Ebay Culture Essay

What is organizational culture? This indefinable combination of values, beliefs, and practice that a corporation posses, which makes the difference between surviving and thriving, succeeding and failing. Most large corporations typically have a strong culture with values and norms appropriate to the organizational purpose. In a big organization, sub-cultures also exist, division to division, office to office. In this part of this group assignment I will describe the organizational culture of one of the most famous internet companies in the world, which is also the largest marketplace in the internet – EBay. Many articles and books have been written in recent years about culture in organizations, usually referred to as â€Å"Corporate Culture. † The dictionary defines culture as â€Å"the act of developing intellectual and moral faculties, especially through education. This paper will use a slightly different definition of culture: â€Å"the moral, social, and behavioral norms of an organization based on the beliefs, attitudes, and priorities of its internal community. Every organization has its own unique culture or value set. The culture of the organization is typically created unconsciously, based on the values of the top management or the founders of an organization. Organizational culture has been defined as â€Å"a pattern of basic assumptions, values, or beliefs and norms of behavior. According to O’Reilly, organizational culture defined as the values shared by members of an organization. These basic values may be thought of as internalized normative beliefs that can guide behavior inside an organization. If organizational culture is developed as an organization learns to deal with the dual problems of both external adaptation and internal integration, then values that enhance the organization’s capability in these two functions should be useful for it. To the extent that members of an organization share the same sets of values, thought processes, and languages, they will have similar mind-sets and behaviors as they integrate their efforts inside the organization and adapt to environmental changes. Research has documented a variety of outcomes that are related to organizational culture. For example, organizational culture has been found to relate to organization growth and organization performance. Other studies have shown that its effect can be observed directly at the individual level, in outcomes such as commitment, resource allocation decisions, retention, and perceived attractiveness of an organization. Given the dramatic changes in both the external environment and the internal structure of worldwide organizations, organizations that emphasize cultural values that relate to external adaptation and internal integration should be more effective than those that do not. The character of any corporation or an organization characterized by set of values and principles by which the founders and the upper management run the company from its creation when it’s really begin to become part of the DNA of the company. I believe that companies form culture very early on and they get imprinted very early on with a sense of right and wrong. And it starts from the top. It started with the CFO, the President, and CEO. According to Whitman, sis he had innate sense that they needed at EBay to establish very early on what the code of behavior was going to be, what the code of ethics would be. EBay’s internal company culture was very dominant and strong. Even though its culture had great influence of its member’s behavior, the culture encourages its members to feel more commitment. Employees were expected to be open and honest, to treat one another with respect, and to speak up if they believed they were not being treated in this manner. EBay functioned as being a nonhierarchical, democratic organization that encouraged ideas and feedback from all employees. The culture at eBay characterized as being open and low risk, where employees were encouraged to express their opinions despite their different points of view. Mistakes were acceptable, but employees were encouraged to truly learn from them. According to Whitman, unlike other companies where different views and opinions from the senior management were barely heard , at EBay they do not have â€Å"punishes† attitude, meaning that there is no penalty for being on the wrong side of an issue or changing your mind in the face of better information. If an employee`s point of view contradict with his/her colleague when you end up convinced to be wrong, the culture is to appreciate your opinion and at the same time to come with the approach of: â€Å"ok? hat’s smart. You’re right. Let’s move on. † In addition, As role models, senior managers had to act with a high degree of professionalism and respect. EBay does not encourage people who scream loud or pound the tables. At EBay, it’s pretty even-keeled culture. Sustaining its culture provide a better understanding of the strength of the culture. As EBay grew , in order to conserve the unique internal culture of the organization, EBay made sure it hires only individuals who fit with the culture of the organization. In order to emphasize the importance of its culture, EBay`s CEO Meg Whitman, met with new candidates and describe eBay’s values and to set expectations for how each employee would support and contribute to the company’s culture. According to EBay founder Pierre Omidyar, experience was not the only quality they were looking in potential applicants, but for someone who really understands the significance of its both internal and external communities and that person should express its most respect to these communities. Moreover, measuring the community and organization very often represents a major challenge in terms of being sure the values and culture of EBay are being communicated correctly. Therefore, on the organizational side, they had to be sure they were hiring quality employees who fit with the culture; they could not afford to let that slip. Even though most well establish cultures resist changes, EBay was able to accept changes within its upper management and the way it works. For example, when Whitman arrived EBay she tried to make some changes because she felt they were needed the way the company goes and in order to adapt to these new changes. An example would be her trying to set up these meetings, but no one had a calendar. According to Whitman, at EBay this was a culture where appointments were not needed because of its small size – there were only 35 people at the company. So she laid out a calendar and asked people to sign up for appointments. She did not appreciate the feedback; the employees did not like the changes. What ended up happening was that the employees who had previously worked in big companies signed up for multiple meetings, and the people who had worked primarily in start-ups didn’t sign up at all. Furthermore, EBay`s culture was designed to mirror its external community culture. Very important element of EBay`s culture is a respect for its community. It goes far beyond â€Å"the customer is always right† because eBay wouldn’t exist if it weren’t for its community The meetings helped Whitman realize just how special the chemistry was between eBay’s internal and external communities. EBay’s internal culture mirrored many of the characteristics of its external community culture in tangible ways: they were empowered to develop recommendations, and the company employed a nonhierarchical, team-based approach to problem solving. According to Omidyar this configuration was so important: Internally, EBay had to share the same values as their community because they indirectly influence the community in everything they do. Everything EBay put on the Web site, every press release, every utterance to the press, every corporate action, every deal, every partnership that happens in any part of the organization eventually trickles down to the community. EBay rely on all of its executives and then their managers to continue to communicate the culture. The message should trickle down to the very last employee, so that everyone really understands what we’re about and what our values are. EBay also encourage its employees to call the upper management if we’re doing something that is not quite right. EBay empowered everyone to be a guardian of the culture – everyone.

