Travel And Tourism Industry Of Greece Tourism Essay

Travel And Tourism Industry Of Greece Tourism Essay Greece is one of the most well known goals on the planet. Greece comes in the fifteenth spot on the planet rating of visitor goals, since, as indicated by the National Statistical Service of Greece, it gets in excess of 15 million vacationers consistently, after nations, for example, the USA, China, Spain and Great Britain. As indicated by the 2009 Travel Tourism Competitiveness Report distributed by the World Economic Forum, Greece holds the 24th in general situation among 133 nations, third spot in the prioritization of movement the travel industry subindex, ninth spot in the quantity of World Heritage social locales, fifth spot in the travel industry foundation and first spot in the doctor thickness subindex.. Request Supply: All out interest: The quantity of global the travel industry visit over has been consistent increment from 14.2 million of every 2004 to 17 million out of 2008. It is required to arrive at 20 million in next scarcely any years, double the countrys populace. Vacationer Arrivals http://www.investingreece.gov.gr/documents/divisions/diagrams/the travel industry/tourism_arrivals1_en.jpg Source: Greek National Tourism Organization and National Statistical Services of Greece Key markets Source areas Greece has today figured out how to get one of the most loved visitor goals among Europeans, Asians and Americans. Roughly 85% of appearances begin in Western Europe: 21.2% from the United Kingdom, 17.5% from Germany, 8.8% from Italy, 5.3% from France, 5.2% from Holland, and 7.5% from the Scandinavian nations. Notwithstanding, noteworthy quantities of guests from Eastern Europe, USA and China are making Greece their favored goal. As per a study directed in China in 2005, Greece was casted a ballot as the Chinese people groups number one decision as a traveler goal. In November 2006, Austria, similar to China, reported that Greece was the most loved visitor goal for its residents. It makes a more extensive base of birthplace nations and new requests for administrations, offices, and attractions. Flexibly: Right now, in excess of 9,000 lodgings work in Greece. As indicated by the Hellenic Chamber of Hotels, the quantity of lodgings in Greece was by grouping (bedplaces): Star rating Number Beds 5 star 176 64,913 4 star 994 176,631 3 star 1,804 163,077 2 star 4,460 231,333 1 star 1,677 57,298 All out 9,111 693,252 535 inns were worked a work in progress Law 3299/04 in the time of 2005 to 2009 in Greece, with an all out financial plan of à ¢Ã¢â‚¬Å¡Ã¢ ¬ 2.6 bn, 44% (à ¢Ã¢â‚¬Å¡Ã¢ ¬ ~1.2 bn.) of which was sponsored by the legislature. The quantity of beds included through these speculations is roughly 50,000. The breakdown per inn classification is as per the following: The following are key insights about expense per room and appropriations paid out by the legislature, per inn class The Greek government has declared designs for another Development Law, giving money related motivating forces to interest in Greece as broad tax cuts and sponsorships of up to half. Monetary Impacts Gross domestic product Contribution: Greeces TT Direct Industry is required to contribute 7.0% to Gross Domestic Product (GDP) in 2010 (EUR15.4bn or US$22.8bn), ascending in ostensible terms to EUR27.9bn or US$36.4bn (8% of aggregate) by 2020. The TT Economy commitment (% of aggregate) should ascend from 15.5% (EUR33.9bn or US$50.2bn) to 17.3% (EUR60.7bn or US$79.1bn) in this equivalent period. Business Greeces 418,000 TT Direct Industry occupations represent 10% of complete work in 2010 and are gauge to add up to 483,000 occupations or 11.1% of the aggregate by 2020.The commitment of the Travel Tourism Economy to business is required to ascend from 18.8% of all out work, 785,000 occupations or 1 in each 5.3 occupations in 2010, to 21% of all out business, 916,000 employments, or 1 in each 4.8 occupations by 2020. Industry Challenges Greek travel and the travel industry is influenced by monetary emergency in 2009 The quantity of appearances to Greece was diminished influenced by the 2009 monetary emergency. In Q3 2010 number of global appearance in Athens drop by 5.2% in contrast with 2009 prompting a ytd drop of 5.3% The RevPAR in Athens dropped by - 11.3% in Q3 prompting a ytd drop in the RevPAR of - 6%. The RevPAR in Thessaloniki proceeded with its sharp drop, - 22% Resort lodgings, in any case, indicated a noteworthy improvement in their Total RevPAR, by 5.1%, prompting an inversion of the already negative pattern in the ytd figure, which improved by 4.4%, contrasted with - 4.0% in Q2. Along these lines, fears that Greek the travel industry would fall this year didn't emerge. Greece 2010 obligation emergency The Greece obligation emergency, which began toward the start of 2010, exacerbated the impacts of the worldwide financial emergency on the Greek travel and the travel industry. The obligation emergency will surely influence customer trust in the nation and is required to adversely affect outbound and residential traveler streams in 2010, particularly as the bailout has included the European Union joined with the IMF. Different troubles anticipated: The further increment of the VAT on neighborliness administrations to 11% from July first, 2010 (from 9% toward the start of the year) will negatively affect the productivity of the business by and large, especially in blend with the value decreases occurring because of current economic situations. The Hotel Federation and the Hotel Employees Union have declared that they have arrived at a multi year concession to work relations; compensation increments will be 1% in 2010 and a further 1% in 2012. Industry Competitiveness: A large portion of the inns in Greece are sorted as 1-and 2-starhotels, which means there is a lot of space for financial specialists to set up 4-and 5-star properties. As indicated by the Greek Hotel Branding Report, marked inns in Greece represent 4% of the all out number of lodgings and 19% of complete accessibility of rooms, while in other European nations this figure lies somewhere in the range of 25 and 40%. Foundation Foundation in Greece is extremely evolved with 40 air terminals all through Greece of which 15 are universal and very much structured national expressway framework. Speculation