The Anti-Marijuana Advertising Campaign :: Research Essays

The Anti-Marijuana Advertising Campaign Public Service Announcements or Public Disservice Announcements?For nearly one hundred and cardinal years marijuana has been illegal in the United States of America. Though marijuana naturally grew in all of our fifty states, it was outlawed due the superior authorisation and durability of hemp rope. This threatened to replace cotton rope, which would cost wealthy cotton accepters a lot of money. To this day marijuana is still outlawed in the U.S., however rope has nothing to do with it. Once slavery and the cotton boom were over hemp made a little bit of a comeback in a smoking form. Then, in the early 1940s the government began releasing anti-marijuana propaganda. In the 1960s when marijuana became popular amongst pop-culture, a photo by the name of Reefer Madness was released depicting marijuana users as fiends and criminals whos normal eachday lives fell apart, and spun out of control due to the addiction to the drug. Even in t he present day organizations, as well as the government, continue to try and sway people from using the substance by personation users as irresponsible idiots. Some examples of behaviors portrayed in the commercials are accidental shootings, running over a little girl on a bike, molesting a passed out girl, supporting terror, and impregnating/becoming impregnated. I feel that these advertisements are ridiculously tasteless and misleading. Through personal experience, surveys, an interview, and a case study I imagine to prove that marijuana users do not behave in the fashion that the anti-marijuana campaign ads would suggest, and furthermore, I expect to find that the ads so grossly misrepresent the parkland user, even those who do not use disagree with the negative portrayals. I also challenge you to think about the suggested situations and behaviors from the commercials, I feel that youll see every situation and behavior in the advertisements is much more feasible to a person under the influence of alcohol than under the influence of marijuana. In wander to test my theory I was going to need to use a few different methods of obtaining data. The first method is for me to just use past experiences from my own life. I use marijuana on a regular basis and have friends who do as well, so this is a good base for flavour at how people act when using the substance.

Understanding the the Romantic Imagination with Ramond, Wordsworth and

spirit the the Romantic Imagination with Ramond, Wordsworth and Shelley Works Cited Not IncludedThe way to find the real world is non merely to measure and observe what is outside us, but to break out our own inner ground. This ground, this world where I am mysteriously present at one time to myself and to the freedoms of other men, is not a visible, objective and determined anatomical structureIt is a living and self creating mystery of which I am myself a part, to which I am myself my own unique door. (Thomas Merton in Finley 45) We have spent a good deal of this semester concentrating on the sublime. We have asked what (in character) is sublime, how is the sublime described and how do different writers exemplify the sublime. A sublime experience is recognizable by tell apart words such as awe, astonishment and terror, feelings of insignificance, fractured syntax and the general inability to describe what is being experienced. comprehension and interpretation of the sublime are directly linked to personal circumstance and suffering, to spiritual beliefs and yet expectation (consider Wordsworths disappointment at Mont Blanc). It has be accrue evident that thither is a transition space between what a traveller experiences and what he writes a intrust wherein words often fail but the experience is intensified, even mum by the traveler. This space, as I have understood it, is the imagination. In his quest for spiritual identity Thomas Merton offers the above quotation to illustrate what he c whollys interpenetration between the self and the world. As travel writers engage nature through their imagination, Mertons description of the inner ground is an appropriate one for the Romantic conception of the imagination. ... ...here are similar aspects to from each one writers experience. Engaging the imagination, Ramond, Wordsworth and Shelley have experienced a kind of iodine conscious of the self as the soul they are simultaneously aware of freedoms of other men. I suggested in the introduction that the imagination is a transition place wherein words often fail but the experience is intensified, even understood by the traveler. For all three writers the nature of the imagination has, amazingly, been communicable. Ramond and Wordsworth are able to come to an articulate conclusion virtually the effects imagination has on their perceptions of nature. Shelley, however, remains skeptical about the power of the imaginative process. Nonetheless, Shelleys experience is as real, as anxious as that of Ramond and Wordsworth. Notes 1. Duncan Wus foot note, page 403. 2 Tintern Abbey. Line 97. Understanding the the Romantic Imagination with Ramond, Wordsworth and Understanding the the Romantic Imagination with Ramond, Wordsworth and Shelley Works Cited Not IncludedThe way to find the real world is not merely to measure and observe what is outside us, but to discover our own inner ground. This ground, this world where I am myst eriously present at once to myself and to the freedoms of other men, is not a visible, objective and determined structureIt is a living and self creating mystery of which I am myself a part, to which I am myself my own unique door. (Thomas Merton in Finley 45) We have spent a good deal of this semester concentrating on the sublime. We have asked what (in nature) is sublime, how is the sublime described and how do different writers interpret the sublime. A sublime experience is recognizable by key words such as awe, astonishment and terror, feelings of insignificance, fractured syntax and the general inability to describe what is being experienced. Perception and interpretation of the sublime are directly linked to personal circumstance and suffering, to spiritual beliefs and even expectation (consider Wordsworths disappointment at Mont Blanc). It has become evident that there is a transition space between what a traveler experiences and what he writes a place wherein words often fai l but the experience is intensified, even understood by the traveler. This space, as I have understood it, is the imagination. In his quest for spiritual identity Thomas Merton offers the above quotation to illustrate what he calls interpenetration between the self and the world. As travel writers engage nature through their imagination, Mertons description of the inner ground is an appropriate one for the Romantic conception of the imagination. ... ...here are similar aspects to each writers experience. Engaging the imagination, Ramond, Wordsworth and Shelley have experienced a kind of unity conscious of the self as the soul they are simultaneously aware of freedoms of other men. I suggested in the introduction that the imagination is a transition place wherein words often fail but the experience is intensified, even understood by the traveler. For all three writers the nature of the imagination has, amazingly, been communicable. Ramond and Wordsworth are able to come to an articu late conclusion about the effects imagination has on their perceptions of nature. Shelley, however, remains skeptical about the power of the imaginative process. Nonetheless, Shelleys experience is as real, as intense as that of Ramond and Wordsworth. Notes 1. Duncan Wus foot note, page 403. 2 Tintern Abbey. Line 97.

Essay --

The article grants the macroeconomic indicators influences on profitability of firms recompense on KSE 100 index (construction and material).the macroeconomic indicators include FDI, INTEREST RATE, EXPORT, and IMPORT. In this study we are taking 19 companies regarding construction and materials listed in KSE 100 index. To check the effect of Profitability on firms earnings through EBIT, ROE, ROA. Fertility in construction and material sector market plays a vital role in the economy of Pakistan, thus profitability is all important(p) for responsive construction and materials sector in KSE 100 index.According to a paper done, whose intension to find out the effect of macroeconomic gages on humble and medium enterprises effectiveness which indicates that In contemporary years, Lithuania applies considerable interest to SMES productivity, but investigation associated to the valuation of complicated macro aspects and their impact on the think performance of Small and Medium Enterprise s is not satisfactory. (Bekeris, 2012) It has been observed that FDI has positive impression on firms out...

Planet of the Apes Essay -- essays research papers

Planet of the ApesWhen Planet of the Apes opened in theaters, few people knew what to expect. To most, the idea of a movie with the premise of a planet full of intelligent apes went against e precisething they had been taught. The initial attraction was the superb cast, spearheaded by Charlton Heston who portrays Taylor, an astronaut who crashes onto the planet. Heston was joined by many usual actors and actress such as, Roddy McDowell as Cornelius, Maurice Evans as Dr. Zaius and Kim Hunter as Zira. Though the cast may have been the initial draw, the content is what has made the movie Planet of the Apes a classic that will reside to be enjoyed for generations to come.The movie Planet of the Apes deals with a great number of issues that come up in everyday societal life. If peerless looks closely at the reputation, it is very easy to realize that Planet of the Apes is not at all approximately apes, but truly about mankind. It is a story about the human condition, and the port h umans interact with their natural environment. It is a story about the dangers of religion, and even more powerfully a warning about the dangers of a politically active church. Planet of the Apes is a political allegory. From the beginning to the end of the film, the viewer is shown a picture of a world ruled by a heavy turn over government, and led by apes that represent the church and state alike. The main character that is an example of this is Dr. Zaius, Chief Prosecutor and Defender of the Faith, who rules both(prenominal) nat... Planet of the Apes Essay -- essays research papers Planet of the ApesWhen Planet of the Apes opened in theaters, few people knew what to expect. To most, the idea of a movie with the premise of a planet full of intelligent apes went against everything they had been taught. The initial attraction was the superb cast, spearheaded by Charlton Heston who portrays Taylor, an astronaut who crashes onto the planet. Heston was joined by many popular actors and actress such as, Roddy McDowell as Cornelius, Maurice Evans as Dr. Zaius and Kim Hunter as Zira. Though the cast may have been the initial draw, the content is what has made the movie Planet of the Apes a classic that will continue to be enjoyed for generations to come.The movie Planet of the Apes deals with a great number of issues that come up in everyday societal life. If one looks closely at the story, it is very easy to realize that Planet of the Apes is not at all about apes, but truly about mankind. It is a story about the human condition, and the way humans interact with their natural environment. It is a story about the dangers of religion, and even more powerfully a warning about the dangers of a politically active church. Planet of the Apes is a political allegory. From the beginning to the end of the film, the viewer is shown a picture of a world ruled by a heavy handed government, and led by apes that represent the church and state alike. The main ch aracter that is an example of this is Dr. Zaius, Chief Prosecutor and Defender of the Faith, who rules both nat...

Biometric Security Technology Essay -- Technological Computers Essays

Biometric Security TechnologyYou have seen biometric engineering science in the films Mission Impossible and Gattaca. The technology has also graced the covers of many weekly news magazines. But many people, even though the technology has been widely talked about for the last half decade, argon as yet surprisingly unawargon of what biometrics are and why the technology is so important for computer security and personal identification.Biometrics are automated methods of recognizing a person based on a physical or behavioral characteristic (2001). Essentially, biometric security technologies are used to accurately identify individuals on a unique trait. The most common biometric security techniques used currently are signature verification, face geometry, finger scan, hand geometry, passive iris scan, retina scan, and voice chump (2004c).According to The Biometric Consortium, enterprise-wide network security infrastructures, government IDs, secure electronic banking, investing a nd other financial transactions, retail sales, law enforcement, and health and social services are currently benefiting from biometrics (2001). Though biometric technology will soon be commonplace on personal home computers and small company computer systems, the high comprise of biometric security means that, for the most part, currently only federal, state, and local governments, the military, and large corporations will be able to afford the new technology. That said, however, hardware manufacturers and software developers are currently creating and selling products for the office user who wants to protect their machines from nosey coworkers (2004a). And Microsoft, developer of the world?s most popular computer operating system, said newer versions ... ...ion.html 23 June 2004.(2002, February 18). About Biometrics. instruction Technology Laboratory. Online. Available http//www.itl.nist.gov/div893/biometrics/about.html 23 June 2004.Bertolucci, James. (2004a, June 25). Products for the Paranoid. PC World Online. Available http//www.pcworld.com/news/ bind/0,aid,116573,00.asp 23 June 2004.Mace, Scott. (2004b, February 24). Gates Previews Security Projects. PC World Online. Available http//www.pcworld.com/news/article/0,aid,114916,00.asp 23 June 24.O?Brien, James A. (2004c). Management Information Systems Managing Information Technology in the Business Enterprise. New York McGraw-Hill.Newell, Adrienne. (2004d, March 19). Are Biometrics Coming to a PC Near You? PC World Online. Available http//www.pcworld.com/news/article/0,aid,115289,00.asp 23 June 2004.