Couplings Elements Essay

Couplings are mechanical elements that ‘couples’ two drive elements which enables motion to be transferred from one element to another. The drive elements are normally shafts. We tend to see lot of applications of the couplings mainly in the automobiles, for example the drive shaft which connects the engine and the rear axle in a bus or any automobile is connected by means of a universal joint. In order to transmit torque between two shafts that either tend to lie in the same line or slightly misaligned, a coupling is used. Based on the area of applications there are various types of coupling available. But they are generally categorised in the following varieties 1. Rigid Couplings 2. Flexible or Compensating Couplings 3. Clutches to are a type of Coupling – We will the dealing on them separately. RIGID COUPLINGS Rigid Couplings are mainly used in areas where the two shafts are coaxial to each other. There are many types of couplings that fall under the rigid couplings category. They are  · Rigid Sleeve or Muff Couplings- This is the basic type of coupling. This consists of a pipe whose bore is finished to the required tolerance based on the shaft size. Based on the usage of the coupling a keyway in made in the bore in order to transmit the torque by means of the key. Two threaded holes are provided in order to lock the coupling in position. The photo shows a type of the rigid sleeve or muff coupling.  · Flanged Coupling – The coupling basically consists of two flanged end pieces as shown in the figure. A spigot and recess is provided in the flanges to provide location between them. The flanges are connected firmly by means of fitted bolts which are tightened accordingly to the torque to be transmitted. FLEXIBLE OR COMPENSATING COUPLINGS Flexible couplings are normally used in areas where the coaxiallity between the connecting shafts is not always assured and in areas where there is a possibility of occurrence of shocks in the transmission is applicable. They are also called as Elastic Couplings. By construction these couplings tend to have a elastic member in between the two connecting entities. The different types of flexible couplings are 1. Flanged Pin Bush Couplings 2. Bibbly Coupling 3. Gear Tooth Coupling 4. Tyre couplings 5. Elastomeric Couplings – This consists of jaw type and S-flex couplings. 6. Oldhams Coupling 7. Universal Coupling or Hooke’s Coupling 8. Bellows Coupling Each of the above couplings are quite unique in their construction and we can deal in detail on their constructional and working aspects in separate articles. BIBBLY COUPLING: This article deals with Bibby Resilient type couplings. The article describes constructional aspects of the coupling and the selection procedures for the coupling. * Named after its Inventor Dr. James Bibby in 1917, this coupling is still one of the most sought after flexible couplings for heavy shock applications. Let us now look at the constructional features of the coupling. 1. The Coupling consists of two flanges or hubs specifically mounted on the drive and the driven shafts respectively. These hubs contain axial grooves cut on their circumference. 2. The two couplings are joined or held together by means of a specially designed grid spring. 3. The total assembly is enclosed in a casing or shell filled with grease for low speed applications or, in high speed application with high viscosity oil. Now let’s look at the working aspect of the coupling and how it tends to reduce vibration and prevents the build up of resonance in the system. a.) The specially designed spring is wound up through the grooves forming a series of resilient bridges throughout the periphery of the coupling. b.) The grooves are tapered up at the edges (see photo) in order to provide extra flexible spans to the spring at normal loads and tends to support the spring at the sides whenever overloading occurs. c.) The stiffness of the spring depends on its unsupported length of each of its flexible span. The unsupported length tends to vary with the loads producing a varying stiffness for the coupling based on the loading. d.) This action tends to produce a detuning action altering the torsional vibration frequency of the system that prevents the build-up of resonance. Some applications of Bibby Couplings are 1. Cement Mills – in grinding and crushing machinery. 2. Cranes 3. Conveyors 4. Turbines 5. Marine Auxiliaries 6. Paper Mills Bibby couplings can be used for applications with powers varying from as low as 1 h.p to about 100,000 h.p. per 100 rpm of the coupling. Correspondingly the couplings are available in varying sizes ranging from 100mm diameter to 4000mm diameter. Bibby couplings are capable of taking axial and radial misalignments to a very small extent only. It is necessary for the user to ensure that both axial and radial misalignments are kept to the minimum possible. Selection procedure for Bibby Couplings: The selection of the Bibby coupling is mainly based on the torque being transmitted by the coupling. Each coupling has a characteristic value for the torque transmitted by it to the revolutions per minute of the coupling. The rating of the coupling is given by Rating = Maximum power to be transmitted in h.p/ r.p.m of coupling In order to account for contingencies like shocks, sudden stops, stalling, etc. a factor of safety is to be considered during selection of the coupling. Rating of coupling to be Selected = Max. power of coupling* Factor/ r.p.m. of coupling The chart containing the factors to be considered is given below based on the application and driving machinery. See the selection chart below for the selection of corresponding coupling based on the power. Note: This chart is an indicative for the selection of the Bibby coupling. Kindly refer to an actual manufacturer’s catalog for selection as ratings may vary from manufacturer to manufacturer. GEAR COUPLING: This article deals with Gear Couplings. The article describes constructional aspects and selection procedures for flexible gear couplings. * Couplings are used as connecting elements between two shafts. The complexity in the type of connectivity, the power to be transmitted and the area of application tend to play a vital role in the selection of the type of the coupling. Gear Couplings belong to the category of flexible couplings that are capable of transmitting very high torques. Constructionally the gear coupling utilizes the advantages of gear engineering; practically the coupling is a complete gear assembly. Let us now look into the constructional aspects of the coupling. 1. The gear couplings consists of a forged sleeve with internal teeth cut on its inside. The forged sleeves are normally two halves possessing internal gears in both of them. In certain cases the forged sleeve tends to remain a single piece. 2. Two hubs with external teeth containing the same number of teeth as in the internal gear is present with each one being mounted on the driven and driver shaft respectively. The tooth profile of the external teeth is normally crowned in order to take up more loads. 3. The entire assembly in normally enclosed and is provided with gaskets at the joints and O-rings at vantage points in order to prevent the leakage of the lubricant filled inside the coupling, 4. Lubrication plugs are provided at vantage points in order to lubricate the couplings during predetermined intervals of time. Tooth forms in the Coupling: Three types of external teeth are used in gear couplings. The only difference is the manufacturing methodology of the same. a.) Straight Teeth: The external teeth in the hub are straight. During the condition of misalignment in the coupling the contact pattern between the internal gear and the external gear tends to be line type of contact as shown in the figure. b.) Crowning with constant radius: The external teeth are barrel shaped with a constant radius in order to increase the area of contact and move the area of contact to a near middle portion of the teeth. c.) Crowning with variable radius: The external teeth are barrel shaped with a variable radius instead of constant radius. This increases the area of the contact significantly compared to that of the constant radius crowning. The maximum degree of misalignment permissible in gear couplings is from 0.5 Degrees to 1.5 Degrees. This varies with the size of the coupling being used. Selection procedure for gear coupling: The gear couplings are selected based on the torque ratings. 1. 1. The torque transmitted by the coupling is to be determined. 2. 2. Based on the application the appropriate service factor needs to be determined. A reference chart on the service factors is shown below. 3. 3. The equivalent torque is to be determined by multiplying the service factor with the torque transmitted. 4. 4. Select the coupling based on the equivalent torque value calculated. A reference selection chart is given below for example. JAW TYPE ELASTOMERIC COUPLING: This article deals with Jaw type Elastomeric coupling. The article describes the constructional aspects of the coupling and selection procedures. * Couplings are indispensable mechanical power transmission elements used for connecting shafts. Flexible couplings in particular are used in areas where misalignment needs to be accommodated (the flexibility is highly restricted based on the type of Elastomeric material used) and also to take up shock loads at the driven end, thus protecting the driving element like a motor or such. Jaw Type Couplings tend to have a flexible member or Elastomeric member between the two metal components. The flexible member is also called the â€Å"Spider.† The Spider material can be made from different types of rubber or plastic possessing varying degrees of hardness in order to suit the load carrying capacity of the system torsional characteristics. The constructional features of the Jaw type coupling are shown below. The dimensional drawing as wel l as the nomenclature of the coupling is also enclosed. Here as some of the key aspects on the constructional features of the Jaw type coupling. These points are to be considered for the proper selection of a coupling. – The metal hub is constructed of sintered iron, cast iron, or aluminium or stainless steel. The type of metal hub is mainly based on the area of operation of the coupling and its inertia aspects. – The spider is normally made up of a nonmetallic element like rubber, urethane, hytrel because of their Elastomeric properties and in very rare cases bronze is used. BEAM COUPLING: A beam coupling A beam coupling, also known as helical coupling, is a flexible coupling for transmitting torque between two shafts while allowing for angular misalignment, parallel offset and even axial motion, of one shaft relative to the other. This design utilizes a single piece of material and becomes flexible by removal of material along a spiral path resulting in a curved flexible beam of helical shape. Since it is made from a single piece of material, the Beam Style coupling does not exhibit the backlash found in some multi-piece couplings. Another advantage of being an all machined coupling is the possibility to incorporate features into the final product while still keep the single piece integrity. Changes to the lead of the helical beam provide changes to misalignment capabilities as well as other performance characteristics such as torque capacity and torsional stiffness. It is even possible to have multiple starts within the same helix. The material used to manufacture the beam coupling also affects its performance and suitability for specific applications such as food, medical and aerospace. Materials are typically aluminum alloy and stainless steel, but they can also be made in acetal, maraging steel and titanium. The most common applications are attaching encoders to shafts and motion control for robotics. Oldham Animated Oldham coupler An Oldham coupling has three discs, one coupled to the input, one coupled to the output, and a middle disc that is joined to the first two by tongue and groove. The tongue and groove on one side is perpendicular to the tongue and groove on the other. The middle disc rotates around its center at the same speed as the input and output shafts. Its center traces a circular orbit, twice per rotation, around the midpoint between input and output shafts. Often springs are used to reduce backlash of the mechanism. An advantage to this type of coupling, as compared to two universal joints, is its compact size. The coupler is named for John Oldham who invented it in Ireland, in 1821, to solve a paddle placement problem in a paddle steamer design. * * it is recommended to use manufacturer’s alignment target values to set up the machine train to a defined non-zero alignment, due to the fact that later when the machine is at operation temperature the alignment condition is perfect Coupling maintenance and failure Coupling maintenance is generally a simple matter, requiring a regularly scheduled inspection of each coupling. It consists of: * Performing visual inspections, checking for signs of wear or fatigue, and cleaning couplings regularly. * Checking and changing lubricant regularly if the coupling is lubricated. This maintenance is required annually for most couplings and more frequently for couplings in adverse environments or in demanding operating conditions. * Documenting the maintenance performed on each coupling, along with the date.[2] Even with proper maintenance, however, couplings can fail. Underlying reasons for failure, other than maintenance, include: * Improper installation * Poor coupling selection * Operation beyond design capabilities.[2] The only way to improve coupling life is to understand what caused the failure and to correct it prior to installing a new coupling. Some external signs that indicate potential coupling failure include: * Abnormal noise, such as screeching, squealing or chattering * Excessive vibration or wobble * Failed seals indicated by lubricant leakage or contamination.[2] Checking the coupling balance Couplings are normally balanced at the factory prior to being shipped, but they occasionally go out of balance in operation. Balancing can be difficult and expensive, and is normally done only when operating tolerances are such that the effort and the expense are justified. The amount of coupling unbalance that can be tolerated by any system is dictated by the characteristics of the specific connected machines and can be determined by detailed analysis or experience.

How and why did Greek writers, painters and sculptors compare and Essay

How and why did Greek writers, painters and sculptors compare and contrast the values and virtues of Greeks and Barbarians - Essay Example Greek history has uncertain beginnings and varying boundaries because it encompasses eras of expansion over many centuries.In this context Greek authors, artists and sculptors took it for granted that Greek culture was superior to the othercultures When the Greek civilization was at the height of its powers in the archaic and classical periods, from around 800 BC until about 300 BC it ruled vast areas of the Eastern Mediterranean and much further inland, exacting tribute from conquered peoples and passing on its illustrious literature and culture to many other tribes and nations. In this context Greek authors, artists and sculptors simply took it for granted that Greek culture was superior to the cultures that could not demonstrate the advanced technologies that the Greeks possessed. Some cultures like the Egyptians, for example, had great cities, stone monuments and works of literature which earned the respect of the Greeks, but those who preferred a nomadic lifestyle were regarded simply as ‘barbarians.’ Very often this label was used in ignorance, and it served to make as big a distance as possible in Greek minds between those who were within its extended territorial reach, and those who were beyond it. In short, all that was culturally good and proper and admirable was Greek, and all that the barbarian cultures represented was depicted in opposite terms. In modern language we would call this a stereotype, and then, as now, there was some truth in this stereotype, but it was by no means the full story. This paper explores the way that Greeks define and depict themselves and the barbarians through various artefacts including literature, painting and sculpture. It covers the values and the virtues of Greek and of barbarian as seen from the Greek point of view, both positive and negative, as demonstrated through actions and outward appearance. Hall points out that there were hundreds of tragedies written for fifth century Athenian theatre and that more than half of them introduce barbarian characters, choruses and locations, even when there is no need for these details in the main plot: â€Å"Supernumerary foreign characters or choruses, and the ubiquity of allusions to the other, inferior, world beyond Hellas, therefore provide evidence that barbarians were a particular preoccupation of the Greek tragedians. 1 Hall identifies two main areas of difference between Greeks and barbarians. The first is political, thanks to the Greek commitment to democracy as a form of government for a modern state: â€Å"Greeks are democratic and egalitarian; the barbarians are tyrannical and hierarchical†2 although this conveniently overlooks the fact that Greek wealth and leisure to depended upon a large underclass of slaves who were mostly non-Greeks. The second area of difference that Hall observes is harder to define, and lies in the area of psychology and attitude, whereby the barbarian is cast in the role of â€Å"other.† T his notion permeates Greek thinking and this kind of polarization is a tendency which has been present in European history ever since. It is important to remember that our modern understanding of race and nationhood may not exactly match the way that these ideas were understood in early Greek history. Greece was made up of a collection of small city states, and they had ties with the center of Greek culture in Athens, but they also had ties with the geographical areas surrounding them, some of which differed greatly from the Athenian norms. Different Greek cities had different perspectives. Geary notes that the fifth century Greek historian Herodotus indulges in a certain amount of simplistic â€Å"us and them† thinking, but at the same time probes the backgrounds of the peoples such as the Persians whom the Greeks encountered as enemies in long and bitter wars: â€Å"Herodotus invented both history and ethnography.† 3 This is not, however ethnography as we would under stand it today. Geary explains that for Herodotus it is not biological or political factors that connect a group

