Lady Macbeth do a dirty deed. So when the king was murdered the animals in the Kings castle went ‘haywire’ as Ross says, â€Å"and Duncan’s horses, a thing most strange / Beauteous and swift, the minors of their race, / turn’d wild in nature, broke their stalls, flung out, / Contending ’gainst obedience as they would.† (Ross, 2.4.14) This would show that a person has done something that they should not and obstructed the circle of life; in this case, â€Å"†¦Macbeth does murder sleep†¦Ã¢â‚¬  (Macbeth, 2.2.395); in other words Macbeth killed Duncan to take his position. There is also many other parts where nature acts as events happen for example when Malcolm and his army from England proceed marching to Dunsinane to confront Macbeth. Because at this point the weather appears to be dark and scary like someone is going to die. The second example is clothing; this distinguishes them from good and evil. For example light clothes are worn when the character wearing them is in a good and positive role and dark clothes are worn when the character wearing them is in a bad and evil role. Relating to Macbeth, this shows him as well as Lady Macbeth changing from noble and loyal to the king to trying to take him over. At the start Macbeth shows to be wearing purple and other loyal colors in the graphic novel but towards the end he had turned to a tyrant and started wearing red symbolizing blood and dark clothes. But also clothing is used to represent people and used to tell how good or bad a person is for example when Macbeth hears that he has been given the position of the Thane of Cawdor, he asks Angus why he is being dressed in â€Å"borrowed† robes (1.3.7) because he knows that the Thane of Cawdor still lives. Blood shows to play a huge part in Macbeth: Macbeth is a warrior at start and towards the end but then towards the middle he shows his ambition and turned to kill anyone in his way, in this case King Duncan and Banquo and Macduff’s Family. Make thick my blood,/ Stop up/ th’ access and passage of nature/ Shake my fell purpose, nor keep peace between/ Th’ effect and it! (Lady Macbeth, 1.5), this shows that lady Macbeth is talking to and telling spirits to make her blood thick and make her stronger so that they can commit a crime. Also that blood can symbolize who they are and what they do. Macbeth also says it will have blood, they / say: blood will have blood. / Stones have been known to move and trees to speak (Macbeth, 3.6). Blood plays a big part in Macbeth because Macbeth and Lady Macbeth have been playing with the scale of life and disrupting it with blood and murder. Showing blood, nature and clothing in the play can make symbolism and imagery in the play better. Blood is used in most of Shakespeare plays. The nature used in these plays is called pathetic fallacy and this is another factor embedded in most Shakespeare plays. In Macbeth he is a warrior but a tyrant trying to take over the king. Clothing can play a role to describe what kind or how a person is. At conclusion Macbeth shows symbolism and imagery to describe many aspects of the play and it does help the reader or the audience get a better perspective and in-depth view of the characters and how they behave.

History 20th Century Essay

The historical past of a particular country is essential in understanding its present situation as well as in planning the future. Past events served as a basis as to why particular situations happen in the present. In relation to this, lesson learned in the past also becomes a guide in order to avoid previous mistakes. Being the case, analyzing a country’s history is indeed important. These ideas also holds true in the case of the 20th century African American leadership. The era of slavery in the United States of America holds a very important part in their history. It was during the time wherein the southern region of the country capitalizes in the exportation of cotton that this slavery of African American took place. As such, maltreatment of these people happened that is characterized by the discrimination and segregation of the African Americans from the whites. This is also the reason why many African American leaders started to go against this inhumane treatment and asked for changes. Their efforts might have taken a long time before it made a difference but it was worth it. It is also essential that primary resources are use in studying and analyzing the history of African American leadership because it should be taken into consideration that majority of the people who are in power during those times as well as at the present are whites. As such, some of them are capable of manipulating the information about the African American history. Studying the leadership of these African Americans is important because they epitomize how people struggle in order to fight for their rights. They also embody a turning point in the United States history because it was due to their leadership that the country reassesses their idea of freedom and democracy. Furthermore, it plays an important role for the country to understand the present state of African Americans as well as the development and areas for improvement of the situation of these people. Moreover, the lesson learned from this experience would aid the people to make things better so that the mistakes done in the past would not happen again.

Economics and Lead Time

CASE ANALYSIS FOLDRITE FURNITURE CO. : PLANNING TO MEET A SURGE IN DEMAND Submitted to: Submitted by: Dr. P. K. Dash Abhinav  Anand Operations Management PGDM-BHU010 Case facts about FoldeRite Furniture:- * Established in 1987 * Throughout 1990s company grew organically. * 1999-2006 annual growth rate 3. 5%. (More than market growth rate) but one competitor grew by 6% annually. * In 2006 company’s performance was very bad due to following concluded reasons- * Loss of productivity and yields caused by high labor turnover. Cost of raw materials was increasing * Increasing proportion of unskilled labor. * Continuous acquisition of small firms which distracted management from their main issues. * This thing also generated liquidity shortage * These things resulted in reduced margins as well as increased lead time from 4 to 6-8 weeks. Major policies that company adopted after change in management:- * New CEO marshal Epstein from a major consumer goods company was appointed. * Man ufacturing VP Jose Ramose was hired. Together they decided 4 major goals:- * Continued innovation in both products and processes, * Customer responsiveness: producing high quality products that fulfilled market needs, and providing quick service, * Lean manufacturing, and * Retention of a well-trained, stable, and productive workforce, with reduced turnover. * Reduced no of products to provide high quality products. Consequences:- * All these helped in reduction of lead time. * They had a $60M revenues and profitable despite recession Ques-(01) what are the Manufacturing Options available with Mr. Martin Kelsey? Ans. The objective of the aggregate plan was to demonstrate cost-effective ways to meet the demand while maintaining productivity, quality, reliability and providing on-time delivery at effective yields. The following are the manufacturing options with Mr. Martin Kelsey: 1. The first option available was to ask the staff to work an extra shift. 2. Increase the staff temporarily to take advantage of idle production capacity. 3. Changing the designs of the cloud chair slightly to require one minute less in assembly 4. To increase the amount of inventory using a constant level of production. 5. The last option available with Kelsey was subcontracting part of work, such as the manufacture of seats for stackable chairs. Q2. What are the financial implications of the three options? How does it impacts the lead time? Wages of the Skilled workers is = 19 + 33% of 19 = 25. 27 Wages of the Unskilled workers is = 9 + 10% of 9=9. 9 Change Strategy In alstrong, the hiring cost would be zero for skilled and $2593. 5 for unskilled labors. The layoff cost would be $327288 for skilled $349752 for unskilled labours In case of cloud chairs, the hiring cost would be zero for skilled and $633. 6 for unskilled labours. The layoff cost would be $264342 for skilled $533520 for unskilled labours In case of green comfort, the hiring cost would be zero for skilled and $1662. 5 for unskilled labours. The layoff cost would be $214058 for skilled $231270 for unskilled labors Subcontracting Strategy In case of cloud chairs, units subcontracted cost would be $720355. 32. In case of alstrong, units subcontracted cost would be $46959. 28. In case of green comfort, units subcontracted cost would be zero. The lead time will reduce in all the 3 cases. Ques (03) what are the risks? How does each of the options accommodate changes in economy and environment? Ans. The risk associate with it are: Financial Risk:- * According to their CFO Yung credit situation is tight. * They have to generate cash from costly resources as expensive as 12% p. . Human resources Risk:- * Hiring a skilled worker would cost $1500 * Supervisor cost for these workers $25 per hour + 33% for benefits * Training of unskilled worker takes 4 weeks during which full wages are paid. Changes in economy and environment are as follows: 1. If staff would be doing overtime than it would increase the productivity in short run but at the same time this would have lead to fatigue and boredom among the staff leading to decrease in efficiency. 2. Hiring staff temporarily would automatically increase the cost of training and would also require management and supervision resources. 3. If the demand did not materialize than laying of the workers would demoralize the remaining workforce and cost the company in adding unemployment. 4. Another major concern was the cost of carrying inventory beyond two weeks. Ques-(4) Weighing options in term of non-financial implications Ans. The non-financial implications are: 1. Overtime work done by Employees: This will affect the profitability in short term in a positive manner but in long term as the workers do have chance of getting fatigue it might lead to decrease in quality of product which in turn decrease the profitability. The overtime formula will not affect the relationship among employees but the competitiveness will affect if the efficiency decreases in long run. 2. Increasing the staff This will lead to increase in profitability in short term as well as in long term if company does not lay off workers. The sales will increase if the efficiency of work increases as a result of increase in workers. . Changing the Design In short term there will be a decrease in profitability as the company would have to pay a onetime charge of $15000 but in long term as because of innovation the profitability will increase. Dut to innovation the company will have a competitive and also the sales will increase as it’s a new designed product. 4. Sub contracting The company will focus in th e core area which will lead to profitability in short term and long term both. This will further lead to increase in sales as a result of efficient production. The employee morale will also be boosted because of increase in sales.

