Holocaust Report Essays - Responsibility For The Holocaust

Holocaust Report The Holocaust Sitting here, I watch the guard patrol the fence like a wolf waiting to pounce on its prey. The stench of burning flesh is in the air. I can't see anything past the barb wire in the distance. I can only see soldiers in the main yard of the compound. To the right of me, I spot a group of people who are lined up to go into a building covered with camouflage. The soldiers are yelling ?shnel, shnel? as they herd the people into the building like a group of cattle. In the back of this building I see a cloud of smoke rising into the dark sky. Some people say that once the soldiers take you there, you never come back. They say the smoke you see is not really smoke, it is the souls of the people that have disappeared in there. There are many people here that I have never seen before. They all look so different. Some still have meat on their bones, some look like a rack of bones. These soldiers do not feed us often. Only on certain days do they let us out of the permanent shelter that we are in. I feel like I have no energy, and I have not eaten in days. I wonder if I will I ever live through this. This is what Jewish people and Gypsies had to go through in World War 2. They were persecuted by Hitler's army of Nazis. These people did not harm anyone, but Hitler felt they threatened the new Germany he was building. Hitler blamed them for the economic hardship they were going through. Just because they were Jewish, they were sought out and put into concentration camps. These people were brought to these camps to be eliminated. If you did not meet the criteria for the ?New Germany?, then you would be eliminated. How can someone just forget about what happened back then? To me, that is not easy to forget about. I think you must study past atrocities to understand our own times. The world let it happen once, and that is enough. We should learn from our mistakes and apply that to the future. If we focus on what is going on now, and not learning what went on in the past, we can English Essays