Heat stroke monitoring device Essay Example | Topics and Well Written Essays - 750 words

Heat stroke monitoring device - Essay Example The human body has a natural ability for temperature regulation. Thus, an increase in the subject’s core temperature makes the sweat glands on the skin to dilate having a cooling effect on the skin. To the person observing from the camera, it appears that the subject’s core body temperature is reducing when in fact it is rising (O'Kane & Sandick). There are also heats sensors that are based on infrared technology for example thermoelectric sensors that are used in medical institutions. Medical officers have used passive infrared sensors over the years to detect aural temperatures accurately. The passive sensors allow the observer to measure the surface temperature of the subject without having direct connection with the subject. Passive infrared sensors, like the aural thermometer, enable doctors take dependable aural temperature measurements while at the same time avoiding damage to the eardrum, the eardrum is part of the ear that is near the hypothalamus. The hypothal amus, located in the brain, has a function of regulating core body temperature; in essence, the human body will be reacting to the temperature of the hypothalamus. For this reason, determination of core body temperature is possible using the eardrum since it exists at approximately the same temperature level as the whole body. In addition, other heat stroke monitoring devices that have been in use include thermistors and thermocouples. Thermistors have their advantages, as they are easily measurable; have a long lifespan, and are small. They also have a quick response time, and do not need temperature referencing; the thermocouples can measure a range of temperature depending on the needs of the user. Their disadvantage is that they are non-linear and needs significant linearization algorithms for them to be efficient. Moreover, the voltage output of the element for sensing temperature in thermocouples is lower in comparison with other devices that have the capacity to change voltag e signals from analog to digital. Wet bulb globe temperature is mostly used to measure heat stress as per the proposal of the Ministry of Labor. Developers made wet bulb globe temperature to use heat radiation and atmospheric humidity in measuring heat stress. Division of heat exposure is on categories like a worker’s physical activities or acclimatization to the environmental conditions among others. Basing on these categories, there is an adjustment on the types of clothing and protective equipments for each worker. Wet bulb globe temperature needs specialized tools and expertise for them to be effective in measuring heat stroke. Wet bulb globe temperatures available in the market today have their disadvantages. They cost a lot, are large and bulky, as one has to transport the distilled water together with the measurement unit (â€Å"Microchip†). There has been some advancement in this front since the introduction of devices such as the Kestrel 4000 Pocket Weather Tr acker. This heat sensor monitor can calculate Wet bulb globe temperature values lower than 2.18 deg C that is the lowest a complete setup gives (Nielsen-Kellerman). Design Goal, Criteria, and Constraints There is need for heat stock sensor that is easy to use by someone without any medical expertise (Croce and Jenna).The design goal of the project is to come up with a wristband for measuring core body temperature that easy to operate. Since it

Critical Thinking Questions - Week 4 (675) Assignment

Critical Thinking Questions - Week 4 (675) - Assignment Example Alterations in the material that a particular student learns may differ with that of another learner in a different content area. Every learner is unique. They vary in numerous ways such as physical traits, cognitive aptitudes, experiences, social settings, backgrounds and personalities. Teaching experience and contemporary research postulates that every brain has a distinct state and experiences impact from previous experiences. With such knowledge, success-oriented teachers understand that students cannot go through the same education plan. Research and experience ensues to present insights regarding the human brain. Every learner is unique and has exclusive opportunities. It is, thus, reasonable that every learner learns differently and has different preferences, wants, interests and likes. This addresses the need for differentiated instruction in learning institutions (Tomlinson, 2001). It is pertinent to consider a learner’s background when examining and designing a lesso n framework. The cultural orientation of learners differ with the nature of learning that the culture values and the way the culture understands the learning concept. When structuring the lesson, it is paramount to determine how different students’ backgrounds may implicate on dynamics and learning in the classroom. It is also important for instructors to overlook the possible assessment when designing a lesson structure (Gregory & Chapman, 2013). Determining the method of assessment is essential to knowing the method that would elicit positive feedback in terms of excellence in the classroom. Determining the learner’s background in lesson framework design ensures that the instructor designs a framework that that benefits all students at every level. The best lesson framework is that which aids in the collection of accurate data regarding every student in the classroom, which meets the learning needs of all the learners. The teacher should concentrate on areas where th eir students are not performing as anticipated. Instructors should further emphasize on driving positive improvement in such weak areas to meet the learning needs of each and every learner in the classroom (Gregory, 2008). Through differentiated instruction, the student can perform exemplarily because with the assessment intelligence, the instructor is able to monitor their performance and assess their achievement. Instructors can differentiate product, content and process for learners. Content differentiation refers to an alteration in the material that the student learns. For instance, if the classroom goal is for students to draft persuasive essays, some are learning how to write topic sentences and support sentences, while the others learn how to utilize outside sources and defend their views. Process differentiation inculcates the differentiation of how the learner accesses the learning material. One learner in the classroom may explore a learning centre as the other gathers in formation from the internet. Product differentiation concerns the modification of how the learner depicts what they have learned (Tomlinson, 2001). For instance, in demonstrating a comprehension of a narrative\s plot, one learner may compile a play when the other drafts an account of an event. Teachers should choose differentiation approaches rooted in the proper prospectus and learners’

The Contract between Darcy and Wickers Essay Example | Topics and Well Written Essays - 1500 words

The Contract between Darcy and Wickers - Essay Example Darcy has a cause of action against Wickers in this case. As borne out by the facts, the two entered into a contract by which Wickers are to withhold any information he may have known about the life of Kitty while under his custody in consideration of the 50,000 pounds which Darcy will give to him. The object of the contract therefore is for the peace of mind of Darcy not to be molested by the adverse public image on him, Kitty may bring in the event the life of the latter is exposed to the public. This contract does not in any way violate the law, public policy or public moral. Rather, the contract forged by Darcy and Wickers is the law between them. When Wickers reneged in his obligation not to do a certain act, i.e., to withhold from the public his knowledge of the life of Kitty, he has already incurred liability therefore. Coming now to the possibility of Darcy’s claim relating to damages for mental distress, it is unequivocal that Darcy suffered mental distress by reason of the act of Wicker in disclosing to the media his knowledge of the life of Kitty under his custody. In the ordinary course of things, a politician with a fiancà ©e whose family affair is better off insulated from the public would be greatly affected, with respect to his political career, in the event such family issue is exposed to the public. This is especially true when such disclosure is malicious and unwarranted, coupled with the fact that there is an agreement to the contrary. Although the above cited case does not fall squarely on the present case, the principle enunciated is equally applicable. Wickers, in disclosing to the media an otherwise private information has committed what was termed in Campbell as misuse of private information. The cause of action of Darcy is bolstered by the contract Wickers have entered with him. True, one may argue that the person who should have suffered damages is Kitty and that the damage supposedly suffered by Darcy is remote. But that prop osition is only relevant when there is no pre-existing contract on the non-disclosure of such information. At the risk of being repetitious, the cause of action of Darcy is anchored on breach of contract by Wickers and as a result, the former incurred damages although, no pecuniary damages are involved.

Management accounting - contemporary approach Essay

Management accounting - contemporary approach - Essay Example The paper starts off with a brief review of literature concerning historical trends in management accounting and then develops understanding into modern issues while introducing recent systems of management accounting, discusses a breakthrough development in performance measures viz. balanced scorecard and identifies various budgetary controls and their relationship with the managerial performance. The management accounting system emerged and developed initially during the 19th century. At first it was solely used by managers for obtaining cost information such as direct labour and direct material etc used in the manufacturing process. Further, the management accounting was developed in the same century to obtain information concerning subordinate activities and impact of specific products on company profits. It was then also utilised for estimating costs (standard cost) and comparing it with actual costs i.e., variance analysis (Johnson & Kaplan, 1987). Atkinson et al. (1997) describe management accounting as a process through which the economic transactions of an organisation are acknowledged, gauged, accounted and examined. This process of management accounting needs to be endogenous to the organisation, which directs the flow of organisational decisions vis--vis operation and investment. Despite the criticality of management accounting in the process of managerial decision-making and performance towards the accomplishment of organisational goals, there remain substantial concerns regarding the bias and malpractice exercised on the part of managers. These concerns lead to the development of various controls enabling the organisations to oversee the conduct of managers and supervisors, and to make them accountable for their activities impacting organisational goals. This is referred to as the management control, and Anthony and Govindarajan (1998, p17) delineate it as, "Management control is the process by which managers influence other members of the organization to implement the organization's strategies. The system used by management to control the activities of an organization is called its management control system." Hopwood (1972) previously figured out various demoralised activities on the part of the managers, such as budgetary slacks and exploitation of performance measures vitiating the role of management accounting. Merchant (1985) describes various controls to be enforced at managerial level so as to set standards and gauge outcomes of managerial activities and decision-making. The most significant control pertinent to management is the result control, which is achieved either through some performance indicators such as profitability etc or through target identification. Holzer and Norreklit (1991) says that financial accountability control could be also exercised at the management level, where the managers could be held responsible for financial results of the company such as net income, losses etc. In this way, decisions taken under the management accoun

Retail Marketing- Group report Assignment Example | Topics and Well Written Essays - 750 words