Identity Theft :: Journalistic Essays

Identity TheftEveryone loves shopping online, you save time, not exactly money, but who cares when its holi mean solar day time, at least you wont need to fight for a parking spot in the hectic malls. Growing up in Americas technological day and age, almost everyone has a computer or at least knows how to operate one. People like the easy way out, and it has its benefits. Year by year, things seem to take a leak easier and easier. Therefore, people are getting lazier. Well, I say, goodbye laziness, and hello being aware of where you place those important documents. Theres very poor you can do to prevent it, and you wont know its happened to you until its too late. Identity theft is currently the fastest growing cause of robbery in the United States. When a person steals someones identification documents without them knowing, and uses their information, the crime is called Identity Theft. About one in fin victims knows the individualism thief as a relative, roommate, neighbor, or coworker, according to the FTC ID Theft Data Clearinghouse report, says reporter Isham Jones for Realtor Magazine Online. There are two main types of identity fraud that enables people to steal your identity. They are financial fraud, being the most widespread including credit card, bank, telecommunications, tax refund, and several another(prenominal) types of scams. Criminal activity is the other type fraud that involves taking someones identity and using it to commit heinous crimes. Identity theft accounted for 42 percent of the thousands of consumer complaints reported to the FTC in 2001. The FTC processes these complaints through Consumer Sentinel, an electronic clearinghouse available to investigative groups such as the FBI and the U.S. Secret Service as well as to similar groups in other countries, reports waterline reporter Carole W. Butler. There are m any laws that lash out against identity theft and help protect you against it, but it doesnt seem like its scaring any of the criminals. ID theft is still the number one crime in AmericaIdentity theft can happen to anyone, and to avoid being put in a situation like this one you have to review your Credit report at least once a year. Purchase a ruptureder to shred all documents with personal information before throwing them away. Be responsible over every bank statement, and keep them under close watch. Dont consign mail using your unsecured mailbox. Have your social security number changed if it is the same as your drivers license number.

Identity Theft :: Journalistic Essays

Identity TheftEveryone loves shopping online, you save time, not exactly money, but who c atomic count 18s when its holiday time, at least you wont need to competitiveness for a parking spot in the hectic malls. Growing up in Americas technological day and age, almost everyone has a calculating machine or at least knows how to operate one. People want the easy way out, and it has its benefits. Year by year, things seem to get easier and easier. Therefore, people are acquire lazier. Well, I say, goodbye laziness, and hello being aware of where you place those important documents. Theres very little you can do to encumber it, and you wont know its happened to you until its too late. Identity theft is currently the fastest growing type of robbery in the united States. When a person eliminates someones identification documents without them knowing, and uses their entropy, the crime is called Identity Theft. About one in five victims knows the identity thief as a relative, roomma te, neighbor, or coworker, according to the FTC ID Theft Data Clearinghouse report, says reporter Isham Jones for Realtor Magazine Online. There are two main types of identity fraud that enables people to steal your identity. They are financial fraud, being the most widespread including credit card, bank, telecommunications, tax refund, and several other types of scams. Criminal activity is the other type fraud that involves pickings someones identity and using it to commit heinous crimes. Identity theft accounted for 42 percent of the thousands of consumer complaints reported to the FTC in 2001. The FTC processes these complaints through Consumer Sentinel, an electronic clearinghouse obtainable to investigative groups such as the FBI and the U.S. Secret Service as well as to similar groups in other countries, reports Waterline reporter Carole W. Butler. There are many laws that lash out against identity theft and help protect you against it, but it doesnt seem like its scaring any of the criminals. ID theft is still the number one crime in AmericaIdentity theft can happen to anyone, and to avoid being put in a situation like this one you have to review your Credit report at least once a year. Purchase a shredder to shred all documents with personal information before throwing them away. Be responsible over every bank statement, and keep them under close watch. Dont send mail using your unguaranteed mailbox. Have your social security number changed if it is the same as your drivers license number.

Downtown Beirut, Response on Mohsen’s Article Essay

Downtown Beirut a spot pour les bourgeois In his article Downtown Beirut A City of Ghosts? , create in the Alakhbar English journal on Saturday, January 7 2012, Ahmed Mohsen describes the heart of Beirut as an empty, fake, artificial come downing spot for the elite, so distant and alienated from the kitchen-gardening and the civilization of the good old Beirut cognize for its diversity among different social classes.Mohsen considers rebuilding the capital after the traumatizing war have indeed its full-strength identity and covered its alleys with fake architecture that destroyed the historical beauty of what once was known as the Paris of the Middle East. For many, whats known today as Solidere , projects the new post war era, the era of a flourishing economy and an pilot film society. In fact, the new buildings are indeed zipper more than an overpriced imitation of other countries architecture leaving the old Beirut and its rich Middle Eastern history nothing more than a me mory along with its social traditions.Mohsen pointed out in his article that after rebuilding the center of the capital, the original citizens in Wadi Abu Jamil and its surroundings are no hourlong there. According to the authors article Wadi Abu Jamils original residents and owners have vanished. (Page 120) I personally believe that the old Beirut with its old, wrecked buildings and crowded marshy alleys is a unique haven of coexistence between the various religious sects and the different social classes unlike the new Down Town or DT with its new original buildings inhabited by only one social class.The High class. The reconstruction of Beirut put money and artificial beauty over the iodine of the classes and the unity of the different peoples that lived for centuries in Lebanon and their reunification after the devastating war. In his article, the author criticized the fact that only rich people can shop or hang out in the DT saying For those who can afford it, the place to s hop in business district is Beirut souks. (Page 119). In fact, all the shops present in downtown are indeed expensive for the average citizen.But the problem is that even the most basic things in a small shop are a lot more expensive than any other place in the country. Buying a simple cone of ice cream will cost you something most 2000 L. L in Lebanon, but buying it from downtown will cost you about 7000 L. L. All the artificial beauty that is supposed to encourage the Lebanese around the world to go back to their country is in fact, a repulsive, ugly place reserved for the elite and rich tourists from neighboring Arabic countries.

Firm value and share price strategy Essay

BAE facing ch all(prenominal)enges on Intensive competition and budget defence cuts by their major customers should focus on increasing component partholders impartiality by reducing of damages, adapting capabilities to the changing priorities of their customers and improve their Programme execution. Directors should monitor working detonating device expenditures to ensure that unnecessary further debt would be incurred that inevitably has an effect on book values. higher(prenominal) book values (stockholders uprightness) act as a positive in a buyers assessment of purchase price, to some extent providing at least the illusion of a floor in value (Nations Business 2006).4) Recommendations dealing with corporate governance Currently BAE Systems has faced problems facing its shareholders imputable to its criticism received on corporate governance and ethical conduct (Daily Mail 2010). As a recommendation, BAE should follow the financial reporting council (FRC) proposition on putti ng greater emphasis on the principles of UKs corporate governance code, and apply the annual shareholder re-election. This would have a significant impact a wider engagement for the companys shareholders.A necessary midyear review process should be conducted by an external facilitator to help in the emilitary rating process, metrics much(prenominal) as board effectiveness by dealing with issues in a timely manner should be considered. Having a wide and complex set of operations, training dissemination in a timely manner is very important to ensure appropriate decisions. Key performance Indicators should be the guideline across all the managing directors and their performance will be evaluated by comparison of their developed results from targets.5) Critical evaluation of the model used Using financial models can provide actual figures for projection analysis that can create awareness for a companys board of directors (Palmgren 1999). The Residual Income Model can be used as a val uation of the firm, based on its total book value and relief income ( pecuniary Education 2010). During recent historic period it has been used as the primary valuation method due(p) to its measurement of internal corporate performance and feasible estimation of the intrinsic value of common stock.The difference between a residual income and traditional financial statements are for the latter its purpose of preparation is to reflect gelt available to its owners, charges incurred for equity capital and dividends are not included, while the former(prenominal) adds the comp 1nt of cost of equity capital for its calculation (Dodd 2001). Another limitation of the traditional income model is that it may not actually reflect the value of definite business activities.Such in our case with BAE systems numerous acquisitions, on its accounting model it seems that BAE have significantly improved profitability on its strategies, however this could not be all false, but using the residual i ncome approach some of the acquisitions doesnt have the kind of effect, due again to the cost of equity capital (Bild, Guest,Cosh and Runsten 2002). 6) Conclusion BAE Systems being in an industry where intense competition exists should apply necessary strategies to ensure profitability in the coming years both for continuous operation and maximizing shareholders equity.Their current strategies for acquisition may have get aheaded them but the cost of violation of regulation procedures have definitely wedge over all operations. Using financial models like the residual income model, the board of directors can see, what would happen if they continue with their current policies on corporate strategy and governance, it has shown a negative impact on present firms value, thus the recommendation for consideration of a new effective strategy to be enforced across the board. List ofReferences BAE Systems (2010) one-year Report 2009.PDF uncommitted from http//bae-systems-investor- relat ions-2009. production. investis. com/results-reports-and-presentations. aspx 09 May 2010. Brylawski, M. (1995). Developing a circumstance-based Innovation Strategy for a Midsized Aerospace ManufacturerFostering Entreprenuership, Opening Boundaries and Seeding Disruption. PDF Available from . 09 May 2010. Bild, M. , Guest,P. , Cosh, A. , and Runsten, M. (2002). Do takeovers create value? A residual income approach on UK data. PDF Daily Mail (2010).BAE flies into storm with shareholders. Available from . 09 May 2010. Dodd, J. (2001). direct income, residual income and EVA Which metric is more value relevant. Journal of Managerial Issues. Financial Education (2010). The Residual Income Valuation Model. Available from http//financial-education. com/2007/10/30/the-residual-income-valuation-model/ 09 May 2010. Financial Times (2010). FT Market Data BAE Systems.Available from http//markets. ft. com/ft/tearsheets/analysis. asp? s=BA.LSE. 09 May 2010. Nations Business (1996). 10 ways to join on your firms value realise Worth. Available from http//findarticles. com/p/articles/mi_m1154/is_n11_v84/ai_18818240/. 09 May 2010.Palmgren, B. (1999). The Need for Financial Models. Available from http//www. ercim. eu/publication/Ercim_News/enw38/palmgren. html. 09 May 2010. Smith, T & Frost,L. (2008). BAE Buys Tenix defence to Double Sales in Australia. Online Available from 09 May 2010. Wachman, R. (2010). BAE Systems hit by defence cuts.Available from http//www. guardian. co. uk/business/2010/mar/22/bae-systems-defence-spending-cuts 09 May 2010. West, K (2010). BAE goes aggrandizement of the global arms league. Online Available from 09 May 2010. Appendices Appendix 1 Five year Summary Income Statement of BAE Systems. Source retrieved 9 May 2010 Extract from annual Report 2009 http//bae-systems-investor-relations-2009. production. investis. com/financial-information/five-year-summary. aspx Appendix 2 Group Income Statement.Source Extract from one-year Report 2009 for the year ended 31 December. Retrieved 10 May 2010 http//bae-systems-investor-relations-2009. production. investis. com/financial-information/group-income-statement. aspx Notes 2009 ?m intact 2009 ?m 2008 ?m Total 2008 ?m Continuing operations Combined sales of Group and equity accounted investment fundss 3 22,415 18,543 Less share of sales of equity accounted investments 3 (2,041) (1,872) Revenue 3 20,374 16,671 Operating be 4 (20,060) (15,386) Other income 5 465 415 Group operating profit excluding amortisation and impairment of intangible assets 2,038 2,003.amortization 11 (286) (247) Impairment 11 (973) (56) Group operating profit 779 1,700 Share of results of equity accounted investments excluding finance costs and taxation expenditure 233 132 Financial ( disbursement)/income of equity accounted investments 6 (7) 44 Taxation expense of equity accounted investments (23) (37) Share of results of equity accounted investments 14 203 139 Goodwill impairment in respect of equit y accounted investments 14 (121) Contribution from equity accounted investments 203 18 EBITA1 excluding non-recurring items 2,220 1,897 Profit on disposal of businesses2 9.68 238 Pension curtailment gains2 261 Regulatory penalties3 (278) EBITA1 2,271 2,135 Amortisation (286) (247) Impairments (973) (177) Financial (expense)/income of equity accounted investments 6 (7) 44 Taxation expense of equity accounted investments (23) (37) Operating profit 3 982 1,718 Finance costs 6 Financial income 1,573 3,380 Financial expense (2,273) (2,727) (700) 653 Profit before taxation 282 2,371 Taxation expense 8 UK taxation (105) (351) Overseas taxation (222) (252) (327) (603) (Loss)/profit for the year (45) 1,768 Attributable toBAE Systems shareholders (67) 1,745 Minority interests 22 23 (45) 1,768 (Loss)/earnings per share 10 Basic ( breathing out)/earnings per share (1. 9)p 49. 6p Diluted (loss)/earnings per share (1. 9)p 49. 5p Appendix 3 Group Balance Sheet as at 31 December. Source Extract from Annual Report 2009. Retrieved 10 May 2010 http//bae-systems-investor-relations-2009. production. investis. com/financial-information/balance-sheet. aspx Notes 2009 ?m 2008 Restated ?m Fixed assets Tangible assets 2 4 5 Investments in subsidiary undertakings 3 7,070 5,663 7,074 5,668 Current assets Debtors due within one year 4.7,468 9,339 Debtors due after one year 4 14 3 Other financial assets due within one year 262 703 Other financial assets due after one year 5 179 478 Cash at bank and in hand 5 2,804 1,988 10,725 12,511 Liabilities move due within one year Loans and overdrafts 6 (37) (49) Creditors 7 (14,490) (12,873) Other financial liabilities 5 (255) (598) (14,782) (13,520) Net current liabilities (4,057) (1,009) Total assets less current liabilities 3,017 4,659 Liabilities move due after one year Loans 6 (233) (258) Creditors 7 (3) (6) Other financial liabilities 5 (327) (574).(563) (838) Provisions for liabilities and charges 8 (61) (120) (2,393) (3,701) Capital and reserves Issued share capital 10 90 90 Share premium account 12 1,243 1,238 Statutory reserve 13 202 202 Other reserves 12 119 164 Profit and loss account 12 739 2,007 Equity shareholders funds 2,393 3,701 Appendix 4 Group Cash Flow for the year ended 31 December. Source Extract from Annual Report 2009. Retrieved 10 May 2010 http//bae-systems-investor-relations-2009. production. investis. com/financial-information/ exchange-flow. aspx Notes 2009 ?m 2008 ?m (Loss)/profit for the year (45) 1,768.Taxation expense 327 603 Share of results of equity accounted investments 14 (203) (139) Net finance costs 700 (653) Depreciation, amortisation and impairment 1,600 755 Gain on disposal of property, plant and equipment 4, 5 (17) (33) Gain on disposal of investment property 5 (5) Gain on disposal of businesses 5 (68) (238) Cost of equitysettled employee share schemes 52 51 Movements in provisions 52 (115) Decrease in liabilities for retirement benefit obligations (657) (272) Decrease/(increas e) in working capital Inventories 6 46 Trade and other receivables 52 (5).Trade and other payables 433 246 Cash inflow from operating activities 2,232 2,009 arouse paid (250) (249) Interest element of finance lease rental payments (2) (5) Taxation paid (350) (261) Net cash inflow from operating activities 1,630 1,494 Dividends received from equity accounted investments 14 77 89 Interest received 66 156 Purchases of property, plant and equipment (483) (520) Purchases of intangible assets (42) (32) harvest-festival from sale of property, plant and equipment 36 44 Proceeds from sale of investment property 5 Purchase of subsidiary undertakings 27, 29 (357) (1,078).Cash and cash equivalents acquired with subsidiary undertakings 27 33 2 Purchase of equity accounted investments 27 (1) (12) Proceeds from sale of subsidiary undertakings 9 2 131 Cash and cash equivalents disposed of with subsidiary undertakings (60) Proceeds from sale of equity accounted investments 9 70 16 Net proceeds f rom (purchase)/sale of other deposits/securities (209) 164 Net cash outflow from investing activities (808) (1,095) Capital element of finance lease rental payments (13) (18) Proceeds from issue of share capital 5 16 Purchase of own shares (25) (43) Equity dividends paid 28.(534) (478) Dividends paid to minority interests (5) (11) Cash inflow/(outflow) from matured derivative financial instruments 36 (440) Cash (outflow)/inflow from movement in cash collateral (11) 106 Cash inflow from loans 920 Cash outflow from repayment of loans (133) (306) Net cash inflow/(outflow) from support activities 240 (1,174) Net increase/(decrease) in cash and cash equivalents 1,062 (775) Cash and cash equivalents at 1 January 2,605 3,046 Effect of foreign exchange rate changes on cash and cash equivalents 11 334 Cash and cash equivalents at 31 December 3,678 2,605.