Incentives Law: Greeces recently executed PPP (Public Private Partnership) conspire gives critical chances to speculators to take part in new foundation ventures, including marinas and warm springs. The National Strategic Reference Framework (NSRF) for the years 2007-2013 builds up the wide needs for EU Structural Funds Programs in Greece. For the travel industry, NSRF offers huge monetary help, with a financial plan of in excess of 500 million Euros until 2013 A draft Investment Law has been given by the administration remembering money related impetuses for the type of appropriations up to half or comparable motivating forces as tax reductions for organizations doing new ventures or purchasing resources of organizations that have held onto activities. HR Since Greece, a nation of 11 million occupants, has in excess of 17 million guests, instruction and preparing in the travel industry administrations is foremost. The workforce is multilingual, knowledgeable in the travel industry part, and ready to react to new difficulties. From the executives to cooking, HR for the travel industry endeavors is a Greek quality. Lodging Chain Project Organization foundation : Starwood Hotels Resorts Worldwide, Inc. is one of the biggest lodging organizations on the planet. As of December 31, 2009, Starwood Hotel Resorts Worldwide, Inc claimed, oversaw or diversified 992 properties under its nine possessed brands. It has 145,000 representatives around the world, of whom roughly 34% were utilized in the United States. W Hotels is Starwoods extravagance boutique inn brand. The inn brand, which for the most part showcases towards a more youthful group, was propelled in 1998 with its first property, W New York. The brand has extended globally with properties opening first in Mexico City, Seoul, and Istanbul. The W Barcelona lodging was the Ws first in Western Europe and opened in October 2009. The W intends to twofold its number of properties by 2011 with lodgings arranged in Austin, Texas (2010); Taipei, Taiwan (2010); Marrakech, Morocco (2011); Guangzhou, China (2011); Bangkok, Thailand (2011); Paris, France (2011); Athens, Greece (2011); St. Petersburg, Russia (2011); and London, England (2011) Venture: W Athens Astir Palace Beach is going to open on 1 April 2012. It is a piece of Astir Palace Resort adjacent to Arion, a Luxury Collection Resort Spa and The Westin Athens. W Athens is changed over from the 165-room Aphrodite Hotel under a broad restoration. Manageable Concerns : Dreading the spread of Greek obligation emergency, the EU and the International Monetary Fund (IMF) have consented to dispatch a bailout bundle worth about $ 1,000 billion. Be that as it may, the key issue here isn't simply sparing Greece from a momentary obligation emergency, or cut the spending shortfall of the Greek government, however the nation financial aspects development in future As indicated by the simplicity of working together file of the World Bank (WB), Greece is positioned 109, after nations, for example, Egypt, Ethiopia and Lebanon. In rating the business condition of high-pay nations, Greece is practically base, simply above Equatorial Guinea The Euros is more grounded than the cash of different nations those are not in Eurozone, thusly cost to go in Greece is increasingly costly. Nonetheless, Greece needs more lavish lodgings, fairways, and resort for that distinction in cost Costly costs of products and administration in Greece made by the quality of euro, has debilitated the countrys intensity on universal market. This difficult will turn out to be more awful if the work profitability of nations, for example, Germany and France developing continually and increment estimation of the euro. It will push the cost of Greek fares higher that advertise real factors. Greece should change to another money that is more vulnerable than Euro to expand their seriousness. Cã ³ m㠡⠻â„ ¢t gi㠡⠺â £i phã ¡p khã'ng d㠡⠻†¦ dã ng đ㠡⠻æ' Hy L㠡⠺â ¡p thoã ¡t kh㠡⠻⠏i tã ¬nh tr㠡⠺â ¡ng ti㠡â�

ITunes price changes hurt some rankings Assignment

ITunes value changes hurt a few rankings - Assignment Example The article calls attention to that two days after Apple iTunes Music store raised its costs on certain people tracks, the deals plunged and with that the rankings of the melodies. The iTunes top 100 graph enlisted 40 melodies at $1.29 and 60 tunes at the ordinary $0.99 value point. After the value change, the $1.29 melodies lost 5.3 places on the diagram while the $0.99 tunes increased a normal 2.5 outline positions. These progressions give a general thought of how gradual changes in income can be reached. Going here and there the diagram impacts the income incredibly which thus is affected by value changes. These progressions are exclusively diagram position, however a general thought of gradual changes in income can be reached. By taking a gander at the unit deals of the latest Soundscan top track downloads outline, the distinctive between diagram positions can offer a view into how going all over the graph impacts income. A suspicion here is that the iTunes Top 100 outline is ill ustrative of the Soundscan top track downloads graph. Given its market strength, this is a sensible presumption. I picked this article since it gives a smart thought of how little changes in cost can pivot Sales. A noteworthy idea raised by this article is the manner by which how costs adjust the rankings of melodies in the music business. The costs change the rankings and the rankings which thus sway deals and income. This article identifies with part nine of our course book in which key issues identified with starting and reacting to value changes are talked about. Purchaser response to value changes are an aftereffect of the worth the clients find in the value change. (Glenn Peoples) Works Cited Glenn Peoples, Nashville. How iTunes Price Changes Hurt Some Rankings. 10 April 2009. 19 May 2011 . Article: 7 out of 10 Americans state High gas costs hurt This article is identified with an ongoing section that we secured from our reading material. Clients don’t respond to value changes in a straight forward manner. A cost increment is relied upon to bring down deals. This is on the grounds that a brand’s cost and its picture are intently integrated. Value changes will modify buyer recognition about a specific item and the manner in which they need to devour it. In this manner cost is a basic factor. I picked this article since it offers understanding into how value changes in a compulsory ware, for example, gas impacts the normal man. The review was led by USA today in which they inquired as to whether late changes in costs of fuel have affected them monetarily. 