Retail Marketing- Group report - Assignment Example Usually, this kind of buyer/seller relationship is always suitable for purchases which low value. The customer may be more interested in bargain prices as opposed to quality. This is ideal for market conditions that are dynamic and the customer has many options. Value-auditing relationships are those where the customer’s needs are identified. In this kind of relationship, the seller attempts to come up with aspects of his product that are deemed most valuable to the buyer. After figuring out what these are, the seller will try to focus on giving as much as possible of this in order to make sure that the buyer has the most value from the payment he makes. The Value adding relationship is the intermediate between a transactional and a collaborative relationship. Although though there is minimal collaboration between the buyer and the seller, there is some amount of extra care taken by both sides to ensure a better product delivery. Deluxe uses this kind of relationship with some of its customers. This is especially done with the smaller business customers who are just looking for easy marketing solutions with Deluxe. Instead of having a collaborative relationship with the customers, what deluxe des is to provide a powerful web portal that tries to provide a way to make sure that the needs of the customer is met. Every member who visits their website is kindly asked to fill out a simple questionnaire to give feedback about their experience in using the website. This makes it easy for deluxe to know where to improve, but does not eventually lead to a collaborative relationship. Collaborative relationship is a situation where the customer and the buyer end up having a relationship that goes beyond just the transaction of goods (Strauss & Frost, 2001). Apart from exchanging money and goods or services, the parties to transaction in

Settlement of the West over the Whole Period Essay Example for Free

Settlement of the West over the Whole Period Essay In considering the process of the settlement of the West over the whole period, how far can the Louisiana Purchase of 1803 be seen as the key turning point? The war of 1812 was followed by a period of exploration of the West which had been greatly expanded by the Louisiana Purchase of 1803. The process of expansion was huge and resulted in the original 13 states being 45 states by 1906. As well as the Louisiana Purchase, the Mexican-American War and the Californian Gold Rush of 1848, the Homestead Act of 1862 and the Exodus movement from 1879 were all key turning points which helped the process of Westward Expansion. The key criteria for judging a turning point is if the event created opportunities to go west, if it opened up land to settle in and if it had a psychological impact on the nation. The Louisiana Purchase was a very significant event as it increased the size of the United States by double overnight for only $15 million. This was a key turning point in expansion as it opened up a huge amount of land for more settlers (an extra 828,000 square miles). Alongside this it created opportunities for people to travel west as it gave access to the Mississippi river which was important for travel and commerce. This purchase was also significant in the fact that it created a more secure environment for settlers as it eliminated the French from imperial competition, Jefferson believed the French were restricting US commerce and that they tried to control surrounding territory. Therefore this event affected the process of change as it allowed America to spread its resources and encouraged people to move west, such as the Indians which were encouraged to settle there. The most important reason for this event being a turning point was that it opened up a large amount of land to settle in, a lot of the further events which take place would not have happened if it wasn’t for this territory being the United States’ and so provided many reasons for expansion to continue. Another key event which took place was the Mexican American War of 1848 which begun because Texas was a gateway to the pacific and was a great agricultural prospect. This was a key turning point as it had a big psychological impact on the people of America as many believed in the Manifest destiny, in that America had a right to expand, and so supported the annexation of Texas which increased their spirits on westward settlement. Polk deliberately provoked a war as he knew they could easily be overcome. The treaty of Guadalupe Hidalgo was signed in 1848 which ceded California, Texas and New Mexico. Another reason for this being a turning point is that it gave access to the pacific meaning that farming was capable so created further opportunities to go west and again meant that transportation was made easier for commerce. The key reason this was a turning point was manifest destiny which was completed after this event. America had managed to secure land coast-to-coast which was a huge psychological moral boost for America who now knew they had a lot of power with a lot of land. The Treaty of Guadalupe Hidalgo led to California being ceded to Americ a. In 1848 there was the Californian Gold rush which primarily lasted until the early 1850’s with millions of families travelling from around the world to California and surrounding areas in search for fortune. In 1850, California (now a new state) had nearly 40% foreign born inhabitants, showing that this event increased the diversity of people settling West, but also inspired many to go as they believed a new life could be made from the Gold being found. Furthermore it dramatically increased the speed of people moving out west, by 1853 the population was approximately 250,000 whereas in 1848 the Californian territory had less than 1000 inhabitants. The Gold caused a great economic boom which created infrastructures leading to many people settling here and encouraged more to move west. The Californian Gold Rush’s most important reason that it is a turning point in westward expansion is that it created opportunities. It allowed people to make a lot of money from the Gold, but also from new businesses which were now being created due to a new market of people, and because of this and the great boom, many people started to settle here at a very fast rate. In 1862 the Homestead Act was put into place, this allowed farmers to acquire 160 acres of land if they lived there for 5 years, or for 6 months with an additional payment of $1.25 per acre. This was significant as it allowed small scale settlement to develop. In some ways this could be seen as a turning point as it gave farmers a chance to be economically dependent, which gave them opportunities to expand or to do other thing with their money. It also inspired many people to go west and take up these lands which could be seen from figures that show that 400,000 families set up there taking 285 million acres of land. On the other hand, there were points which showed that this wasn’t as significant as it seemed. Most significantly, there was a 43% failure rate for those trying to get land in Nebraska under the Homestead Act showing that it wasn’t as easy to settle west as the act tried to make it. Furthermore, land was put into the hands of men who had no sufficient foresight so even though this land was meant for farming, many people who didn’t know what to do with it took it up and eventually a lot of the land went to waste. This act of 1862 could be seen as a turning point mainly because of how it inspired many people to go west due to the huge amount of land it opened up allowing people to profit from it from farming. To conclude, the Louisiana Purchase which nearly doubled America overnight for just $15million was the key turning point in Westward expansion. This is because the other events which occurred which are all significant in their own right would not have occurred if they did not have the land. The conflict between Mexico and America would not have occurred as Polk would not have been inclined to want Texas as they would not have been near it. Therefore the Treaty of Guadalupe Hidalgo would not have taken place which ceded California. Even though the Gold Rush would have still occurred in 1848, the sudden increase in prosperity due to the economic boom would not have helped America and therefore would not have been made an American state. Lastly, even though the Homestead Act of 1862 was not very successful, it still inspired many families to travel west, increased settlement there and helped westward expansion. However even this would not have happened if it wasn’t for the land being there in the first place due to the Louisiana Purchase.

O great god-king Xerxes Essay Example for Free

O great god-king Xerxes Essay O great god-king Xerxes, I have heard that you are planning to launch a full-scale invasion of the Greek nations following on the steps of your father, Darius. I come here before you to attempt to dissuade you of your plans for Greece. As I am once a prominent citizen of one of the many city-states in the nation, it would do you well to listen to my advice as it contains extensive knowledge of what you are about to face if you push through with your plans. O King, barely ten years ago, your father Darius launched a similar invasion against the Greek city-states in retaliation to the Athenians’ aiding the Ionians in their revolt against his rule. Although it had been initially successful, the invasion was ultimately put to an end by his defeat during the Battle of Marathon. It could be worth noting that, despite the battle being a victory, it was a desperate attack by the Athenian army that caused the defeat of your father’s armed forces. Sparta, perhaps the state with the most powerful military in all of Greece, was absent from the battle and even then the Greeks scored a victory. Each city-state in Greece acts independently from each other. They are each governed by their respective rulers and are not influenced by the affairs of the other city-states. However, it is not impossible for each of them to call for aid to one another as evidenced by the Ionian call for aid during the previous war. Sartus was taken thanks to the aid provided by Athens, who had the major contribution in the allied army, and by Eretria. Sparta had chosen delay sending military aid as it had decided a full moon needed to pass before they do anything and were thus absent from the Battle of Marathon, where your father’s army was defeated utterly. Had Sparta’s forces been present, its superior military might compared to Athens would likely contribute to utter decimation of the Persian forces under your father’s command. However, even then, your father’s soldiers lost under the Greeks. If you attack now, O King, you risk provoking an even greater alliance that can now include Sparta, which is your most formidable enemy on the plains of Greece. The Spartans are a race that places utmost emphasis on military training and raising superior soldiers that have been tested in war. Furthermore, the Spartans will never participate and are not interested in any alliance that will not mean leadership to them. They can be a vain and arrogant nation but with the strength to back their vanity up. If you threaten the entire Greek country now, your Majesty, the major powers of the nation will definitely ally themselves with Sparta at the helm. With Spartan tactics and warriors at the vanguard, your army – no matter how great – will run into serious opposition which can result into an even greater demise than what has happened to your father’s forces in Marathon. As could be expected from any nation, the Greeks have devised battle tactics that are best suited to their terrain. They know their land; you can expect them to take advantage of that and lure your forces into a disadvantage in battle. With a possible alliance under Spartan leadership, the Greek can have a tactical and strategic advantage even if your army is greater in number. O Wise King, great wisdom it would be not to rely on the greater numbers of your armed host. The Greeks, especially the Spartans, will not be easily daunted. They have tactics that can be quite effective when employed in terrain which they know well. For example, your father Darius in Marathon faced a tactic called the phalanx. By definition, a Greek battle line deployed in a phalanx means there is equal strength in all sides of the battle formation. However, in Marathon, the Greek commander faced superior numbers but was able to modify the phalanx into an effective variant: he strengthened the wings of his battle formation while weakening the center. At first you would think that the Greeks were committing suicide and, indeed, the Greeks seemed to be at the point of desperation. However, stronger wings meant that the Greeks managed to hold off the wings of your father’s formations, holding them back and disabling them from reinforcing the center of King Darius’ battle lines. Thus, it was then that the Persian armies were surrounded and routed by the Greek army in Marathon. The results of the battle were horrific. Your father lost a sizable portion of his soldiers, sixty times more than what the Greeks lost in that same battle. A second Marathon is not the only thing that you should worry about in the conduct of battle in this planned invasion. A worse battle awaits your forces if you push through. In Greece, there is a place which we call the â€Å"Hot Gates† or Thermopylae. This place is a narrow pass bordered by a sheer cliff wall on one side, and the sea on the other side. This is a battleground ideal for the phalanx. In such a narrow pass, the phalanx will serve as a wedge that will drive through your attacking forces. The Greeks need only to strengthen their front lines with the rear guard merely pushing the front soldiers forward. In here, the superior numbers of your great army will definitely count for nothing. The Greeks, especially the Spartans and the Athenians, are aware of this pass; they will definitely use this to their advantage to hold off your army while a greater force amasses for retaliation. A Spartan-led phalanx could be as devastating as any phalanx, which had been proven by the Athenian tactics in Marathon. As you could see, Great King Xerxes, the sheer size of your army is both your strength and your liability. To support such a large host, you need a sizable navy to carry supplies back and forth. Your navy will be stretched thin supporting your great army; it will also have to endure against whatever naval counterattacks and offensives that the Greeks may launch against you. You could face a naval situation similar to Thermopylae in Salamis. It is a narrow channel, one which can reduce your navy into a bottleneck and reduce their effectiveness. The Greeks can pick your ships off one by one even if they may be smaller in size. Consider my wisdom in this matter, King Xerxes. I daresay that, even if you hold the greater number of forces, you would find it hard to manage them effectively at smaller levels. The Greeks, my former countrymen, are geniuses both in scholarship and in battle; your father Darius learnt that the hard way in the fields of Marathon under the Athenians alone. With a possible pan-Greek alliance – with the mighty Spartans leading – your forces face yet another humiliating defeat similar to Marathon, only this time you will be facing the combined might of all the city-states of Greece. Abandon this plan now, before this results to destruction of your mighty host. Sources: Wheeler, Kevin. (2001). â€Å"Ancient Greek Battles of Marathon, Thermopylae, Artemisium and Salamis. † Retrieved November 30, 2008, from Ancient World Battles website: http://www. geocities. com/caesarkevin/battles/Greekbattles1. html Lendering, Jona. (2005). â€Å"Phalanx and Hoplites. † Retrieved November 30, 2008 from Livius. org website: http://www. livius. org/pha-phd/phalanx/phalanx. html Lopez, Vincent. (2008) â€Å"Shock Tactics on the Ancient Battlefield. † Retrieved November 30, 2008 from Armchair General website: http://www. armchairgeneral. com/shock-tactics-on-the-ancient-battlefield. htm/5 Stewart, Michael. People, Places Things: Xerxes I, Greek Mythology: From the Iliad to the Fall of the Last Tyrant. Retrieved November 30, 2008 from Messagenet website: http://messagenet. com/myths/ppt/Xerxes_I_1. html Freedom44. (2004). â€Å"The First Persian War Greek Wars. † Retrieved from Free Republic website: http://freerepublic. com/focus/f-news/1196577/posts