Police use of Racial Profiling Essays

Police use of Racial Profiling Essays Police use of Racial Profiling Paper Police use of Racial Profiling Paper I disagree with the vast majority, because I think the use of race in deciding whom to treat as a suspect is Just one of many factors in a police officers decision. According to Nadia Karee Nettle Racial profiling is a form of discrimination by which law enforcement uses a persons race or cultural background as the primary reason to suspect that the individual has broken the law (Para. 1). Others that oppose this view say that it is racist to consider race as a factor in any situation because it is treating a person of one race differently than a person of another race. Law enforcement considering the race of an individual is viewed as a violation of a persons right to equality under the law. And this violation is very accurate if and only if the race is the only factor being considered when suspecting an individual otherwise it is Just another observation about the situation that the law enforcement officer makes. Racial profiling is normally associated with racism even though the act of racial profiling is not inherently racist. According to Randall Kennedy (1999) racial profiling is not necessarily evil or immoral, but it is the use of facts and the environment that make a police officer use race as a factor in deciding whether or not to be suspicious of a certain person (Para. 6). An example of using many factors to identify a suspect would be when a Kansas City DEAD officer stopped a young black man who was acting in suspicious ways in an airport, and information regarding the local area said that gangs of young black men have been moving drugs into the area through major transportation hubs such as the airport (Kennedy, 1999, Para. 1). With the information the agent was given he was able to make an educated guess as to whether or not the young man was worth any more of his attention. When that young man was detained it was discovered that he did indeed have illegal substances on him with the intent to transport it. This situation is a great example of how the police use context clues and piece together a bigger picture using many factors, and one of those factors happens to be race. The Department of Justice fact sheet on racial profiling (2003) states that racial profiling is considered acceptable to use in order to identify terrorists (p. 5). It is considered acceptable to use race in order to narrow a search field so that the chances of finding a terrorist are even greater. This would make sense of why random searches are not actually random, but there is a set of factors that come into play not saying that every random search has a purpose, but it would be pointless to randomly search a 10 year old girl caring a teddy bear with her pregnant mother. Even a federal agency has acknowledged that in order to narrow a search field the use of race as a factor is acceptable. Just because race is used to help narrow a suspect field does not mean racial profiling is racist. Police encounter accusations of racism every day and that is because police have Jobs that require hem to deal with all kinds of people for hours on end, and those people are of all different types of races. Police officers stop people all day long and one of the many ways they do that is with a traffic stop. Police are always in danger because the Job is a dangerous one, but traffic stops are one of the most dangerous occasions that a police officer encounters, because the person the officer Just stopped is a complete stranger and the officer has no idea what is inside the car or if the person has a weapon. It is one of the few occasions where an officer is likely to have zero idea of hat he or she is walking into. Since there is such a big danger with traffic stops the officer must use every piece of information that can be gathered, one of which would be the race of the driver. According to Vito Walsh (2008) when officers go to the police academy to learn to become a police officer they are taught how to identify odd behavior and driving activities as criminal behavior ( p. 91). Police can use intuition and experience to make a decision about a situation. For example if an area has a high rate of Latino Americans participating in illegal immigration a police officer will be more suspicious of a windowless van driving around following every road law to the finest detail with a Latino American driving than he/she would be of a minivan with a 35 year old white female driving. It would be the logical decision to pull over the windowless van because all of the clues point to that being the more likely option, because all of the information the police officer has about the area, and his training tell him that the windowless van would pose a more likely candidate for transporting illegal immigrants. Police discretion involves reasonable suspicion and probable cause. Probable cause Exists when facts and circumstances within a police officers knowledge, which are based on reasonably trustworthy information, are sufficient to warrant a person of reasonable caution to believe that an offense has been or is being committed by the person being arrested (Cox, Macrame, Carmella, 2014, p. 207). The courts system of the United States places discretionary power in the hands of the police and these two terms are deeply rooted in the way police operate when they approach any situation. One of the tools of discretion police officers have is reasonable suspicion, and it is defined as the Objective facts and logical conclusions given a specific set of circumstances (Cox, Macrame, Carmella, 2014, p. 208). Reasonable suspicion is a very good representation of how the police are told to observe facts and make logical conclusions about every situation. Establishing reasonable suspicion is a tough Job though because it needs to be backed up in court if it makes it that far. The situations where reasonable suspicion is most applicable would be with a stop and frisk. As mentioned below the court case Terry v. Ohio established reasonable suspicion as enough to stop an individual and frisk them. Seeing as how reasonable suspicion is based on objective facts and logical conclusions then the law views anything that makes coming to a logical conclusion using objective facts, such as race, perfectly acceptable for police officers use (Cox, Macrame, Carmella, 2014, p. 208). The police are given many powers by the people of the United States in order to serve and protect the public. One of those powers is a terry stop this is the result of a supreme court case know as Terry v. Ohio. This case gives the police power to stop somebody as long as the officer has reasonable suspicion of criminal behavior. They are also allowed to frisk the individual, but only if the officer has reason to believe the individual poses a threat to the officer or other citizens (Nubian Thompson, 1968, p. 33) Although the action that the court has approved is at its heart not racist, because the United States legal system views everyone equally, that doesnt stop some police officers from abusing it and choosing to make racist decisions. In this aspect we trust the police to use their discretion and actually make an unbiased decision that is best for the protection of everybodys rights. The police are given a very large amount of discretion in terms of how they treat people and a pproach situations. We trust them to follow the law and protect everyones freedoms, but there will always be people that abuse the power that is given to them. Stop and frisk policies have become a hot button issue because it leaves the choice of whom to stop and frisk up to the police office. There was a situation in New York city where mayor Michael R. Bloomberg enacted a law giving the police the power to stop anyone if the police officer reasonably suspects he or she is in danger (NYC Criminal Procedure, 2014). According to Mayor Bloomberg in a Huffing Post article (2013) Ninety percent of all people killed in our city -? and 90 percent of all those who commit the murders and other violent crimes -? are black and Hispanic (Para. ). The reason for the majority of people being stopped belonging to a minority is because the areas where the police officers are sent to are areas where a large number of minorities live and the crime rate is really high, and the city feels that it would be more effective to apply police to these high crime areas (Bloomberg, 2013, Para. 2-8). The results are eradicable if this is the case. The only logical conc lusion is that more African Americans, Latino, and other minorities will be stopped and frisked if more police are sent to areas with a high population of minorities. The police are not sent to these areas because of the minorities in the area, but instead they are sent there because of the high crime rates with the intent of lowering that high crime rate and making those areas safer for the innocent residents who are victimized by the criminals that do live in the area. Since there is a lot of discretion given to police officers there are always those few officers that abuse the power given to them and end up making decisions such as whom to stop and frisk based entirely on the race of the individual. Those police officers actions are wrong and not the type of racial profiling that is acceptable. Officers that do use race as a sole factor in determining a suspect cannot properly call their actions racial profiling, but instead those actions should be considered acts of racism. Racist behavior is not tolerated in law enforcement because that would be bringing personal biases into the work place and hat would compromise the individual officers ability to make an unbiased decision. Racist decisions have no place in law enforcement because they create a situation where the eyes of the law do not view someone as equal, but instead are viewed as lesser than other human beings. Police officers who make racist decisions have no place in law enforcement and they are the few that tarnish the reputation of the many. It was previously mentioned that there are many factors leading into a police officer making his/her decision to treat someone as a suspect or not. The police use sat experiences as well as their training in order to identify a suspect using many factors. The environment that the officer is in, including the characteristics and crime rates of the neighborhood plays a part in his/her decision making process. Another group of factors that the police take into consideration is the characteristics of the person being looking at. Factors such as gender, age, and the size to formulate a profile of this individual and decide whether or not to be suspicious of the individual being observed (Albert, Bennett, Dunham, ; Stressing, 2005, p. 369). If the arson of interest is in a neighborhood with a high crime rate and there have been past occurrences of violence towards police officers, then the officer in the area will be more likely to treat everyone with more suspicion. Also if the individual in question is a young Japanese man dressed in a gang outfit in a neighborhood known for its connection to the Japanese mafia then the police officer will take interest in that person, and possibly pursue or stop him. The factors involved in a police officers decisions are a lot more complex than we think, because police look at the environment and the individual both at the same time. Sometimes the complicated line of decision making police officers use may lead the public to make blanket perception about all members of law enforcement. The main reason that citizens disagree with racial profiling is that the public view it as racist and therefore an unfavorable action. Those who oppose racial profiling claim it is racist to use race as a factor at all in deciding to treat someone as a suspect. I disagree with that statement, because the police use race as an aid to help them make a more precise decision about the person they suspect of a crime. There is statistical evidence Enid officers choice to suspect one race over another while investigating a crime. According to the Bis Uniform Crime Report in table AAA (2011) there are crimes that are more common among certain races of people like how 65% of the people arrested for forcible rape were white, and 55. 6% of arrests for robbery were African Americans (FBI). Also in the same report shows that 72. 9% of arson arrests are of someone who is white, and 86. 7% of arrests for gambling are African American (FBI). These statistics go to show that there are indeed certain racial groups of people that commit certain rimes more than others. These particular tables are of national data so the exact numbers vary in every local area so the officers in their respective precincts react differently to the data they collect. Data gathered through research influences something known as the police subculture, because the police react to new crime patterns and those are created using statistical evidence. The police subculture can be described as the shared values, attitudes, and norms created within the occupational and organizational environment of policing (Cox, Macrame, Carmella, 2014, p. 8). Police adopt a whole new view of the world whenever they start their Jobs, and they all adopt a similar if not exactly the same view. The reason this subculture would play such a huge role in all the factors a police officer uses to decide whom to suspect is because the police are always in danger with their line of work and they need every single tool at their disposal in order to protect themselves and other innocent civilians. Due to this subculture that all police become part of, the police in general view every citizen as a possible threat and danger to the public, and homeless, and that requires the police to use any and all environmental factors in order to make an educated decision. (Cox, Macrame, Carmella, 2014, p. 178). Racial profiling as defined before is intertwined with the police subculture and not viewed as a weapon against minorities but more as a tool to be used to aid the police in their efforts to prevent crime and keep the public safe from harm. When people stand up against racial profiling they are painting Just one group to be the subject of racial profiling, and those subjects are said to be the minority populations. Though he African American, Latino American, Asian American, etc.. Populations get profiled so do white Americans. The notable example of this would be the profiling of a serial killer. After a string of murders is identified as serial killings the next decision is to find the person responsible because they are extremely dangerous if they are left in society to run rampant. The police instantly start building a profile of the serial killer, and the first thing they do is assume the suspect will be white because statistically 80% of the serial killers that have been caught are white males (Sun, 2009, Para. ). This is racial profiling, and the police do it so that they can narrow their search field and not have to waste resources in unlikely areas. One could argue that the police doing such a thing makes it likely to skip over the actual suspect, but that is false because all the police are doing is limiting the search field. They are not completely eliminating groups of people from the suspect pool because they do not match the assumption that the serial killer would be white, because this is where the other factors that police look at come into play and they look beyond race for other elites. So it is a moot point to argue that racial profiling could skip over the actual perpetrator, because there are more factors being looked aside from the race of a profile. Race is not Just used against minorities when profiling a suspect, but it is also used against the majority sometimes so this would go to show that race is not used exclusively to target a single race or group of races. The police only use race as a factor in order to narrow a search pool and use their resources wisely while maximizing their effectiveness. Police officers all around the world wake up every ironing and put on a bullet proof vest and go to work to protect and serve the community. Police are forced to confront situations that a majority of Americans will never face in their lives and in order to make decisions the police need to use every aspect of every situation in order to make the safest and most logical decision. Police officers always will have to use the discretion that the citizens of the United States have given to them in order to make the best educated decision they can. Sometimes that Judgment is influenced by race, but that is not the sole factor in the average officers decision.