Define Pneumonia And Explain Health And Social Care Essay

Pneumonia is transmitting that affects either one or both of the lungs. It is non a individual ailment and it whitethorn fox to a greater extent than 30 types of variant engenders, including bacteriums, Fungis and viruses. In immature kids with the age of less than 5 experient ages old, viral pneumonia is the most common type of pneumonia, with its most common cause being the grippe virus. There be m any other(a) viruses that skunk do pneumonia any smudge good, much(prenominal) as respiratory syncytial virus, herpes simplex virus, rhinovirus and terrible acute respiratory syndrome ( SARS ) .Community-acquired pneumonia is the most common type of pneumonia which is acquired in public countries equivalent the school, food formet shop or operative topographic transport. It mogul be ca employ by either bacteriums, Fungis, virus or the thorns present in the air, with the most common cause being the bacterium streptococci pneumoniae. Its beginment fuel at any rate hap pen followers a grippe or cold 1 .Hospital-acquired penumonia which is overly known as institution-acquired pneumonia is acquired in the infirmary, speciall(a)y patch remaining and under disturbance in the intensive attention unit ( ICU ) or using a ventilator to help in stimulate a breathing. It universally besides develops following a major s preachry including thorax surgery or during dialysis in kidney dialysis centres or remaining in chronic attention centres. It has the possible to be really unsafe, oddly to those who be immature, aged or immune-compromised 1 .List the clinical symptoms ( systemic versus respiratory ) associated with pneumonia.Systemic symptoms 2 lowly or high febrility Shaking icinesss Concern Loss of appetency Fatigue, low energy Increased perspiration and clammy tegument Confusion ( peculiarly in the aged )Respiratory symptoms 2 Cough ( whitethorn includes production of light-green or xanthous mucous discrimination, even prodigal mucous secretion in certain types of pneumonias ) Shortness of breath ( might merely happen while mounting up stepss ) Stabbing or crisp thorax hurt which eject decline with deep breath orcoughUsing the SMART-COP tool and the information provided above calculate MR Barnes SMART-COP check out and find if Mr Barnes has mild, chair or terrible CAP.Mr Barnes SMART-COP mark is 6, which mean he has terrible CAP and has a high hazard ( 33 % ) of necessitating intensive respiratory or vasopressor support ( IRVS ) 3 . The mark might be lower than his existent mark though due to the deficiency of information sing Mr Barnes albumen concentration in plasma, mettle rate, mental function and blood pH.Complete the undermentioned intervention program for the direction of Mr Barnes CAP, as would be outlined in the uncomplaining of of s admittance notes, utilizing the tabular array provided.Treatment programExplain the launch for your recommendation/responsewhen make bounteousing in the spa ces. the physician has commited certain streamlets andobservations etcto get stilt the undermentioned IV semiempirical antibiotics ( include endure breaker ) moxifloxacin 400mg IV, daily & A azithromycin 500mg IV, daily.Broad-spectrum antibiotics are required ab initio for the intervention of Streptococcus pneumoniae, Legionella penumophila, and participateal Gram-negative B. Since Mr Barnes is allergic to penicillin, moxifloxacin is apply in topographic point of penicillin.for paracetamol 0.5 to 1g orally or aspirin 600mg orally for pleuritic thorax pain sensation.To tally sufficient analgesia to en adapted equal respiratory motions in add-on to cut leting the hazard of atelectasis and pneumonia.for auxiliary O via rhinal prongs.Because Mr Barnes O impregnation is 89 % which is rather low.for salbutamol 5mg q4h prn via atomizer.For the intervention of airflow restriction or for the break downment in mucociliary clearance.for repetition chest X ray in following 2 yea rss.To do certain that the intervention is effectual for the pneumonia transmittance 1 .withhold Altace tablets.To forestall farther decrease in Mr Barnes blood push per unit area as he is already in hypotensive province.for day-to-day full blood examination ( FBE ) , U & A E s, Creatinine.To look into the white blood cells count and type, and besides to find the badness of Mr Barnes s pneumonia transmittance.for QID observations ( BP, Resp Rate, Temp, O2 impregnation ) .To find whether Mr Barnes is retrieving good from the pneumonia infection.follow up blood and phlegm nuances.To supervise the obliteration of the specific contributive agents of Mr Barnes pneumonia.What changes to prove consequences, observations and patient symptoms would the medical staff and you as do drugsgist proctor, to bespeak that the antibiotic therapy is effectual?I ordain supervise Mr Barnes x-ray consequence, if the x-ray consequence showed that the pneumonia infection country is cut downing so that means the antibiotic therapy is effectual. Furthermore, I impart besides supervise the pulse oximetry or blood gases test consequence, if the O impregnation goes up closer to 95 % so the antibiotic therapy is most probable effectual. in any event this, I will besides supervise the day-to-day full blood examen consequence, the antibiotic therapy is effectual if the white blood cells count is returning to the normal floor. I would besides supervise the consequence of his blood and phlegm civilizations. If the figure of the causative agents of his pneumonia is continuously cut downing, that indicates that the antibiotic therapy is effectual.Besides this, I will besides supervise Mr Barnes temperature, blood force per unit area and respiratory rate as good. If all of them bit by bit returned to their several normal degrees so the antibiotic therapy is effectual. Not merely this, I will besides detect and postulate whether does Mr Barnes initial showing symptoms much(pren ominal) as coughing that produces phlegm, pleuritic thorax hurting and feeling of unease are bettering. If they are bettering, so the antibiotic is most likely effectual.( I ) What common-law(predicate) antibiotic would you urge for Mr Barnes given all afore mentionedinformation?I would urge moxifloxacin, 400mg orally, daily for Mr Barnes 3 .( cardinal ) What would be the recommended length of antibiotic intervention?The recommended continuance of antibiotic intervention is 7 yearss.( cardinal ) In point signifier list the guidance points you would supply to Mr Barnes for thisantibiotic.Take moxifloxacin together with repasts. stay off taking alkalizers, Fe and Zn addendums within 2 hours of taking moxifloxacin as they might come in with the soaking up of moxifloxacin.Be certain to train up moxifloxacin until finish.Moxifloxacin can ensue in giddiness, confusion or faintness, which may so take to cut down ability to drive and/or operate machinery. These make can be exacerb ated by intoxicant ingestion.If experience any tenderness of redness of sinew, bankrupt moxifloxacin, do nt exert, and confer with the physician in the shortest clip as possible.It is common to see sickness, stomachic disturbance and diarrhea while taking moxifloxacin.Ensure plentifulness of fluids brainchild ( 1.5-2L per twenty- quad hours ) while taking moxifloxacin.Avoid from utilizing urinary alkalinisers together with moxifloxacin as on that point is the hazard of cystalluria.Moxifloxacin might increase the caffeine s effects in certain people by suppressing its metamorphosis, hence decrease in caffeine consumption might be required.For the pneumonia caused by the undermentioned pathogens, list the antibiotic ( s ) you would urge for directed therapy . Complete the tabular array below.Pathogen doing the pneumoniaDescription of the pathogenis it gram negative or gram positive bacteriums?is it aerophilic or anaerobiotic?is it a fungus or virus?Antibiotic recommendationNon-MR SA staphylococcal pneumoniaIt is a Gram-positive aerophilic bacteriums. ( facultative anaerobe if is aureus )Di/flucloxacillin 2g IV, 4 to 6 hourly. With penicillinhypersensitivity ( exceptingimmediatehypersensitivity ) Cefalotin 2g IV, 4 hourly.Cephazolin 2g IV, 8 hourly. With immediate penicillinhypersensitivityVancomycin 1.5g IV, 12 hourly.Legionella speciesIt is a Gram-negative aerophilic bacteriums. With mild unsoundnessAzithromycin 500mg orally, daily for 5 yearssORDoxycycline 100mg orally, 12 hoursly for 10 to 14 yearss. With terrible complaintAzithromycin 500mg IV or orally, daily. sum totalCiprofloxacin 400mg IV, 12-hourly.Pseudomonas aeruginosaIt is a Gram-negative aerophilic bacteriums.Gentamycin 4 to 6 mg/kg for 1 dosage, so dosing time interval is determined by nephritic map for a upper limit of either 1 or 2 extra doses.PLUS EITHERceftazidime 2g IV, 8-hourly.ORMeropenem 500mg to 1g IV, 8-hourly.Mycoplasma pneumoniaeIt is a Gram-negative facultative anaerobic bacteri ums.Doxycycline 200mg orally, for the first dosage, followed by 100mg orally, daily.MentionsFamilyDoctor.org family unit paginate on the cyberspace . Leawood, KS American Acedemy of Family Physicians c2012 cited 2012 syndicate 20 . Pneumonia round 9 screens . Available from hypertext reassign communications protocol //familydoctor.org/familydoctor/en/diseases-conditions/pneumonia.printerview.all.htmlAmerican Lung affiliation home page on the net . Washington, DC American Lung Association c2012 cited 2012 Sept 20 . Symptoms, Diagnosis and Treatment about 4 screens . Available from hypertext transfer protocol //www.lung.org/lung-disease/pneumonia/symptoms-diagnosis-and.html.eTG complete home page on the mesh . Victoria, Australia therapeutic Guidelines Limited c2012 updated 2012 Jul cited 2012 Sept 20 . Available from hypertext transfer protocol //etg.tg.com.au.ezproxy.lib.monash.edu.au/conc/tgc.htm? id=27b1fc15b4331af2841f02ef96ddc67bLab Trials Onlin e home page on the net profit . Washington, DC American Association for clinical Chemistry c2001-2012 cited 2012 Sept 20 . Pneumonia about 4 screens . Available from hypertext transfer protocol //www.labtestsonline.org.uk/understanding/conditions/pneumonia/start/3Monash University Studies Online home page on the cyberspace . Victoria, Australia Monash University c2012 updated n.d. cited 2012 Sept 20 . Available from hypertext transfer protocol //muso.monash.edu.au/ webct/urw/lc19907.tp0/cobaltMainFrame.dowebctThe Ohio State University at Mansfield home page on the Internet . Mansfield, OHIO The Ohio State University at Mansfield c2012 cited 2012 Sept 20 . Bacteria Binomials about 32 screens . Available from hypertext transfer protocol //www.mansfield.ohio-state.edu/sabedon/biol4045.htmRowlinson M. C, LeBourgeois P, Ward K, Song Y, Finegold S. M, Bruckner D. A. Isolation of a Strictly Anaerobic Strain of Staphylococcus epidermidis. J Clin Microbiol series on the Internet . 2006 March cited 2012 September 20 44 ( 3 ) about 12 screens . Available from hypertext transfer protocol //www.ncbi.nlm.nih.gov/pmc/articles/PMC1393158/Case bailiwick 2A definition of Epididymo-orchitis ( EO )Epididymo-orchitis is painful redness that involves either the epididymis ( epididymitis ) or the screwballs ( orchitis ) or both together ( epididymo-orchitis ) 1,2 . Due to the fact that epididymis and testiss locate following to for each one other, distinguishing whether the redness merely affects one of these or both together can frequently be hard and therefore, epididymo-orchitis is the normally used term.Sexually transmitted infection much(prenominal) as gonorrhea or chlamydia is the most common cause of EO in younger work forces with the age of & lt 35 old ages old 1 . On the other manus, non sexually familial infection such(prenominal) as urinary man of land infection is the chief cause of EO in fourth-year work forces aged 35 old ages old and above.It can normally be treated by antibiotics with full recovery in most instances without any complications 2 .( I ) Epididymo-orchitis can be acquired sexually or non-sexually supply a elaborateaccount of this statement.Epididymo-orchitis ( EO ) has both types of chief causes, viz. sexual causes and non-sexual causes.Sexual causes include sexually-transmitted infections, with chlamydial and gonorrhoeal infections being the most common 1s 2 . This is the most usual cause of EO in younger work forces although this can besides be the cause of EO in any work forces who are sexually active. In most instances of EO caused by sexually-transmitted infections, the urethra is normally affect and ensuing in urethritis, followed by the infections on occasion distributing down the vessel deferens and farther more to the testicle and epididymis, doing EO.Non-sexual causes include urinary piece of land infections, epidemic parotitiss virus, medicate, operations that involve the urethra or prostate, scrotum hurt and other viral infections, with urinary piece of land infection being the most common cause among thsee 2 . Urinary piece of land infections are normally caused by Gram-negative enteral bacteriums like E. coli which may on occasion distribute to the testicle and epididymis via the vessel deferens 2,3 . This affects all work forces at any age and is the most usual cause of EO in older work forces with the age of 35 old ages and supra. The underfur behind this is that urine flow is normally being partially blocked with increasing age as a consequence of hypertrophied prostate or urethra narrowing, taking to higher hazard of developing urinary piece of land infection and therefore EO as complication.Mumps virus both bit good as other viruses doing viral infections may be able to make the testicles done the blood stream on occasion, and therefore, ensuing in epididymo-orchitis ( EO ) 2 . Medication such as Cordarone may besides hold the side consequence of doing EO which normally occurs with the dosage of more than 200mg. Operation which involves the prostate or urethra may present bacteriums into those places from which the bacterium can distribute to the testicles and doing EO, although this cause is high-flown nowadays thanks to break surgical techniques.