Congestive Cardiac Failure: Causes and Effects

Congestive Cardiac Failure: Causes and Effects Analyse Health Information – Case study The scenario relates to Mr Alby Wright who has been admitted into your ward. His patient history and admission form is available for you to review. Mr Wright’s admission states that he has heart failure (congestive cardiac failure). Clearly define heart failure. What organs and which body systems are affected by this disorder? Congestive heart failure is a condition where the heart muscle becomes less strong and is unable to pump as well as it usually would. The ventricles which most important pumping chambers become bigger or thicker and aren’t able to squeeze or relax as well as they should be able to. This makes it easy for fluid retention to occur especially in the legs, abdomen and lungs (better health channel. 2013). This is all usually caused by diabetes, coronary heart disease, previous heart attack, high blood pressure and or other conditions that have damaged the heart and made it weak. Sometimes the fluid that gets in the lungs and it makes it uneasy to breathe and causes shortness of breath when the person is lying down on their back. This is called pulmonary oedema and can cause other respiratory issues if it not treated (American heart association. 2012). Generally if someone was to have heart failure, it would occur on the left side first mostly but can occur in both sides. If someone is experiencing left side heart failure, the left ventricle doesn’t fully empty and is unable to distribute enough oxygen rich blood around the body which causes heightened pressure in the upper chambers of the heart and the veins that are close to the area which is called systolic failure. Because of the build-up of blood in there, it can cause oedema in the legs, lungs and abdominal organs. The kidneys are affected by this hinders the way that they work and it leads to salt and water retention which causes further oedema. In some cases of heart failure, instead of not being able to pump blood around properly out of the left ventricle there is also unsuccessful relaxation of the left ventricle because the muscle has gone stiff which leads to blood pooling (better health channel. 2013) and also that the heart isn’t able to fully fill with blood during the resting period between each heartbeat (American heart association. 2012). Right sided heart failure usually happens because of left sided failure. When the left ventricle has failed, more fluid pressure is then transferred back through the lungs which damages the right side of the heart. When the right side of the heart loses the strength to properly pump, blood builds up in the veins and that causes swelling in the legs and ankles. The cardiovascular system is affected the most by congestive heart failure. The heart has been weakened and is unable to pump blood efficiently and doesn’t function properly in general and the muscle is also weakened. The respiratory system is affected because of the fluid in the lungs which is also known as pulmonary oedema. This can affect your breathing and leave you short of breath. Fluid may also build up in the liver resulting in an impaired capability to get rid of the body’s toxins and to produce the proteins that the body needs to live. The intestines can become not as good at absorbing nutrients and medicines as that would have when they were healthy (providence health network. 2014) Give a brief overview of the normal function of the body systems affected by this disorder. Cardiovascular system is most affected by this disorder. The functions of this system are to basically keep the blood running and pumping through by the arteries, veins, and capillaries (cliffs notes. 2013). The blood carries important nutrients around the body and helps to remove metabolic waste. The heart, blood vessels and blood help to regulate body temperature by controlling the blood flow to the surface of the skin. The white blood cells help to protect the body from foreign toxins and pathogens. Platelets help to clot blood so that you won’t have excessive blood loss and stop bleeding (cliffsnotes. 2013). Respiratory system function is so you can breathe and supply oxygen to your whole body (how stuff works. 2014). This works by breathing; inhaling oxygen filled air and exhaling carbon dioxide air. First you breathe in air through your nose and mouth and it travels down the windpipe and through the bronchial tubes then into the lungs. The diaphragm and abdominal muscles and make the lungs contract and expand so that you are able to breathe in and out. The bronchial tubes connect to blood vessels which carry blood through your body and exchange gases. The digestive system absorbs and moves the nutrients around the body that it needs to work well and gets rid of what the body doesn’t need as waste. First there is ingestion which is when eaten and then makes its way down into the stomach to be stored and waits for digestion. It then moves into the small intestines where the enzymes and bile work to break down the food where the body can absorb more nutrients that it needs and it continues on its way to the large intestine where it absorbs more fluid to make the solid faeces and moves through and gets excreted as waste (how stuff works. 2014). The liver aids in breaking up fats, absorbing them and digesting them. Urinary system works along with other parts of the body such as skin, lung and intestines to keep up the stability of chemicals and water in the body (live science. 2013).This system’s role is to filter and excrete. Kidneys work at reducing blood pressure by reducing the blood volume. The body filters blood to create urine which goes into the bladder and the bladder fills up until it is full and ready to excrete waste that the body does not need which is urination (live science. 2013). 3. Define the signs and symptoms of heart failure, and explain why these signs and symptoms occur. Breathlessness or shortness of breath is a symptom because when the heart starts failing, the blood in the veins gets backed up in the pulmonary veins because it cannot cope with the supply while trying to carry oxygenated blood from the lungs to the heart. At this point, the fluid is starting to pool in the lungs which hinders regular breathing. A person suffering heart failure may suffer with breathlessness upon exertion including exercise or other activities. As the condition progresses, breathlessness or shortness of breath may even be present while at rest or even sleeping which may cause the person to wake up (USCF medical center. 2014). Fatigue occurs when heart failure develops and worsens; the heart cannot pump the adequate volume of blood that is needed to meet all of the body’s needs. To make up for this, the blood is taken away from less vital such as the limbs to supply the heart and brain. Because of this, people suffering with heart failure usually feel tired, w eak and have difficulty doing normal tasks such as walking, going up stairs, or even carrying items. (USCFmedicalcenter.2014). Someone suffering shortness of breath as a symptom of heart failure will also experience fatigue if they are being woken up with breathing difficulties while they are sleeping. Chronic coughing and wheezing is a symptom because of the fluid backup in the lungs which may cause a thick, whitish mucus like substance called phlegm to be coughed up from the lungs which may even be tinged pink from traces of blood (USCFmedicalcenter.2014). Rapid or irregular heartbeat is a symptom because it may speed up to make up for its inability to pump blood around the body properly. People suffering this in heart failure may experience a fluttering sensation of heart palpitations, or a heartbeat that they are aware of and seems irregular or out of the normal rhythm. It may feel like the heart is racing or pounding hard (USCF medical center. 2014). Lack of appetite/ nausea be cause the digestive system isn’t as vital as the heart or brain so the blood has been pulled away from the digestive systems to these areas instead which means there will be problems with digestion including the feeling of fullness or sickness even though they have not eaten anything (USCF medical center. 2014). Confusion/ impaired thinking because unusual sodium levels in the blood and lessened blood flow to the brain can cause bafflement or memory loss even know the person suffering with this may not even realise, and someone else may pick up on this sign before they do (USCF medical center. 2014). Oedema or swelling due to restricted blood flow to the kidneys which means that they produce hormones which lead to the retention of salt and water. This causes swelling of (most often) in the legs, ankles, and feet. Oedema may also cause weight gain (USCF medical center. 2014). Rapid weight gain can occur as a result of oedema and the fluid retention (USCF medical center. 2014). Heart grows in size because it wants to make its pumping power greater so the muscle mass in the heart gets bigger to make this happen. The chambers inside of the heart also grow larger and stretch so that they can fit more blood in. While the heart grows in size, the cells that control its contractions also grow with it. An enlarged heart does not function as well as a normal sized one and the added muscle mass puts stress on the whole cardiovascular system (USCF medical center. 2014). The heart pumps faster as it tries to circulate more blood around the body. If the heart pumps blood too fast for a long period of time, it can damage the heart muscle and hinder its regular electrical signals, which can cause an unsafe heart rhythm disorder (USCF medical center. 2014). Blood vessels narrow because less blood is flowing through the veins and arteries and that means blood pressure can drop to seriously low levels. Because of this, the blood vessels narrow which keeps the blood pressure higher while the hearts power decreases. Narrowing of the blood vessels also limits the amount of blood that can flow through which may contribute to other conditions such as heart disease, clogged or blocked vessels in the legs or other body parts, or stroke (USCF medical center. 2014). Blood flow is diverted away from less vital areas such as the limbs when there is not enough of it to meet the body’s needs and gets given to more crucial organs such as the heart and brain which are the most important for survival. This can cause limb weakness due to lack of blood in the areas. The areas where the blood is diverted from may deteriorate over time from a lack of oxygen (USCF medical center. 