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? This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joiningThe PANCE and PANRE Exam Academy+ SMARTYPANCE I will bereleasing new episodes every few weeks. The Academy isdiscounted, so sign up now. Resources and Links From The Show Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram Follow SMarty PANCE and The Daily PANCE Blueprint on Facebook My list of recommended PANCE and PANRE review books Interactive PANCE and PANRE NCCPA Exam Content Blueprints Sign up for the FREE Daily PANCE and PANRE email series Join theSmarty PANCE NCCPA Content Blueprint Website Get your free Trello PANCE study schedule Get 20% of any Picmonic membership by using this link Use Code "PALIFE" and get 10% OFF THE RUTGERS PANCE AND PANRE REVIEW COURSE This Podcast is also available on iOS and Android iTunes:The Audio PANCE and PANRE Podcast iTunes Stitcher Radio:The Audio PANCE and PANRE Podcast Stitcher Google Play: The Audio PANCE and PANRE Podcast Google Play Download The Content Blueprint Checklist Follow this link to download your FREE copy of the Content Blueprint Checklist Print it up and start crossing out the topics you understand, marking the ones you don't and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE. Download for PANCE Download for PANRE .et_bloom .et_bloom_optin_5 .et_bloom_form_content { background-color: #e5e0da !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_container .et_bloom_form_header { background-color: #b24a49 !important; } .et_bloom .et_bloom_optin_5 .carrot_edge .et_bloom_form_content:before { border-top-color: #b24a49 !important; } .et_bloom .et_bloom_optin_5 .carrot_edge.et_bloom_form_right .et_bloom_form_content:before, .et_bloom .et_bloom_optin_5 .carrot_edge.et_bloom_form_left .et_bloom_form_content:before { border-top-color: transparent !important; border-left-color: #b24a49 !important; } @media only screen and ( max-width: 767px ) {.et_bloom .et_bloom_optin_5 .carrot_edge.et_bloom_form_right .et_bloom_form_content:before, .et_bloom .et_bloom_optin_5 .carrot_edge.et_bloom_form_left .et_bloom_form_content:before { border-top-color: #b24a49 !important; border-left-color: transparent !important; } }.et_bloom .et_bloom_optin_5 .et_bloom_form_content button { background-color: #445a6d !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_content .et_bloom_fields i { color: #445a6d !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_content .et_bloom_custom_field_radio i:before { background: #445a6d !important; } .et_bloom .et_bloom_optin_5.et_bloom_optin .et_bloom_border_letter { background: repeating-linear-gradient( 135deg, #445a6d, #445a6d 10px, #fff 10px, #fff 20px, #f84d3b 20px, #f84d3b 30px, #fff 30px, #fff 40px ) !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_content button { background-color: #445a6d !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_container h2, .et_bloom .et_bloom_optin_5 .et_bloom_form_container h2 span, .et_bloom .et_bloom_optin_5 .et_bloom_form_container h2 strong { font-family: "Open Sans", Helvetica, Arial, Lucida, sans-serif; }.et_bloom .et_bloom_optin_5 .et_bloom_form_container p, .et_bloom .et_bloom_optin_5 .et_bl oom_form_container p span, .et_bloom .et_bloom_optin_5 .et_bloom_form_container p strong, .et_bloom .et_bloom_optin_5 .et_bloom_form_container form input, .et_bloom .et_bloom_optin_5 .et_bloom_form_container form button span { font-family: "Open Sans", Helvetica, Arial, Lucida, sans-serif; } The Daily PANCE and PANREGet 60 days of PANCE and PANRE Board Certified Review Questions and Answers delivered directly to your inbox. A new question is delivered daily with detailed explanations and answers. It's 100% Awesome and 100% FREE! SUBSCRIBE! 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 []

Classify Sand, Silt, and Clay With This Diagram

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 )

Coconut essays

Coconut essays Coconuts effectiveness shines on... Insomia, arthritis, hypertension try coconectar. Possible prevention, better yet, cure to different ailments would be the latest product fresh from the coconut tree. As markets recognize the use of herbal medicines and the like, the fame of this syrup rises up promoting effectiveness of another cocoproduct. Coconut tree, fame for being the tree of life, has proven much worth because of its parts. These are used for everyday life: the tree itself produces timber, the shell of the fruit becomes plaiting and thatch, the hardened liquid serves as meat of the fruit, and the liquid as drink often may be mixed with alcoholic beverages or sugar syrup. Now, even the flower bears effectiveness. The extracted sap, when concentrated, shows usefulness to prevent or even alleviate ailment. Since bacteria inhibited by the body become more and more resistant to antibiotics and the fame of herbal medicines levels up, the use of the said extract could be more useful. So why not try the new cocoproduct the coconectar. Mr. Jose Gonzales, a researcher in the field of coconut physics and owner of the CocoLegacy Co. Inc., personally discovered the product. It was an inspiration and of my great interest toward the study of coconut that lead me to discover Coconectar, says the Quezon-based researcher. He was already conducting researches about coconut and its effectiveness when, about a year ago, he came across the usefulness of coconut flower and did experiments on it, extracting the juice that eventually showed many components not damaging to the body. He looked for the nutrients of the extract, tried to separate what components were useful and found that there were 24 amino acids, vitamins, minerals, enzymes, growth hormones, and other substances the human body needs which were said to contribute to our resistance to illnesses. According to Mr. Gonzales, Coconectar is...

12 Angry Men Essay Example For Students

12 Angry Men Essay Every man put on trial is considered innocent until proven guilty. In 12 Angry Men Essay this theory can almost be considered false to the jurors involved in this murder case. But one man can be credited with sticking to the innocent until proven guilty theory that most likely saved a mans life. This juror must show 11 other jurors that he can prove with enough valid evidence that this boy is be wrongfully accused of killing his father. Reginald Rose shows us how that one mans integrity can prove to make a big difference in a kids life. Juror #8 can be credited with saving someones life. Under intense and hostile scrutiny juror #8 is the only juror to vote not guilty on the stabbing death of a boys father. #8 doesnt believe straight out that this boy is innocent of this crime. #8 believes that it would wrong to send a boy off to be executed without discussing it first. Jurors #3 and #10 are the most hostile of the jurors. They believe deep down that this boy killed his father. They believe that everything they heard in the courtroom holds true and they dont really want to see this kid live any longer. Juror #8 still had reasonable doubt about the murder. He doesnt want to vote guilty until he has enough evidence that this boy did indeed kill his father. Many different points are made about the boy who supposedly stabbed his father, that are cross examined well by juror #8 who still stands alone at not guilty. All of the evidence that the 11 jurors found contains flaws in them. For instance the woman who supposedly witnessed the stabbing wasnt wearing her glasses. Also the stab wound in the boys father was made so that a taller man or boy could have made that type of wound with a switchblade knife. When these key pieces of evidence becomes clearer to the 11 jurors we start to see jurors questioning there own guilty vote. #9 is the second juror to vote guilty, because he too has some reasonable doubt. As more evidence is put on the table the 12 jurors come together and decide that this boy is innocent. In conclusion, juror #8 believes that every person is innocent until proven guilty. He was given many pieces of key evidence that showed this boys guilt but the evidence was examined carefully, and as more evidence was put out more jurors believed this boy was indeed innocent bringing them all together to believe this boys innocence English Essays .