( two ) a list of the likely causative pathogens of EO ( sexually and non-sexuallyacquired ) and complete the following table 3,4,5,6,7,8,9,10 Name of likely pathogenDescription of the pathogenis it gram negative or gram positive bacteriums?is it aerophilic or anaerobiotic?is it a fungus or virus?Which antibiotic ( s ) is this pathogen normally pliable to?Sexually acquiredChlamydia trachomatisIt is a gram negative, aerophilic, intracellular bacteriums.CefriaxoneAzithromycinDoxycyclineNeisseria gonorrhoeaeIt is a gram negative, aerophilic bacteriums.CefriaxoneAzithromycinDoxycyclineNON-sexually acquiredEscherichia coliIt is a gram negative, facultative anaerobic bacteriums.AztreonamImipenemMump virusIt is a virus.Haemophilus influenzaeIt is a gram negative, facultative anaerobic bacteriums.ChloramphenicolDoxycyclineCeftriaxoneMoxifloxacinNeisseria meningitidisIt is a gram negative, aerophilic bacteriums.CiprofloxacinCeftriaxonePenicillinRifampinMycobacteria TBIt is a gram positive ( phylogenetically ) , stains acerb fast, aerophilic bacteriums.IsoniazidRifampinPyrazinamideA list of the likely marks and symptoms of Epididymo-orchitisThe marks of epididymo-orchitis ( EO ) are 11 Fever.scrotal puffiness.Penile discharge.Groin hurting.Bloody seeds.Pain during interjection or intercourse.Tenderness and puffiness of the affected side s groin country.Tenderness and puffiness of the testis associated with heavy feeling inside it.Pain in the testis exacerbated by striving or bowel motion.Pain associated with micturition.The symptoms of EO which may be seen upon physical scrutiny are 11 Enlarged and stamp testis on the side affected.Enlarged or t ender prostate secretory organ.Groin country of the affected side holding enlarged and tender lymph nodes.What other symptomatic psychometric tests would you anticipate to be hold been done or ordered for Mr Thompson to assistance in the diagnosing of EO?Other diagnostic examinations which I expect to be hold been done or ordered are 11 Testicular ultrasoundUrinalysis piss civilization ( clean gimmick ) which more than one sample might be required, inclusive of initial watercourse, midstream every bit good as following prostate massage.Screening streak for gonorrhoea and chlamydia via urethral vilificationSusceptibility test of the causative agents ( in the instance of bacterial cause ) .( I ) Which intravenous ( IV ) antibiotics would you urge for empiricalintervention of Mr Thompson s Epididymo-orchitis and province the ground ( s ) for your pick?I would urge the undermentioned IV antibiotics for empirical intervention 12 gentamicin 4 to 6mg/kg IV, for 1 dosage, upper lim it of 1 to 2 farther doses dosing interval is so determined based on nephritic map.PLUSAmoxycillin / ampicillin 2g IV, 6 hourly.The ground of taking these antibiotics is that Mr Thompson is most likely to acquire Epididymo-orchitis ( EO ) from a non-sexual cause and his EO is terrible, hence the recommended picks of antibiotics are short-run Garamycin and amoxycillin / Principen harmonizing to the eTG web site. However, as Principen can interact with Coumadin, potentially increasing the hazard of hemorrhage, amoxycillin which might merely somewhat increase the hazard of hemorrhage may be used in topographic point of it with supervising 12, 13 . Besides this, he is besides non holding hypersensitivity to penicillin and therefore, antibiotics belonging to this drug category can be used.( two ) Which trial consequences should be followed up in order to direct antimicrobictherapy?The trial consequences that should be followed up are 3,12 Urine civilizationScreening trial for gono rrhoea and chlamydiaSusceptibility trialTesticular ultrasound of declaration of epididymo-orchitis is slow.( three ) If Mr Thompson s clinical status improved and the physicians wanted to alter his IV antibiotics to an unwritten antibiotic, which one do you believe would be suspend? List the guidance points you would supply for this antibiotic.I think cephalexin 500mg orally, 12 hoursly for the continuance of 14 yearss would be appropriate because the first-line antibiotic trimethoprim is non effectual 12 .The guidance points which I will supply are 14,15 Try to take Keflex without nutrient, slightly 1 hr precedent to meal or 2 hours after a repast.Take Keflex together with a full glass of H2O.It is rather common to see sickness, oppress or diarrhea during intervention with Keflex.Be certain to take the full class of Keflex until finish even when experiencing better.If still see diarrhea ( fallible and bloody stools ) 2 months or more after the last dosage of Keflex, contac t physician in the shortest clip possible.( four ) What would be the entire continuance of intervention with antibiotics for Mr Thompson s EO?Mr Thompson s EO intervention with antibiotic will last for the entire continuance of 17 yearss 12 .( V ) Besides antimicrobic therapy what other therapy ( pharmacological and non- pharmacological ) should be portion of Mr Thompson s intervention program? Non-pharmacological therapyAllow Mr Thompson to rest on bed with his scrotum elevated.Apply ice battalions to the affected scrotum country.What social occasion would you set about to corroborate that Mr Thompson s usual medicines are accurately decreed on the admittance drug graph 16 ?I will transport out a Medicine Management Review.I will do verification with Mr Thompson sing to his medicine explanation which is obtained during his admittance to the infirmary, every bit good as with his community wellness attention supplier where appropriate.If possible, I will seek to corroborate ea ch and every of Mr Thompson s medicine history with a second beginning following the undermentioned hierarchy ofCarer & gt Family & gt nursing place & gt ain medicines & gt community pharmacist & gt general practician ( GP ) .Beside this, I will facsimile the admittance drug chart for the intent of verification to Mr Thompson s GP or community pharmacist if necessary.Furthermore, I will enter down what the physician planned for every listed medicines.I will besides do certain that all the listed medicines matches the medicines that are prescribed on the medicine chart and at the alike(p) clip, taking the physician s program into history.Further informationName of drugExplanation of why you require this informationFor illustrationINR trial consequenceWarfarinTo look into if INR is within alterative scope proctor for warfarin toxicity to find Coumadin dosageBlood force per unit area 17 RamiprilTo guarantee that blood force per unit area is well-controlled within the normal s cope.Serum Lanoxin degree, marks and symptoms of Lanoxin toxicity 17 DigoxinTo guarantee that blood blood serum Lanoxin degree is within curative scope and to avoid Lanoxin toxicity.Heart rate 17 amiodaroneTo supervise for any new marks of arrhythmia.Urine civilization / Susceptibility trial consequence 12 GentamicinAmoxycillin / PrincipenCephalexinTo guarantee that the causative agents for the epididymo-orchitis is susceptible to these antibiotics and that they are suited antibiotic picks.Body weight, serum electrolytes 12 FrusemideTo look into whether frusemide dose titration is required or non.There are legion possible drug related jobs in this instance ( & gt 10 ) . List of three ( 3 ) possible drug-related jobs associated with Mr Thompson s medicine you, as the druggist, would expect and sketch how you would pull off them and/or proctor for them 13 .Digoxin and CordaroneProblems May take to digoxin toxicity ( such as sickness, cardiacarrhythmias and emesis ) .Managemen t Reduce Lanoxin dosage by around 50 % and supervise the serum Lanoxin degree every bit good as expression out for marks and symptoms of Lanoxin toxicity. If discontinuance of Lanoxin is possible so discontinue Lanoxin.Amiodarone and CoumadinProblems May increase the hazard of serious or even fatal hemorrhage.Management Reduce the dosage of Coumadin by around 1/3 or 1/2 and supervise the factor II clip every bit good as INR valueAmiodarone and isobutylphenyl propionic acidProblems May increase isobutylphenyl propionic acid s plasma degree.Management Caution with the concurrent usage of Cordarone and isobutylphenyl propionic acid. Monitor often for NSAID-related inauspicious effects and see seting the dosage of isobutylphenyl propionic acid.MentionsSexual Health home page on the Internet . Kingston upon Thames, Surrey Sexual Health c2012 cited 2012 Sept 21 . Epididymo-orchitis about 4 screens . Available from hypertext transfer protocol //www.sexualhealthkingston.co.uk/sexual -health-information/stis/men/epididymo-orchitisHealth Information and Advice home page on the Internet . England Egton Medical Information Systems Limited c2012 cited 2012 Sept 21 . Epididymo-orchitis about 9 screens . Available from hypertext transfer protocol //www.patient.co.uk/health/Epididymo-orchitis.htmNZSHS home page on the Internet . New Zealand The New Zealand Sexual Health family Incorporated c2012 cited 2012 Sept 21 . Epididymo-orchitis_2009 about 3 pages . Available from hypertext transfer protocol //www.nzshs.org/treatment_guidelines/Epididyomo-orchitis_2009.pdfEuropean Bioinformatics Institute home page on the Internet . Cambridge, UK c2012 cited 2012 Sept 21 . Chlamydia trachomatis about 2 screens . Available from hypertext transfer protocol //www.ebi.ac.uk/2can/genomes/bacteria/Chlamydia_trachomatis.htmlThe Ohio State University at Mansfield home page on the Internet . Mansfield, OHIO The Ohio State University at Mansfield c2012 cited 20 12 Sept 20 . Bacteria Binomials about 32 screens . Available from hypertext transfer protocol //www.mansfield.ohio-state.edu/sabedon/biol4045.htmNHS Clinical Knowledge Summaries home page on the Internet . mellowed Holborn, London discipline Institute for Health and Clinical Excellence c2011 cited 2012 Sept 20 . CKS Clinical Knowledge Summaries about 3 screens . Available from hypertext transfer protocol //www.cks.nhs.uk/scrotal_swellings/background_information/causes/epididymo_orchitisChamberland S, LEeuyer J, Lessard C, Bernier M, Provencher P, Bergeron M. G, The Canadian Study Group. Antibiotic Susceptibility Profiles of 941 Gram-negative Bacteria Isolated from Septicemic Patients throughout Canada. Clin Infect Dis series on the Internet . 1992 Oct cited 2012 September 21 15 ( 4 ) about 15 pages . Available from hypertext transfer protocol //www.jstor.org.ezproxy.lib.monash.edu.au/stable/pdfplus/4456676.pdf? acceptTC=trueSill M. L, Tsang R. S. W. Antibiotic Susceptibility of Invasive Haemophilus influenzae Strains in Canada. Antimicrob Agents Chemother series on the Internet . 2008 April cited 2012 September 21 52 ( 4 ) about 7 screens . Available from hypertext transfer protocol //www.ncbi.nlm.nih.gov/pmc/articles/PMC2292521/Cochrane Summaries home page on the Internet . Oxford, UK The Cochrane collaboration c2012 cited 2012 Sept 21 . Antibiotics for forestalling meningococcal infections about 2 screens . Available from hypertext transfer protocol //summaries.cochrane.org/CD004785/antibiotics-for- staying-meningococcal-infectionsDUJS Online home page on the Internet . New hampshire Dartmouth College Hanover c2008 cited 2012 Sept 21 . Antibiotic Resistance of Tuberculosis about 6 screens . Available from hypertext transfer protocol //dujs.dartmouth.edu/winter-2009/new-trickes-for-an-old-foe-the-threat-of-antibiotic-resistant-tuberculosisPubMed Health home page on the Internet . Bethesda, MD National Center f or Biotechnology Information c2012 cited 2012 Sept 21 . Orchitis about 5 screens . Available from hypertext transfer protocol //www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002259/eTG complete home page on the Internet . Victoria, Australia Curative Guidelines Limited c2012 updated 2012 Jul cited 2012 Sept 20 . Available from hypertext transfer protocol //etg.tg.com.au.ezproxy.lib.monash.edu.au/conc/tgc.htm? id=27b1fc15b4331af2841f02ef96ddc67bMicromedexA 2.0 home page on the Internet . U.S Thomson Reuters c1974-2012 updated n.d. cited 2012 Sept 21 . Available from hypertext transfer protocol //www.thomsonhc.com.ezproxy.lib.monash.edu.au/micromedex2/librarian/ND_T/evidencexpert/ND_PR/evidencexpert/CS/5A8A78/ND_AppProduct/evidencexpert/DUPLICATIONSHIELDSYNC/75C929/ND_PG/evidencexpert/ND_B/evidencexpert/ND_P/evidencexpert/PFActionId/pf.HomePageUniversity of Washington home page on the Internet . Seattle, Washington University of Washington c2012 cited 2012 Sept 21 . Mos t Normally confident(p) Drugs Anti-Infectives about 61 pages . Available from hypertext transfer protocol //courses.washington.edu/pharm504/ABXPresentation.pdfDailyMed home page on the Internet . Bethesda, MD U.S. National depository library of Medicine c2012 cited 2012 Sept 21 . Keflex ( Cephalexin ) capsule Advancis Pharmaceutical Corporation about 14 screens . Available from hypertext transfer protocol //dailymed.nlm.nih.gov/dailymed/drugInfo.cfm? id=6490 nlm34076-0Department of Health home page on the Internet . Melbourne, Victoria Department of Health c2012 cited 2012 Sept 21 . Medication Reconciliation On Admission about 8 pages . Available from hypertext transfer protocol //www.health.vic.gov.au/sssl/downloads/qld_tool.pdfMedsafe Home Page home page on the Internet . Wellington New Zealand Medicines and Medical Devices Safety Authority c2012 cited 2012 Sept 21 . Keep an fondness on Amiodarone Patients about 4 screens . Available from hypertext transfer protocol //www.medsafe.govt.nz/profs/puarticles/amiod.htm AmiodaroneCase Study 3A brief description of Tuberculosis ( TB ) and how it is transmitted.Tuberculosis ( TB ) is an infective bacterial disease which most often affects the lungs 1 . However it is besides able to impact other organic building parts like the spinal column, kidney and encephalon 2 . Terbium can be fatal if it is non being treated decently. Patients with active Terbium can be treated by antibiotics intervention with the continuance of six months while patients with latent Terbium can besides be treated so that active TB will non develop 1,3 . Those patients with latent TB have a life-time hazard of 10 % to develop active TB disease and this hazard is much higher for those with compromised immune systems such as diabetic patients or human immunodeficiency virus patients 1 .Terbium is transmitted from human to human via the air 3 . The TB bacterium is propelled into the air whenever a individ ual infected with active Terbium of the lungs or pharynx sneezings, speaks, coughs, tongues or sings 1,3 . Merely really few figure of the TB bacterium is required to be inhaled by another individual for that individual to be infected with it 1 . However, a individual who is infected with TB bacteriums but non yet manifest the disease ( latent TB ) will non convey the TB bacteriums to other individual.The likely pathogen ( s ) .The likely pathogen doing TB is the bacteriums Mycobacterium TB 1 .A list of those individuals at the greatest hazard for undertaking TB in peculiar in Mrs Rawat s instance 1,2 .Young grownups who are in their old ages of extremum productiveness, in this instance, Mrs Rawat s lone boy Neel.Workers in installations or establishments where they are working aboard with other people who have high hazard of TB infection such as the nursing places, correctional installations and infirmaries. In this instance, Mrs Rawat herself and besides her collechills and fevers in the local infirmary where she is working part-time.Patients who are immuno-compromised, particularly HIV patients. In this instance, certain patients ( those who have weakened immune system ) in the local infirmary where Mrs Rawat is working part-time.Tobacco users.Persons who are stateless.Injection drug users.The marks and symptoms of pneumonic TB 2 .Chest hurtingPersistent bad cough that lasts more than 3 hebdomads, with blood or phlegm.Weight loss.Chills.Fatigue or failing.Loss of appetency.Sweating at dark.The diagnostic trials ( microbiological, radiological etc ) and clinical information used to corroborate the diagnosing of TB 2 .Tuberculin skin trial ( besides known as the Mantoux tuberculin skin trial ) It is carried out by shooting a little sum of tuberculin into the lower portion of the arm s tegument. After around 48 to 72 hours, capable wellness attention worker will look for country that is raised, difficult or swollen. If such country is present, i ts size will be measured by utilizing a swayer. The inflammation entirely is non considered as portion of the reaction. This trial s consequence is dependent on the size of such country mentioned above every bit good as the hazard of the individual being tried and true to be infected with TB ( TB ) bacterium and if the individual being tested is infected, the patterned advance towards TB disease. A positive trial consequence will intend that the individual being tested is infected with TB bacteriums. However, whether the infection is latent TB or active Terbium can non be determine by this trial. In add-on, this trial may give a glowering positive trial consequence for some people who have received the bacille Calmette-Guerin ( BCG ) vaccinum for TB disease earlier, hence extra trials may be postulate in instances of positive trial consequence for this trial.TB blood trial ( besides known as the interferon-gamma release checks ( IGRAs ) ) This trial chiefly measure the responsive ness of the immune system of the individual being tested towards the causative bacterium for TB by making blood proving in the research lab. Presently there are two IGRAs that have been approved by the U.S. Food and Drug Administration ( FDA ) which are QuantiFERONA-TB Gold In-Tube trial ( QFT-GIT ) and T-SPOTA.TB trial ( T-Spot ) . A positive trial consequence will bespeak that the individual being tested is infected with TB bacteriums. This trial nevertheless, will non be able to find the TB infection is active TB or latent TB. For people who have received the BCG vaccinum for TB disease and those who ca nt happen appropriate clip for 2nd assignment of tuberculin skin trial, this trial is the preferable trial method.Medical historyPatient s TB exposure, disease, or infection history is obtained. Demographic factors such as age, origin state and business which may increase the exposure hazard of the patient to TB are besides considered. In add-on, medical conditions of the patient which may besides increase the hazard of the development of latent TB infection to active TB disease are besides determined.Physical scrutinyThis might give of import information sing the patient s overall status every bit good as other factors which can alter the TB intervention program. For illustration, HIV infection position.Chest radiogramThis is for the sensing of thorax abnormalcies. In instances of TB infection, lungs lesion may appears anyplace in divers(prenominal) form, size, denseness and cavitation. This is deficient to definitively name TB but can be used in a individual who has had positive trial consequence in the tuberculin skin trial or TB blood trial in order to govern out the possibility of that individual holding pneumonic TB. diagnostic MicrobiologyThe presence of TB disease can be indicated by acid-fast-bacilli s ( AFB ) presence on a phlegm vilification or any other specimen. Confirmation of the TB diagnosing can non be made based on acid-fast microscopy ent irely although it is speedy and easy due to the fact that non all acid-fast-bacilli are M. TB. For this ground, civilization of all the initial samples, irrespective of their AFB vilification consequences is needed to corroborate the TB diagnosing. A positive M. TB civilization confirms the TB disease diagnosing.Drug oppositionAll the initial M. TB isolated from every patients is required to undergo drug immune trial every bit first as possible so as to guarantee the most effectual intervention for the patients. For those TB patients who do non demo sufficient response to intervention or those who still have positive civilization consequences following intervention that lasted for three months or more, this trial should be repeated.Once the diagnosing of TB has been confirmed Mrs Rawat will be commenced on an anti-TB drug regimen. In your presentation address the followers( I ) What is the treatment doctor induce to make by jurisprudence?The treating doctor is obligated by jurispr udence to describe both clinically suspected and besides confirmed TB instances to the designated section within the timeframe of 24 hours 2 .Depending on provinces, the handling doctor might be besides obligated to describe non-adherent patients with TB, where non-adherent might include intervention surcease, go forthing the infirmary against medical advice or failure in following to intervention program every bit good as other preventative steps to avoid TB transmittal 2 .( two ) List the drugs ( and the day-to-day dosage of each ) that you think Mrs Rawat will be commenced on for standard short-course therapy of TB. Using the tabular array below, for each of the four drugs used in the standard short-course therapy of TB outline the followersName of the drug & A dose 4 List the common side effects 5,6 Main guidance points you would supply to the patient about this drug- in point signifier 7,8,9 .Isoniazid 300mg orally, daily for 6 months.Peripheral neuropathy, GI upset, m etabolic alterations, blood dyscrasias, hepatic alterations, vitamin B6 lack.Be certain to take all the medicine boulder ashes coating.Avoid ingestion of intoxicant to forestall farther liver harm.Take on an empty tummy, at to the lowest degree half an hr before repasts and at bedtime.Rifampicin 600mg orally, daily for 6 months.Itching, concern, confusion, diarrhea, vision alterations, giddiness, flushing, sleepiness, behavior alterations, tummy spasms, piss, perspiration, phlegm, and cryings ruddy stain.Be certain to take all the medicine boulder clay coating.If tegument or eyes develop xanthous stain or if urine discolours to cola coloring material, contact physician every bit shortly as possible.May cause perspiration, urine and cryings to hold orange stain which is non harmful.Avoid have oning contact lenses because rifampicin can stain them for good.Avoid ingestion of intoxicant to forestall farther liver harm.Take on an empty tummy, at least half an hr before repasts and at bedtime.Ethambutol 750mg orally, daily for 2 months.Appetite loss, tummy disturbance, purging, custodies or pess numbness and prickling due to peripheral neuritis.Be certain to take all the medicine boulder clay coating.Avoid ingestion of intoxicant to forestall farther liver harm.Avoid from taking alkalizers together with ethambutol, infinite more than 2 hours apart.Pyrazinamide 1500mg orally, daily for 2 months. run disturbance, weariness.Be certain to take all the medicine boulder clay coating.Avoid ingestion of intoxicant to forestall farther liver harm.( three ) Which of the four anti-TB drugs in the standard short-course therapy causes peripheral neuritis? What extra addendum is prescribed at the same time to prevent/ minimise this inauspicious consequence from happening?Isoniazid, ethambutol, rifampicin and pyrazinamide can do peripheral neuritis 7, 10 . Pyridoxine ( vitamin B6 ) can be prescribed at the same time to prevent/ minimise peripheral neuritis from happening 11 .( four ) Prior to the first dosage of the antecedently mentioned anti-TB drugs, Mrs Rawat will necessitate to undergo a series of pre-therapy trials and baseline measurings name these trials and briefly explain the ground for each.Name of pre-therapy trial 4 Name of drug ( where relevant )Explanation of why this information/ trial is requiredWeightRifampicin, ethambitol, pyrazinamide 4 To find the appropriate antibiotics dose to be use 4 . colorful map trialsIsoniazid + rifampicin, pyrazinamide 12 To supervise for hepatotoxicity potentially caused by the TB drugs 12 .Nephritic map trialsEthambutol 4 To supervise nephritic clearance and prevent accretion of ethambutol in the organic structure if nephritic clearance diminutions 4 .Ocular sharp-sightednessEthambutol 4 To supervise for marks of optic toxicity 4 .Colour vision provingEthambutol 4 To supervise for marks of optic toxicity 4 .Full blood countTo supervise for anemia, neutropenia and lymphocytopenia 13 .H IV proving after appropriate guidanceRifampicin 4 To find the hazard of rapid patterned advance of TB disease / reinfection and besides possible important drug interactions with antiretroviral drugs in instance of HIV-positive 4, 14 .Screening for chronic viral hepatitis ( B and C )Isoniazid + rifampicin, pyrazinamide 12 To find the hazard of hepatotoxicity potentially caused by the TB drugs 12 .( V ) Use the Cockcroft-Gault expression to cipher Mrs Rawat s Creatinine Clearance and province the dosage ( s ) of the medicine ( s ) you would give Mrs Rawat.Ideal organic structure weight = 57.2kgAge = 60kgHeight = 165cmSerum creatinine = 260 micromol / LCreatinine clearance = 0.85= 18.38 milliliters / min Ethambutol s dose demands to be changed to 600mg orally, daily for 2 months 4 .( six )Name callings of the interacting drugs 15 Mechanism of the drug interaction & A clinical consequence 15 Clinical direction 15 Rifampicin Cardizem CadmiumRifampicin may bring on the metamo rphosis of diltiazem CD, doing loss of the consequence of Ca channel blocker and hence, might ensue in clinical marks and symptoms of angina or high blood pressure.Increases the dosage of cardizem Cadmium.Rifampicin LosecRifampicin might bring on the CYP2C19 and CYP3A4-mediated metamorphosis of Losec, ensuing in reduced Losec plasma concentrations.Avoid from utilizing Losec together with rifampicin.( seven ) If Mrs Rawat was 26 old ages old and on no regular medicines what other factors do you necessitate to see when make up ones minding on anti-TB therapy?The other factors which I need to see are whether 4 Are the causative beings for the disease susceptible to rifampicin, INH and pyrazinamide?Is all drugs included in the regimen able to be tolerated by Mrs Rawat and that she is able to to the full adhere to the intervention?Is there lawsuit screening disseminated or cardinal nervous system TB?Is there presence of extended cavitation on the initial thorax X ray?Is there satisfa ctory response to the intervention?Is Mrs Rawat is pregnant and/or suckling?*Why is it of import to follow up these trial consequence?It is of import to follow up these trial consequence because of drug immune concern. It is of import at all clip to utilize multidrug regimens to cover the likeliness of initial drug opposition every bit good as forestalling immune beings from emerging 4 .