2014). Increased urination at night because if the patient suffering heart failure lays down all day, the fluid that has been accumulating in their legs all day may move back up into the blood stream and gets taken to the kidneys and is excreted as urine (heart failure matters. 2014). Low blood pressure because the hearts power has decreased and the veins have narrowed. Chest pain if your heart failure is due to a heart attack. List the information taken on his admission that demonstrates these signs and symptoms. Cyanotic Appetite loss Confusion and anxiety Low blood pressure Temperature below 35.8 degrees Sa02: 87% on air Respirations: 32 Low blood pressure Constipation Do you think his diabetes is related to his leg ulcer and amputated left toe? Explain. Yes. High blood sugar levels in diabetic patients damage nerves and blood vessels which results in poor circulation to the feet and may cause ulcers, infection, and amputation. This is more likely to happen if the patient has had diabetes for a long amount of time, they smoke, they don’t move around much, or their blood glucose levels have been high for an extended period of time (diabetes Australia. 2014). One of the medications he is taking is Lasix. What is the action of Lasix? Which body systems are affected by it? Explain why you think Mr Wright is ordered Lasix. Lasix is a diuretic. It increases the amount of urine that is made in the kidneys and excreted as waste (c health. 2014). It is also used to regulate and control slight to moderate high blood pressure. It affects the urinary system because it involves the kidneys and the cardiovascular system because it involves the heart. I think that Mr. Wright is ordered Lasix to get rid of the excess fluid that would be built up in his body and to lessen the oedema. List three conditions in Mr Wright’s relevant medical history that are commonly associated with ageing. Glaucoma Type 2 diabetes Arthritis Using Mr Wrights admission history and assessment, list the factors that may impact on his safety whilst in hospital and when he returns home. Hypotensive- low blood pressure He needs a walking stick because he is unsteady on his feet He gets anxious, especially about his dog. This can sometimes cause an asthma attack. He gets confused His vision is impaired and gets blurry after he has eye drops and he also needs reading glasses. What other health professionals will be involved in his care and what services can they provide for Mr Wright. Paramedics will care for Mr Wright in the ambulance and pass him over to emergency. Mr Wright needs a doctor to in emergency to diagnose him. General Nurses will be involved to provide care for him and to care for his wounds. A diabetes educator can be involved to help him to understand the needs of his condition and set up an action plan and give him support. A dietician can also help with this condition and set up meal and nutrition plans etc. Exercise physiologist assists patients to have a physical lifestyle to prevent and manage chronic conditions. A pharmacist will dispense his prescriptions so he can have medications and to give information on them. He may be able to talk to a psychologist to improve his anxieties, especially about his dog (better health. 2013). List the nursing documentation you would expect to be used in the care of Mr Wright. Progress notes Medication chart Vital signs chart Nursing history and assessment Care plan Asthma action plan FBC- fluid balance chart Wound monitoring chart Falls risk assessment (tafesa. 2014) UCSF medical center. 2014. heart failure signs and symptoms. [ONLINE] Available at: http://www.ucsfhealth.org/conditions/heart_failure/signs_and_symptoms.html. [Accessed 04 April 14]. heart failure matters. 2014. need to urinate at night. [ONLINE] Available at: http://www.heartfailurematters.org/en_GB/Understanding-heart-failure/Need-to-urinate-at-night. [Accessed 08 April 14]. better health channel. 2013. congestive heart failure. [ONLINE] Available at: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Congestive_heart_failure_%28CHF%29. [Accessed 08 April 14]. American heart association. 2012. types of heart failure. [ONLINE] Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/Types-of-Heart-Failure_UCM_306323_Article.jsp. [Accessed 08 April 14]. c health. 2014. drug factsheets. [ONLINE] Available at: http://chealth.canoe.ca/drug_info_details.asp?brand_name_id=210#Indication. [Accessed 09 April 14]. providence healthcare network. 2014. congestive heart failure. [ONLINE] Available at: http://providence.net/facilities/heart-failure.html. [Accessed 09 April 14]. pt direct. 2014. major functions of the cardiovascular system. [ONLINE] Available at: http://www.ptdirect.com/training-design/anatomy-and-physiology/cardiovascular-system/major-functions-of-the-cardiovascular-system-2013-a-closer-look. [Accessed 09 April 14]. diabetes australia. 2014. diabetes and your feet. [ONLINE] Available at: https://www.diabetesaustralia.com.au/Living-with-Diabetes/MindBody/DiabetesYour-Feet/. [Accessed 09 April 14]. TafeSA, 2014. Acute Care Flow Charts. In: Flow Charts. s.l.:Government of South Australia. better health . 2013. allied health. [ONLINE] Available at: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Allied_health. [Accessed 10 April 14]. cliffs notes. 2013. functions of the cardiovascular system. [ONLINE] Available at: http://www.cliffsnotes.com/sciences/anatomy-and-physiology/the-cardiovascular-system/functions-of-the-cardiovascular-system. [Accessed 10 April 14]. how stuff works. 2014. what is the function of the respiratory system?. [ONLINE] Available at: http://health.howstuffworks.com/human-body/systems/respiratory/function-respiratory-system.htm. [Accessed 10 April 14]. how stuff works. 2014. how the digestive system works. [ONLINE] Available at: http://health.howstuffworks.com/human-body/systems/digestive/digestive-system2.htm. [Accessed 10 April 14]. live science. 2013. urinary system. [ONLINE] Available at: http://www.livescience.com/27012-urinary-system.html. [Accessed 10 April 14]. Chikungunya Fever: A Review Of The Literature Chikungunya Fever: A Review Of The Literature The Newala and Masasi Districts of the Southern Province, Tanzania, reported its first dengue-like outbreak in 1952-1953, on the basis that this epidemic involved debilitating joint pains and shorter incubation period, thereby excluding dengue (Robinson 1955). The infection was called chikungunya; a word from the Makonde dialect describing patients contorted posture (Lumsden 1955). Chikungunya is an arthropod borne virus (arbovirus) of the genus: Alphavirus from Togaviridae family. It is transmitted to humans mainly by the day biting mosquito species Aedes aegypti and Aedes albopictus (Townson and Nathan 2008). Moreover, Aedes aegypti eggs collected from the Tanzanian outbreak were used for the first isolation of Chikungunya virus (CHIKV) (Ross 1956). CHIKV contains a positive-sense single stranded RNA genome, enclosed in an icosahedral nucleocapsid, all enclosed in a phospholipid bilayer envelope. Embedded in the envelope are multiple copies of two encoded glycoproteins E1 and E2, a small glycoprotein E3, and a hydrophobic peptide 6K (Strauss and Strauss 1994). However, the roles of these glycoproteins are not elucidated, but it can be assumed that it could facilitate the attachment of the virus to host cell. History Subsequent to the Tanzanian epidemic, several outbreaks have been reported worldwide, including the Indian Ocean Islands; La Reunion (Renault et al. 2007), Mayotte (Sissoko et al. 2008), and the Maldives (Yoosuf et al. 2008). There were outbreaks whereby Chikungunya had concurrence with other infections; with Dengue (Ratsitorahina et al. 2008, Yoosuf et al. 2008) and with Plasmodium falciparum infection (Pastorino et al. 2004). Moreover, Chikungunya have been imported into several European countries; United Kingdom (HPA 2007), France (Hochedez et al. 2007), Germany, Switzerland, Denmark, Poland (Panning et al. 2008), with Italy witnessing its first CHIKV outbreak in 2007 (Rezza et al. 2007). Aim of review The Italian outbreak has demonstrated that only one viraemic person was required to instigate an outbreak and due to increased population movement worldwide, CHIKV could extend to pandemic proportions (Rezza et al. 2007). Furthermore, the outbreaks could have been underestimated due to its concurrence with other infections. Thus, this literature review will demonstrate to the reader that the Western medicine should be planning for CHIKV outbreaks which are becoming increasingly possible due to world climate change. Clinical Features Chikungunya is a mild and self limiting infection (Rezza et al. 2007) with incubation period of 2-7 days (Robinson 1955). Patients usually presents with a number of clinical features, with fever, fatigue, joint pain, anorexia, and nausea presenting as common clinical features (Table 1). Arthalgia and myalgia mainly involves the extremities of wrists, ankles, hands, feet and phalanges, while skin rash and petechiae are manifestations of haemorrhage (Kannan et al. 2009). During the La Reunion outbreak, Gà ©raldin et al. (2008) observed vertical transmissions from mother to child, with newborns presenting with chikungunya infection without prior mosquito bites. These neonates became symptomatic between 3-7 days postpartum, with presentation of fever, pain, poor feeding, disseminated intravascular coagulation (DIC) with gastrointestinal and cerebral bleeding, petechiae, and distal joint oedema. Encephalitis, thrombocytopenia and haemorrhagic fever were presented as severe neonatal infec tions; however, no fatalities were reported (Gà ©rardin et al. 2008). Transmission of CHIKV CHIKV requires two types of hosts to complete its replication cycle. Firstly, Aedes mosquito species transmits the virus to animals, and act as definitive hosts. Secondly, humans and other animals become infected with the virus and act as intermediate hosts. The transmission between the natural hosts (primates, birds, rodents and others) and the definitive hosts involves the sylvatic (main) cycle (Pardigon 2009). By disrupting this cycle, humans became incidental hosts, resulting in urban transmission cycles yielding epidemics. These humans could transmit CHIKV directly to domestic mosquitoes (Gould and Higgs 2009) and indirectly to domestic animals such as fowl, pigeons and goats (Lumsden 1955). When an Aedes mosquito ingests viraemic blood meal, CHIKV replicates in the salivary glands and ovaries, sites where it can be excreted. Upon another blood meal, the mosquito injects the viraemic saliva into a susceptible host. Contrary, within the ovaries, CHIKV is transmitted to the mosqui toes eggs by vertical transmissions (Figure 1). The