Energy resources and their impact on economy Essay

Energy resources and their impact on economy - Essay Example The reason behind this is that the utilization of these forms of energy is heavily technologically dependent and these technologies are still in the stages of infancy. There are many difficulties in implementing these technologies, some of them being their higher costs and sophistication of usage procedures to the common layman. Coal is a fossil fuel that is formed in the earth's crust from slow metamorphosis of organic matter under high temperature and pressure conditions. The rate at which coal is formed is very slow and it takes millions of years for the formation of coal. Coal originally formed from ancient plants that after death were decomposed and somehow buried under layers of sedimentary rocks. With the passage of time more and more layers of sediments formed on this decomposed plant matter. This exerted high pressure and resulted in increase of temperature. Over millions of years these physical conditions caused coal to form from the elements carbon, hydrogen, oxygen, nitrogen, sulphur, and mineral compounds that were present in the plant matter. Coal formation began during the carboniferous period known as the first coal age which spanned 360 to 290 million years before the present day. Coal deposits are fo... There exists a hairline difference between the terms "reserves" and "resources". Reserves are coal deposits that be extracted profitably with the application of technology where as resources are an estimate of the world's total coal deposits. All the resources may not be reserves because some of them are not commercially accessible. Total recoverable reserves of coal around the world are estimated at 1,001 billion tons-enough to last approximately 190 years at current consumption levels. Historically, estimates of world recoverable coal reserves, although relatively stable, have declined gradually from 1,167 billion tons at the beginning of 1990 to 1,083 billion tons in 2000 and 1,001 billion tons in 2003. The most recent assessment of world coal reserves includes a substantial downward adjustment for Germany, from 73 billion tons of recoverable coal reserves to 7 billion tons. (International Energy Outlook 2005) The coal reserves are geographically distributed as follows: Europe, in cluding all of Russia and other countries that made up Soviet Union, 44 percent; North America, 28 percent; Asia, 17 percent; Australia, 5 percent; Africa, 5 percent; and South America, 1 percent. (Speight 2003) A substantial quantity of coal consumed is burned in electric power stations to produce electricity. When coal is burned energy is obtained in the form of heat. In a power station that uses coal as the fuel, this heat converts water into super heated steam at high pressure which is made to rotate a turbine connected to a dynamo to produce electricity. The steel industry uses coke. Coke is a hard substance consisting of nearly pure carbon and is obtained by heating coal in absence of air. The coke is combined with iron

Reflection assignment for The Pearl by John Steinbeck Essay - 1

Reflection assignment for The Pearl by John Steinbeck - Essay Example For instance in La Paz the Song of the Family is sung by Juana to keep away evil; at the start, amidst the Song of the Family, the appearance of a scorpion leads to the beginning of the Song of the Evil. This therefore means that an event that is bad or unpleasant may bring about the Song of Evil to one’s mind and afterwards the Song of the Family to fight such evil as happens in La Paz and interchangeably as happens at the beginning. At other times however, songs may interplay feeding one another as when Kino is busy diving for pearls. The five things Kino wishes to do with the money from the Pearl include; a proper marriage for him and his wife in church, a harpoon, a rifle, proper clothing for his family and sending his son Coyotito to school so that he can become schooled. They are important to Kino because by wedding properly in church, his respect will increase in the community and his wife will be happy. In addition to that, if his son gets schooled, then it means he will be able to read and also open books, Coyotito will also know and it is through him that they will also get informed. These wishes reveal the fact that humans are always searching and yearning for big and better things and are never satisfied by what they have. They are insatiable and want to better their lives no matter what stage of life, race or class they are in. The five things that Kino desires to do after selling the pearl include; marrying his wife in church which represents an opulent and fashionable way of marrying, mostly practiced by the rich. Kino also wishes to buy his son a cap for yachting together with a sailor suit from the US. This represents the good life that is enjoyed by the rich and Kino simply is dreaming of what the rich do with their money. Human beings envision that buying clothes and dressing expensively is one way of looking rich. Kino also desires for his son to go to

Holdens Perception of Others in Catcher in the Rye Essay -- Catcher R

Holden's Perception of Others in Catcher in the Rye J.D. Salinger's novel Catcher in the Rye revolves around Holden's encounters with other people. He divides all people into two different categories, the "phonies" and the authentics. Holden refers to a "phony" as someone who discriminates against others, is a hypocrite, or has manifestations of conformity. A person's age, gender, and occupation, play a key role in how Holden interacts with them. Holden shows a particular liking towards children over adults. He values the innocence and authenticity of children and he tries to protect them from the phoniness and evil of the world. When he goes back to his old school at the end of the novel to give a note to Phoebe, he sees an obscenity on the wall that infuriates him. He says, "Somebody'd written `F*** you' on the wall. It drove me near damn crazy. I thought how Phoebe and all the other little kids would see it, and then finally some dirty kid would tell them-all cockeyed, about it and maybe even worry about it for a couple of days. I kept wanting to kill whoever'd written it" (201). When Holden's sister Phoebe demands that he tell her one thing that he really likes, Holden's responds saying, "I like Allie...And I like doing what I'm doing right now. Sitting here with you, and talking and thinking about stuff..." (171), showing that he's most content in the simple and innocent world of his childhood. Holden has a respect for women that he views as unnatural. He feels that his sexual desires should be similar to those of his roommate Stradlater and peer, Luce. Holden shows his confusion by saying, "The thing is, most of the time when you're coming close to doing it with a girl, a girl that isn't ... ...c artistry to "phony" artistry, Holden lost respect and his opinion of his brother changed. Holden divides people into the "phony" and authentic groups based on age, gender, and their occupations. The novel revolves around Holden's encounters and interactions with the people, which makes Holden decide subconsciously not to try to escape society through death. But, ultimately he learns that you cannot protect the innocent from the "phonies" of the world. Works Cited If You Really Want to Know: A "Catcher" Casebook.   Ed. Malcolm M. Marsden. Chicago: Scott, Foresman, 1963.   68-73. Crispell, Diane.   "The Holden Syndrome."   American Demographics.   Aug. 2001.   Online.   7 June. 2003.   Available http://www.marketingtools.com/Publications/AD/96_AD/9608_AD/9608AF01.htm Salinger, J.D.   The Catcher in the Rye.   Boston: Little, Brown, 1991.