Personal Finance Essay

1. Are you considered a default risk? How would a lender evaluate you based on â€Å"the five C’s† of character capital, collateral, and conditions? How could you plan to make yourself more attractive to a lender in the future? I do not believe I would be considered a Default Risk because I have a good credit score and I try to pay off what I spend on my credit cards that same month or fairly quickly so I don’t have to pay high interest rates. Based on the five C’s†¦ Character-I would be considered as a good character due to employment, residential, and repayment history. Capacity- I try not to carry high balances on my credit cards, therefore, my debt obligation is fairly low. Capital-Capital would be considered mediocre due to my asset and collateral base. Collateral- I would no have much collateral because most of my assets are in my spouses name. Conditions-I may be considered a risk under conditions considering I work for the auto industry. To make myself more attractive to a lender, I would probably use my credit cards more often and build up my credit history to make it stronger. I would also add my name to my spouses mortgage because he owned the home before he met me. I would also increase my income by working full-time opposed to part-time that way I could show that I would be able to afford to have a higher balance on my credit card. 2. Identify the last two items (consumer goods and durable goods) you purchased. Alternatively, select any two items you purchased during the last two months. Choose diverse items and analyze each item interms of the following factors: a. Why did you buy that item? How did you decide what to get? I recently bought an Ipad and a new pair (good) of running shoes. I bought the Ipad basically for a portable electronic reading device and something I bring with to keep up with my school work and it will also assist me with my job at work. I also decided to buy a really good pair of running shoes for walking & jogging. I usually purchase shoes that cost around $40-$50 but have never been happy with them. Where did you get your information about the item? I did a lot of research online and I also asked some of my peers who have these items their opinions and I also read reviews. Where did you go to buy the item? I bought my Ipad at the Apple store and I bought my shoes online. In what kind of market did you make your purchase? The market seems to be picking up so I would say it is a striving market. Where did the money come from for your purchase? I used money that was given to me as a gift from my parents to buy the Ipad and the shoes came from money I earned at work. How much did you pay for the item, and how did you pay for it? The Ipad was approximately $400.00 and the shoes were approximately $150.00 h. How would you rate your satisfaction with your purchase? I am very happy with both of my purchases. I am glad I did the research before I bought them and sometimes it’s better to get the more expensive item because I do believe you get what you pay for. i. If or when you purchase that type of item again, what might you do differently? The only thing I would do differently is be a little more patient and wait for the items to go on sale or find a coupon to use. 3. For a car you would like to drive, calculate and compare what it would cost you to buy it and to lease it. Use the Lease versus Buy Calculator athttp://www.leaseguide.com/leasevsbuy.htm. What would be the advantages of owning the car? What would be the advantages of leasing it? For your lifestyle, needs, and uses of a vehicle, should you buy or lease? 2014 Ford Explorer to lease it for 24 month, 12,000 miles per year with an A-Plan discount and $2500 down payment the payment would be $335 per month. To Purchase the vehicle on a 60 month loan with $2500 down would be $589 per month. The advantages of buying a vehicle is that it is a major investment, better finance rates, you do not have worry about miles, you can sell it to recover some equity or trade it in to purchase something new, you can keep it as long as you would like. It is your vehicle once it is paid off. The advantages of leasing a vehicle would be a low monthly payment, no down payment, getting a new car more often, fewer maintenances concerns, not having to worry about selling the vehicle, and GAP coverage is usually included if the vehicle is totaled. In our family we do both we have one vehicle we purchased and one we lease. I do not drive a lot of miles and I work at a dealership so I like to get a new vehicle every 2 years. I also like not having to worry about the vehicle breaking down etc†¦ We also own a vehicle so we do not have to worry about going over mileage if we take road trips, we have something that is ours to use as equity and we have a very good interest rate. 4. You are considering purchasing an existing single-family house for $200,000 with a 20 percent down payment and a thirty-year fixed-rate mortgage at 5.5 percent. a. What would be your monthly mortgage payment? The payment would be $908.46 per month. b. If you decided to buy two points for a rate of 5 percent, how much would you save in monthly payments? Would it  be worth it to buy the points? Why, or why not? The payment would be $888.75 and yes it would be worth it because you are saving $22.71 per month and that would add up over a 30-year period to $8175.60. c. When should you consider an adjustable-rate mortgage? If you are only planning on having a mortgage for a short time it would be wise to consider an adjustable-rate mortgage because the rate stays the same for 5 years then it could change afterwards either or the better or the rates could go up significantly.

Online Rating of Professors Statistics Project Example | Topics and Well Written Essays - 1500 words

Online Rating of Professors - Statistics Project Example Online rating of professors has grown popularity with the site RateMyProfessor.com. In the website, students are able to rate their professors in terms of the overall quality by which they are able to deliver their lessons, from the categories easiness, helpfulness, clarity, and prior interest in the subject. Professors are also given a chili-pepper icon when the reviewer thinks that the professor is â€Å"hot† in terms of physical looks. Some controversy has risen from the website as students and even professors devour the results as if it were an official ranking method. Some students even go to the extent of basing the schools and classes that they will take on the reviews made at the website. To make the ranking process â€Å"fair† to the professors, these members of the academe are allowed to respond to the feedbacks given to them through the â€Å"Professors Strike Back† portion of the website. Understandably, heated exchanges can occur as both students and professors defend themselves and their views. Some professors tend to be sensitive about the issues hurled against them while others choose to dismiss the ranking site entirely. All these aside, this paper wants to investigate if there are underlying factors affecting the overall quality rating of professors at Rate My Professor. As such, this study poses the following research question: RQ: Do differences in underlying factors affect the overall quality rating of professors?... A summary of these descriptive statistics are given in Table 1. Box plots reflecting the behavior of the data are also provided in Figures 1 to 5. Table 1. Summary of Descriptive Statistics. Descriptive Statistics Dept Division num easiness overall count 730 730 730 730 730 mean 46.24 2.2 34.27 3.327 3.712 sample variance 598.07 0.96 683.18 0.541 0.693 sample standard deviation 24.46 0.98 26.14 0.735 0.832 minimum 2 1 10 1.2 1.4 maximum 96 4 168 5 5 range 94 3 158 3.8 3.6 Figure 1 shows that most of the data from the graph is concentrated in the second quarter. Then to the third quarter, then evenly spread to the first quarter, and the fourth quarter. There does not seem to be any outlier in the graph. Figure 1. Box plot for the variable â€Å"Department† Based on Figure 2, there is no first quarter data from the graph. Either that it is insufficient to generate a first quarter, or the first quarter is so concentraated that the data could not show. It is most likely that the d ata is insufficient to generate a first quarter. Figure 2. Box plot for the variable â€Å"Division† Figure 3 shows that most of the data is concentrated on the first quarter. Then on the second quarter, then the third, then the fourth. The one thing that makes this graph interesting is the high amount of outliers in the graph, which is not seen from the other graphs. Figure 3. Box plot for the variable â€Å"Num† Figure 4 shows that most data are concentrated on the third quarter, followed by the last and third, and a really spreaded first quarter. There is a possibility that there is an outlier in the first quarter. Figure 4. Box plot for the variable â€Å"Overall† Figure 5 shows that data are mostly concentrated in the second quarter. And

Budgettting Assignment Example | Topics and Well Written Essays - 500 words

Budgettting - Assignment Example That is; the key members involved in the project did estimate the costs related to materials, equipments, utilities, and resources needed to perform the required to complete the Germantown tree planting activity. The cost estimates of this project was done basing on a vendor bid analysis, where the receptive bids from skilled and qualified vendors provided the baseline cost estimate for every particular component integrated with the budget. Nevertheless, these costs estimate will be refined during the course of the project to include any additional details as it becomes available. The direct costs include the costs that are related to the project. These costs include cost incurred while buying tree seedling, supplies such as fertilizers and planting shovels. These costs account to more than a half of the budget spending. Indirect costs include costs that enable successful completion of the project. For instance, the personnel will require utilities such as water during the event. The tree planting exercise will call upon the outsiders and they will be given refreshments hence adding to the cost of the project. The cost associated with the promotion and advertising will be indirect costs to the project. In the variable costs changes with the level of activity being undertaken, one of the variable costs is the cost of the personnel. The more personnel turn for the activity, the higher the costs that will be incurred during the event. Similarly, the more the costs of food will tend to be higher hence making the cost of the budget to be higher. In such a program, the theme touches on a global phenomenal: Climate change. If the organization applied for grants, the application has a higher chance of being successful. Some of the organization that provides likelihood for sponsoring the project includes, United Nations Environmental Program, World Forest Service, Food and Agriculture

Alexis de Tocqueville, Democracy in America Vol II, Part 1, Chap 1-11 Essay

Alexis de Tocqueville, Democracy in America Vol II, Part 1, Chap 1-11 - Essay Example Alexis believes that the doctrines and methods of Descartes, Luther and Voltaire are applied best in America (Gutenberg). Although Americans are more liberal in thought and practice yet Christianity holds a mystical power; with politics or laws not affecting change on the religious beliefs (Gradesaver). Alexis regards that Americans are deep rooted in their ideology because they have not gone through any democratic revolution, thus no major shift in their ideological concepts has resulted (Tocqueville). Alexis says that societies only prosper when they have thoughts, ideas and actions that they have in common, and commonalities result from common belief systems and not following individual paths (Gradesaver). Tocqueville suggests that man does not have enough time to define and explain all the truths on his own and thus has to believe already established truths, which have either been established by people of superior intellect or by societies (Gutenberg). He thinks that every man’s intellect complies with the higher authority to a varying degree; no mind can be completely independent and free of all authority (Gradesaver). American people are more apt to believe in religion due to the majority of society believing in it, as the majority of people are believed to have equal capability of believing the truth thus; religion finds its strength based in public opinion (Tocqueville). Alexis believes that the tendency of American people to investigate every truth independently; unconsciously leads them to reverting to the behavior and attitudes of mankind and thus a generalization of views emerges (Tocqueville). Americans believe in equality which gives birth to generalization; the English are more inclined towards an aristocratic way of life, thus leading to particularity and negating individuality (Gutenberg). On the other hand, according to Tocqueville, Americans do not revert to

Childhood Obesity in Society Essay Example | Topics and Well Written Essays - 3000 words

Childhood Obesity in Society - Essay Example Causes There are numerous causes for obesity in general and childhood obesity in particular. In each of these, the society seems to have a role, however obscure it may be. The three most important are listed below. Dietary/ Food Habits: The effects of eating habits on childhood obesity are difficult to determine. A three year randomized controlled study of 1,704 3rd grade children which provided two healthy meals a day in combination with an exercise program and dietary counseling failed to show a significant reduction in percentage body fat when compared to a control group. This was partly due to the fact the even though the children believed they were eating less their actually calorie consumption did not decrease with the intervention. At the same time observed energy expenditure remained similar between the groups. This occurred even though dietary fat intake decreased from 34% to 27% (Caballero et al., 2003). A second study of 5,106 children showed similar results. Even though the children eat an improved diet there was no effect found on BMI (Nader et al., 1999). Why these studies did not bring about the desired effect of curbing childhood obesity has been attributed to the interventions not being sufficient e nough. Changes were made primarily in the school environment, whereas it is felt that they must occur in the home, the community, and the school simultaneously to have a significant effect (Kolata, 2007). Researchers at the University of North Carolina at Chapel Hill studied national beverage consumption patterns for over 73,000 Americans between 1997 and 2001 and found the following: overall calories from sweetened drinks went up... As the report stresses the effects of eating habits on childhood obesity are difficult to determine. A three year randomized controlled study of 1,704 3rd grade children which provided two healthy meals a day in combination with an exercise program and dietary counseling failed to show a significant reduction in percentage body fat when compared to a control group. This was partly due to the fact the even though the children believed they were eating less their actually calorie consumption did not decrease with the intervention. At the same time observed energy expenditure remained similar between the groups. According to the research findings the popular thinking is that diet sodas help people to lose weight, since they are low in calories, data from the San Antonio Heart Study found that the more diet soda a person drinks the greater is the likelihood that he or she will become overweight or obese. ‘On an average, for each diet soft drink our participants drank per day, they were 65 percent more likely to become overweight during the next seven to eight years and 41 percent more likely to become obese,’ said Sharon Fowler, MPH, faculty associate in the division of clinical epidemiology at the University of Texas Health Sciences Center in San Antonio. Other, more recent unpublished findings from Fowler back this up. While parents and schools may need to do a better job of promoting regular exercise and better dietary choices, the viral distribution of these soft drinks doesn’t help.