desiccated nature of these eggs enables it to survive longer periods in the environment, where they are hatched during the rainy season (Gould and Higgs 2009). Figure 1. The overview of CHIKVs transmissions cycle in mosquito and human (Evenor 2010). Aedes mosquito becomes infected after taking a blood meal from an infected intermediate host Upon another blood meal, the Aedes mosquito injects viraemic saliva into a susceptible host The viraemic blood travels to the gut, where CHIKV undergoes replication within the gut wall The egg later developed into a mosquito infected with CHIKV CHIKV travels to the ovaries, where it is transmitted to the mosquitos eggs by vertical transmission The intermediate host becomes viraemic with presentation of clinical features CHIKV penetrated the gut wall, where it is disseminated through the bloodstream CHIKV travels to the salivary glands, where it undergoes replication Distributions of Aedes albopictus and Aedes aegypti Aedes aegypti was the predominant vector during earlier outbreaks in Africa (Lumsden 1955), and it has been implicated in some recent outbreaks in Africa (Gould et al. 2008) and Indonesia (Laras et al. 2005). However, Aedes albopictus have been described as the main vector implicated in a number of recent outbreaks, between 2005 to 2007 (Leroy et al. 2009, Pagà ¨s et al. 2009, Ratsitorahina et al. 2008, Renault et al. 2007, Sissoko et al. 2008). In the Gabonese outbreak involving both vectors, Vazeille et al. (2008) hypothesised that Aedes albopictus is a more suitable vector for CHIKV than Aedes aegypti, as it has a higher susceptibility for the virus. The two vectors have been recovered from several breeding sites with some overlap (Table 2). Tyres have been the main source of Aedes albopictus larval importation into Italy, in 1992, from Atlanta, USA. Consequently, the trade of these used tyres within Italy had caused large infestations of Aedes albopictus in Linguria, Veneto, Lom bardy and Eimlia-Romagna regions, by the end of 1995 (Knudsen et al. 1996). Aedes aegypti larvae predominate inside home, whereas Aedes albopictus larvae predominate outside home (Preechaporn et al. 2006). Table 2. The natural and artificial breeding sites for Aedes aegypti and Aedes albopictus larvae. Natural and artificial breeding sites Incidence of Aedes aegyptilarvae Incidence of Aedes albopictus larvae References Barrels X Gould et al.2008 Drums X X Gould et al.2008, Ratsitorahina et al.2008 Buckets X Ratsitorahina et al.2008 Flower pots X Gould et al.2008 Discarded cans X X Preechaporn et al.2006, Ratsitorahina et al.2008 Coconut shells X Preechaporn et al.2006, Ratsitorahina et al.2008 Clay water jars X Gould et al.2008 Mango tree holes X Lumsden 1955 Wetlands X X Vazeille et al.2008 Discarded tyres X X Preechaporn et al.2006, Ratsitorahina et al.2008 Plant pots X X Preechaporn et al.2006, Ratsitorahina et al.2008 Gardens X Adhami and Reiter 1998 Discarded plastic bottles X Adhami and Reiter 1998, Preechaporn et al.2006 Wet containers X Ratsitorahina et al.2008 Banana trees X Preechaporn et al.2006 Plant axils X Preechaporn et al.2006 Animal pans X X Preechaporn et al.2006 Plastic containers X X Preechaporn et al.2006 Cement tanks X X Preechaporn et al.2006 Ant guards X Preechaporn et al.2006 Preserved areca jars X Preechaporn et al.2006 Small and large earthen jars X X Preechaporn et al.2006 Key: (X):- present, (-):- absent. Effect of climate change Outbreaks have been associated with climatic conditions such as temperatures and high rainfall. Temperatures influence the developmental rate of Aedes albopictus larvae to adult mosquitoes, with the rate optimising at temperatures between 25 to 30oC (Straetemans 2008). Thus, Tilson et al. (2009) argued that mean monthly temperatures above 20oC are required to initiate an outbreak, as illustrated by the Italian outbreak that was initiated in June and subsided in September when the monthly average temperatures were 22oC and fell below 20oC. Mean annual rainfalls over 500mm is required (Straetemans 2008) to provide suitable breeding environment for the mosquitoes to expand their population (Lumsden 1955); as a result, most outbreaks have been associated with high rainfall (Lumsden 1955, Pastorino et al. 2004, Renault et al. 2007, Sissoko et al. 2008, Yoosuf et al. 2009) as illustrated in Table 3. In 2009, the UK Met office (2010) recorded a mean annual rainfall and temperature of 1201.3 mm and 9.2oC, respectively. The rainfall is sufficient to initiate an outbreak; however, the low temperature is insufficient to support the mosquitoes life cycle. Therefore, the question is what would the impact be to the UK if the climatic condition changes to favour this mosquito? Table 3. Mean temperature and the amount of rainfall that were reported during several outbreaks. Country Duration of the outbreak Mean monthly Temperature (oC) Months mean monthly temperature were collected Amount of Rainfall (mm) Months high rainfall were recorded Reference Tanzania 1952 1953 21.8 28.5 Jun Nov 1203 Jan Dec 1952 Lumsden 1955 Bogor Aug Dec 2001 24 26.2 Jan 2000 Dec 2001 NA Laras et al.2005 Bekasi Jan 2002 26.2 29.6 Jan 2001 Dec 2002 1931 Jan Feb 2002 Laras et al.2005 Maldives 2006 2007 NA NA 970 Nov Dec 2006 Yoosuf et al.2009 Key: NA- not available Distribution of Chikungunya outbreak Mayotte (French Overseas Territory), an island of the Comoros archipelago, encountered its first CHIKV outbreak imported from Grand-Comore in mid-April 2005 (Renault et al. 2007), with 6346 reported cases (in two waves), observed by the surveillance system implemented throughout the island by the local French Health Authority, Dass (Direction des affaires sanitaires et socials) Mayotte. The first (minor) wave commenced in April 2005, it later peaked in week 18 and the infection rate diminished in June, with the virus maintaining low levels thereafter, during the temperate and dry season. However, the second (major) wave began during the first week of May 2006, peaked during the hottest and rainiest months around March/April 2006 and reduced to control levels by July 2006 (Sissoko et al. 2008). In March 2005, a chikungunya infection which started in Grande-Comorre was imported into La Reunion (French Overseas Territory), becoming its first severe reported case involving two waves of outbreak, as observed by the epidemiological surveillance system implemented by the islands local Health Authorities (Renault et al. 2007). Firstly, a (minor) wave commenced in March 2005, peaked in May 2005 and decreased at the beginning of July to approximately 100 cases where the level was maintained during the austral winter. By December 2005 the second (major) wave began; however, the capacity of the surveillance system at the time was insufficient to evaluate the number of cases, as the number of cases was increasing exponentially. This resulted in an underestimation of the number of reported cases with possible misdiagnosis with Dengue fever which circulated the island the previous year (Renault et al. 2007). By April 2006, the Regional Health and Welfare Office reported 203 deaths that w ere directly (due to low immune status) or indirectly (in associations with other underlying conditions) attributed with chikungunya infection, with a low mortality rate of 0.3/1000 people (Renault et al. 2007). The Maldives encountered its first CHIKV outbreak involving 11879 confirmed and suspected cases on 121 of the 197 inhabited islands, observed by the surveillance system implemented by the Epidemiology Unit of the Department of Public Health (DPH), from December 2006 to April 2007 (Yoosuf et al. 2008). The outbreak commenced at the beginning of December 2006, peaked in week 6 and subsided to control levels by week 11 before halting in April 2007. The epidemic was thought to be associated with post-tsunami construction activities which provided breeding sites for mosquitoes. Moreover, approximately five to six elderly patients died as result of co-morbidity and other conditions (Yoosuf et al. 2008). Figure 2: Global Distribution of chikungunya virus, 1952 to 2009. The cases represented on the map are either confirmed cases or suspected cases (Evenor 2010). References: 1 Krastinova et al. 2006, 2 Rezza et al. 2007, 3 Pastorino et al. 2004, 4 Sissoko et al. 2008, 5 Lumsden 1955, 6 Tamburro and Depertat 2009, 7 CDC 2009, 8 WHO 2008, 9 Yoosuf et al. 2009, 10 Leroy et al. 2009. Importation into Europe England In 2006, the United Kingdoms (UK) Health Protection Agencys (HPA) Special Pathogens Reference Unit (SPRU) reported 133 imported cases of chikungunya (Table 4). The majority of these tourists had travelled to the Indian Ocean islands (68), between March and August 2006, where outbreaks were circulating, with Mauritius being the main destination site involving 58 imported cases, followed by 6 in the Seychelles, and 4 in Madagascar. However, when the outbreaks were in decline, only one case was detected in December (HPA 2007). Between August and December, 44 cases were imported from India and 10 cases were imported from Sri Lanka, between November and December; countries with reported recent chikungunya outbreaks. Also imported into the UK, where one case from Nigeria, one from Tanzania, one case from Kenya, and one case from Australia. There had been no mention of chikungunya outbreak in these countries. However, the article did not state whether there had been reported sightings of Ae des mosquitoes in UK (HPA 2007). Table 4. The number of cases was identified by different methods from the 133 imported cases, in the UK. Identification of the imported cases Number of cases Laboratory confirmed case 45 Probable case 30 Suspected case 35 Past exposure 23 France The Pitià ©-Salpà ªtrià ¨re Hospital in Paris, France, reported 80 cases of Chikungunya infection imported by tourists who recently visited the Southwest Indian Ocean region, between March 2005 and August 2006. The majority of cases (52) were imported from La Reunion (Hochedez et al. 2007), a popular destination site for French tourists (HPA 2006). Other destination sites reported were; Mauritius with 18, Comoros with 4, Madagascar with 3, and Mayotte with 2 cases (Hochedez et al. 2007). Within the same period, Metropolitan France reported 766 imported cases, which correlated with the two waves of the La Reunion outbreak (Figure 3). At the peak of the first La Reunion outbreak, an average of 20 cases was imported to France monthly. However, between August and November 2005, during the Southern Hemisphere winter, the cases decreased (Krastinova et al. 2006). A month after the peak of the second outbreak, the number of imported cases drastically increased. It can be