7 out of 10 Americans trusted it did. The greater part of them asserted that they have needed to make changes to represent more significant expenses of gas. 21% of them felt the effect so vigorously that they trusted it endangered their way of life. (Stauss) Stauss, Gary. 7 out of 10 Americans state high gas costs hurt . 18 May 2011. 19 May 2011 . Article: Apple and Starbucks report music as sociation The article discusses the Apple and Starbucks music organization. Under this organization, clients at Starbucks will have the option to remotely peruse, search for music, purchase and download music from the iTunes Wi-Fi Music Store at Starbucks on their iPod contact, iphone, Mac or PCs running iTunes in a partaking area. They will likewise be accessible to profit the new â€Å"Now Playing† administration under which the name of the tune playing in the Starbucks store at that specific second will be appeared. They will at that point have the option to purchase and download melodies legitimately to their gadget. The organization will profit both Apple and Starbucks and is a great case of even promoting. I chose this article since I felt that having free access to the iTunes Wi-Fi Music store and the Now Playing administration of Starbucks is an incredible approaches to pull in clients to both Starbucks and Apple iTunes. It will trigger more prominent incomes for the two organizations. This

Podcast Episode 77

Welcome to episode 77 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA content blueprint (download the FREE cheat sheet). Special from today's episode: Download your copy of the Free Trello Smarty PANCE NCCPA Blueprint Study Plan Follow The Daily PANCE Blueprint on Instagram Follow The Daily PANCE Blueprint on Facebook This week we willbe coveringten general board review questions based on theNCCPA PANCE and PANRE Content Blueprints. Below you will find an interactive exam to complement the podcast. The Audio PANCE and PANRE Physician Assistant Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full boardreview includes over 2,000 interactive board review questions andis available to all members of thePANCE and PANRE AcademyandSmarty PANCE. You can download and listen to pastFREE episodes here,oniTunes, onGoogle Play MusicorStitcherRadio. You can listen to the latest episode, take an interactive quizand download your results below. Listen Carefully Then Take The Practice Exam If you can't see the audio player click here to listen to the full episode. Podcast Episode 77: Ten Question PANCE and PANRE Podcast Quiz The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson. 1. A 10-month-old girl was admitted to the hospital for cardiac catheterization. Her history included cyanosis noted at about 6 weeks of age, increasing over the last 7 months and becoming more severe with crying or physical activity. The chest x-ray demonstrates a "boot-shaped heart." A presumptive diagnosis of tetralogy of Fallot (TOF) was made on admission. TOF has 4 components, which of the following below is NOT PART of the diagnosis? A. Pulmonary valve stenosis B. VSD C. Overriding aorta D. Right ventricular hypertrophy E. ASD Click here to see the answer Answer: E, ASD In 1888, Fallot described a congenital heart defect composed of four characteristics (a) large ventricular septal defect (VSD) (b) right ventricular outflow obstruction (pulmonary valve stenosis) (c) overriding aorta (d) right ventricular hypertrophy. The main characteristic of TOF is cyanosis. Hypercyanotic spells or tet spells are paroxysmal episodes in which the cyanosis acutely worsens. Crying, feeding, or defecating can bring on these episodes. Review NCCPA Blueprint Topic: Tetralogy of Fallot 2. A 65-year-old man presents with pain in his right knee. He says he fell and banged it up fairly bad approximately 6 months ago but that it had since recovered spontaneously and provided no further trouble until now. On examination, his temperature is 37.5 C and his blood pressure is 125/70 mm Hg. He has an inflamed, tender, swollen right knee. No other joints are affected. No other abnormalities are found on physical examination. A plain radiographic examination of the right knee reveals streaking of the surrounding soft tissue with calcium deposits (chondrocalcinosis). What is the definitive diagnostic test of choice for this patient's disease A. A plasma level B. A random urine test C. A 24-hour urine D. A synovial fluid analysis E. Gram stain plus culture and sensitivity Click here to see the answer The answer is D: A synovial fluid analysis A definitive diagnosis of gout is made bydemonstrating negatively birefringent, needle-shaped monosodium urate crystals under a polarizing microscope. Although an elevated serum uric acid concentration is often seen in acute gout, it is neither as sensitive nor as specific a test as the demonstration of uric acid crystals in the synovial fluid under a microscope. Serum uric acid levels can be normal in patients with acute gouty arthritis. The diagnosis of septic arthritis can be ruled out by appropriate Gram stain and culture of the same specimen of synovial fluid obtained for examination with the polarizing microscope. Review NCCPA Blueprint Topic: Gout and pseudogout (Lecture) 3.What is (are) the major difference(s) between polymyalgia rheumatica (PMR) andpolymyositis? A. Marked proximal muscle weakness in polymyositis B. Marked proximal muscle tenderness in polymyositis C. Elevated muscle enzymes such as creatine kinase (CK) in polymyositis D. a, b, and c Click here to see the answer The answer is D:a, b, and c The differences between Polymyalgia Rheumatica (PMR) and polymyositis on clinical examination are as follows: There is marked weakness associated with proximal muscle pain in polymyositis There is often marked muscle tenderness (versus joint pain in PMR) associated with the proximal muscle pain in polymyositis Laboratory examination reveals elevated muscle enzymes only in polymyositis Polymyositis Pearls Polymyositis is an autoimmune-mediated