Consuming Salt Assignment

Salt is made up of 40 percent sodium and 60 percent of chloride, is a very important part of daily lives as it helps maintain your blood’s water content, balances acids and bases in your blood, and it helps in the movement of electrical charges which are in your nerves throughout your muscles. A human being should consume about 2400 mg of salt daily. On average, humans tend to go over the recommended amount. The food industry adds 75 percent of the sodium that we humans consume. The following additives resemble plenty of sodium: color developer, which assists in the colour development in meats.Fermentation controller, which does the organic check in cheeses and baked goods. Binder, which helps to hold the meat together when being cooked. Texture aid, allows dough to expand and prevents from tearing apart. Salt is a part of the food processing. Only way to reduce your intake on dietary salt is to purchase low salt processed foods and switch from processed foods to fresh foods. Look for sodium free, very low sodium, reduced sodium or unsalted terms on the food labels of the food your purchase. You could also try avoiding food items which contain more than 180 milligrams of sodium.Another strategy to avoid dietary salt intake is look out for these food products. Example, bacon, cheese, canned vegetables, anchovies, cooking sauces, gravy, salad dressings, hot dogs, ham, sea salt, soy sauce etc. These edibles contain high amounts of sodium in them and humans should try avoiding them as much as possible. However, manufacturers have tend to lower the amount of sodium inside these edibles, so there is a possibility of finding these food products in low salt form. Always make sure to check the food label when buying any food product so that way you are aware of what you are consuming.There is also another way to approach food when it comes down to lowering your salt intake. For instance, you could go on a low sodium diet. Instead of avoiding high sodium foods you can make few adjustments. You could cook herbs, spices, fruit juices, and vinegars for flavour rather than salt. Eat fresh vegetables, use less salt than the recipe calls for, and choose low salt frozen dinners. When eating outside, ask for your food to be prepared with only a little salt. There are five unique and healthy ways alternatives to salt.It is important to know how much salt you’re consuming because consuming too much could lead to high blood pressure and other serious health issues. Sesame is an alternative to salt and it could be added in your food because of the taste similarity to salt. It is a natural product and could be used on your bread, salad, chicken and vegetables. You should choose sesame over salt because it is made naturally and it adds a lot of flavour to your food without having to worry about the health risks. Another alternative is garlic.This is very beneficial to your health and is said to be an antioxidant if eaten in small amounts and can he lp get rid of colds and congestion. It is mostly added to chicken, salad, bread, and fish to give good flavour. It is also good for your heart and body. It is recommended that you pick fresh garlic over the powder form because the health benefits are stronger in the fresh garlic. Cumin is also a very beneficial alternative to salt because it resembles a lot of properties of antioxidants and it helps maintain a healthier immune system. Cumin has a similar taste to salt but the smell and the texture are very much different.

The Impact Of Romanticism On Science Across Time - 822 Words

It seems radical and conformist to the point of truism to state that â€Å"science† was, historically, a definably romantic endeavour. The heroic, transcendent and improvement focused elements of scientific endeavour have been celebrated, but few sources directly acknowledge the conferred values of the romantic. The interdisciplinary overlap that existed before the lath eighteenth and early nineteenth century definition of scientific application, research, art and academia is rarely discussed in direct examinations of scientific methodology. Similarly, the embrace of the subjective, the social and the highly experimental amongst earlier natural philosophers sits uneasily within a thoroughly structural examination of science. It is subsequently difficult to reconcile enlightenment grounded assertions that the primary focus of science has always been the discovery of natural â€Å"rules† and their applications, through pure logic and reason. Within this paper, the influences and cultural changes that the romantic movement brought to the categorised scientific discipline will be discussed. Reference will be made to how romanticism has (and has not) helped to shape functions and perceptions of science across time. A conclusion will then be made as to the extent and nature of romantic influence, within post-eighteenth century Western science. From Descartes Cartesian Dualism onwards1, the scientific (i.e. that which perceives the world through reductive methodology) has often beenShow MoreRelatedEdgar Allen Poe And Nathaniel Hawthorne1705 Words   |  7 PagesRomanticism was a literary movement that swept through virtually the country of Europe, the United States, and Latin America that lasted from 1750 to 1870. Romanticism praised imagination over reason, emotions over logic, and intuition over science-making ways for a vast body of literature. The Romantic style resembled a fanciful character of medieval romances. This Era stressed on self-expression and individual uniqueness that does not lend itself to precise definition. Among the characteristicsRead MoreJean Jacques Rousseau s Work Essay941 Words   |  4 Pagesfact his work leaves a legacy so large that you can trace almost all modern revolutions back to his writings. In 1749 Rousseau competed for an essay prize where the challenge was to write about if the advances that society has had in the arts and sciences has brought pureness to human morals. He submitted the essay and won first prize which vaulted him into the spotlight over night. He wrote that â€Å"intellectual advances had brought not moral purification but corruption, not improvement but decline†Read MoreEssay on Impact of the Industrial Revolution on History2331 Words   |  10 Pagescommunication, science, and medicine took place altering society and ways of life. People were changed along with culture (Miller, 489-97). However, throughout these ever flexing times, one thing remained nearly consistent-literature. Of course, even the arts were revolutionized. During the Industrial revolution literature, as it usually does, reflected the dramatic, social, and economic developments taking place throughout the world. Artists revealed in their work a sense of the rapidly changing times andRead MoreAmerican War Of Independence And The French Revolution Essay1755 Words   |  8 Pages Romanticism as a movement is as rebellious as its content. Lynch and Stillinger attempt to define it historically rather than continuously, naming it the â€Å"shortest †¦ period in British literary history† (3). They place it within the timespan of 1785 to 1832, beginning between the American War of Independence and the French Revolution and ending with the passage of the Reform Act in British Parliament. In this time of reflection and change, authors re-examined the previously discarded medieval romancesRead MoreA Well-known Literary Gothic, Frankenstein, by Mary Shelley1120 Words   |  4 PagesFrankenstein, written by Mary Shelly, introduced many new themes and ideas while it became one of the most well know literary gothics of all time. At the young age of 19, Mary Shelly began to write the novel of Frankenstein, soon following Mary published Frankenstein in March of 1818. According to biography.com â€Å"Mary would finishes writing Frankenstein within a year of first writing it due to a bet with Percy Shelley, her husband†. Mary was a girl who engrossed herself in her writings and wasRead MoreEffects of Realism in Literature and Art2037 Words   |  9 Pages Two significant time periods in literature and art were the periods of Romanticism and Realism. Before Realism was really brought into literature, Romanticism was the style of choice. Authors of the Romanticism phase generally depicted their characters as heartfelt and full of intuition. These characters were most often known to follow their own hearts instead of their logic. Authors were responsible for building characters who â€Å"placed greater emphasis on the value of intuition and imaginationRead MoreTaking a Look at Landscape Paintings1821 Words   |  7 Pagesgroup a passing fad or has this group of artists remained firmly grounded in the history of American painting? Though the origins of the name ‘Hudson River School’ are a bit of a mystery, (most commonly claimed to be a phrase coined from a New York Times journalist), this group of dynamic painters was an artful force of nature. The two most notable artists leading this movement were Thomas Cole (often co nsidered the founder) and Frederic Edwin Church. Cole was born and raised in Bolton, EnglandRead More History Of Music Essay2522 Words   |  11 Pagesthemselves in the arts of the time also. The common question â€Å"Does art imitate life, or does life imitate art?† when inspected proves rhetorical: they are parallel mirrors which reflect each other. W.H. Auden best expressed this when he said, â€Å"A verbal art like poetry is reflective; it stops to think. Music is immediate, it goes on to become.† Tracing the course of musical development through history shows how closely music (of all the art forms) in particular represents the time in which it was writtenRead MoreNaturalism Literary Period2601 Words   |  11 Pagesnaturalization after the Civil War, where many in bustling developing cities suffered from poverty and its poorly prevented consequences. The American naturalist movement was important due to the introduction of themes involving popular apprehension during this time period including; man vs. nature, man vs. society, sex trade, wasted potential due to uncontrollable forces, and man’s animalistic features such as basic instincts. Naturalism is a literary movement that developed into a literary style consisting ofRead MoreMovie Review : Star Wars1971 Words   |  8 PagesWilliams could not manage. Star Wars is a movie about action, science fiction, adventure, and contains a very masculine tone overall; but this does not mean that it lacks of a feminine touch . The romantic themes played across the movies give that feminine touch that is always needed and in this case very appealing to the movie and the audience. The score of the Star Wars movies is the perfect example to prove that musically, romanticism is still used in this era. There are numerous romantic themes