Relationship interaction Essay Example | Topics and Well Written Essays - 500 words

Relationship interaction - Essay Example & Mrs. Smith. In the film Brad and Angeline play a married couple who both work as highly paid assassins. However, neither one in the beginning realizes that the other kills for a living. The couple, in the introduction of the film, was having marital problems but closer to the climax and the new found awareness that they were both in the same line of work, their romance rekindled. This marital problem which seemed to manifest upon the discovery of each other’s line but instead rekindled their lost romance can be gleaned on the following dialogue where there seems to be a disconnect in their COMMUNICATION CODES: The audience might have the initial impression that the couple is in conflict and their marriage is about to breakdown. What happened in fact was the opposite because the couple just needs a little adventure and â€Å"fire† in their relationship and this seeming conflict rekindled that romance again albeit this method is quite unusual. This just shows that Brad and Angelina had a majestic chemistry that transcended on film and generated a unique essence to the movie. It was obvious to notice the true attraction the actors had for each other despite the acted conflict. In addition to the theories observed between the couple’s roles during the movie, the nature of their off camera intimate relationship correlate with the INDEPENDENT COUPLES theory; THIS CONCEPT DESCRIBES MARRIED PARTNERS WHO EXHIBIT SHARING AND COMPANIONSHIP AND PSYCHOLOGICALLY INTERDEPENDENT BUT ALLOW EACH OTHER INDIVIDUAL SPACE. After shooting the movie Mr. Mrs. Smith, Angelina was quoted saying. † We both have been married before, so its not marriage that necessarily keeps some people together.† Brad and Angelina have been in a lasting relationship for over five years but have not married. However, they are committed to raising their children together and continued to allow the other to pursue their movie careers. Pitt and Jolies relationship became one of

Management Accounting and the Modern Business Enviroment Essay

Management Accounting and the Modern Business Enviroment - Essay Example It ensures the appropriate use of and accountability for an organization's resources. Management accounting also comprises the responsibility for the preparation of financial reports for the non-management groups such as regulatory agencies and tax authorities. Simply stated, management accounting is the accounting for the planning, control, and decision-making activities of an organization." (Shim & Siegel, pg 1, 1998) Management accounting presents the executive professionals with the foundation in making educated business decisions that would allow them to be superiorly equipped in their management and be in command of functions. In contrast to financial accountancy information (which, for public companies, is public information), management accounting information is used within an organization (typically for decision-making) and it is generally classified and accessible by a select few. Its foremost focus is on the formulation of strategies, planning and assembly of business activities and the optimal exploitation of resources. The aspects of decision making, protection of assets and the assistance in making of financial reports are also amongst the fundamental principles working behind the concept of management accounting. The accounting practitioners and mentors of the late 1980s became conscious of the drastic transformation of the fundamentals of global business environment. This led them to diligently work in the development of novel skills and techniques that could cater the needs of the rapidly varying business environment. This transformation of business methodologies is known as the transition from the 'traditional' to the highly developed and sophisticated business technologies. "The business environment in recent years has been characterized by increasing competition and a relentless drive for continuous improvement. Several approaches have been developed to assist organizations in meeting these challenges, including just-in-time (JIT), total quality management (TQM), process reengineering, and the theory of constraints (TOC)." (Garrison and Noreen, 1999) TQM engross focusing on the client, and it utilizes methodical problem solving using teams made up of front-line personnel. Benchmarking and the plan-do-check-act (PDCA) cycle constitute the particular TQM tools. Any internal strife in the organization is shunned due to the emphasis on teamwork, a focus on the client, and facts. On the other hand, Process Reengineering revolves around the entire restructuring of a business procedure so that non-value-added activities are eradicated and prospects for blunders are truncated to a minimum. It relies more on outside experts than TQM and is thus more prone to be promulgated by top management. Where as, the theory of constraints, highlights the significance of administering the organization's limitations. (Garrison and Noreen, 1999) Just-In-Time (JIT) Manufacturing Just-In-time manufacturing or JIT originated in Japan and has been in practice in the country since the early 1970's. It was developed and improved by Taiichi Ohno of Toyota, who is now acclaimed to be the pioneer of the concept of JIT. "The idea was developed by Taiichi Ohno as a procedure to meet client demands with the least possible delays. JIT was therefore, initially, principally used to manufacture goods so that client orders

Case Study On A Patient With Necrotic Fasciitis Essay

Case Study On A Patient With Necrotic Fasciitis - Essay Example It spreads easily on the focal plane within the affected tissue. Depending on their origin, they can be categorized as poly or microbial. The monomicrobial infections occur due to group A streptococcus. It is common among the healthiest individuals, and those who historically experienced such cases such as trauma, intravenous drug, and surgery. Studies indicate that the post-operative necrotizing fasciitis accounts for twenty eight percent of all the other cases (Davis et al, 2008) . As noted by Chsn, Withey, and Butler (2006) 3 percent of wound infection occur as a result of a vein stripping, and saphenofemoral junction. Other studies showed that incidences of NF have increased and there occurance rate is thought to range between 0.4 to 0.53 each year in the U.S (Anaya & Dellinger, 2006). Worth noting, is the fact that both pre-existing co-morbidities, the young and healthy persons are affected. Various studies have explored this area, however, early diagnosis for a satisfactory tre atment is still a challenge (Balaji, 2008; Anaya & Dellinger, 2006; Cha & Falanga, 2007). With a view to close up this gap, this paper explores the case study of a twenty one year old woman with a history of Knee trivial injury (Diagram 1). The patient was first treated and admitted for septic arthritis. It was followed by diagnosing her with necrotizing fasciitis, which was treated successfully. Background information. NF or the Necrotizing fasciitis involves a soft tissue severe infection reported to rapidly progress into the human tissue (Balaji, 2008). The disease progresses into the subcutaneous and fascia tissues and in some cases can affect the skin and other muscles. From the 18th century, this rare infection has been identified by different names such as hospital gangrene, Foutnier’s gangrene, phagedena gangrenosum, and the Meleney’s gangrene (Ahn, Mulligan, & Salcido, 2008). Ahn, Mulligan, & Salcido, 2008), Anaya & Dellinger, 2006). This disease is common to individuals with immune systems that are compromised after some chronic illness. A good number of infections are as a result of organisms which can be found in the skin of an individual (Chan, Withey, & Butler, 2006). The disease occurs in those individuals having an apparent normal condition. It starts locally at the trauma site which could be minor, non-apparent, or even severe. The patients have been reported to have pain complaints, which may appear excessive even from the extern skin appearance. The patients, on the other hand, have been reported to display signs such as fever, inflammation, and tachycardia (Balaji, 2008. The Case study. A twenty one year old woman from an emergency department of a different hospital was referred to the orthopedic unit. The patient had no co-morbidities, and had a trivial injury history of her right knee. Accidentally, she hit his right knee to a wall some days back, thus sustaining an abrasion on the knee. She complained of pain on her knee th e following day hence being forced to stop working. The pain increased during the night, and was forced to attend the department of emergency the following day. She had been referred to the emergency unit with suspicions of cullulitis or sepatic arthritis. When she arrived, she had a systematically stable and a febrile though considerable pain. Her joint had reduced movements, but increased pain. The vascular and the neurological limb examinations of the patient were

Essentials of Evidence-Based Practice Essay Example | Topics and Well Written Essays - 2000 words

Essentials of Evidence-Based Practice - Essay Example e status of vasectomy via interviews; most of the interviews involved telephoning, administration of questionnaires, the use of the healthcare centres registries, as well as the physical interview by nurses. Among the participants of the research included patients that had experienced the vas deferens’ surgical operation. In order to control the cases study various controls were taken into account; these included individuals that were diagnosed with skin and lung cancer. Other conditions such as digestive disorders and rehabilitation problems, as well as the neighbours of the patients were also treated as the controls of the case study (Bernal, Latour and Gomez, 2012). However, as regards they made decisions regarding the relevance of the primary studies, Bernal, Latour and Gomez (2012) do not point out the modality of selecting the papers for a review. The quality of the methodology was evaluated by taking into consideration a number of threats that are likely to be absent or present with respect to the validity. Among the threats included misclassifying of a disease and inadequacy of selecting the controls. Bernal, Latour and Gomez (2012) carried out an observation on a population of 221,238. Out of this population, 14,334 were categorized under case-control studies, while 206,904 fell under the cohort studies; there were nine case-control studies, and five cohort studies. Following the research, Bernal, Latour and Gomez (2012) claimed that the experimental evidence that was attained regarding the relationship between prostate cancer and vasectomy was characterized by a low level of quality. It was identified that there are several biases with respect to the sources; the sources attempted to overestimate the effect of vasectomy. In this respect, the evidence that was experienced does not advocate for a change in the family planning; this is due to lack of justified evidence. Similarly, the evidence does not indicate whether individuals who have experienced

Air Conditioning System Design for the Commercial Office Building Essay

Air Conditioning System Design for the Commercial Office Building - Essay Example Central systems are used for circulating conditioned air to different parts of the building. The primary advantage of such systems is maintaining of uniform temperatures throughout the building. While designing the system air distribution, temperatures and cost-effectiveness are important criteria. The system is comprised of plenums for supply and return; ducts; fittings; and associated components. Air handling units operate as a package unit with plant units. The system is assembled with pipework, ductwork and electrical connections at the site. The fan is placed upstream of the heater battery and cooling coil as the fans operate ideally when the system resistance of the outlet. The air distribution system is a separate distribution system as there are the specific temperature and humidity requirements. The air leakage limit is in accordance with the operating static pressure in excess of 750Pa according to the Code of Practice. The fan system has been designed as the sum of all fans required for the design conditions. Considerations include intake of outdoor air; circulation of air between heating and cooling source and space to be air-conditioned. Exhaust is to the outdoors. According to the Code of Practice Supply of constant air volume at design conditions does not exceed 1.6 W per L/s based on total fan motor power required for constant air volume fan system; and 2.1 W per K/s of supply air quantity for variable air volume system. Each floor has been considered as a zone, and individual thermostatic controls operate each air conditioned zone. However, controls do not permit heating and cooling operation simultaneously, or heating previously cooled air or vice versa. The air conditioning system includes automatic control devices for regulation of temperature. The thermostatic controls are able of adjusting setpoint temperature for the space being served.  A humidistat has been included as a part of a system that is capable of adding or removing moisture for maintaining specific humidity levels.