inflammatorydestruction of musclesleading tomuscle weakness Patients with polymyositis experienceproximalsymmetric (bilateral)muscle weakness Theshoulders and hipsare the parts of the body most commonly affected by polymyositis Early fatiguewhile walking andinability to rise from a seated position Diagnosis The three autoantibodiesanti-Jo-1,anti-SRP, andanti-Mi-2, are associated with polymyositis Creatine kinaselevels areincreasedin polymyositis Electromyographycan detect regions of dead muscle cells Muscle biopsycan showendomysial inflammationand various stages of necrosis Treatment Initial treatment of polymyositis involves suppressing the immune response withcorticosteroids Methotrexateis used for long-term immunosuppressive therapy in polymyositis Review NCCPA Blueprint Topic: Polymyositis (ReelDx + Lecture) 4. Clinical features of botulism include all of the following except A. Paresthesia B. Dysphagia C. Diplopia D. Fixed/dilated pupils Click here to see the answer The answer is A: Paresthesia Paresthesia is not a feature of botulism while dysphagia, diplopia, and fixed dilated pupils are. Botulism Pearls Caused by aneurotoxinelaborated byClostridium botulinumagram-positive bacillus, which is ananaerobic, spore-forming bacteria Associated withhome-canned foodproductsandhoney in infants(wait until babies areat least12 monthsbefore introducing honey) Presents withdouble vision,drooping of eyelids,inability to make facial expressions, anddifficulty swallowing Autonomic nervous system effects may causedry mouth, postural hypotension, nausea, vomiting, and constipation Can lead to completeflaccid paralysiswhich is deadly if itinvolves respiratory muscles In infants,symptoms include constipation and generalized weakness, with weak crying, poor feeding, lethargy, and loss of head control(floppy baby syndrome) Diagnosis Diagnosis is bytoxin assays Sometimeselectromyography Treatment Treatment issupportive The greatest threat to life isrespiratory impairmentand its complications IV botulinum immunoglobulin/heptavalentbotulinum antitoxin Correct canningandadequate heatingof home-canned foodbefore serving are essential Canned foods showing evidence of spoilage and swollen or leaking cans should be discarded Review NCCPA Blueprint Topic: Botulism 5. A 59-year-old male complains of "flashing lights behind my eye" followed by a sudden loss of vision, stating that it was "like a curtain across my eye." He denies trauma. He takes Glucophage for his diabetes mellitus and atenolol for his hypertension. He has no other complaints. On the fundoscopic exam, the retina appears to be out of focus. Which of the following is the most likely diagnosis? A. Central retinal vein occlusion B.Retinal artery occlusion C.Retinal detachment D.Hyphema Click here to see the answer The answer is C: Retinal Detachment Patients with retinal detachment frequently complain offlashes of light or floatersthat occur during traction on the retina as it detaches. This isfollowed by loss of vision. In small detachments, the retina may appear out of focus, but with larger detachments, aretinal fold may be identified. Central retinal vein and artery occlusioncausepainless, variable loss of vision.Exam showsretinal hemorrhagesin all quadrants andedema of the optic disk Hyphemais usually associated with trauma and is a collection ofblood in the anterior chamber Retinal Detachment Pearls Retinal detachment is aseparation of the neurosensory retinafrom the underlying retinal pigment epithelium Look forsudden increase or change in floatersalong withcurtain or veil across the visual field Often is spontaneous, but may have an underlying cause example recent cataract surgery Myopia (nearsightedness)is a risk factor for the development of retinal detachment Retinal detachment is usuallyunilateral Retinal detachment usually presents with defects in theperipheral visual field Diagnosis Diagnosis is byfundoscopy retinal detachment is visualized as crinkling of retinal tissue and changes in vessel direction Ultrasonographymay help determine the presence and type of retinal detachment if it cannot be seen with funduscopy Treatment Retinal detachment is anophthalmologic emergency Staysupine(lying face upward)withhead turnedtowards the side of the detached retina Pneumatic retinopexyis a procedure for the management of retinal detachment that involves cryoretinopexy followed by injection of an air bubble in the vitreous Review NCCPA Blueprint Topic: Retinal detachment (Lecture) 6. The first dose of the combined vaccine of measles, mumps, and rubella (MMR) is usually given at age A. 12 months B. 6 weeks C. Birth D. 9 months Click here to see the answer The answer is A: The first dose of MMR is given at age 12 15 months and a second dose at age 4-6 years Mumps Pearls Mumpsis aviral disease that is part of theparamyxovirus family. It presents withparotitis(painfulparotidgland swelling),orchitis, oraseptic meningitis. It is transmitted throughrespiratory dropletsand has anincubation period of 12-14 days Prodrome offever,malaise, andanorexia Parotid enlargement(usually bilateral but not always synchronous) 24 h later Swelling ofsubmaxillaryandsubmandibular glands Orchitis(usually unilateral) withtesticular enlargementtwo to three times normal size Mumps is the most common cause ofpancreatitis in children Diagnosis During an outbreak, a diagnosis can be made by determining recent exposure and parotitis.Usually, the disease is diagnosed on clinical grounds, and no confirmatory laboratory testing is needed If there is uncertainty about the diagnosis, a test of saliva or blood may be carried out; a newer diagnostic confirmation, usingreal-time nested (PCR) technology, has also been developed As with any inflammation of the salivary glands, the serum level of the enzymeamylaseis oftenelevated CSFdemonstratesincreased lymphocytesanddecreased glucose Treatment There is no available cure for mumps andtreatment is supportive Symptoms usually last for 7-10 days and patients are contagious for up to 9 days after onset May need to providescrotal supportif painful or swollen testicle (as in case presentation) MMR vaccine is given at 12-15 monthsthen again at4-6 years of age Review NCCPA Blueprint Topic: Mumps 7. A 28-year old sub-fertile woman presents to you on account of dysmenorrhea, deep dyspareunia, dyschezia, and pelvic