*On obtaining these consequences, which of the four anti-TB therapy drugs could perchancebe ceased and under which fortunes?Ethambutol can be perchance ceased if the lab trial consequence showed an TB isolate which is susceptible to isoniazid and rifampicin 16 .As a druggist what could you make to promote or help Mrs Rawat s conformity with all her medicines? How could you supervise patient conformity?I will explicate to Mrs Rawat about the intent of each and every of her medicines, every bit good as their name, dosing frequence, dose, common side effects and besides their timing of disposal 17 . After that, I will hold Mrs Rawat reiterating back to me the information which I have told her and besides inquire her inquiries sing what she is non able to understand. In add-on, I will seek to set up follow-up with her and inquire her about how is her medicine-taking traveling on. I will besides measure her chance of non-adherence through the usage of validated tools like the Morisky medicine attachment questionnaire if the expected clinical effects of her medicines do non look to be at that place. Following this, I will turn to every of her concerns or jobs which result in non-adherence and at the same clip, normalize and sympathize with her in order to promote her responses. I will besides supply her dose disposal AIDSs as appropriate so that it will be much easier for her to hive away and cognizing when to take her medicines every bit good as their dose. I can besides affect her household members such as her hubby or her boy in bettering her medicines attachment by remindi ng her to take her medicines at the dosing clip. Last, I will stress on the effects if she fails to take her medicines as indicated, particularly on wellness effects and the ultimate impacts on her households.I could supervise her conformity by oppugning her regarding pill taking or through other methods for illustration, pill numeration and urine drug proving if appropriate and available ( urine should be discoloured to orange coloring material for the minimal continuance of 6 hours since last rifampicin dosage and may even show over 12 hours ) 4 . Other than these, the Morisky medicine attachment questionnaire can be used for this utilization 17 .Briefly list in point signifier the on-going monitoring should be under taken whilst Mrs Rawat is on anti-TB therapy drugs? ( specific to TB drugs merely, for the intent of this instance ) 4 .Attachment to the anti-TB therapy drugs.Sputum civilization ( if phlegm is still being produced ) .Ocular sharp-sightedness and color vision monitoring every bit good as monitoring of ocular symptoms ( while she is still taking ethambutol ) .Liver map trials.Her organic structure weight.Nephritic map trials.Mentions macrocosm Health Organization home page on the Internet . Geneva, Switzerland World Health Organization c2012 cited 2012 Sept 22 . Tuberculosis about 3 screens . Available from hypertext transfer protocol //www.who.int/topics/tuberculosis/en/Centers for Disease have got and Prevention home page on the Internet . Atlanta, GA Centers for Disease Control and Prevention c2012 updated n.d. cited 2012 Sept 22 . Available from hypertext transfer protocol //www.cdc.gov/MedlinePlus home page on the Internet . Bethesda, MD U.S. National Library of Medicine c2012 cited 2012 Sept 22 . Tuberculosis MedlinePlus about 6 screens . Available from hypertext transfer protocol //www.nlm.nih.gov/medlineplus/tuberculosis.htmleTG complete home page on the Internet . Victoria, Australia Curative Guidelines L imited c2012 updated 2012 Jul cited 2012 Sept 20 . Available from hypertext transfer protocol //etg.tg.com.au.ezproxy.lib.monash.edu.au/conc/tgc.htm? id=27b1fc15b4331af2841f02ef96ddc67bMIMS Online home page on the Internet . London, England UBM Medica Ltd c2012 updated Sept 2012 cited 2012 Sept 22 . Available from hypertext transfer protocol //www-mimsonline-com-au.ezproxy.lib.monash.edu.au/Search/Search.aspxMedlinePlus home page on the Internet . Bethesda, MD U.S. National Library of Medicine c2012 cited 2012 Sept 22 . Rifampin MedlinePlus Drug Information about 6 screens . Available from hypertext transfer protocol //www.nlm.nih.gov/medlineplus/druginfo/meds/a682403.htmlHRSA HIV/AIDS Programs home page on the Internet . U.S U.S. Department of Health and Human Services c2012 cited 2012 Sept 22 . Mycobacterium TB about 19 screens . Available from hypertext transfer protocol //hab.hrsa.gov/deliverhivaidscare/clinicalguide11/cg-623_mycobacterium_tb.htmlSansom L. N, editor. Australian pharmaceutical pharmacopeia and enchiridion. 21st erectile dysfunction. Canberra Pharmaceutical Society of Australia 2009.BC Centre for Disease Control home page on the Internet . British Columbia, Canada BC Centre for Disease Contorl c2012 cited 2012 Sept 22 . Ethambutol about 1 page . Available from hypertext transfer protocol //www.bccdc.ca/NR/rdonlyres/F59D94C9-BDFC-4E2D-A8DB-C915F1FE8660/0/EthambutolCounsellingSheet_Field.pdfWorld Health Organization home page on the Internet . Geneva, Switzerland World Health Organization c2012 cited 2012 Sept 22 . WHO Public Assessment Report about 2 pages . Available from hypertext transfer protocol //apps.who.int/prequal/WHOPAR/WHOPARPRODUCTS/TB180part1v1.pdfUniversity of Pennsylvania Health System home page on the Internet . Philadelphia, PA Penn Medicine c2012 cited 2012 Sept 22 . Guidelines for the Management of Adverse Drug Effects of Antimycobacterial Agents about 60 pages . Available f rom hypertext transfer protocol //www.uphs.upenn.edu/TBPA/treatment/managingsideeffects.pdfThompson N. P, Caplin M. E, Hamilton M. I, Gillespie S. H, Clarke S. W, Burroughs A. K, Mclntyre N. Anti-tuberculosis medicine and the liver dangers and recommendations in direction. Eur Respir J series on the Internet . 1995 cited 2012 September 22 8 about 5 pages . Available from hypertext transfer protocol //erj.ersjournals.com/content/8/8/1384.full.pdfJemikalajah J. D, Okogun G. A. haematological indices in human immunodeficiency virus and pneumonic TB infections in parts of Delta State, Nigeria. Saudi Med K series on the Internet . 2009 cited 2012 September 22 30 ( 2 ) about 4 pages . Available from hypertext transfer protocol //www.smj.org.sa/PDFFiles/Feb09/13Hema20080806.pdfHIV InSite Gateway to HIV and AIDS Knowledge home page on the Internet . San Francisco University of California c2012 cited 2012 Sept 22 . Tuberculosis and HIV about 30 screens . Available f rom hypertext transfer protocol //hivinsite.ucsf.edu/InSite? page=kb-05-01-06 S3XMicromedexA 2.0 home page on the Internet . U.S Thomson Reuters c1974-2012 updated n.d. cited 2012 Sept 22 . Available from hypertext transfer protocol //www.thomsonhc.com.ezproxy.lib.monash.edu.au/micromedex2/librarian/PFDefaultActionId/evidencexpert.ShowDrugInteractionsResultsHeartland National TB Center home page on the Internet . San Antonio, TX Heartland National TB Center c2012 cited 2012 Sept 22 . Diagnosis & A Medical Management of TB Disease about 76 pages . Available from hypertext transfer protocol //www.heartlandntbc.org/ knowledge/archives/tbnucama_20120718_1040.pdfAmerican Medical Association home page on the Internet . Chicago, IL American Medical Association c2012 cited 2012 Sept 22 . Tacticss to better drug conformity about 13 screens . Available from hypertext transfer protocol //www.ama-assn.org/amednews/2011/10/03/prsa1003.htmCase study 4What is unhealthful e ndocarditis? Explain the difference between obscure and uncomplicated.Infective endocarditis ( besides known as bacterial endocarditis ) is an infection which affects that bosom s interior liner ( endocardium ) or the bosom valves 1 . It happens at the damaged site of endocardium or bosom valves where there is thrombocytes and fibrin depositions. When certain micro-organisms ( most frequently bacteriums, but besides can be fungi or other bugs sometimes ) gained inlet into the blood watercourse and colonise on the thrombocyte and fibrin deposition site, flora will be formed and this can take to unhealthful endocarditis 1,2 . The consequence from this is holes or growings on the bosom valves or the valve tissue will hold scarring, both of which will take to a leaky bosom valve 1 . If left untreated, it may ensue in decease 2 .Complicated pathogenic endocarditis is when big flora or multiple emboli are involved 2 . If the morbific endocarditis patient has experienced the symptoms of morbific endocarditis for over 3 months or has experienced secondary infected events, the morbific endocarditis is besides complicated. Otherwise, the morbific endocarditis will be unsophisticated morbific endocarditis.In Simon s instance what would you anticipate the likely pathogens to be?I would anticipate the likely pathogens to be Staph. aureus, unwritten streptococcus and entercococci, Gram-negative ( enteral ) rods, Fungis ( chiefly Candida ) or coagulase-negative staphylococcus 2 .List the marks ( that may be seen on physical scrutiny ) and symptoms of morbific endocarditis. The marks of morbific endocarditis are 2 Heart conkPetechiaJaneway lesions ( ruddy musca volitanss that are present on the thenar of custodies and pess s colloidal suspensions )Osler s nodes ( painful ruddy sores that present on finger tips and toes ) The symptoms of morbific endocarditis are 2, 3 FeverUnusual wearinessNight workout suitsLoss of weightMuscle achings and strivings ( in ague morbific endocarditis )Flu-like symptoms ( in ague morbific endocarditis )Heart failure symptoms ( in chronic morbific endocarditis )Joint hurting ( in chronic morbific endocarditis )Outline the diagnostic trials, blood trials, microbiological trials etc that would be used to corroborate the diagnosing of morbific endocarditis and direct antibiotic therapy.Patient s clinical physical scrutiny and besides showing ailment s history 2 . This helps with the diagnosing and besides narrow down the range of likely causative pathogen.Using stethoscope to listen to bosom 2, 3 This is to enable physician to listen to the patient s thorax for distinguishable sound that indicates new bosom mutter or sound alteration in old bosom mutter.The cause of bosom mutters are the defective bosom valves sound andcertain bosom defects.Blood civilizations 2, 3 Different organic structure country s blood samples are taken to find the presence of any pathogen in the blood stream. This is besid es done to find theexact causative pathogen and besides the pathogen s sensitiveness to differentantibiotics for intervention.Echocardiography 3 This is used to detect valve construction and map, every bit good as bosomwall gesture and besides the overall bosom size. This trial is the most dependablediagnosing trial so far for morbific endocarditis.Chest x-ray 2 This is used to look out for any grounds that indicates cardiac failure.Urine dipstick 2 This is for the sensing of any hematuria & A proteinuria which are theclinical characteristics showing in 60 % to 70 % of morbific endocarditisinstances.Temperature 1, 2 This is to look into for the presence of febrility which is one of the chiefsymptoms of morbific endocarditis.Serum urea & A electrolytes 2 This is to look into for any nephritic damage.What empirical endovenous ( IV ) antibiotic regimen would you anticipate Simon to be commenced while expecting the microbiology consequences? Specify the doses for each o f the antibiotics.The empirical endovenous ( IV ) antibiotic regimen that I expect Simon to be commenced is 4 Benzylpenicillin 1.8g IV, 4 hourly.PLUSDi/flucloxacillin 2g IV, 4 hourly.PLUSGentamicin 420mg IV, for 1 dosage, followed by the finding of dosing interval for either 1 or 2 extra doses harmonizing to Simon s nephritic map.At this point in clip, which antibiotic would you anticipate Simon to be prescribed? What would be the expected continuance of intervention?I would anticipate Simon to be prescribed di/flucloxacillin 2g IV, 4 hourly 4 . The expected intervention continuance is 4 hebdomads although in Simon s instance, the continuance may be shorten to 2 hebdomads if there is microbiological and clinical response in the clip period of 72 to 96 hours since the beginning of the antibiotic intervention.If methicillin-resistant staphylococci aureus was the causative pathogen in Simon s instance( I ) Which IV antibiotic would you anticipate to be prescribed?I would anticipate the IV antibiotic, Vancocin to be prescribed 2, 4 .( two ) Is this antibiotic chiefly cleared by the kidneys or the liver?This antibiotic is chiefly cleared by the kidneys 4 .( three ) At what dosage ( given that Simon s creatinine clearance is 116ml/min ) ?1.5g every 12 hours 4 .( four ) How would this drug be administered and why?This drug would be administered intravenously because it has a really low unwritten bioavailability and hence, it must be given intravenously for the intervention of systemic infections such as morbific endocarditis in order for it to be effectual 5, 6 .( V ) What curative drug monitoring is involved when utilizing this antibiotic? When should the first trough degree be taken? What is the mark trough degree?The curative drug monitoring that is involved is vancomycin trough concentrations measurement 4 . The first trough degree should be taken before the 4th or the 5th Vancocin dosage and the mark trough degree is 15 3mg/L.( six ) If the consequ ence of the trough degree was 27mg/L, how would you render this consequence? Would you urge a dose accommodation? If yes, what would it be?This trough degree consequence is higher than the recommended mark trough concentrations for Simon 4 . I would urge a dose accommodation and adjust the Vancocin dosage to= 0.83g= 0.8g