Bullying Essay Example | Topics and Well Written Essays - 1000 words - 2

Bullying - Essay Example Although the UK does not have legal definitions of bullying under their current law, some states in the US have laws that address it, and categorize it into three fundamental types. They are physical, verbal and emotional. According to the US legal system, bullying cultures develop in all contexts where human beings interact ranging from the workplace, family, school to social gatherings. Bullies are inclined towards negativity, and workplace bullies are likely to have been poor academic performers in school. They feel negatively toward themselves and have difficulties solving problems with others. Most of them come from backgrounds characterized by poor parenting and conflict within the family. At the workplace, bullying can take place in the simple one on one form or the more complex type where the key bully has accomplices willing to frustrate co-workers. This paper will discuss the health, legal and social consequences employees and their organizations may face in the event that bullying takes place in the workplace. A workplace’s culture is reflected in its beliefs and values, and what the management accepts as normal behavior. Positive and ethical cultures promote the adoption of appropriate behavior and mutual respect among co-workers. On the other hand, when the management condones inappropriate attitudes and behaviors, majority of the employees will assume bullying to be a normal trend (Haight, 2005). A survey established that bullying at the workplace is driven by varying factors and, ironically, 57 percent of co-workers in the US have a tendency of being hostile and unsupportive to the already bullied colleague. An individual may use his position of authority or physical dominance to harass those he perceives as weaker. Based purely on their perception of weakness, they frustrate the efforts of their colleagues, who in turn end up performing dismally. To deal with their own inadequacies, low self esteem and personal grudges, bullies usually pu t down others by sabotaging their reputation or projects they are working on. This not only demoralizes the victim, but harms the company’s schedules by unnecessary delays and incurring expenses. One may also fall victim to others who view them as threats to their position or employment as a whole. In such cases, the bully spends so much time on efforts to tarnish the achievements of their perceived enemy at the expense of productive company work, hence, wasting innovation. Many workplace bullying victims suffer post traumatic stress disorder. This is so because they have found a passion and self-identity in their work, yet a bully is using the same work to pull them down. When prolonged, it causes panic attacks, loss of concentration, depression, insecurity and stress breakdown. The victims are prone to become overly sensitive, hyper vigilant and irritable with mood swings. In the end, they rely on alcohol, nicotine or caffeine to calm down. A study conducted by a doctor in the UK revealed that 20 percent of co-workers who witnessed a colleague being bullied or suffer the consequences of bullying were also affected and opted to change jobs (Einarsen et al, 2003). 98 percent of those who stayed on were distressed. The overall effect observed on such workers was lack of productivity. They caused more accidents, were often absent, handled customers poorly, exhibited no motivation and forced the company to

Erosion Lab Report Example | Topics and Well Written Essays - 1250 words

Erosion - Lab Report Example For instance, a young school aged boy did an experiment in his own backyard, right in the middle of the garden. He packed a mound of dirt, and his plan was to measure the affects of erosion over a twelve week period, caused by elements of the weather-the wind and the rain. When his experiment began, the mound of dirt was 42 inches wide and 19 and inches tall. The second week, the dirt mound had spread more than 2 inches outward and dropped approximately 3 inches. Each week, measurements were taken and the data was charted. Unfortunately, the experiment was never finished because it was wrecked (Riordin). Nevertheless, it showed how the elements of the weather can have a great affect on bare soiled mounds, such as the one that was constructed in the Riordin's garden. On a larger and more professional scale than that of a school boy, scientific researchers across the United States experimented with erosion. Their reason for doing so is because they wanted to understand how erosion affected different types of soil in an effort to improve agriculture. In this instance, they wanted to figure out how to best deal with the effects of erosion, while conserving water and soil at the same time. From this in depth experimentation, The Universal Soil Loss Equation was developed, which is considered by those in the field of agriculture to be one of the greatest developments in history, as it concerns the conservation of soil and water (U.S. Department of Agriculture, 2009). Research began in central Utah in the year 1912 on land that was overgrazed and no longer fit for use at the time. A.W. Sampson and Associates were the ones who conducted experiments during this time and at this location. In 1917, field erosion plot research was conducted in Missouri by M. F. Miller and his other colleagues. In 1929, congress provided $160,000 of funding to erosion research, as a result of the severe drought that was faced, as well as the Dust Bowl storms that took place. As resource continued, the equation was perfected, and so were water and soil conservation methods. Today, software has been designed from this exact equation that is in use by the Department of Agriculture, as well as commercial farmers (U.S. department of Agriculture, 2009) Because we are working with stiff time constraints, we will not be able to conduct such long and drawn out experiments. We must experiment with erosion on a smaller time scale, and the experiment must take place in an environment that we can easily control. The experiment that is being conducted in this case will consist of three dirt mounds, ten inches high, that are built upon a tray lined with paper, all of them constructed differently. One dirt mound will consist of dirt that is packed together to form a sort-of mountain. The sides will be steep, and the top will be flat. The second mound will be constructed exactly the same; however, there will be a flat layer of pottery clay on top of the flat part of the mound. The third mound will be constructed in the same fashion as the other two, but this one will have grass seed planted on it. The seed will be planted on top, as well as on all sides. The dirt is to be a bit wet, but not too wet, so as to be able to properly form the mound s. All three of the mounds will be kept near a sunny window to simulate the environment of nature outdoors, as this type of environment is realistic, as it will enable the grass to grow and the artificial rain to dry up. Once all mounds are formed and the experiment

How Did Hip-Hop Start Research Paper Example | Topics and Well Written Essays - 1250 words

How Did Hip-Hop Start - Research Paper Example Contrary to popular belief, hip hop music was not originally an American invention. Although one can of course claim that due to the fact that it of all within the United States, it somehow holds the title of being American, the fact of the matter is that DJ Kool Herc was originally Jamaican and had only come to the United States three years prior to exhibiting this unique style of music within the birthday party he presided over. Before delving into the actual nuts and bolts of how hip-hop was defined within DJ Kool Herc’s individual style, it is necessary to discuss some of the primal influences that he experienced within Jamaica. Firstly, it can and should be understood by the reader that Jamaica represented a unique environment in which former African slaves far outnumbered Caucasians. As a function of the way in which British trade, sugar plantations, run manufacturing, and slave trading were affected for much of Jamaica’s history, this demographic differential was realized. In such a way, as compared to the United States Jamaica had a more homogenous culture that shared in distinct societal, musical, religious, and other levels of self identification and oneness. In such a way, DJ Kool Herc’s early influence was with regards to the fact that he was raised in the capital of Jamaica, Kingston, and regularly accompanied his father’s band in many musical performances (Brunson 7). One particular aspect of DJ Kool Herc’s style that was developed and evolved within Jamaica was with regards to how he emulated the toasting style that many Jamaican DJs utilize as a means of talking over four toasting the records he spun. This in and of itself was a primal influence with regards to the way in... It is the further hope of the researcher of this essay, that by engaging with the information within this essay, the reader will calm to a more full and complete understanding of the way in which and pop music was born and why it has developed in the unique way in which it has. As with many forms of art and expression, hip-hop was born during the early 1970s. Beyond merely giving birth to this defining genre of uniquely American music, this particular decade was fertile ground for the development and expression of new art forms, music, means of understanding, philosophy, and a range of other expression and thought related activities. Due to the way in which society was beginning to cast off the balance that it previously defined it and actively seeking to create new realities and means of expression to fit the needs and trends of the current generation, hip-hop was yet another in a long line of new wave expressionism that ultimately caught on and has prevailed for over 40 years now. Just as with rock ‘n roll before it and jazz before rock ‘n roll, hip-hop has its roots in the evolution in combination of many other types of music. It is also hoped by the author that after reading the preceding discussion and analysis of hip-hop and its birth, one will be able to calm to the realization in conclusion that hip-hop not only was an evolution from existing forms of music but was like any other development something that links the artistic talents and expressions of a number of different individuals in order to fully manifest itself.

Discussion Week 7 Advertising Media and Integrated Marketing Assignment

Discussion Week 7 Advertising Media and Integrated Marketing Communications (IMC) - Assignment Example The social media is least costly, can demonstrate the product vividly, and is able to reach a wide range of clientele. The weaknesses noted in social media are its lack of emotional appeal or ability to vividly demonstrate the product. Finally, newspaper is also least costly and could provide more information on the product, as required. However, the weaknesses of newspapers include the lack of target, reach and vividness in presentation; as well as in providing emotional appeal (Selecting Advertising Media and Determining Advertising Budgets, 2014). To create the advertising budget, three ways were actually suggested: (1) to use historical figures or a percentage of past year’s sales; (2) to determine the amount that competitors spend and earmark a similar budget; and (3) determine the advertising goal and the resources of the company and work out how the goal could be reached (Selecting Advertising Media and Determining Advertising Budgets, 2014). 2. From the e-Activity above, outline the design for an IMC campaign that would use a different media other than the one used in the product or service you reviewed. For example, if the advertisement you reviewed was designed for the radio, consider the details for a complimentary Web or magazine advertisement. One of the most effective advertisements shown is the â€Å"Volkswagen-Darth Vader 2011 Super Bowl Commercial† (Volkswagen-Darth Vader 2011 Super Bowl Commercial, 2011). The design of an IMC campaign for the same advertisement, using a different media would actually be challenging. According to Iacobucci (2014), the IMC should â€Å"ensure that a company’s various advertising efforts send a coherent story across the different customer touch points† (p. 159). Therefore, the most appropriate medium to relate the main thrust of the advertisment (other than through the commercial shown through YouTube) would be in a magazine advertisment. The details that could be provided