pain of a few months duration. Physical examination revealed nodularity of the uterosacral ligaments, tenderness in the pouch of Douglas, and a fixed retroverted uterus with positive cervical excitation tenderness. What is the most likely diagnosis? A. Endometriosis B. Pelvic inflammatory disease C. Adenomyosis D. Uterine leiomyoma The diagnosis is generally made by A. Detection of increased estrogen levels B. Endometrial biopsy C. Pelvic ultrasound D. Laparoscopy E. CT of the pelvis Click here to see the answer Answer: A, endometriosis, and D Laparoscopy Endometriosis, which is the presence ofbenign endometrial tissue outside of the uterine cavity typicallypresents as described in this clinical vignette. Remember the three ds Dyspareunia, dyschezia (difficulty in defecating) and dysmenorrhea Definitive diagnosis is made bylaparoscopy and confirmed with a biopsy Imaging tests(eg, ultrasonography, barium enema, IV urography, CT, MRI)are not specific or adequate for diagnosis.However, they sometimes show the extent of endometriosis and thus can be used to monitor the disorder once it is diagnosed. Incorrect Answers: Patients with PID may have similar symptoms with endometriosis, but also presents with fever and vaginal discharge Patients with adenomyosis (acondition in which endometrial tissue exists within and grows into the uterine wall) present with uterine mass with or without pressure symptoms and menorrhagia Uterine leiomyomas cause chronic painful bleeding and are common in women in their late thirties and early forties. Review NCCPA Blueprint Topic: Endometriosis (Lecture) 8. A 45-year-old obese Caucasian gentleman arrives at your clinic for a routine check-up after having some blood work done during a workplace health screening. He is found to have an LDL cholesterol level of 550 mg/dL. He states that his father and brother had high cholesterol and both died at a young age from a heart attack. He has a follow-up appointment with his cardiologist because of some occasional chest pain and abnormalities seen on his EKG. Additionally, you notice that he has well-demarcated yellow deposits around his eyes. He is started on high dose statin and his LDL at 12 weeks is 350 mg/dL. What is the next best step in this patient's management? A. Continue high dose statin, the patient's LDL is at goal B. Add niacin 100 mg three times daily C. Add ezetimibe (Zetia) 10 mg daily D. Add a PCSK9 inhibitor E. Refer to a lipid specialist Click here to see the answer The answer is C: add ezetimibe 10 mg If LDL-C is not at goal after 6-12 weeks the next best step for the treatment offamilial hypercholesterolemiais to addezetimibe 10 mg dailyand check again in 6-12 weeks. If at that time the patients LDL is still not at goal (ideally 150) refer to lipid specialist to consider adding a PCSK9 inhibitor. Pearls Familial hypercholesterolemia (FH)is the most common autosomal dominant genetic disease. The clinical syndrome (phenotype) is characterized by extremely elevated levels of low-density lipoprotein cholesterol (LDL-C) and a propensity to early-onset atherosclerotic cardiovascular disease. In general,homozygotes manifest the disease at a much earlier age than heterozygotes and the disease is more severe. HomozygousFH patients are rare and have an estimated prevalence of approximately 1:300,000 to 1:400,000 HeterozygousFH is estimated to occur in 1 in 200 to 250 individuals in the United States. It is estimated that about 7 percent of American adults have an untreated lipoprotein cholesterol 190 mg/dL but only 1.7 percent carry an FH mutation Patients withundiagnosed homozygous familialhypercholesterolemia (FH)develop severe, premature, atherosclerotic cardiovascular disease anddie before age 20 in many cases. In patients with a negative or unknown family history, an untreated LDL-C level of 190 mg/dL (4.9 mmol/L) suggests FH. This value is greater than the 90th percentile for age and sex. Diagnosis The diagnosis ofheterozygous familial hypercholesterolemia (FH)is made withgenetic testing or clinical criteria.A causative mutation in the LDLR, APOB, or PCSK9 gene(s) secures this diagnosis When genetic testing is not available or not felt to be necessary, you can use theDutch Lipid Clinic Network criteria, which assigns points based on low-density lipoprotein cholesterol (LDL-C) levels, personal history of early atherosclerotic cardiovascular disease (ASCVD), family history of early ASCVD, or high cholesterol in a first-degree relative, and personal and physical examination finding Treatment Patients withhomozygous familial hypercholesterolemia (FH) intensive LDL-C lowering, whichtargets a minimal value of 150 mg/dL(3.9 mmol/L) In addition to a high-dose statin (atorvastatin 80 mg daily or rosuvastatin 40 mg daily), most homozygous patients will require additional therapies such asezetimibe, a PCSK9 inhibitor, or potentially LDL-C apheresis Review NCCPA Blueprint Topic: Hypercholesterolemia 9.What best describes the time that preeclampsia is commonly seen? A. Before 18 weeks of pregnancy B. After 18 weeks of pregnancy C. After 16 weeks of pregnancy D. After 20 weeks of pregnancy E. Before 12 weeks of pregnancy Click here to see the answer The answer is D, after 20 weeks of pregnancy Preeclampsia is a systemic disease characterized by hypertension that is accompanied by proteinuria.Preeclampsia usually begins after the 20th week of gestation;however, it can appear at any time during pregnancy. It occurs most frequently in the final trimester. Pearls Preeclampsiais a systemic disease characterized byhypertensionthat is accompanied byproteinuriaafter the20th week of gestation. If left untreated, preeclampsia can lead to serious, and even fatal, complications. Risk factors include nulliparity, age younger than 19 or older than 35, obesity, multiple gestations, positive family history, pre-existing hypertension or renal disease, and diabetes mellitus. Eclampsiais defined as thedevelopment of seizuresin awoman with preeclampsia. Diagnosis Hypertensionwithproteinuria Mild Preeclampsia BP 140/90 160/110 Proteinuria 300 mg/24 hours or +1 on dipstick BP 160/110 Proteinuria 5g in 24 hours or no urine or 3 +on dipstick ***HELLPSYNDROME Hemolysis, elevated liver enzymes, and low platelets Treatment Delivery is the only cure for preeclampsia. The decision to induce depends on the stage of