Irony in Hamlet Essay - 3148 Words

Many literary critics point to the considerable irony that exists in Shakespeares Hamlet. This paper examines the play for instances of irony and surveys their interpretation by critics. Howard Felperin comments on Hamlet’s â€Å"ironic consciousness† of the fact that he is unable to quickly execute the command of the ghost: Eliot’s unhappy judgments are worth considering here, if only because they are based on an intuition of Shakespeare’s creative process that is so near to and yet so far from the one presupposed in the present essay. He imagines Shakespeare grappling with his archaic sources in the attempt to naturalize, rationalize, and psychologize – generally speaking, to streamline and neoclassisize them – and†¦show more content†¦(1) The play begins with the changing of the sentinels on a guard platform of the castle of Elsinore in Denmark. Recently the spectral likeness of dead King Hamlet has appeared to the sentinels. Tonight the ghost appears again to Barnardo, Marcellus and Horatio, a very close friend of Hamlet. Horatio and Marcellus exit the ramparts of Elsinore intending to enlist the aid of Hamlet, who is home from school, dejected by the â€Å"o’erhasty marriage† of his mother to his uncle less than two months after the funeral of Hamlet’s father (Gordon 128). There is a post-coronation social gathering of the court, where Claudius pays tribute to the memory of his deceased brother, the former king, and then, along with Queen Gertrude, conducts some items of business, for example dispatching Cornelius and Voltemand to Norway to settle the Fortinbras affair, addressing Polonius and Laertes on the subject of the latter’s return to school abroad. Right at the outset of the drama , there is irony exhibited in the manner in which Shakespeare characterizes King Claudius – he is simply stupendous – and yet, shortly hereafter, he is revealed as a truly evil, thoroughly diabolical sort. George Lyman Kittredge, in his book, Five Plays of Shakespeare, describes the Bard’s excellent characterization of Claudius: KingShow MoreRelatedIrony in Hamlet970 Words   |  4 PagesIn Act 3, Scene 4, Hamlet is asked by his mother, Gertrude, to reveal what was making him act like he was crazy. Hamlet believes that Gertrude is truly having a heart to heart with him and really desires to put Hamlet’s troubles to ease. However, what Hamlet does not know is that Gertrude allows Polonius to hide being the arras to overhear their conversation for King Claudius. As the audience, we are aware that Polonius is in the room with Gertrude and Hamlet, but Hamlet is unaware of his presenceRead MoreEssay on Irony in Hamlet1749 Words   |  7 PagesIrony in Hamlet  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚   This essay will discuss the issue of irony in Hamlet by dealing with the problems that arise as a result of Hamlets attempt to avenge his fathers death. One of the central problems is the clash between Hamlets overpowering need to believe in the ghost of his father, who is the authoritative figure in his life, and the awareness that he lacks empirical knowledge of the truth. In trying to achieve this knowledge, Hamlet sets out on a mixed mission of accusation,Read MoreEssay on Hamlet – the Irony1973 Words   |  8 PagesHamlet – the Irony  Ã‚        Ã‚  Ã‚   The existence of considerable irony within the Shakespearean tragedy Hamlet is a fact recognized by most literary critics. This paper will examine the play for instances of irony and their interpretation by critics.    In his essay â€Å"O’erdoing Termagant† Howard Felperin comments on Hamlet’s â€Å"ironic consciousness† of the fact that he is unable to quickly execute the command of the ghost:    Our own intuition of the creative or re-creative act that issuedRead MoreTheme Of Irony In Hamlet732 Words   |  3 PagesIrony is a literary device that signifies the opposite of its intended meaning. It is used for humorous or emphatic effect. A rhetorical device that conveys a message that is clear to the audience but unknown to the character. There are three types of irony which include: 1). Dramatic irony : Occurs when the audience knows something that the characters do not. 2). Situational irony : Occurrence of unintended circumstances of events. 3). Verbal irony: Occurs when the speaker says the opposite ofRead MoreDramatic Irony in Hamlet Essay2946 Words   |  12 Pages     Ã‚  Ã‚   Dramatic irony in the Shakespearean tragedy Hamlet has long been the subject matter of literary critical reviews. This essay will exemplify and elaborate on the irony in the play. David Bevington in the Introduction to Twentieth Century Interpretations of Hamlet identifies one of the â€Å"richest sources of dramatic irony† in Hamlet: Well may the dying Hamlet urge his friend Horatio to â€Å"report me and my cause aright To the unsatisfied,† for no one save Horatio has caught more than a glimpseRead MoreEssay about Dramatic Irony in Hamlet1199 Words   |  5 PagesDramatic Irony is Hamlet What is Dramatic Irony? -Dramatic Irony is when the words and actions of the characters in a work of literature are known to the audience or reader, but they are not known to certain characters in the story. The reader or audience has a greater knowledge of many of the characters themselves. -Shakespeare employs dramatic irony in many of his tragedies, so that the audience is engaged, and so they are able to witness characters errors in their action, predict the fateRead MoreEssay about The Irony in Hamlet by William Shakespeare659 Words   |  3 Pages The Irony in Hamlet In the book Hamlet by Shakespeare, irony is used numerous times in order to give the reader insight on what is going on. As stated in the Merriam-Webster dictionary, irony is an action that is understood by the audience but not by the characters in the play. If this strategy were not included in this drama, it would take away the whole purpose. This play would consist of no suspense and would be extremely boring to the reader because the characters would know as much as theRead MoreEssay about The Profound Irony of Shakespeares Hamlet 2407 Words   |  10 PagesProfound Irony of Hamlet      Ã‚  Ã‚   Irony, or the â€Å"hiding what is actually the case† in order to â€Å"achieve special rhetorical or artistic effects† (Abrams 135), is amply demonstrated in Shakespeare’s tragedy Hamlet.    In his essay, â€Å"Reforming the Role,† Mark Rose discusses the irony involved with the ghost’s appearance:    The ghost binds Hamlet to vengeance, but there is another and more subtle way in which the spirit of his father haunts the prince. It is one of the radical ironiesRead More Use of Irony in A Streetcar Named Desire and Hamlet Essay706 Words   |  3 Pages In both A Streetcar Named Desire and Hamlet, Tennessee Williams and William Shakespeare, respectively, demonstrate their abilities to create engaging plays which work on several levels in order to produce the desired effect. One of the most important characteristics of these plays is the playwrights success in using their words to create the worlds surrounding their works. Both Shakespeare and Williams effectively use irony in the aforementioned plays, both in the plot Read MoreWilliam Shakespeares Hamlet1172 Words   |  5 PagesHamlet is a complex story that uses many literary devices to help develop the characters in Hamlet. One dominant device is irony. The main plot of the story revolves around irony. Hamlet is a witty character and loves to use irony. Hamlet’s use of irony displays how he insults people, discovers useful information, and reveals his true character. The use of irony in this story helps to add depth to each character, which is why Hamlet is one of Shakespeare’s most complex stories. There are three types