Mandatory HIV Testing Essay Example for Free

Mandatory HIV Testing Essay Imagine Las Vegas disappearing overnight and leaving nothing behind but empty stages and barren casinos, becoming nothing short of a ghost town. If all the people that have died from HIV/AIDS in the United States since the beginning of the epidemic were taken out of one geographical region, Las Vegas could easily be erased. The three most common ways to contract HIV are: unprotected sex with an infected partner, injecting drugs using an unsterilized needle that has been used by someone who is infected or during pregnancy, labor or delivery or breastfeeding where the mother transmitted the virus to her child. If an infected woman, not seeking treatment, becomes pregnant, the chance of her transmitting the infection to her child ranges from 15-45%. An infant, who has not even had the chance to speak, walk, or enjoy life, has such a high risk of contracting a deadly infection because the mother did not consult with her doctor and seek the appropriate treatment during her pregnancy. Did she not seek treatment because she did not know that she was infected, did she know but was too ashamed to relay the information, was she afraid she could not afford treatment? If routine HIV tests were conducted along with all the other blood tests throughout a pregnancy, infections would be indentified, treated with precaution and it would allow doctors to dramatically reduce the risk of mother-to-child HIV transmission. With effective interference, the chances would be reduced to below 5%. With this knowledge, HIV screening must be made mandatory for those seeking any form of prenatal care. The Center for Disease Control and Prevention (CDC) estimates that 1,148,200 people (13 years and older) in the United States are living with HIV; 18% of those people are unaware they are infected. The infection rate has stabilized over the last few years to roughly 50,000 new infections each year—that means that someone in the US is infected with HIV every 9 minutes. HIV and AIDS are not the same. HIV stands for Human Immunodeficiency Virus. This strand cannot stand as a virus alone and reproduce; it needs to infect the cells of a living organism. Normally, the immune system fights off unwanted viruses but this particular virus attacks the immune system directly, preventing it from destroying the unwanted virus and repairing damaged cells. AIDS is a condition that is caused by the irreparable immune system. When the immune system is damaged this badly, it is incapable of  fighting off any infection. If left untreated, it takes, on average, ten years for someone to develop AIDS from the date of infection. This average takes in to account a healthy diet and lifestyle—not someone who may be suffering from malnourishment or other unrelated illnesses. Women are more susceptible to being infected with HIV through heterosexual sex and infected needles than men. The number of HIV positive women in the US, of child-bearing years, is still growing at a rapid rate. They account for roughly 23-25% (11,000-12,500) of new infections each year. In a recent study conducted by the CDC, only one in five women between the ages of 18 and 64 report that they have been tested for HIV in the last twelve months. Among those women who are HIV positive, 31% of them were diagnosed in the later stages of HIV, resulting in an AIDS diagnosis within one year. Women who are HIV positive have the possibility of transmitting the virus to their child during labor or post labor, during breast feeding. There are approximately 2000 babies being born with HIV each year and more become infected as a result of breastfeeding. This is by far the smallest group of people infected per year, but this number could be reduced to almost zero, if proper interventions were mandatory. When women think or realize that they are pregnant, they seek out a gynecologist or other medical professional to aid them throughout their pregnancy. They are put through numerous blood tests to ensure they have the appropriate vitamin and glucose levels. They even undergo a STD test that tests for a variety of sexual transmitted diseases, excluding HIV. Some professionals offer the test and try to convince their patient that it is important, but some still refuse. Implementing mandatory HIV tests for pregnant women ensure that more people get tested, educate on the effects of HIV, are able to get treatment, and dramatically reduce the chance of their child contracting the virus. The test should be performed with the routine STD test at the beginning of the pregnancy and then once again before labor, because it can take up to six months for the virus to show up during a screening. The woman would know whether she has contracted HIV and have the ability to discuss the options with the doctor. Treatment should accompany the pregnancy, if needed, at no cost. The treatment for the baby after delivery would also incur no cost. A major, non-political, concern about  mandatory testing is the cost associated with treatment. It does not seem logical, but HIV treatments are extremely expensive. It costs thousands of dollars each year for medications and regular doctor’s visits. For people who have full coverage insurance, the cost for the medication is almost completely covered but they still have to pay the co-pays to visit the doctor. There are also federally funded programs to assist with HIV costs, and though they might regulate which medications patients can take, most doctors would prefer that a patient be taking some sort of medication rather than none at all. And finally, there are other programs such as Medicare and Medicaid that assist those who are HIV positive. Although some states will not grant acceptance in the Medicaid program unless the diagnosis is AIDS, many states will cover the costs with a positive HIV status. All of these options must be presented after the baby is born and doctors should work with their patients to find the best option. Another concern, brought up on the political floor, is that mandatory testing violates the Constitution. If a mother knows the status of her or her child, involuntarily, that violates her right of privacy and subjects her to discrimination; she could lose her job, insurance, face discrimination in society or physical abuse at home (McMillion). Making sure that no infant is involuntarily infected with HIV should be the first priority, of not only health care providers but by mothers themselves. The American Medical Association (AMA) was originally against mandatory testing because there was little a doctor could do to help treat the pregnant mother and unborn child. With new discovery of AZT, the treatment used to reduce the rate of transmission, the AMA has reversed their opinion (Schuyler). The mandatory testing will not allow women to forever remain ignorant about their status. It forces women to face the disease much earlier in their lives and presents them with a choice, a choice that replaces the one that was taken away—let the HIV take its course but help reduce her baby’s chance, seek treatment for her and the baby or do neither of them and take the risk of exposing her child.

Henri Fayol Principals Essay Example for Free

Henri Fayol Principals Essay Principle 1: Division of work According to Fayol’s principle one of management, division of work, he proposed that â€Å"work can be performed more efficiently if it is divided into smaller elements and assigning specific elements to specific workers† (Rodrigues 2001, p. 880). Contrary to this principle, workers might get bored of doing the same task. For instance in a factory, work is divided into many parts where each of the worker is responsible for a specific task. Eventually these workers will be proficient in their job, where it will become a routine work. However, if they were to continue to perform the same routine task over a very long period of time, they might lose interest or become too complacent. They are not being challenged or made to encounter new or different situations during the job. Thus, this does not create opportunities for them to develop new skills. Employees need to be exposed to job opportunities so that they will be able to pick up new skills, and not just focusing on a specific task. If these employees are given the opportunity to develop new skills, it will give them a sense of importance and belonging in the organisation, and these new knowledge will inspire and motivate them to be more engaged and have a better understanding in their work. Every employees would seize it as an opportunity whenever they face challenges (McGregor Harpaz, cited in Rodrigues 2011, p. 881). Therefore, organisation should come out with methods and tools that are able to increase the opportunities and challenges of the employees (Schmitt, Zacher de Lange 2013, p. 516). To support this, employers can provide workshops and trainings for employees to broaden their skills and specializations. This will also open up the employees’ room for professional development. For example, Singapore Workforce Development Agency, WDA encourages employees, professionals, managers and executives to upgrade and build up on their skills through skills-based trainings (Singapore Workforce Development Agency 2012). Opportunities given to employees at work will allow them to learn and gain more skills and knowledge. In addition, this will also boost up their growth and confidence level in their work as they are empowered with multi responsibilities. In the presence of job enrichment, employees are able to deepen their job responsibilities and have control over their work (Dickie Dickie 2 011, p. 71). Job enrichment will benefit the organisation as it will reduce the number of absenteeism, turnover  intentions and social loafing while increase employees’ job satisfaction, organizational commitment and individual productivity (Davoudi 2013, p. 107). In other words, organisation should encourage and send their employees for skills upgrading to stretch their capabilities. In contrast to Fayol’s understanding that an employee doing one task will increase their efficiency, employee that have more than one skill will benefit the organisation as their knowledge has become greater than before. Another disadvantage to this principle in this 21st century context is the impact of technology whereby machines has taken over some but not all, specialised jobs (Rodrigues 2001, pp. 880-881). Back to the factory example; then people were hired to do manufacturing jobs such as assembling cars. Each worker was given a specific task to assemble a car, but now these tasks are carried out by robots, where they are able to do more than one task (John Markoff 2012). As a result these workers might lose their jobs. Thus this principle, to a certain extent, it may not be relevant today. There are still organisations who practice this principle, but with the fast moving technology and employees who are eager to learn, it might not apply to this day. ? The managers have the power to instruct their employees to perform work that they give. Thus in this principle, managers give their employee rights (authority) and let them be responsible to complete the task (responsibility) that is being delegated to them (Bushardt et al. 2010, p. 9). In this context, it shows that the manager’s role is authoritative, which makes the subordinates have to follow the manager’s instructions (Cheng 2004, p. 91). Managers must stay in mind that they must have a shared understanding with their employees when they assign the task to them (Miles, cited in Evans et al. 2013, p. 24). They must take in consideration not to misuse their authoritative power to the extent that their employees have no choice nor say when their managers delegate the task to them. When the manager and the employee have a common goal, it will open up opportunities for employees to share opinions and make decisions to accomplish the required task. This also allows the managers to understand their employees and get engaged with them. In support of this, managers need to be a good example to their employees so that they will feel inspired and motivated to reach their organisational goals. Hence, managers have to be a transformational leader by moving their team forward to inspire and motivate them (Warrick 2011, p. 12). Whenever someone thinks of a leader, he will associate them with acquiring power, influence and authority (Dickie Dickie 2011, p. 83). One can have power and authority, but only a few are able to influence, inspire and motivate their employees. Fig 1.1 Leader behaviour continuum (Tannenbaum Schmidt, cited in Dickie Dickie 2011, p. 87) The two-dimensional model in fig 1.1 explains that managers’ role of authoritativeness and sub-ordinates empowerment has to be balanced between managers and the employees. Employees are able to participate in the decision making by voicing out their ideas to their managers. Managers can then make a decision based on this shared understanding (Tannenbaum Schmidt 1973). Hence, employees are given the permission to complete the given task which was based on a clear and discussed understanding with the manager. In contrast of Fayol’s perspective, delegation of work to the employees should be tasked responsibly with a shared understanding. Thus, employees will feel that their role in the organisation is worthy and  trusted. References Davoudi, SMM 2013, Impact: Job Enrichment in Organizational Citizenship Behaviour, SCMS Journal of Indian Management, p. 107, Business Source Complete, EBSCOhost, viewed 21 November 2013. Dickie, L Dickie, C 2011, Cornerstones of Management, 2nd edn, Tilde University Press, Australia, p. 71. Rodrigues, CA 2001, ‘Fayol’s 14 principles of management then and now: A framework for managing today’s organizations effectively’, Management Decision, vol. 39, no. 10, pp. 880-889. Schmitt, A, Zacher, H de Lange, AH 2013, ‘Focus on opportunities as a boundary condition of the relationship between job control and work engagement: A multi-sample, multi-method study’, European Journal of Work and Organizational Psychology, vol. 22, no. 5, p. 516, Business Source Complete, EBSCOhost, viewed 17 December 2013. Singapore Workforce Development Agency 2012, About WDA, Singapore Workforce Development Agency, viewed 12 January 2014, . John Markoff 2012, Skilled Wo rk, Without the Worker, New York Times, viewed 12 January 2014, . ? Principle 2: Authority and responsibility Bushardt, SC, Glascoff, DW, Doty, DH, Frank, M Burke, F 2010, ‘Delegation, Authority and Responsibility: A reconfiguration of an old paradigm’, Advances in Management, vol. 3, no. 9, p. 9. Cheng, BS, Chou, LF, Wu, TY, Huang, MP Farh, JL 2004, Paternalistic leadership and subordinate responses: Establishing a leadership model in Chinese organizations, Asian Journal of Social Psychology, vol. 7, no. 1, p. 91. Dickie, L Dickie, C 2011, Cornerstones of Management, 2nd edn, Tilde University Press, Australia, p. 83. Dickie, L Dickie, C 2011, Cornerstones of Management, 2nd edn, Tilde University Press, Australia, p. 87. Evans, WR, Haden, SSP, Clayton, RW Novicevic, MM 2013, ‘History-of-management thought about social responsibility’, Journal of Management History, vol. 19, no. 1, p. 24. Tannenbaum, R Schmidt, WH 1973, ‘How to choose a leadership pattern’, Harvard Business Review, vol. 51, no. 3, p. 164. Warrick, DD 2011, ‘The urgent need fo r skilled transformational leaders: integrating transformational leadership and organization development’, Journal of Leadership, Accountability and Ethics, vol. 8, no. 5, p. 12. ?