pregnancy and the severity of the disease Patients with preeclampsia without severe symptoms are generally induced into laborafter 37 weeksgestation in severe preeclampsia delivery is performed at 24-26 weeks If less than 34 weeks antenatal steroidspromote fetal lung development Intravenousmagnesium sulfate as seizure prophylaxis) Review NCCPA Blueprint Topic: PANCE Blueprint Reproductive System (7%) Hypertension disorders in pregnancy 10. A 36-year-old male who is hospitalized because of severe injuries from a motor vehicle accident develops a rapid onset of profound dyspnea. The initial chest x-ray shows a normal heart size with diffuse bilateral infiltrates. A follow-up chest x-ray shows confluent bilateral infiltrates that spare the costophrenic angles. Which of the following is the best clinical intervention for this patient? A. Tracheal intubation B. Bilateral chest tube insertion C. Type-specific packed cells D. Colloid solutions E. Provide supplemental oxygen Click here to see the answer The answer is A Tracheal intubation Tracheal intubation with the lowest level of PEEP is required to maintain the PaO2 above 60 mmHg or SaO2 above 90% in a patient with ARDS Pearls Acute respiratory distress syndrome (ARDS)is a type ofrespiratory failurecharacterized byfluid collecting in the lungsdepriving organs of oxygen The underlying abnormality in ARDS is Permeability of alveolar-capillary membranes development of protein-rich pulmonary edema(non-cardiogenic pulmonary edema) ARDS can occur in those who arecritically illor who havesignificant injuries Three clinical settingsaccount for75% of ARDS cases: Sepsis syndrome (most common cause) Severe multiple trauma Aspiration of gastric contents (alcoholics), toxic inhalation, near-drowning People with ARDS havesevere shortness of breathand often are unable to breathe on their own without support from a ventilator Occurring12-24 hours after the precipitating event Tachypnea,pink frothy sputum,crackles Diagnosis Chest radiographshowsairbronchogramsandbilaterally fluffy infiltrate Normal BNP, pulmonary wedge pressure, left ventricle function and echocardiogram Treatment Treatment involvesidentifying and managing underlying precipitation and secondary conditions Tracheal intubationwith the lowest level PEEP to maintain PaO2 60 mmHg or SaO2 90 ARDS isoften fatal, the risk increases with age and severity of illness Review NCCPA Blueprint Topic: PANCE Blueprint Pulmonary (10%)Acute respiratory distress syndrome (Lecture) [spoiler title=C Looking for all the podcast episodes? 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You have Successfully Subscribed! document.createElement('audio'); http://traffic.libsyn.com/pasquini/Episode_77_-_The_Audio_PANCE_and_PANRE_-_Ten_Mixed_Audio_Physician_Assistant_Board_Review_Questions.mp3Podcast: Download (24.6MB) | EmbedSubscribe: Apple Podcasts | Android | Email | Google Podcasts | Stitcher | RSS | PANCE and PANRE Podcast Playerhttp://traffic.libsyn.com/pasquini/Podcast_Episode_75_Ten_PANCE_and_PANRE_Audio_Board_Review_Questions.mp3Podcast (thepalife): Download (28.8MB) | EmbedSubscribe: Apple Podcasts | Android | Email | Google Podcasts | RSSView all posts in this seriesThe Audio PANCE and PANRE Board Review Podcast Episode 1The Audio PANCE and PANRE Board Review Podcast Episode 3The Audio PANCE and PANRE Board Review Podcast Episode 5The Audio PANCE and PANRE Board Review Podcast Episode 7The Audio PANCE and PANRE Board Review Podcast Episode 9The Audio PANCE and PANRE Board Review Podcast Episode 11The Audio PANCE and PANRE Board Review Podcast Episode 13The Audio PANCE and PANRE Board Review Podcast Episode 15The Audio PANCE and PANRE Board Review Podcast Episode 17The Audio PANCE and PANRE Board Review Podcast Episode 19The Audio PANCE and PANRE Board Review Podcast Episode 21The Audio PANCE and PANRE Board Review Podcast Episode 23The Audio PANCE and PANRE Board Review Podcast Episode 25Cardiology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 27Pulmonology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29Gastroenterology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 31EENT 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 33Genitourinary 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 35Musculoskeletal 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 37Reproductive System 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 39Episode 41: The Audio PANCE and PANRE Board Review PodcastEpisode 43: The Audio PANCE and PANRE Bo ard Review PodcastMurmur Madness: The Audio PANCE and PANRE Episode 45Episode 47: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 49: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 51: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 53: General Surgery End of Rotation Exam The Audio PANCE and PANRE PodcastEpisode 55: The Audio PANCE and PANRE Board Review PodcastEpisode 57: The Audio PANCE and PANRE Board Review PodcastEpisode 59: Emergency Medicine EOR The Audio PANCE and PANRE Board Review PodcastEpisode 61: The Audio PANCE and PANRE Board Review PodcastEpisode 63: The Audio PANCE and PANRE PA Board Review PodcastPodcast Episode 65: Hepatitis B Breakdown With Joe Gilboy PA-CPodcast Episode 67: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 69: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 71: Ten PANCE and PANRE Board Review Audio QuestionsPodcast E pisode 73: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 77: The Audio PANCE and PANRE Board Review Podcast You may also like -Podcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review QuestionsWelcome to episode 75 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA content blueprint (download the FREE []Episode 63: The Audio PANCE and PANRE PA Board Review Podcast Ten MixedNCCPA PANCE Content Blueprint Multiple Choice Questions Welcome to episode 63of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as Icover ten PANCE and PANRE Board review questions from []Episode 61: The Audio PANCE and PANRE Board Review Podcast Ten MixedNCCPA PANCE Content Blueprint Multiple Choice Questions Welcome to episode 61of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as Icover ten PANCE and PANRE Board review questions from []

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Europe after the Protestant Reformation and the Catholic...