The Black Civil Rights Movement - 2150 Words

The Black Civil Rights Movement of the 20th century pushed for and achieved different levels equality through its many prominent activists. Prior to the movement, millions of Black Americans faced brutal abuse and segregation with little to no government action taking place against such wrongdoings. The movement included passionate advocates for black equality such as Rosa Parks, Dr. Martin Luther King Jr. and Malcolm X. These civil and human rights activists inspired millions of Americans to join in the cause for justice and equality for all through their many unique styles. Malcolm X was one prominent civil rights activist known for his fiery demeanor and controversial beliefs. The underlining aspect in Malcolm’s life was that he adamantly believed in was the importance to the devotion of Islam. Through the religion Islam Malcolm X identified himself as a human being and used his knowledge to inspire others. Malcolm X’s relationship with Islam advanced him as a civil rights activist among black Americans, which promoted social change. In his childhood, Malcolm X experienced blatant racism towards his family. Malcolm X was born Malcolm Little in Omaha Nebraska on May 19, 1925. He was the son of Baptist Minister Earl Little and his mother Louise Norton Little and one of four children. Malcolm Little’s father preached that black Americans deserved the same rights as white Americans, but as a result of the times blacks made less money and were persecuted by the KKK. MalcolmShow MoreRelatedThe Black Civil Rights Movement1120 Words   |  5 Pagessociety. From women to gay rights but it is undeniable that the black civil rights was the bloodiest and most violent among them. Two methods were used to bring message to the people: the violent or the non-violent way. Most activists and civil rights group like Martin Luther King Jr., NAACP (National Association for the Advancement of Colored People) and CORE (Congress of Racial Equality) at that time chose for the latter but one did not follow that lead: the infamous Black Panthers Party. Each methodRead MoreThe Black Civil Rights Movement1873 Words   |  8 Pagestypical experience of an African American throughout the twentieth century, but believe it or not this kind of cruel behavior stills exists in the United States to this very day. Even after all the black civil rights movement, Blacks are continuously getting oppressed, especially by whites, of their equal rights which completely go against the most rudiments of any society’s rules and are entirely unethical. We have all heard Martin Luther King Jr.’s final line from his famous â€Å"I Have a Dream SpeechRead MoreThe Black Power Movement And The Civil Rights Movement1468 Words   |  6 PagesThe Black Power movement began towards to the of the Civil Rights Era. The Black Power Movement began in the 1950s and 1960s, many African Americans grew tired of the ineffective, peaceful protests so they turned to violence. Although it was not a formal movement and it contributed to a big turning point in history. The goal of the Black Power movement was to gain equal rights with whites. Even though it was violent many people thought it was necessary to the equal rights African Americans deservedRead MoreThe Black Civil Rights Movement Essay1088 Words   |  5 PagesThe Black Civil Rights Movement The Black civil rights movement emerged as a mass movement in the 1950s but its long term origins go back much to the abolition of slavery and the failure of States to implement the 14th and 15th amendments which guaranteed ex-slave rights as defined in the constitution. Just after the end of slavery the reconstruction era began, it allowed blacks many opportunities thatRead MoreBlack Power And The Civil Rights Movement1675 Words   |  7 Pagesthat the growth of Black Power was the most important factor in the weakening of the civil rights movement in the 1960s? Black power is a political slogan that was aimed to promote the ideas of the black racial group. There have been mixed views on weather it weakened the civil rights movement or strengthened it, this involved many factors. Some of the thing’s that weakened the movement was the use violence, organisation and leadership and the CORE ideas and the message of the black power. HoweverRead MoreThe Chicano And Black Civil Rights Movement1610 Words   |  7 PagesA significant struggle during the Chicano and Black Civil rights movement was employment, and discrimination in the workplace. First, a case pertaining to this issue during the Chicano movement was Bernal v. Fainter in the year 1984. This was a case where the Supreme Court of the United States  «Ã‚  ruled that the Equal Protection Clause prohibited the state of Texas from barring noncitizens from applying for commission as a notary public. » The result of this case came about, as the court realized,Read MoreThe Black Peo ple And The Civil Rights Movement1741 Words   |  7 Pagesthe history of black people in America, we have come a long way. We still have a long way to go, even though some progress has been made. Black people started as slaves, who were the victims of rape, murder, and many other brutal things. Then came the civil rights period where most black people were free persay, but still lacked basic human rights. Today, black people in America are living in a place that appears to be equal and racially unbiased. This however, is not true. Black people are stillRead MoreThe Black Man And The Civil Rights Movement985 Words   |  4 Pagesthere was a â€Å"Black Lives Matter†, a movement to stop the injustice that is happen to African American. Mrs. Morial generation went through the Civil Rights Movement, which was about trying to dismantle the Jim Crow laws created to keep people of color enslaved by placing barriers and depriving them of being free to live as equals that are not segregated from the mainstream. In addition, causing them to have to be socially isolated in concentrated areas; Therefore, the Civil Right Movement was in supportRead MoreBlack Power And Civil Rights Movement1580 Words   |  7 PagesThe nuanced historical debate over the concept of black power divides Civil Rights movement historians into two distinct categories. One grouping of historians interpret the issue of black power as a vague top-down strategy utilized to incite controversy. The other group of historians promote a bottom-up approach to black power, arguing that the statement reflected the already present ideals of the black community and best encompasses the path to their liberation. The former group likewise criticizesRead MoreBlack Americans And The Civil Rights Movement Essay1505 Words   |  7 PagesIntroduction The Civil Rights Movement affectively gained black Americans use of public accommodations, the right to vote, fair employment and housing opportunities. Although, legislation had been passed the spirit of racism and segregation remained in American society. Gaps between black and white societies widen leaving black American men public enemy number one. Historically black communities are plagued with poverty, unemployment, violence and high incarceration rates. Subsequently, black children have