Public Speaking Anxiety for ESL Students

Public Speaking Anxiety for ESL Students Findings The purpose of this research is to determine the primary factors of public speaking anxiety and speaking English as a second language amongst students from LG221 and LG241. Besides that, to check upon the gender differences between these students when it comes to public speaking anxiety, whether gender differences have an impact towards the level of public speaking anxiety. Last but not least to find out the relationship between students’ public speaking anxiety as well as fears for negative evaluation by their peers and educators. Upon completion of both the questionnaires, the data was tabulated and analyzed by calculating the mean values in order to obtain needed information. In addition to finding the connection between students’ public speaking anxiety together with their fears for negative evaluation, Karl Pearson’s correlation method is used. Result Figure 4.0 illustrate the demographic data of this research. Samples for this research consist of students of Bachelor of Applied Language Studies (Hons.) Malay Language for Professional Communication, also known as LG221 and LG241 of MARA University of Technology (UiTM), Shah Alam. Participants are at the ranging of 20 to 24 years old. The total numbers of participants are 50 students consisting of 27 male and 23 female. Figure 4.0 Factors of Public Speaking Anxiety (PSA) To determine the underlying factors behind both male and female students public speaking anxiety, factor analysis was accomplished on the of the 34 item in the PRPSA questionnaires. All 34 items are then characterized onto six different factors that are related to making public speaking. These six factors are as followed: Positive speaking perceptions. Emotional effects of speech anxiety. Physical effects of speech anxiety. Lack of preparation. Feeling vulnerable. Perfectionist. Out of 34 items in PRPSA, 12 items are put into the first factor which was labelled positive speaking perception (Factor 1). Items loading on this factor pertained to the positive feeling a person has during the preparation and actual speech presentation. Students with this kind of attitude tend to have little or no problem when giving a speech. Besides that, six items are put into the second factor which was labelled emotional effect of speech anxiety (Factor 2). Items loading on this factor pertained to the supposed emotional consequences a person feels during the preparation of the speech, as well as when asked to give a speech. The third factor is labelled physical effects of speech anxiety (Factor 3) with six items loaded into it that pertained to the supposed physical consequences a person feels during the preparation of the speech. The fourth factor is labelled lack of preparation (Factor 4) and is loaded with three items from PRPSA. These three items pertained to the perceived consequences of insufficient speech preparation. Meanwhile, the fifth factor is labelled vulnerability (Factor 5) with four items put into it. Items loading on this factor pertained to the perceived feeling of helplessness during the preparation of the speech. Lastly, the sixth factor is labelled perfectionist (Factor 6) with three items from the PRPSA that pertained to the supposed consequences of being perfectionist. The mean value of each items scored by both male and female students as well as the total mean value were calculated to check upon the real reason to the occurrence of public speaking anxiety amongst students as well as to distinguish the differences in public speaking anxiety between the two gender as shown in Table 4.0. Table 4.0 Within these six factors of the PRPSA that has been characterized, the factor Emotional effects of speech anxiety scored the highest with a mean of 3.52. Although the result is moderate, it still shows that most students tend to have public speaking anxiety because they have a sense of nervousness together with uneasiness when giving a speech and this can negatively affect students’ speech by making them seem unsure about what they are saying. The next factor resulting in students’ public speaking anxiety is Perfectionist with a mean of 3.13. Students who are considered themselves perfectionists tend to have a tendency to set standards that are so high that they either cannot be met, or are only met with great difficulty. Perfectionists tend to believe that anything short of perfection is horrible, and that even minor imperfections will lead to catastrophe. This is followed by the third factor which is Vulnerability. Factor vulnerability scored a mean of 3.13. This factor shows that students think about an upcoming encounter negatively and may intensify feelings of anticipatory anxiety associated with the encounter. Besides that, speakers’ will also have depressive thoughts about their speech and this may contribute to public speaking anxiety before, during, and after a speech performance which lead to them believing they will not succeed when giving a speech. Factor Lack of preparation is found to be factor number four with a mean of 2.93. The level of preparation determines the level of students’ success in giving speeches. Most students hardly prepare enough for their speeches. This is often because they do not start their preparation early as to why they resort to a last minute approach, which then lead to them feeling unprepared and unready for a speech. The final factor that leads to students having public speaking anxiety is Physical effects of speech anxiety with a mean of 2.89. Speech anxiety can overwhelm the senses, the thoughts, as well as the body. Some of the common symptoms of speech anxiety include shaking, sweating, butterflies in the stomach, dry mouth, rapid heartbeat, and squeaky voice. The first factor which is Positive perceptions towards speech anxiety is not an underlying factor to students’ public speaking anxiety. This factor is actually the opposite of it. Positive perceptions towards speech anxiety factor scored a mean of 3.34. This proves that students’ public speaking anxiety is not that serious. However these students need improvement as it is hinted that students are still not that keen towards the importance of English speech proficiencies. More importantly, it is known that the students still felt uncomfortable and unsure of their own potentials and that that they are still not capable of handling themselves during speeches. Gender Differences in Public Speaking Anxiety On the other hand, to determine whether there is a difference in public speaking anxiety between male and female student, the mean value for PRPSA of each gender is distinguished. Results are as shown in Table 4.1. Table 4.1 The above table revealed that although both male and female students fell in the moderate level of PRPSA, female students tend to have a higher public speaking anxiety level as their mean value is bigger as compared to the male students. On Figure 4.1, it can be seen on which aspects students, whether male or female, face their difficulties when giving a speech. This figure is based on the factors that have been deducted from PRPSA. Figure 4.1 Despite the female students monopolizing all factors, there are some items from PRPSA that the male students scored higher mean values as compared to the female students. Examples of these items include; Statement 13: â€Å"I am in constant fear of forgetting what I prepared to say.† From the statement above, 28 out of 50 students agreed to it with 16 of them being male students. It can be concluded that male students experienced more anxiety compared to male respondents in terms of forgetting to say things they know even though the result is quite similar. Statement 30: â€Å"During an important speech I experience a feeling of helplessness building up inside me.† On the hand, 17 out of 50 students agreed to statement above with 10 of them being males students while the other 7 are female students. In this statement, it can be said that the male students can still be nervous and more anxious compared to the female students. For the gender differences in public speaking anxiety, it can be indicated that both male and female students are equally anxious when involve in giving speeches although the male students show less significant anxiety as compared to the female students. Correlation between Public Speaking Anxiety and Fear of Negative Feedback In order to determine the correlation between two variables and they are students’ public speaking anxiety together with their fears of negative feedback, Karl Pearson’s Correlation Coefficient method is being used. Karl Pearson’s Correlation Coefficient In statistics, the Pearson product-moment correlation coefficient (r) is a common measure of the correlation between two variables X and Y. When measured in a population the Pearson Product Moment correlation is designated by the Greek letter rho (Ï ). Whilst computed in a sample, it is designated by the letter r and is sometimes called Pearsons r. Pearsons correlation reflects the degree of linear relationship between two variables. It ranges from +1 to -1. A correlation of +1 means that there is a perfect positive linear relationship between variables whereas a correlation of -1 means that there is a perfect negative linear relationship between variables. A correlation of 0 means there is no linear relationship between the two variables. Correlations are rarely if ever 0, 1, or -1. The result of the correlation could indicate whether correlations are negative or positive. Mathematical Formula: The quantity r, called the linear correlation coefficient, measures the strength and the direction of a linear relationship between two variables. The linear correlation coefficient is sometimes referred to as the Pearson product moment correlation coefficient in honour of its developer Karl Pearson. The mathematical formula for computing r is: n = number of pairs of scores ∑xy = sum of the product of paired scores ∑x = sum of the x scores ∑y = sum of the y scores ∑x ² = sum of squared x scores ∑y ² = sum of squared y scores The strength and significance of the coefficient. The following general categories indicate a quick way of interpreting a calculated r value: Results for the relationship between public speaking anxiety and fear of negative feedback were displayed in a graphical representation Figure 4.2. From the table 4.2, it can be seen that the result showed a weak correlation between the students’ public speaking anxiety and their fear of negative evaluation as it only scored 0.256. This proves that the relationship between two variables is weak and not very significant. Table 4.2 Figure 4.2 The mean value for fear of negative evaluation score was 51.5. This demonstrates that the average for fear of negative evaluation level is in moderate level. However, out of 50 students that answered the questionnaire, 9 students fell on the high level for fear of negative evaluation, 27 students are on the moderate level while the remaining 14 students have low level for fear of negative evaluation as illustrated in Figure 4.3. Figure 4.3 The students average anxiety level also fell on the moderate level that is at mean value 106.02. From the 50 students that answered the questionnaire, none of the students fell in highly active category. Meanwhile, 94% of the students are in the moderate category while the remaining 6% are in the low category. This can be illustrated as shown in Figure 4.4. Figure 4.4