argued that Fran ce is at risk of future outbreaks, in view that some of its inhabitants are constantly visiting the Southwest Indian Ocean regions (Hochedez et al. 2007), mainly La Reunion and also due to the inhabitation of Aedes albopictus (Krastinova et al. 2006). Figure 3: Correlation between imported cases of Chikunugunya in metropolitan France to the estimated number of cases in the La Reunion outbreak (Krastinova et al. 2006). Italy Chikungunya was apparently imported into Italy by a male tourist coming from the Kerala province in India, who developed febrile illness two days into his holiday. The region he visited was Castiglonia di Cervia in June 2007. This was recorded by Ravenna provinces local health unit in the Emilia Romagna region, northeastern Italy where 205 people developed CHIKV infection (Rezza et al. 2007). The vector, Aedes albopictus, was implicated in the spread of the virus which was then imported from Castiglione di Cervia into Castiglione de Revenna two villages separated by a river. Mosquito control measures implemented in the area resulted in a reduction in chikungunya infection. However, the control measure was not implemented in other villages and therefore a new wave occurred. The virus isolated from the outbreak contained the same mutational change (Ala226Val) in the membrane fusion E1 glycoprotein as the Indian Ocean variant, thereby suggesting that the Kerala strain could have origina ted from the Indian Ocean outbreak (Rezza et al. 2007). Other European Countries Tourism has been one of the main methods of CHIKV distributions worldwide, including its importation into several European countries. In 2006, the Bernhard-Nocht Institute for Tropical Medicine in Hamburg, Germany examined 720 samples from 680 European patients who became symptomatic upon return to Germany, Belgium, Switzerland, Denmark, and Poland from several destinations (Table 2) (Panning et al. 2008). The majority of patients had recently visited countries in the Indian Oceans; Mauritius, the Seychelles, La Reunion and Madagascar, and other countries; Bali, Indonesia, Sri Lanka, India, Malaysia, Kenya and Thailand. Moreover, most of these countries have been implicated in recent CHIKV outbreaks. No outbreaks were reported in these European countries; however, future outbreaks can be hypothesised (Panning et al. 2008). Table 5. The country of origin and the holiday destinations of patients presented at the Bernhard-Nocht Institute for Tropical Medicine in Hamburg, Germany. Exact destinations were only available for 27.8% of patients, and exact itinerary were not available (Panning et al. 2008). Country of origin Number of patients Germany 515 Belgium 99 Switzerland 42 Denmark 22 Poland 2 Total Nos. of patients 680 Holiday Destinations (Regions with Chikungunya Epidemic) Number of patients Mauritius 92 The Seychelles 23 La Reunion 18 Madagascar 9 Bali 2 Indonesia 6 Sri Lanka 5 India 28 Malaysia 2 Kenya 1 Thailand 3 Concurrence with Dengue Fever and Malaria In 2006 and 2007, Madagascar and Gabon reported co-infections between Chikungunya and DENV-1 or DENV-2 respectively (Ratsitorahina et al. 2008, Leroy et al. 2009). Contrary to CHIKV, dengue virus (DENV) is of Flavirivirus genus from Flaviridae family; consisting of four antigenically distinct but closely related serotypes (DENV1-4). It is transmitted by Aedes aegypti and Aedes albopictus, also CHIKV transmission vectors (Cook and Zumla 2009). DENV and CHIKV have similar clinical features (Yoosuf et al. 2008). However, the only difference is that CHIKV has arthalgia (). The extended incubation period of DENV (5-8 days) differentiated it from CHIKV (2-7 days); however, the difference is insignificant (Cook and Zumla 2009). Thus, serological diagnosis can be used to differentiate DENV to CHIKV (Ratsitorahina et al. 2008). Ratsitorahina et al. (2008) and Leroy et al. (2009) confirmed Aedes albopictus as the predominating transmission vector of both CHIKV and DENV1 or 2. However, neither study stated whether the vector could simultaneously harbour both viruses. Moreover, the study by Vazeille et al. (2008) demonstrated that Aedes aegypti has a higher susceptibility to DENV-2 virus and a lower susceptibility to CHIKV; whereas Aedes albopictus is a more efficient vector for CHIKV than DENV-2 (Vazeille et al. 2008 and Moutailler et al. 2009). Leroy et al. (2009) further demonstrated this theory in the Gabon outbreak, as the majority of the patients had CHIKV compared to DENV-2. In May 1999 and February 2000, the Matete and Kingabwa quarters of Kinshasa in the Democratic Republic of Congo (DRC) reported two Chikungunya outbreaks. CHIKV was the main contributing factor in the first outbreak; however, during the second outbreak, evidence confirmed possibility of co-infections between CHIKV and Plasmodium falciparum (Pastorino et al. 2004). Malaria is a parasitic infection, of the Apicomlexa phylum, that mainly infects hosts red blood cells. It is transmitted by Anopheles species, whereas CHIKV is mainly transmitted by Aedes species. Plasmodium falciparum is one of the four species of Human Malaria (including Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale). However, Plasmodium falciparum is the most severe form of Malaria (Cook and Zumla 2009). Pastorino et al. (2004) hypothesised that co-infections could be due to long term latency of Plasmodium falciparum, the presence of both transmission vectors in the area or the pathogens sharing the same vec tors. An experimental investigation by Yadav et al. (2003 as cited by Pastorino et al. 2004) demonstrated that urban Anopheles stephensi (Plasmodium falciparum vector) could transmit CHIKV. Lack of Research We are still in the preliminary stages of understanding the interaction between CHIKV and host immunity (Kam et al. 2009), despite increasing number of reported outbreaks, there are insufficient evidences of up-to-date quality research (Panning et al. 2008). Therefore, outbreaks should be utilised to implement entomological and epidemiological system in improving our poor knowledge of the virus (Pialoux et al. 2007). Chretien and Linthicum (2007) argued that the Italian outbreak should provide opportunities for developed countries to strengthen the public-health system of developing countries in order to reduce the worldwide spread of outbreaks. These can be done by implementing Entomological and Virological surveillance in Aedes albopictus infested areas (Charell et al. 2008). Renault et al. (2007) utilised Deltamethrin insecticides to eradicate adult mosquitoes, whereas Rezza et al. (2007) utilised synergised pyrethrins. Furthermore, both authors utilised the biological larvicide, Bacillus thuringiensis israelensis, to destroy breeding sites (Renault et al. 2007, Rezza et al. 2007); however, Renault et al. (2007) later utilised Fenitrothion and temephos. Other control measures include educating the community on personal protection (Ratsitorahina et al. 2008). Although, no commercial vaccine has been approved, several candidates have been tested including the Formalin inactivated CHIKV vaccine for the Indian strain, DRDE-06, ECSA genotype (Tiwari et al. 2009). Therefore, the author believes that future outbreaks can be avoided if more research on CHIKV is undertaken, and a worldwide surveillance system is implemented. Conclusion This review has demonstrated that tourism is one of the main methods of CHIKV distributions worldwide, as it was the reason of several outbreaks. CHIKV was transported throughout the Southwestern Indian Ocean islands by viraemic tourists visiting different islands (Figure 2) and Kerala, India, which was then imported into Italy (Renault et al. 2007, Rezza et al. 2007, Sissoko et al. 2008, Yoosuf et al. 2008). However, outbreaks require temperatures above 20oC and annual rainfall over 500mm to maintain Aedes mosquitoes populations (Straetemans 2008, Tilson et al. 2009). Therefore, England is one of the least at risk country, as Aedes albopictus is not present, and the temperature is unfavourable to maintain mosquitoes life cycle (HPA 2007, Met Office 2010). Countries such as France and Italy are at high risk, due to the presence of Aedes albopictus and the introduction of CHIKV; although, Italy is the most at risk due to a recent outbreak (Krastinova et al. 2006, Rezza et al. 2007). T he eminent climatic changes could result in rising temperatures and increased rainfall that would favour the establishment of Aedes albopictus worldwide. All these emphasises the need for Western medicine to plan for future CHIKV outbreaks, by implementing a worldwide surveillance system in order to monitor outbreaks and to perform vector control measures (Charell et al. 2008). Chikungunya have concurrence with Malaria and Dengue Fever (Leroy et al. 2009, Ratsitorahina et al. 2008); furthermore, evidence suggests wrong classification of Chikungunya due to its resemblance to Dengue fever. CHIKV is constantly mutating, thus constant development of a new vaccine is required (Tiwari et al. 2009). Thereby, further researches are needed.

Oscar Romero :: essays research papers

Oscar Romero was at first a quiet, ordinary priest in the democratic country of El Salvador. But things change once newly appointed Arch-Bishop. Romero quickly finds out the way the country is run by the military. The poor people of Salvador are missing and being executed by the military. Romero tries to stop these events through the power of the Church. Raul Julia plays Oscar Romero the soft spoken priest turned Arch-Bishop. His character goes through a metamorphoses from beginning to end that eventually gets him killed. The one moment in time that really changes the way he acts is the death of Father Grande. Fr. Grande was a preacher to the poor or anyone who wanted to listen to the Word of the Lord. By the killing and torturing of people Romero gets very angry and says STOP! In one scene while in prison listening to a priest get tortured, he doesn’t understand why one human being would do this to another. We are all human and why should their life be taken away if they have done nothing. The Church in this movie are people very strong in their faith and stand up for what they believe in. For example, When the people of one city walk right into a church that has been taken over by the military. This shows their willingness to die for God. Other acts show the people of El Salvador courage and deep faith. I thought that this was a very good movie. The strong imagery and sadness that these events really occur in El Salvador and other countries like it. The words of Romero were inspiring, the way he presented himself after every bad act by the military he just turned the