Supply Chain Management in Hospital Free Essays

string(114) " resident dentist and aided by visiting dental surgeons, who can undertake and perform complex dental procedures\." Pantai Hospital Ipoh (PHI), registered under Paloh Medical Centre Sdn. Bhd, was established in year 1996 owned by Pantai Group, part of IHH Healthcare Berhad; one of the most significant healthcare operators in the world that provide premium healthcare services in Asia, Central and Eastern Europe, the Middle East and North Africa. The hospital is strategically located in Ipoh and easily accessible within a 5 minutes drive from the North-South Highway Interchange and the Ipoh City Centre. We will write a custom essay sample on Supply Chain Management in Hospital or any similar topic only for you Order Now Pantai Hospital Ipoh was started to serve the local communities of Ipoh, and has since grown to become one of the private premier healthcare providers in Perak, and the northern region of Malaysia. Pantai Hospital Ipoh started with just only 76 beds, and now has 180 beds and 82 consultant specialists, providing quality care and treatment aided by qualified nurses and other allied healthcare professionals. In partnership with various health insurers and corporate organizations, PHI has established itself as a preferred provider, allowing greater and easier access to its healthcare services, which extends beyond just a single hospital through the extensive network of more than 10 Pantai and Gleneagles Hospitals, all part of IHH Healthcare Berhad. Through the use of appropriate technology and skills, Pantai Hospital Ipoh is firm in its vision to be the trusted professionals of healthcare delivery, from prevention, detection to treatment and care, when it matters most. Apart from providing a wide range of modern facilities and the expertise of many consultant specialists, the hospital is staffed with warm and friendly personnel who are dedicated to give our customers the personalized attention and quality care they deserve. Central to its commitment towards quality healthcare, PHI strives to provide excellence in service and its future will be built on welcoming change innovation, today and tomorrow. In year 2005, Pantai Hospital Ipoh has successfully obtained ISO 9001:2008. The Hospital continuously seeks to improve the organization’s performance and the outcome of cares. With this, PHI has started the adoption the best and safe practices for all the clinical and non-clinical areas which guided by Malaysia Society in Healthcare Quality. Since the inception of Pantai Hospital Ipoh in 1996, the hospital has increased tremendously the disciplinary medical and surgical specialties. Listings below are the specialties provided by Pantai Hospital currently: †¢ Anaesthesiology †¢ Cardiology †¢ Colorectal Surgery †¢ Cardiothoracic Anaethesiology Cardiothoracic Surgery †¢ Dental / Oral Surgery †¢ Dermatology †¢ Ear, Nose Throat Surgery (ENT) †¢ Gastroenterology †¢ General Surgery †¢ Haematology †¢ Immunology †¢ Infertility †¢ Internal Medicine †¢ Nephrology †¢ Neurology †¢ Neurosurgery †¢ Orthopaedic Surgery †¢ Obstetrics and Gynaecology †¢ Ophthalmology †¢ Paediatrics †¢ Pain Management †¢ Plastic and Reconstructive Surgery †¢ Psychiatry †¢ Urology †¢ Rheumatology †¢ Respiratory †¢ Radiology To facilitate the services mentioned above, Pantai Hospital Ipoh has established the following facilities and services: a. 24hrs Accident Emergency To provide 24-hour services for emergency as well as less urgent cases that uses a triage system to determine the severity of each case, to ensure that priority is given to patients with the most urgent medical need. b. Ambulance Services Our ambulance service provides transportation of patients throughout Malaysia with includes: †¢ 24-hour Prompt Emergency Response-Time †¢ Specialized transport services †¢ Inter-hospital / inter-clinic transfers †¢ Doctor / nurse escort to provide immediate in-ambulance care †¢ Ambulance pick-up for calls within Ipoh City c. Physiotherapy Rehabilitation Centre The centre offers a wide range of rehabilitation programmes to help patients to achieve functionality and mobility. Amongst the broad spectrum of services include preventive care, and the treatment as well as management of movement disorders arising form medical conditions and lifelong disabilities. d. Imaging Service Pantai Hospital Ipoh has a complete range of imaging services including Multi-slice CT Scanner, Magnetic Resonance Imaging (MRI), X-rays, ultrasound doppler scans and mammography. The department operates 24 hours, serving in-patients, outpatients as well as patients referred from external healthcare providers. e. Dietetic Counselling PHI’s dietitian provide individualized programs and counseling for patients, based on the doctor’s recommendations and patient’s condition. The dietitian also ensure that all food served to patients are low in fat, salt and sugar and ultimately meet the specific nutritional requirement of individual patient’s medical conditions and the doctor’s diagnosis. f. Pharmacy Service The hospital’s pharmacy is open 24 hours, dispensing medications for both inpatients and outpatients. Pharmacy staff also offer Patient Counselling Service; to advice patients on the correct way of taking as well as storing their medications. This service also extended to bed-side counseling for inpatients. g. Pathology and Laboratory Services PHI’s pathology services are managed and provided by Pantai Premier Pathology Sdn Bhd, The lab offers a full range of laboratory services and tests that are performed by skilled and experience personnel with sophisticated equipments. Pathologists are available for clinical consultation on concerns related to appropriate test utilization, assistance in test result interpretation or any other concerns which may occur in the course of patient management. h. Diagnostic and Endoscopic Centre The centre provides treadmill to perform Stress Test to facilitate cardiac assessment; nad machines for ECG and Echo Cardiograms as well as Carotid Duplex to assess arterial blockages. The centre also carries out Dobutamine Stress Echo as an alternative method for those patients whose condition makes them unsuitable to undergo a Stress Test but urgently need cardiac assessment and 24-hour Ambulatory Blood Pressure Monitoring as well as Holter Monitoring which provides round-the-clock ECG monitoring especially for patients who complain of palpitations and/or sudden blackouts. The Endoscopic Centre facilitates varies type of scopes including gastroscopy, colonoscopy bronchoscopy, cystoscopy and ERCP. i. Brain and Nerve Centre The centre is equipped with machines which carry out the following procedures: †¢ Electroencephalogram (EEG) †¢ Nerve Conduction Study (NCS) †¢ Electromyogram (EMG) †¢ Visual Evoked Potential (VEP) Study †¢ Brain Auditory Evoked Potential (BAEP) Study j. Sleep Study Sleep Studies are conducted is a sleep laboratory; help doctor confirm certain sleep disorders. k. Haemodialysis Centre The Putri Dialysis Centre is a well equipped centre that is designed to provide patients with a comfortable environment including waiting areas for accompanying family members, light refreshments and audio-video entertainment. l. Dental Services PHI has a well equipped dental clinic with a resident dentist and aided by visiting dental surgeons, who can undertake and perform complex dental procedures. You read "Supply Chain Management in Hospital" in category "Essay examples" m. Health and Wellness Centre It provides a wide range of premium screening programmes that will equip the customer with the knowledge and awareness to help to maintain optimum health. . Parking Valet Service Pantai Hospital Ipoh offers complimentary parking services, further enhanced by a free Valet Service, which operates during the following hours: Monday to Friday- 7. 00am – 7. 00pm Saturday- 7. 00am – 5. 00pm Sunday- 9. 00am – 5. 