Research Designs and Methods Assessment

Research Designs and Methods Assessment Shallene K Green Research Designs and Method There are three most commonly used research designs used in human lifespan development research. These designs are used widely to test traits and characteristics in human development. They include cross-sectional, longitudinal and cross-cultural designs (Toplak, West Stanovich, 2014). To understand each design, is to look at how each can change and affect a life. Cross-sectional research design is a method used by researchers to study humans of different ages who have the same character and trait of interest at a single time. Researchers obtain the information that is currently seen in a population, but they do not change the variables. This research design explains the traits that exist within a population, but they do not show the cause and effect relation between variables. In addition, the design allows researchers to look at various things at once such as income and poverty among others (Toplak, West, Stanovich, 2014). A longitudinal research design is a study that observes one group of a population at different times. In this study, the researcher follows the same group of subjects during various stages of development to measure variables. Cross-cultural study involves the comparison of groups from different cultures. This is a very important way of measuring human development. People may vary largely depending on cultures, and behaviors. (Toplak, West, Stanovich, 2014). Throughout their lives, humans undergo various stages of development. Studies are very important in understanding how humans learn, act and mature (Toplak, West Stanovich, 2014). To understand the difference and apply the learnings it to better understand humans. Research studies are very important in learning things such as social stereotype. The knowledge of stereotypes increases with the advancement in age, and it means that younger children may not know some of these stereotypes. For example, there might be a stereotype that football should be played by the boys but not girls. Younger children may not be exposed to this stereotype and, therefore, cannot make a judgment. This creates a pattern in that younger children do not have this bias, but older children will have formed an opinion (WU, Hillman, 2013). A trend in older and mature humans are more error prone than at a younger age. If children are made aware of this stereotype, they may as well lead them to making conjunction errors. The knowledge of this stereotype is apparently known to older ages than in younger ages (Toplak, West, Stanovich, 2014). What is found is that thinking capacity largely varies with age. A study showed most young ages struggle a lot with reading and often use a lot of efforts to understand or even respond. Older ages find reading easy and effortless as more of a second nature. These changes are well observed throughout the growing and gaining of a child, and periods are established with developmental trends (WU Hillman, 2013). Different methods offer numerous ways which the scientist uses to get information. In a cross-sectional study, the researcher will use interviews to get information on a certain trait in an age group, and it will be used it to compare with another age group (van de Weijer, Van Cleempoel, Heynen, 2014). Interviews are mainly conducted in the initial stages of a project. This information obtained through interviews might be valuable but may not be valid since it is subjective (Toplak, West, Stanovich, 2014). In a longitudinal study, a researcher may opt to use observation methods to obtain information. This method measures the changes in traits and characteristics at different times while be watched. Observation is a very reliable method since the information gathered is not subjective, but it is based on what the researcher sees and observes to report (Toplak, West, Stanovich, 2014). Across cultural studies, literature reviews collect information. Since this study compares different traits in different cultures, the scientist may refer to past studies that have been conducted regarding the cultures in question. Literature materials will include newspapers, magazines, reports and any other published materials. This method is well preferred because it is not expensive (WU Hillman, 2013). A study conducted in a high school showed that games and gaming culture could become a problem that may initially be complex to be fun filled. Gaming culture was also established to make an unfamiliar task appear familiar. This was by providing a language that students could understand. The students could easily use the gaming language to communicate with each other which made it fun filled. Findings showed that high school students could understand given feedback from other students who were younger. It clearly showed that negative remarks badly affected them. What was shown is that students have to believe that they have in possession the competence required to perform a task (WU Hillman, 2013). A observation method that has it strengths and limitations. Its strengths arise from the fact that the researcher gets firsthand information. It provides access to people in real life situation. Its limitation is its too subjective and depends on the role of the researcher (WU Hillman, 2013). The interview has its strength in that it enables the researcher to capture verbal and non-verbal cues. The major limitation of interviews is that it is too costly (Burns, 2014). Video recordings provide accurate and up to date information that is so useful to the researcher only that it is so expensive (WU Hillman, 2013). The changing economic and social context has been a factor influencing outcomes of human development. Households and families have largely been changing to respond to the economic and social changes (Toplak, West, Stanovich, 2014). There has been changing perspectives on the family diversity. Some researchers have thought that small families are easy to maintain than larger families. And with research it can direct or change the thought of families going forward. References Burns Cunningham, K. (2014). Social research design: framework for integrating philosophical and practical elements. Nurse Researcher, 22(1), 32-37. (Toplak, M. E, West, RF, Stanovich, K.E. 2014) rational thinking and cognitive sophistication: van de Weijer, M., Van Cleempoel, K., Heynen, H. (2014). Positioning Research and Design in Academia and Practice: A Contribution to a Continuing Debate. Design Issues, 30(2), 17-29. WU, C, Hillman, C.H. (2013).aerobic fitness and the attentional blink preadolescent children. Neuropsychology, 27(6), 642-653