The Battle Against Human Trafficking in Europe : Policy Evaluation

The Battle Against sympathetic Trafficking in Europe Policy Evaluation Samira Misra Webster University Abstract This paper seeks to evaluate the policies of the European Union tell at armed combatting human trafficking in whole its forms. The current plans of the European Commission and the coupled Nations are presented, and the rationale behind them is scrutinized. Research shows that the European Union discerns the fuss of human trafficking as a complete denial of human rights, and proposes action to bring to justice the responsible psyches.The European Unions perspective is one ground on the pillars of democracy freedom, transparency, the law, and security. This paper argues that the aforementioned perspective is non sufficient in ameliorating the situation. It proposes a broader approach to the construction and formula of a across-the-board strategy, encompass the root causes underlying human trafficking, as headspring. The chief weaknesses of current constitution appear to be its implementation, and EU wide co-ordination.With the identification of these weaknesses, this paper proposes signifi tint neaten by regulatory durationncies for tangible action against the catastrophic reality of the trafficking trade. Ana, a girl from Quito, Ecuador fell in love with her husband at the young age of 20. What she thought would be the best decision of her life, ended up leading her to living in a nightmare. Her husband worked at a brothel in Quito, hiding his profession from Ana. Ana left her husband, along with her toddler, and moved in with her mother phone line little. She soon met the owner of a sm alone salon, a lady who would talk intimately Europe, and the lifestyle of the people in that location.Ana quickly became starry-eyed and accepted an offer to move to Paris to make money. She was completely unaware of what lay ahead. When she r some(prenominal)lyed Paris, she came to know that no job awaited her, other than prostituting herself on t he streets to pay pole her debts for her trip to Paris. Her pimps collected most of the money she made, and escape was too risky as the trafficking networks were systematic and tear down connected with law enforcement. Ana did not return to Ecuador for three years, and lived her life, risking it every single day just to make ends meet. This is only ne of thousands of horror stories of the victims of human trafficking (Knierim, 2012). accord to the United Nations Office of Drugs & Crime (UNODC), human trafficking is defined as the The recruitment, transportation, transfer, harbouring or receipt of persons, by federal agency of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation.Exploitation shall include, at a minimum, the exploit ation of the prostitution of others or other forms of call forthual exploitation, forced labour or services, thralldom or practices similar to slavery, servitude or the removal of organs. (UNODC, 2012). The sex trafficking industry has become the fastest growing industry in the world, and offenders continue to slip between the cracks of the legislative system (UNHCR, 2010). Data indicates that the number of trafficked victims detected in 2006, in West and Central Europe was 7,300 (UNODC, 2006, p. 229).Transcrime suggests a multiplier of 20 for every victim detected, which means that it is estimated that the actual statistic is 20 times what is known, This leads to a possible statistic of 140,000 victims in Europe. It is hard to say what should cause greater concern, the staggering numbers (which are a buttoned-up estimation), or the fact that the trafficking industry continues to boom. well-nigh trafficked victims in Europe come from Balkan countries, and from Russia. Europe als o shows the bombasticst number of nationalities of victims than any other region of the world.Victims are recruited into the sex trafficking trade through force, misrepresentation, false promises and coercion. Young, vulnerable women are lured into traps through promises of opportunities such as jobs, study abroad programs, modelling careers, vacations and the like. Research shows that acquaintances, friends or relatives largely involve recruitment within Europe. (UNODC, 2010, p. 225) Human trafficking is a deeply complex, and multi-faceted issue. It has three main dimensions culpable, human rights, and socio-economic.In order to effectively combat human trafficking in the European Union, measures that turnout all aspects need to be devised and implemented. This essay will seek to illustrate that the European policies thus far have taken a very bound attendpoint to the challenges of trafficking, and need to extend their vision to incorporate solutions to the root causes of the sex trade. In the first part of this paper, the policies (to date) to fend for trafficking will be examined, as well as the rationale they stem from.The second part will identify the main problems with these policies, and propose changes necessary for the EU to effectively confront the prevalence of trafficking. European Union Policy European Commission In the past decade, the widespread problem of human trafficking has gained increasing media attention. However, this rise in media coverage does not entail an change magnitude effort for measures to be taken. Rather, it triggers a false sense that enough is being to combat trafficking. Yet still, few nations remain immune to its adverse effects. Most countries are source countries, transit countries, or destination countries.It is important to note that within Europe, every nation has its own policy framework against the issue, but scrutinizing each system is beyond the scope of this research paper. For the argument, which this e ssay seeks to propose, it is more useful to examine the policies of European organizations dedicated solely to trafficking. The discussion will be a chronological presentation of the steps taken by the European Union. The role of the European Commission (EC) is to propose legislation in the collective interest of the EU, as well as assist in its implementation.Usually, the commission initiates legislation to meet requirements under EU treaties. In May 2003, under the Brussels Declaration on human trafficking, a policy framework was introduced, which recognized the importance of addressing the human rights violations of trafficking that threatened the freedom and security of victims. It called for cooperative action on regional, national, and international levels by governments, regulatory bodies and NGOs. Thereafter, in 2004 a EU directive was issued Directive2004/81), and introduced a forgeion period in which victims could recover without being deported for illegal migration. If t hey decided to cooperate with enforcement officials and provided cover information about their traffickers, they would be granted a temporary residence permit through which they could pursue education and career opportunities (European Commission, 2004, p. 261). Although the EC released some policy statements between 2004 and 2011, there were very few noticeable changes in strategy. More recently, the EC has taken a supposedly comprehensive initiative against this phenomenon.In 2011, the European fantan launch a framework outlining legal punitive measures concerning trafficking offences, as well as preventive measures to aid victims (Directive2011/36/EU). Under this policy, offenders of trafficking (including partial participants aiding in the process) were qualified to five to ten years of imprisonment depending on the crimes they committed. Furthermore, the Directive stated, Member States may decide not to prosecute or impose penalties on victimsof trafficking in human beings f or their involvement in criminal activities which they have been compelled to commit. (European Commission, 2011, p. 01). The aftercare procedures consisted of the possible provision of accommodation, medical care, and interpretation and translation services. Children were required to receive psychological assistance and get at to education. All victims were required to be protected sufficiently from abusers and trauma. Preventive measures highlighted by Directive2011/36/EU included education and ken initiatives, and training for police in identification of offenders and victims. The main improvement in this directive from the last version was that it had broadened the definition of trafficking to include more forms of exploitation.The Directive2011/36/EU demonstrates an approach largely interested with the criminal and human rights violation aspects of human trafficking, but ignores the circumstantial aspect (the socio-economic conditions which lead people to trafficking). jibe to the Directives sympathiseing, trafficking of persons is first and foremost an implicit negation of basic human rights for the immense physical and psychological abuse endured by victims. Secondly, it is a criminal offense (or several) on the part of the ffenders, as they partake in heinous crimes of violence, oppression, and cruelty, which trivialize the worth of a human life. The latest strategy was released in June 2012, when the EC adopted the, EU Strategy towards the Eradication of Trafficking in Human Beings (2012-2016). This strategy essentially puts forward detailed concrete steps to meet the aims of the previous Directive2011/36/EU. Main objectives of the agenda are identification and protection of victims, increased legal action against offenders, enhanced coordination and cooperation of states in policy implementation, and increased preventive measures.The EU Strategy towards the Eradication of Trafficking in Human Beings force out only be analyzed conceptually for shortcomings as it has just been put into place. However, despite periodic revisions, it is clear that the ECs view remains essentially unchanged. The outlook continues to be concerned with law enforcement and organized crime (European Commission, The EU Strategy towards the Eradication of Trafficking in Human Beings, p. 4-6). United NationsOther than the EC, the United Nations also recognizes human trafficking as a pressing concern for the international community, and acknowledges its duty to mobilize Member States to act against it. In 2002, the UN TIP Protocol (also known as Palermo Protocol) was adopted by the United Nations to prevent, suppress, and punish trafficking in persons, especially women and children (U. N, 2002, p. 1). In December 2003, this protocol came into effect, signed by 117 countries. The UNODC is responsible for upholding the Palermo protocol.Additionally, the UNODC launched its Blue Heart Campaign, directed at increasing awareness and involvement in combatt ing the trafficking trade. Evaluation Sex trafficking is a complex issue, which requires an in-depth analysis and understanding of the various dimensions of the problem. The phenomenon of trafficking is immoral and unethical on numerous counts, and therefore the fight against it must confront them all. After a closer insight into the sex trade, it can be reiterated that there are socio-economic, criminal and uman rights standards our society is based on, all of which human trafficking neglects. This section identifies the notice loopholes in current anti-trafficking procedures. Data Collection A rather significant issue, which inherently cripples the efficiency of policy-making, is the lack of data on human trafficking. This expresses a concern not with the content of the policies, but rather with the construction of policies, as knowledge of the nature of trafficking remains incomplete. Concrete, reliable data on human trafficking is an essential basis for all good programs, inter ventions, policy and legislation.Without this data it is not possible to know the extent or the true nature of the trafficking problem, nor understand the complexity of the issues involved. As a result, practitioners and policy-makers are unable to act and react appropriately and effectively(International Centre for Migration Policy Development, 2008, p. 205). There are several reasons for the dearth of empirical data and statistics. Perhaps the most noteworthy reason is the unwillingness of victims to come forward and report the crimes committed against them.This is because they apprehension for their personal safety, or fear being prosecuted for crimes such