00pm o. Concierge Service Complimentary concierge service s are provided for patients who discharged from the hospital, to help to transport their bags and belongings from their respective ward to the lobby, where Customer Care Assistant are at hand further assist the patient to alight their mode of transportation. . Financial Counselling Financial Counselling service was initiated to assist patients and their family members in managing the medical cost incurred from seeking treatment at Pantai Hospital Ipoh by offering cost estimation prior to procedure and assistance in getting financial aid from Employees’ Provident Fund (EPF) and relevant financial institution, should be arise. q. Other Services Other services that provide by Pantai Hospital Ipoh include; †¢ Hospital Cafetaria – certified halal providing a variety of local and international cuisine †¢ Bread Legend – offering wide choice of breads and buns †¢ Convimart – a mini convenience store selling magazines, snacks, drinks, gifts and fruit baskets. †¢ Natural Health Farm – Offering various health products that promote better health and longevity of human body, skin and hair. †¢ Ipoh Medical Supplies – offering a range of common medical supplies and equipment. †¢ Banking facilities – An ATM machine is strategically located at the hospital lobby. Internet Access – provides free WIFI access through-out the hospital for everyone Patient that require for inpatient treatment could be admitted through the Emergency Department or through Specialist Consultant or General Practitioner Clinic. Pantai Hospital Ipoh offers a range of room types, to cater individual needs and demands; however theses are subject to availability and if a particular room type is not available, option will be provided and efforts will be made to have the requested room type provided as soon as it is available. Below are the room rates which are subject to 6% Government Tax. Meals are complimentary to all patients. Room TypesRates Per Day (RM) †¢ Executive Deluxe Room330. 00 †¢ Deluxe Room250. 00 †¢ Single Room160. 00 †¢ Double-Bedded Room110. 00 †¢ Four-Bedded Room60. 00 †¢ ICU / CCU150. 00 †¢ Isolation Room 150. 00 †¢ Nursery25. 00 †¢ Day Case35. 00 †¢ Incubator 105. 00 Supply chain is the lifeblood of a healthcare organization. The supply chain process is the essential link for all programs and services offered by a hospital, and hence any improvement in managing the supply chain can positively impact bottom line profitability of any hospital’s operations. As most departments in Pantai Hospital Ipoh depend heavily on supplies, materials management can ease or cramp a hospital’s operations. From a low cost needle to a high-end orthopaedic implant, special instruments or pieces of linen, supplies are indispensable during a patient’s stay at the hospital. Quality care cannot be provided on time unless required material is available in adequate quantity. As such Pantai Hospital Ipoh, has established a purchasing department to centralize the purchasing all medical supplies, medical equipment and instrument, consumables, stationeries and toiletry within the hospital. The department not only to purchase but to perform price negotiation to ensure every item that purchased is the lowest price but of course without comprising the quality. Together with Store Department, Purchasing Department determines the minimum and maximum level for every single item for re-ordering purposes. To determine the minimum and maximum level, a few factors will be observed; the usage of them item / product, location of the supplier, the availability of the item / product in the market and delivery schedule. Thus, the purchasing needs to communicate with all the relevant departments and the supplier to ensure that is no shortage of all supplies and at the same time to ensure our store department is not holding too much stock. At our Pharmacy Department, the department also performed the similar task as purchasing department but limited to pharmaceutical products. This is because pharmaceutical products need specialized person who is the pharmacist with the consultation of specialist consultants to understand the drugs usage and its complication. Pantai Hospital Ipoh not only subscribes to patented / original drugs but also generic drugs that provide the same effectiveness comparing to the original drugs but much lower in price. As generic drugs are less expensive, it could help to lower down the overall treatment cost that could enjoyed by the patient. The supply chain does not stop at the purchasing and pharmacy department. It is important that the purchased medical supplies and drugs are delivered to all the respective wards, clinics, operation theatre and other relevant departments to ensure no interruption of patient care. Hence, a supply chain system has been developed from early stage of sourcing and ordering to the patient consumption. As mentioned earlier, sourcing and ordering is done by purchasing and pharmacy department. Once the goods arrived to hospital, the respective store; general store and pharmacy store, will received their goods. The respective store will entered the stock into our Hospital Information System, and from there the stock will be arranged in the store systematically. The wards, departments and operation theatre will requisite their items based on their pre-set minimum and maximum level. For those high activities department for example operation theatre, they are allowed for three time requisition a week and as for less or average activities, will allowed to requisite their stock two times a week. As if any urgent requisition, store will allowed with valid reason. The receiving wards or departments will then store their stock in their respective store and label all stocks. The ward or department will consume the item(s) based on ‘first in first out (FIFO)’ method to ensure no there is no expiry products. Ward and departmental clerk will ensure all the availability of the stocks is at a path level. At Pantai Hospital Ipoh, we also understand that supply chains may be more efficient and inexpensive by outsourcing of certain services. The main services that outsources are housekeeping. UMC Service Master, a well-known company in healthcare providing housekeeping services, has been appointed to manage housekeeping in the hospital. The programs offered by UMC Service Master has successfully provided measurable results by improving quality, containing costs, training and motivating employees and minimize risks. The company also takes over some of the nurses’ daily routine jobs for example bed making for inpatient and discharge patient. This enables the nurses to concentrate on the more critical matter which is patient care. Beside the purchasing, stock management and outsourcing, Pantai Hospital Ipoh also involved in a supply chain with international and local insurance companies and managed care organization or third party administrator. The insurance companies, managed care organization and third party administrator will signed a partnership agreement with the hospital to become panel hospital and to provide cashless healthcare facilities for their policyholders that are covered under their purchased policy. The treatment requested could be outpatient, daycase and/or inpatient depending on their policy terms and conditions. The process started when a patient requested for treatment; front office staff will request a guarantee letter (GL) from the respective insurance company, managed care organization or third party administrator by providing an initial medical report to them. The company will process the claim based on the initial report and if the case is covered, the company will issue the hospital a guarantee letter for payment. If the patient was admitted, hospital would to provide discharge summary and the total bill to the respective company for payment guarantee. Some companies do cover for the post-hospitalization up to 60 days of discharge. Our Marketing department also practices supply chain in their marketing activities. They has established a programme known as ‘Pantai Putri Member of Affiliation Program (PPMAP)’ to recruit general practitioner (GP) in Perak region to become part of PPMAP member. The objective is to obtain referral of patients to the hospital from the GPs, as Pantai Hospital Ipoh understands that GPs could be a good source of generating business. In return of the referral, Pantai Hospital will support their clinic by providing them on-going education and promoting their clinic by recommending to the local public and during any road show organized by Hospital Pantai Ipoh. This will generates a strong back to back support and mutually benefited. For the past few years, there was a lot of development and improvement taken place in Pantai Hospital in related with supply chain management but the hospital is still facing challenges in managing the effectiveness of supply chain system. The challenges can be classified at below: a. Lack of Product Management b. Limited Sourcing and Services c. Outdated IT systems d. Lack of Inventory and Distribution Management Lack of Product Management First, the hospital could categorize the products in terms of cost, criticality and other criteria. For instance, bed linen may be less critical and represent a low cost to the hospital; paracetamol may be urgently required but inexpensive; while specialist cancer drugs may be both urgent and costly. This product categorization will dictate