Inotropes, Vasopressors and Vasodilators

Inotropes, Vasopressors and Vasodilators Suruchi Hasija, Jatin Narula ,Vandana Maravi. ADRENERGIC RECEPTORS AND SIGNALING PATHWAYS The main control over cardiac contractility is provided by the ÃŽ ²Ã¢â‚¬â€œadrenergic signaling pathways and that over the vascular tone by both ÃŽ ±- and ÃŽ ²Ã¢â‚¬â€œadrenergic pathways. The ÃŽ ± and ÃŽ ² receptors are stimulated by catecholamines circulating in the bloodstream and those released locally from the adrenergic nerve endings. The two main subtypes of ÃŽ ²Ã¢â‚¬â€œadrenergic receptors (ÃŽ ²Ã¢â‚¬â€œARs) in the cardiovascular system are the ÃŽ ²1 and ÃŽ ²2 subtypes. Myocardial ÃŽ ²1 and ÃŽ ²2-AR stimulation leads to increased contractility, whereas vascular ÃŽ ²2-AR stimulation induces vascular smooth muscle relaxation. Drug binding to myocardial ÃŽ ²Ã¢â‚¬â€œARs activates stimulatory G protein. This leads to activation of the enzyme adenylate cyclase that catalyzes the conversion of ATP to cAMP. A cascade of intracellular reactions finally leads to the physiological effect of increased myocardial contraction or vasodilation. The ÃŽ ±Ã¢â‚¬â€œadrenergic receptors (ÃŽ ±Ã¢â‚¬â€œARs) are further classified as ÃŽ ±1 and ÃŽ ±2 subtypes. ÃŽ ±1-AR on vascular smooth muscles are the main mediators of vasoconstriction. ÃŽ ±2-AR on the neurons function in a negative feedback loop to control ÃŽ ±-adrenergic vasoconstriction. Stimulation of ÃŽ ±1-AR coupled to G protein activates phospholipase C which in turn raises intracellular Ca+2. Stimulation of ÃŽ ±2-AR coupled to inhibitory G protein inhibits adenylate cyclase, thereby lowering intracellular Ca+2. INOTROPES Inotropy or contractility is the intrinsic property of the cardiac myofibril. It defines the amount of work that the heart can perform at a given load. Contractility is primarily determined by the availability of intracellular calcium. Depolarization of the cardiac myofibril leads to the entry of a small amount of Ca+2 into the cell which triggers the release of additional Ca+2 from intracellular storage sites (sarcoplasmic reticulum). The binding of Ca+2 to troponin, displacement of tropomyosin from the binding site on actin and formation of actin-myosin crossbridges eventually leads to contraction of the myofibril. All inotropic agents act by increasing intracellular calcium. Catecholamines, phosphodiesterase inhibitors and calcium sensitizers are the broad classes of available inotropic agents. Catecholamines Catecholamines comprise the major type of available inotropic agents. Their chemical structure includes a catechol ring, catechol hydroxyl groups and variable side chains. Endogenous(present naturally in the body) catecholamines include epinephrine, norepinephrine and dopamine, and synthetic catecholamines include isoprenaline, dobutamine, dopexamine and fenoldopam. Besides acting directly on adrenergic receptors, some catecholamines may act indirectly by releasing or inhibiting reuptake of norepinephrine at the nerve terminal or by metabolism to form norepinephrine. Table 1: Site and mechanism of action of sympathomimetics Table 2: Haemodynamic effects of catecholamines and phosphodiesterase inhibitors CO=cardiac output, dp/dt=force of myocardial contraction(change in pressure/time), HR=heart rate, SVR=systemic vascular resistance, PVR=pulmonary vascular resistance, PCWP=pulmonary capillary wedge pressure, MVO2=myocardial oxygen consumption Modified from Lehmann A, Boldt J: New pharmacologic approaches for the perioperative treatment of ischemic cardiogenic shock. J Cardiothorac Vasc Anesth 19:97-108, 2005. Epinephrine Epinephrine, a naturally occurring catecholamine, is secreted from the adrenal medulla. The effects on ÃŽ ²Ã¢â‚¬â€œARs predominate at lower doses and on ÃŽ ±Ã¢â‚¬â€œARs at higher doses (> 0.1  µg/kg/min). It increases heart rate (HR), stroke volume (SV) and coronary blood flow (CBF). The rise in blood pressure (BP) results from increase in HR and cardiac output (CO). Systemic vascular resistance (SVR) decreases at low doses (ÃŽ ²2-AR effect) but increases at high doses (ÃŽ ± effect). It is metabolized in the liver by the enzymes catechol-O-methyl transferase (COMT) and monoamine oxidase (MAO), and the metabolites are excreted in urine. It has arrhythmogenic potential. In cardiac surgical patients it is used as an infusion at 0.01-0.4  µg/kg/min to wean patients with poor ventricular function off cardiopulmonary bypass (CPB). (Tables 1 and 2) Norepinephrine Norepinephrine is the postganglionic neurotransmitter in the sympathetic nervous system. It acts on ÃŽ ±1–AR, ÃŽ ±2–AR and ÃŽ ²1–AR, and has negligible action on ÃŽ ²2–AR. The ÃŽ ²1-AR action predominates at lower doses, thereby increasing inotropy, SV and CBF. It increases BP and SVR; but decreases HR. The CO remains unchanged. It has arrhythmogenic potential. The clinical dose range is 0.01 to 0.1  µg/kg/min. Like epinephrine, it is easily oxidized. It is metabolized by COMT and MAO and taken up by the sympathetic neurons. It decreases renal, hepatic, mesenteric and splanchnic blood flow. Dopamine Dopamine is a neurotransmitter in the central and peripheral nervous system. It is the immediate metabolic precursor of norepinephrine and epinephrine. It acts on ÃŽ ±Ã¢â‚¬â€œARs, ÃŽ ²Ã¢â‚¬â€œARs and dopaminergic receptors (DA1-DA5). At 0.5-3  µg/kg/min it increases renal and mesenteric blood flow (dopaminergic effects), between 3-8  µg/kg/min it increases HR and contractility (ÃŽ ²-AR effects) and, above 8  µg/kg/min it causes vasoconstriction (ÃŽ ±-AR effects). Intravenous dopamine does not cross the blood brain barrier. It is metabolized in the liver by COMT and MAO. Isoprenaline Isoprenaline has pure ÃŽ ²Ã¢â‚¬â€œAR agonist activity. It causes an increase in HR and contractility (ÃŽ ²1-AR effect) and decreases SVR (ÃŽ ²2-AR effect). CO increases due to combined ÃŽ ²1 and ÃŽ ²2-AR effect. It dilates pulmonary, skeletal, renal and mesenteric vascular beds. It is indicated in the treatment of pulmonary hypertension, bradycardia (especially after orthotopic heart transplantation), heart block and conduction abnormalities. It is used in the dose 0.01 to 0.1  µg/kg/min. it is metabolized in the liver by COMT. It is arrhythmogenic. Dobutamine Dobutamine is primarily a ÃŽ ²1-AR agonist and has positive inotropic effects. It causes modest increase in HR (ÃŽ ²2-AR effect) and decrease in SVR (ÃŽ ²2-AR effect). The clinical dose range varies from 2-15  µg/kg/min. It is particularly indicated in patients with myocardial pump failure. Its chemical structure lacks the hydroxyl group of catecholamines. It is metabolized in the liver, although not by COMT and MAO. It increases SV, CO and CBF. The arrhythmogenic potential is less than other catecholamines. Dopexamine Dopexamine is a synthetic analog of dopamine. It has potent ÃŽ ²2-AR and dopamine agonist properties and little ÃŽ ²1-AR and ÃŽ ±-AR activity. It causes vasodilation, increase in HR and inotropy. CO and renal blood flow are increased. It is used in the dose 1-10  µg/kg/min. It undergoes methylation and sulfation in the liver and is taken up into the tissues via extraneuronal catecholamine uptake mechanisms. Unlike other catecholamines, it lacks arrhythmogenic potential. Fenoldopam Fenoldopam mesylate is a dopamine DA1 receptor agonist that causes systemic and renal arteriolar vasodilation. It increases renal blood flow at doses of 0.05-0.1  µg/kg/min and reduces BP at 0.1-0.3  µg/kg/min. Phosphodiesterase inhibitors Phosphodiesterase inhibitors act by preventing the breakdown of cAMP, thereby prolonging its physiological response. They do not act via ÃŽ ²-AR stimulation. Their addition to a catecholamine has a synergistic effect in increasing inotropy. They also produce vasodilation and are termed ‘inodilators’. They improve myocardial diastolic relaxation (positive lusitropic effect) and augment coronary perfusion. The clinically used phosphodiesterase inhibitors include amrinone, milrinone and enoximone. Amrinone Amrinone is a bipyridine derivative. It provides positive inotropy and decreases SVR. The decrease in SVR is apparent immediately after administration, whereas positive inotropy is appreciable after 10-15 minutes. They are particularly useful in heart failure by increasing forward flow. It is administered as a bolus loading dose (0.5-1.5 mg/kg) followed by infusion (5-20  µg/kg/min). The potential side effects are thrombocytopenia (2-3%), gastrointestinal upset, myalgia, fever, hepatic dysfunction, ventricular arrhythmias and allergy. Milrinone Milrinone is a derivative of amrinone and is 20 times more potent. It does not cause fever or thrombocytopenia. It is administered as a bolus loading dose (50  µg/kg over 10 minutes) followed by infusion (0.375-0.75  µg/kg/min). Enoximone Enoximone is an imidazole derivative that has more pronounced vasodilatory effect than inotropic effect. It is administered as a bolus loading dose (0.5-1 mg/kg) followed by infusion (5-10  µg/kg/min). Levosimendan Levosimendan is a new inotropic agent belonging to the class of calcium-sensitizing agents, i.e., it sensitizes the myocardium to the actions of calcium. It has vasodilating and anti-ischemic properties mediated by opening of K+-ATP channels. The haemodynamic effects include increase in SV and CO and reduction in filling pressures, mean arterial pressure (MAP), mean pulmonary artery pressure (MPAP) and SVR. It also promotes lusitropy. It is useful in patients with compromised left ventricular function, difficulty in weaning from CPB and right ventricular failure. It is used in a loading dose of 12  µg/kg over 10 minutes followed by an infusion of 0.1  µg/kg/min. Calcium chloride Calcium ions play an important role in excitation-contraction coupling in the cardiac myofibrils. It has positive inotropic effect that is effective after CPB and in the short-term treatment of myocardial pump failure. The rise in BP occurs secondary to increased inotropy and vasoconstriction. However, it can attenuate the ÃŽ ²-AR effects of epinephrine in the postoperative cardiac surgical patients. It is administered in the dose of 2-4 mg/kg every 10 minutes. Calcium Gluconate the clinically available compound of calcium ,contains less than half of ionized calcium and has to be metabolized in the liver before action. VASODILATORS Vasodilators cause relaxation of arterial smooth muscle thereby reducing SVR and MAP. In addition, they also have venodilating property. They aid discontinuation of CPB by decreasing preload, right and left ventricular afterload, improving lusitropy and CBF. They are useful in the perioperative treatment of systemic and pulmonary hypertension, myocardial ischemia and ventricular dysfunction complicated by excessive pressure or volume overload. Sodium nitroprusside Sodium nitroprusside (SNP) acts by acting as a substrate for the formation of nitric oxide (NO) in the vascular endothelium. Binding of NO to its receptor induces a conformational change in the enzyme guanylate cyclase and production of cGMP from GTP. cGMP is the second messenger that eventually leads to vascular smooth muscle relaxation via numerous intermediate steps. SNP predominantly causes arterial and arteriolar vasodilation, but at high doses venodilation also occurs. Reflex tachycardia is apparent with its administration. SV and CO are increased only if the preload is maintained with intravenous fluids. SNP has a potential to cause ‘coronary steal’ phenomenon in patients with coronary artery disease as the epicardial coronary arteries also dilate diverting blood away from the stenosed endocardial coronary arteries. It decreases pulmonary vascular resistance (PVR) and MPAP. It abolishes hypoxic pulmonary vasoconstriction and may contribute to hypoxia. The infusion rate is 0.5  µg/kg/min, and titrated to effect. It is reconstituted in a dextrose-containing solution. SNP is sensitive to light, therefore the infusion syringe and tubing are wrapped with opaque material to prevent light induced structural breakdown of the drug. Cyanide toxicity may occur with the use of SNP above 1.5 mg/kg acute dose or 8  µg/kg/min chronic infusion. SNP is used during hypothermic CPB to promote uniform cooling by preventing cold induced vasoconstriction, to reduce the perfusion pressure, to reduce afterload by decreasing SVR and to increase pulmonary blood flow by decreasing PVR. Nitroglycerin Nitroglycerin (NTG) acts by the same mechanism as other nitrates. NTG is primarily a venodilator and reduces ventricular preload and myocardial oxygen consumption. NTG is of particular importance in patients with congestive heart failure as it unloads the left ventricle. It has modest effects on SVR and BP. It reduces PVR. The starting dose of intravenous nitroglycerin is 0.5  µg/kg/min which may be titrated to effect. Attention must be paid to the fluid status as CO may drastically reduce. At higher doses systemic vascular dilation occurs. NTG is helpful in coronary artery disease because it causes epicardial coronary artery dilation. It is metabolized in the liver. Methemoglobinemia occurs at high infusion rates. Intravenous nitroglycerin has a half-life of 1-3 minutes. Tolerance develops when administered for more than 8 hours. Nitric oxide Nitric oxide (NO) is the endothelium derived relaxing factor. Its mechanism of action has been described above. It has a very short half-life of 5 seconds. Inhaled NO promotes pulmonary vascular dilation. It can be used upto 80 parts per million (ppm) in patients with severe right ventricular failure and pulmonary arterial hypertension. As inhaled NO is rapidly taken up by the heme group of guanylate cyclase, it only acts locally in the pulmonary vascular bed causing pulmonary vasodilation. It has no systemic effects. Phenoxybenzamine Phenoxybenzamine is a non-competitive ÃŽ ±1 and ÃŽ ±2-AR blocker. It decreases PVR and SVR, thereby increasing CO. It is used to promote vasodilation during deep hypothermic circulatory arrest for uniform cooling and for the treatment of pulmonary hypertension. Phenoxybenzamine is a very potent and long acting vasodilator. It was traditionally used for afterload reduction, pulmonary vasodilatation, and in adrenal tumors such as pheochromocytoma. Phentolamine, a shorter acting agent is now more commonly used. VASOPRESSORS Vasopressors act on arteries and arterioles to increase SVR (ÃŽ ±-AR effect). They have some ÃŽ ² –AR effect also. Catecholamines such as norepinephrine, and epinephrine and dopamine at high concentrations are potent vasoconstrictors. In addition, sympathomimetics such as phenylephrine, methoxamine, ephedrine, metaraminol and mephentermine are also vasoconstrictors. They are metabolized by COMT and MAO. Phenylephrine Phenylephrine is a pure ÃŽ ±1-AR agonist and its primary action is to increase SVR. Reflex bradycardia may be seen. Vasoconstriction of renal, splanchnic and other vascular beds occurs. Coronary perfusion pressure is increased due to increase in diastolic pressure. The intravenous bolus dose is 50-100  µg and infusion rate is 0.5-1.0  µg/kg/min. Its effect is apparent in 1 minute and lasts upto 20 minutes. It is commonly used to increase SVR and therefore the perfusion pressure on CPB. Mephentermine Mephentermine has direct action on ÃŽ ±-AR and ÃŽ ²-AR, and indirect action by releasing norepinephrine at the nerve terminal. It increases CO and SVR. Its acts immediately on intravenous injection and it’s action lasts 30 minutes. It is used in 15-45 mg bolus doses and as 0.1% infusion titrated to effect. Vasopressin Vasopressin,a hormone of the anterior pituitary is a potent vasoconstrictor. It mediates vasoconstriction by inhibiting K+ ATP channels on vascular smooth muscles and blunting the rise in cGMP (due to NO and ANP) and cAMP (due to ÃŽ ²2-AR stimulation). It is one of the modalities of treating vasodilatory shock after CPB. It is used in the infusion dose of 0.01-0.1 U/min for this purpose. At higher doses it has the potential to cause renal and splanchnic vasoconstriction. It is also administered as a bolus dose of 40 U i.v. during cardiopulmonary resuscitation. Suggested reading Hoffman TM. Newerinotropesin pediatric heart failure. J Cardiovasc Pharmacol. 2011 Aug;58(2):121-5 Rognoni A, Lupi A, Lazzero M, Bongo AS, Rognoni G. Levosimendan: from basic science to clinical trials. Recent Pat Cardiovasc Drug Discov. 2011 Jan;6(1):9-15. Tavares M, Rezlan E, Vostroknoutova I, Khouadja H, Mebazaa A. New pharmacologic therapies for acute heart failure. Crit Care Med. 2008 Jan;36(1 Suppl):S112-20. Petersen JW, Felker GM. Inotropesin the management of acute heart failure. Crit Care Med. 2008 Jan;36(1 Suppl):S106-11 Ward RM, Lugo RA Cardiovascular drugs for the newborn.Clin Perinatol. 2005 Dec;32(4):979-97 Hug CC Jr. Making a choice ofinotropesandvasodilatorsin clinical situations.J Card Surg. 1990 Sep;5(3 Suppl):272-7 Stanford GG. Use of inotropicagentsin critical illness. Surg Clin North Am. 1991 Aug; 71(4):683-98.