Europe after the Protestant Reformation and the Catholic Counter Reformation The period immediately following the Protestant reformation and the Catholic counter reformation, was full of conflict and war. The entire continent of Europe and all of its classes of society were affected by the destruction and flaring tempers of the period. In the Netherlands, the Protestants and the Catholics were at eachother’s throats. In France it was the Guise family versus the Bourbons. In Bohemia, the religious and political structures caused total havoc for over thirty years; and in England, the Presbyterians thought that the English Anglican Church too closely resembled the Roman Catholic Church. Religion was the major cause of the widespread†¦show more content†¦Everything was being destroyed, weather different houses, churches, businesses, and even schools. When the fighting subsided, the economy of France, especially its commerce, was shattered, leaving it vulnerable and extremely weak. Power was one of the most necessary ingredients towards the prospe rity of their governments, and became more important to the countrys well being and future. The thirty years war was yet another example of religious strife in Europe. Rudolf II the ruler of Bohemia tolerated Protestants in his country, but his successor Ferdinand II did not and pushed the work of the counter reformation. The Bohemians rebelled, and Ferdinand exiled and executed them. They were told to register and sell their property and leave within fourteen days to prevent further trouble and embarrassment. (Dietrich). When the truce between Spain and the Dutch ended, fighting in Germany and the Netherlands resumed. Ferdinand then issued the Edict of Nantes (which he would later suspend due to opposition by nobles), which gave Catholics back all their land that the Protestants had taken. France then entered the war, seizing the opportunity to attack their opposing Catholic power, the Hapsburgs. They also attacked Ferdinand. One third of Germanys total population was killed, but this was not theShow MoreRelatedCounter Reformation And The Counter Reformation849 Words   |  4 PagesElectronic Encyclopedia published an article about Catholic Reformation, and it wrote that â€Å"Counter Reformation, 16th-century reformation that arose largely in answer to the Protestant Reformation; sometimes called the Catholic Reformation. Although the Roman Catholic reformers shared the Protestants revulsion at the corrupt conditions in the church, there was present none of the tradition breaking that characterized Protestantism. The Counter Reformation was led by conservative forces whose aim was bothRead MoreThe Catholic Reformation And The Jewish Torah1229 Words   |  5 Pagesthe Catholic Reformation. However, whether this reformation can be simply called the Catholic Reformation is a question that needs to be adressed. The Catholic Reformation, also known as the Counter Reformation, was the period of Catholic revival that began with the Council of Trent and ended at the close of the Thirty Years War. The Counter Reformation was initiated in response t o the Protestant Reformation. I believe that the Catholic Reformation would be better described as the Counter ReformationRead MoreCauses Of The Protestant Reformation1635 Words   |  7 PagesThe Protestant Reformation was the 16th-century religious movement that took place in the Western church. Having far-reaching political, economic, and social effect, the Reformation became the basis for the founding of Protestantism, one of the three major branches of Christianity. Without the changes caused by the Renaissance during the fifteenth century, the Reformation would not have been possible (Haigh). Reformers like Martin Luther, John Calvin, and Henry VIII challenged the Catholic churchRead MoreThe Protestant Reformation And The Reformation Essay1379 Words   |  6 PagesThe Protestant Reformation Why the Protestant Reformation is considered a significant development in the Christian Church. The Protestant Reformation was an event which occurred within the Catholic Church during the 16th century. This Reformation was prompted by Martin Luther’s ‘95 theses’ which were a list of 95 criticisms towards the church. The Reformation formed another branch of Christianity called Protestantism which is comprised of many different Christian denominations including AnglicanRead MoreThe Decline Of The Protestant Reformation1276 Words   |  6 PagesIntroduction: The Protestant Reformation was a religious act in the 1500’s that split the Christian Church in Western Europe and led to the establishment of many new churches. It effected spiritual thought, philosophy, political work, and the economies of several countries all around the world. The effects of the Reformation can still be felt in modern times. Stimulated by a devout and renowned German Monk, Martin Luther, this reformation sent shockwaves throughout Europe and played a significantRead MoreChanges Brought on By the Renaissance Period Essay534 Words   |  3 Pagescentury Europe was a time of religious and social change. It was a time of new art, architecture, and literature through the Renaissance and new discoveries through the scientific revolution. The 16th century also brought about great change in religion through the Protestant and Catholic Reformations. The Protestant Reformation and Catholic Reformation of the 16th century greatly changed individual freedoms, indivi dual liberties, and the influence of religion. The start of the Protestant ReformationRead MoreMartin Luther and the Catholic Church894 Words   |  4 Pageswhat his works taught. The Protestant Reformation was a movement during the 16th century, which aimed to reform some beliefs and practices of the Roman Catholic Church. The reformation was led by a German monk named Martin Luther and was further modified by John Calvin, a French theologian and Henry VIII, the king of England. The ideas bought forward by these individuals started the Protestant Reformation, which triggered wars, prosecutions and the Counter-Reformation. Martin Luther was responsibleRead MoreMartin Luther And The Protestant Reformation1461 Words   |  6 PagesThe Protestant Reformation was the 16th-century religious, political, intellectual and cultural upheaval that disintegrated Catholic Europe, setting in place the structures and beliefs that differ from Catholic Church and in future triggered wars and fights and persecutions. In northern and central Europe, reformers like Martin Luther, Thomas Muntzer, Ulrich Zwingli, John Calvin and Henry VIII challenged papal authority and questioned the Catholic Church’s practices, such as â€Å"indulgence† and â€Å"enoughRead MoreThe Art Of Reformation By Martin Luther985 Words   |  4 PagesThe Art of Reformation The year 1517 is claimed by Christianity to be the original spark of a reformation that changed the face of the most prevalent religion in the western world, beginning in Germany and soon enveloping the known world in an upheaval of beliefs and values. However, due to the fact that Protestant faiths became their own religious, social and political powers, the correct term for this movement would not be ‘reformation’ but in fact ‘revolution’. The so-called Protestant Reformation’sRead MoreCatholic Reformation Essay1053 Words   |  5 Pagesa new sect of Christianity. This process was not calm or peaceful in the slightest. Protestant leaders like Martin Luther and John Calvin fiercely attacked and denied traditional Catholic beliefs, causing much controversy and debate upon religion. Many regions of Europe as a whole were converted to Protestantism, and many more Protestants emerged in areas where Catholicism remained the state religion. The Catholic faith became less and less appealing to people as the abuses of the clergy were now