as illegal immigration, prostitution or drug abuse. In extreme cases, victims are monitored by offenders and do not have the retrieve to law enforcement. Other contributing factors are obstacles in legal frameworks, poor data aggregation methodologies, and reluctance of agencies to share their information. This undermines t he foundation upon which policies are devised. Approach to combatting trafficking EC policies against trafficking largely ignore problems such as gender inequality, race and class differences.The International Labor Organization (ILO) estimates that 43% of trafficking victims are used for forced commercialised cozy exploitation, of which 98% are female (ILO, 2008, p. 3). Although Europe has long recognized the importance of gender equality, it does not view the problem of human trafficking as deterrent example of gender inequality. Trafficking predominantly affects women, and it is because women are disadvantaged compared to men in society, that they are more susceptible to becoming victims. The leading cause of trafficking is the desperate need of latent victims to flee from poor standards of living.Presently, the EU is not taking sufficient measures to support the empowerment of disadvantaged (impoverished, uneducated, ethnic minorities, etc. ). The harsh EU migration and bord er laws posit the options women have for better anticipations. This can (sometimes) be the reason for women seeking illegitimate and unregulated forms of escape. The argument propositioned here, is that thus far, the EU has taken a closed view of trafficking, and has designed policies aimed at short- bound band aid solutions, and has failed to devise long term strategies to eliminate the conditions which cause people to resort to risky and life-threatening behavior.In addition, these short- term policies are not gender responsive either, and lack mechanisms to help women (specifically) overcome their susceptibility to such crimes. Human trafficking is a result of a chain of events based on unjust social and economic environments, to which women frequently fall victim. Women are physically weaker and hence more vulnerable to physical harm. In addition, the cultural and social norms (e. g. gender stereotypes, and social roles) that surround most women aggravate the likelihood of t he exposure to crimes against them.As of now, gender equality policies apply mainly to EU citizens, whereas most victims of trafficking are non- EU citizens. It is counterproductive to have policies seeking to ensure equal rights, which fail to extend to outsiders (even illegal immigrants). Current anti-trafficking measures have been said to be collateral damage, as they explicitly authorize government action against victims such as deportation, and prosecution for petty crimes (Uhl, 2010, p. 122). These ostensibly supportive measures are in effect punitive for women and dissuade them from seeking help.Surprisingly, nearly half of trafficking recruiters are also women. Female victims, desperate to find an escape from the unfathomable abuse, become exploiters over time (UNODC, 2010, p. 227). Policies addressing the socio-economic problems faced by women in areas of unemployment, welfare, education, immigration etc. would empower them, and prove more productive in tackling the issue from preventive, punitive and rehabilitative aspects. In essence, the European Union fails to recognize that human trafficking is partially the end result of societal gender inequalities.Although there are separate initiatives battling gender inequality, under social agendas, the European Union can kill two birds with one stone by incorporating these measures in fighting trafficking as well. Rathgeber (2002) asserts, Integrated and operational structures need to be developedto counteract the feminisation of poverty (p. 163). Academic critics of European trafficking policies (such as Rathgeber and Askola) endorse integration of strategy and procedures to overcome social gaps such as economic class, gender, or race. LegislationThe next key shortcoming in the European policy is the implementation of legislation. Although laws have been passed deeming trafficking of humans as punishable, few nations have used them to convict perpetrators. The implementation of the law so far has been la cks, which could only have further discouraged victims to come forward and testify. Despite the European Commissions view of trafficking from a crime and justice standpoint, enforcement officers are not equipped with the proper tools for identification and protection of victims, and not all legal institutions are equipped with legislative frameworks.Frequently, victims are offered through front businesses such as beauty salons, massage parlors or escort services, which make it hard for police officers to diagnose as trafficking rings. The United States Department of Health & Human Services (2008) reports that lots victims do not consider themselves to be victims, because they are unaware of their rights and are kept too isolated from communication to be informed of the action they can take. In addition, in Eastern European countries, as well as a few others, trafficking rings are so well connected, that they branch as far out as law enforcement authorities.This could mean that poli ce officials are willing to either turn a blind eye to, or go into in criminal activity. In order to have legislation actually serve its purpose, European policies must categorize concrete ways for the identification of offenders and victims. law enforcement agencies assume that there are clear, visible signs of trafficking activity such as locked doors, low sanitary standards, same working and living space, etc. Rather than relying on superficial symptoms like these, Uhl (2010) suggests that victims can be better detected through a profile, or characteristics based on demography and behavior (p. 23). Identification ties back into being able to recognize that particularly vulnerable slice of society- uneducated and poverty stricken. Legal measures should also guarantee the protection of victims from criminal prosecution and not leave it to the judgment of the enforcement officer, or circumstances. The current Directive does not state this as a requirement, and these grey areas are considerable obstructions to effective execution of justice. According to the UNODC, law enforcement bodies also do not place sufficient priority on charging offenders, as they are aware that it rarely results in a conviction.A large majority of victims and witnesses are deported, or locked up for crimes, which makes their statements unusable in court proceedings. In addition, offenders disappear under the radar and are known to flee the surface area as well. The failure of legislation is result of other shortcomings, rather than a shortcoming in itself. Each inefficiency snowballs to make the presence of legislative tools futile. Harmonization It seems fit to assume that the European Commissions policies reflect uniform standards between nations because they claim to act in the interest of the European Union.However, this is not the case. Although, the EC has the same anti-trafficking strategy for all its members, different states interpret and enforce the policy differently, an d some states simply do not uphold the EU standard. The absence of co-ordination and co-operation is yet another way in which convicted offenders escape investigation in court. The initial intention of the strategy is lost across borders, as states continue to pick and choose slices of strategy to administer.This is principally bloodsucking on the level of regulation in each country, as well as on national priorities. In several source countries, especially in the Balkans, corruption is widespread and dishonest officials often work with traffickers or turn a blind eye to unlawful acts (Rathgeber, 2002, p. 153). By definition, what constitutes trafficking also varies from country to country. whatsoever definitions include several forms of exploitation (e. g. bad labor conditions), while others only deal with more severe forms.Therefore, the Directive, which is supposed to tackle the same form of trafficking in a dependable way across nations, ends up being translated to suit specif ic national standards such as border control, labor conditions, migration law, and sexual faith (Askola, 2007, p. 214). A tentative solution is the establishment of a regulatory legislative body in charge of enforcing the correct application of strategies of the European Commission. Its branches should be established in Member States to regularly monitor execution in accordance with the EU standards.Moreover, the strategies need to avoid ambiguities, which encourage nations to modify implementation. The Directive2004/81 allows for authorities to repair whether temporary residence should be granted or not, based on specific circumstances. In having such loopholes, enforcement bodies become more occupied with the determination of these circumstances, and less with the native objective of assistance and rehabilitation. European countries have shown limited understanding of trafficking as an issue in itself, despite all the research and analysis there is available on the subject.When examining European Commission approaches to social and economic discrepancies across EU nations, it is evident that there are programs in place, which are built with the primary purpose of establishing equality, and eradicating hierarchy based on gender and class. However, these steps have been relatively ineffective, and lack synchronization across borders. Trafficking is one of the outcomes of the failure of the EUs measures against poverty, income inequality, lack of welfare and benefit programs, and social services for children, education opportunities, psychotherapy and medical assistance, and rehabilitation.It is these dire circumstances that create desperation for money and through it, the prospect of an improvement in living standards. Conclusion Human trafficking is a problem, interlinked to several existing social, political, geographical and economic disadvantages. In order to formulate a comprehensive response to control the proliferation of trafficking, and the tragic outcomes on victims, the European Union must pay heed to the social and economic root causes.The strategies of the past decade reflect a generally conservative approach, as well as one that deals with trafficking as a problem in it, rather than a problem resulting from several other problems. There is little real improvement in the progressive refinement of EU policies. The European Commission has recognized the scope of the problem, and urgency to combat human trafficking, yet the measures are proving unsuccessful. Rather than portraying human trafficking as merely a variation of organized crime, it is critical to acknowledge its social, political, economic and criminal aspects as well.Human trafficking is an outcome of failed social measures, ones that are not directed to fighting the conditions from which it arises. Synchronization and coordination between European nations are the first steps to remodeling strategy design and enhancing the influence of legislation. Gender sensiti vity and assistance to women should be a top priority in EU policy, to help women shift from their underprivileged position in society. From an evaluative perspective, until these actions are taken, we are likely to see iterative adjustments to current EU policies with little advancement in the right direction.References Askola, H. (2007). Violence against women, trafficking, and migration in the European Union. European Law Journal, 13(2), 204-217. Doi10. 1111/j. 1468-0386. 2007. 00364. x Cochintu, I. , Tutunaru, L. , Stoicu, N. , & Valea, D. (2011). International cooperation against human trafficking. Juridical Current, 14(2), 78-86. Nieuwenhuys, C. , & Pecoud, A. (2007). Human trafficking, information campaigns, and strategies of migration control. American Behavioral Scientist, 50(12), 1674-1695. Rathgeber, C. (2002). The victimization of women through human trafficking An outcome of war?.European Journal of Crime, Criminal Law & Criminal Justice, 10(2/3), 152-163. doi10. 1163 /157181702401475340 Skrivankova, K. (2006). Combating trafficking in human beings. 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