supply chain design. For example, drugs and medical equipment might be ordered directly from the manufacturers’ own stock, often at short notice and in unpredictable quantities, requiring storage relatively nearby. Medical supplies, on the other hand, will be subject to a more regular supply chain, providing greater flexibility in responding to emergencies. Secondly, hospital and specialist doctor should work under one vision and direction in providing the best service at a reasonable cost. In heealthcare industry, we understand specialist consultants are independent contractors with considerable clout and specific preferences for supplies and some variations in supplies and processes are accommodated to ensure patient safety. These Preference Items accountable for more than 50% of total medical supply spending in PHI. This provide an opportunity for supply chain savings in the area of physician buy-in especially with respect to changes in purchase and use of high-cost clinical items. It is commonly perceived that physicians are resistant to change. He points to the fact that data which supports the decision to use a particular supply can go a long way in convincing a physician to use a particular supply. PHI could establish a product evaluation and review committees which consist of clinical experts, purchasing and finance personnel to overcome the problem. The purpose of the committee is to decide to purchase and universally adopt cost-effective items for use within all hospitals and the decision making is by team consensus. The finance and purchasing personnel could educate the clinical experts on the financial impact of various supplier options. Therefore, the use of consensus, instead of majority rule, in the decision making process minimizes any postsourcing disagreement and results in the high compliance rate and buy-ins from all physicians. This will helps purchasing to further negotiate and obtain lower price from the supplier as the hospital is now buying exclusively from the supplier only with bigger quantity. Thirdly, in PHI product cost assessment, hospital must evaluate the ‘total cost’ rather than just ‘unit product cost’ in determining the types of products to purchase. The cost of a product is evaluated from the types of raw materials used for the product and how this will impact the disposal cost associated with the product. For example, the use of analog X-Ray equipment may have a lower unit cost initially, but the tool utilizes X-ray film that contained mercury, may result in a significant disposal fee which needs to be calculated in the total cost. Hence, hospital should to considering total cost has resulted in significant cost savings. Sourcing and Services Effective management of the external supply chain typically covers every facet of procurement activity – such as supplier selection, contract negotiation, planning and implementation, distribution and delivery – while taking factors such as risk, reward into account. There are 9 Pantai Hospital and 2 Gleneagles Hospital in whole Malaysia, as such Centralize Group Purchasing is possible. Centralize Group Purchasing have provided significant cost saving opportunities for hospitals by taking advantage of economies of scale in purchasing from select vendors for many hospitals at once. Cost saving includes better contract terms, price reduction, rebates and overhead costs. Purchasing Systems and Technology Pantai Hospital Ipoh has an outdated Hospital Information System (HIS) to manage their supply chains, known as Procare. These outdated data management systems do not have the capacity to meet the changes and needs today. The challenge faced by PHI is how to seamlessly transition the wealth of data without disrupting the existing purchasing system and inter-departmental integration. One identified area in supply chain structure that PHI could further improve on is in the area of purchasing systems and technology. PHI can explore new technologies and leverage on what has been successfully done in other Pantai hospitals to enable staffs to access faster, more valuable and easier access to necessary supply information when ordering. At time hospital spend significant resources to reconcile purchase orders and invoices due to mismatched item numbers and units of measure. Another challenge that PHI faces is in identifying personnel capable of understanding the old technology used by the existing IT systems to effectively move it to a newer platform. Although this is not a unique problem faced by PHI, there is no industry standard that can easily help provide a cost- and time-effective solution. Hence, the technology upgrade for PHI’s purchasing system remains an area to be addressed and recognized by the management. Once improved, the flexibility of the system will allow KP a more detailed view of its purchasing process and use of products, which will in turn provide better insight into creating a more effective cost structure. Inventory and Distribution Management It is critical for PHI to maintain a sufficient level of inventory at all times to ensure the needs of patients are always met. Failure to do so could result in the loss of life. In a hospital, managing its inventory is not easy as there are thousands of inventories, both medical and non-medical products. The distribution mechanism is also very important to ensure the product(s) is delivered to the end user in the hospital. PHI’s general store often mismanaged of the inventories, the current inventory system is ineffective and inefficient. The challenge that PHI is facing is that the management is unable to provide a sufficient storage and no proper and experience staff to head and managed the store. To overcome the issue, first PHI need to engage an experience staff who has know about inventory management and to review and examine the overall existing available storage space to maximize the current storage with the assistance of shelf, cabinet or compactor. Secondary storage could be developed to separate the medical and non-medical items. PHI could incorporate radio frequency identification technology (RFID) into its inventory management system. RFID systems have a broad range of potential benefits for the health care industry. These include medical device and asset tracking, improved visibility of inventory and supply chain management, and improved patient safety by preventing drug counterfeiting. In our current distribution, the store depend on the departmental clerk to requisite their stock. As mentioned early, some departments / patient care units replenish their stock 3-times a week but some are only 2-times a week. Especially, the patient care unit, inventory management for them is a hassle as they are focusing on patient care. At time, the unit forgot to replenish their stock; patient care was affected due to unavailability of the product. This challenge often faced by the medical staff. The distribution system should be improved to be more effective to prevent and to solve the issue. The general store could establish a system whereby there will be person in the store to monitor the availability of the stock via our Hospital Information System – Procare and since minimum and maximum ordering has already been fixed, the general store staff could deliver the stock(s) which is under path level to the respective patient care unit. The store would have better control of overall inventory and distribution and improvement activities could be carried out more efficient and effective. A good inventory management programme is always patient-centred. While inventory is concerned with financial issues, hospitals are in the business of serving patients. Although technology has an important role to play, the emphasis should be on using it in a way that makes a difference to the quality of patient care. Automating inefficient processes may not yield any productive result. Processes should be reengineered to make them more patient-friendly. Cost-effectiveness, time consciousness and safety are key drivers of a patient-centered approach. Once this goal is clear, technology can support and drive the efforts towards realizing efficiencies and improving the quality of health care services. Reference: 1. Pantai Hospital Ipoh’s company profile (K. K. L. I. U. No. (0320/2012/C) 2. Asian Hospital Healthcare Management – article on Materials Management in Healthcare ‘A patient-centred approach’ 3. Supply Chain Management in Hospital: A Case Study by Samuel Toba, Mary Tomasini, Y. Helio Yang, San Diego State University, San Diego, CA – published in California Journal of Operations Management, Volume 6, Number 1, February 2008 How to cite Supply Chain Management in Hospital, Essay examples