Grapes Of Wrath By Steinbeck Essay Example For Students

Grapes Of Wrath By Steinbeck Essay The Grapes of Wrath by John Steinbeck is considered a classic novel by many inthe literary field. The trials and tribulations of the Joad family and othermigrants is told throughout this novel. In order to gain a perspective into thelives of Oakies, Steinbeck uses themes and language of the troublingtimes of the Great Depression. Some of these aspects are critiqued because oftheir vulgarity and adult nature. In some places, The Grapes of Wrath has beenedited or banned. These challenges undermine Steinbecks attempts to add realityto the novel and are unjustified. In 1939, The Grapes of Wrath was published andcame under fire for its content. Vulgarity and the misrepresentation of apreacher were the main complaints that led to the ban and burning of the novelfrom St. Louis, Missouri libraries in September 1939. Vulgarity may be prevalentin the book, but it has its purpose. Steinbeck used some vulgar terms toaccurately represent the lingo and slang that was used by the people of the1930s . Most of the terms that were considered vulgar may be a bit distasteful,but is nothing that is not heard on the streets today. Extreme profanity is notextraneous in the novel, in fact, it is tame compared to slang terms used today. Casy, the former preacher that was traveling with the Joads, is not be given theconnotation as the most holy man. Casy did not consider himself a minister atthe time The Grapes of Wrath takes place. But I aint a preacher nomore is spoken many times by Casy in denial that he is a man of the cloth. Indeed, Casy is brutally killed in the novel, but it does not go into graphic,violent detail. Once again, Casys feelings against the employers and governmentwere common to the time and were used to state that idea. Another point ofcontroversy lies on The Grapes of Wraths closing sequence. In this finale, anold man nurses from Rose of Sharon, a young women whose baby was deliveredstillborn. Some believe this is pornographic, sexually oriented, and improper,especially for young children. In fact in some states, the sequence is takenout. This sequence may be a vulgar, but it is an essential element to the noveland is in no way pornographic. It shows the desperation of the migrants to doanything to survive, no matter what the implications may entail. Those who aremissing this ending, such as those who read editions in Texas, are missing thisimportant element of The Grapes of Wrath. These readers may never fullyunderstand the lives of migrants in the 1930s . The novel may have some adultc ontent, but it was never meant to be read by young children. The targetaudience, ages over 14, can look beyond the visual picture and fully ascertainthe sections deeper meaning. Others may critique Steinbecks use of socialisticand anti-government messages. During the 1930s, these ideas were very common. In fact, Upton Sinclair, a socialist writer, was nearly elected governor ofCalifornia. Living conditions, the opposition between the Californians and theOakies, and the inability to break out of the depression all addedto beliefs of the times. Steinbeck was not advocating socialism, he was justreflecting the times. Without these individual beliefs of the redsand other people that showed either socialistic or anti-establishment messages,the reader would get a dry, unfulfilled perspective of the lives of peopleduring the Great Depression. Censorship does have its place in society. Thereare many things that are too risquà ©, degrading, and should not be shown. .u2ae2d9210c15a414a7e8713296c801a5 , .u2ae2d9210c15a414a7e8713296c801a5 .postImageUrl , .u2ae2d9210c15a414a7e8713296c801a5 .centered-text-area { min-height: 80px; position: relative; } .u2ae2d9210c15a414a7e8713296c801a5 , .u2ae2d9210c15a414a7e8713296c801a5:hover , .u2ae2d9210c15a414a7e8713296c801a5:visited , .u2ae2d9210c15a414a7e8713296c801a5:active { border:0!important; } .u2ae2d9210c15a414a7e8713296c801a5 .clearfix:after { content: ""; display: table; clear: both; } .u2ae2d9210c15a414a7e8713296c801a5 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u2ae2d9210c15a414a7e8713296c801a5:active , .u2ae2d9210c15a414a7e8713296c801a5:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u2ae2d9210c15a414a7e8713296c801a5 .centered-text-area { width: 100%; position: relative ; } .u2ae2d9210c15a414a7e8713296c801a5 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u2ae2d9210c15a414a7e8713296c801a5 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u2ae2d9210c15a414a7e8713296c801a5 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u2ae2d9210c15a414a7e8713296c801a5:hover .ctaButton { background-color: #34495E!important; } .u2ae2d9210c15a414a7e8713296c801a5 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u2ae2d9210c15a414a7e8713296c801a5 .u2ae2d9210c15a414a7e8713296c801a5-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u2ae2d9210c15a414a7e8713296c801a5:after { content: ""; display: block; clear: both; } READ: The red pony EssayPornography, extreme sexual content, and extreme gratuitous violence does nothave its place in literature or in society. The Grapes of Wrath does not haveany of these above aspects. Of those who choose to ban this book and other worksof literature with questionable themes, many of them are wrapped up in politicalcorrectness. In literature, life should be shown like they it is, not as someonewould like it to be. As much as political correctness advocates would like tochange things for the better, they cannot change the past no matter how hardthey try.

Test og mongolian history Essays - , Term Papers

Test og mongolian history 1. . (5 ) e ? .1415-1620 .1510-1600 .1515-1612 .1416-1622 2. . (5 ) e ....................................e e . 3. . (15 ) . ? ........................................................................................................................................... ........................................................................................................................................... 4. , ,, ? (5 ) ..................................... 5. .(10 ) 1. . 2.e . 3.ee . 4.e . 6. , . (15 ) ? ...................................................................................................................................................................................................................................................................................................................................................................................................................................7. . (5 ) I- e ............ ....... ......... . 8. . (5 ) , ................................. . 9. 3 . (10 ) E 10. e- ................................................... . (5 )