Statement of Purpose. The social work profession Personal

Of Purpose. The social work profession - Personal Statement Example The settings of social work practice may include hospitals, the homes of service users, schools, and other voluntary organizations (Horne, 1999). In my human service experiences and interactions with others, I have incorporated the values of social work in numerous ways. In the practice of my profession, I have paid significant attention to the social work values of service, dignity and worth of the person, social justice, integrity, importance of human relationships and competence (Sue, 2005). I have always held dear the social work value of service based on the reason that the primary goal of my profession is to help those in need to address the social problems, which they may be facing. As the social work value of service to clients purports, social workers should volunteer some of their professional skills with no expectation of financial return. I have successfully done this since I have assisted most of my clients without any expectation of getting returns from them. Another co re social work value includes social justice, which is based on the ethical principle that social workers should challenge social injustice (Vass, 1996). In my experience and interactions with others, I have pursued change on behalf of the oppressed and vulnerable persons in society. While working with diverse groups of persons, I have realized the need to acknowledge their ethnic, as well as cultural diversity. In the practice of social work profession, social workers should respect the dignity and worth of the person. As such, social workers should aim at treating clients and all persons in a respectful and caring manner (Turner, 2011). I have held this value to the latter; I have always promoted the self determination of clients in the decisions they make. In a socially responsible manner, I have sought to resolve the conflicts between client interests and interests of the broader society. Integrity can be regarded as one of the core values in the practice of social work; social workers have the obligation to behave in a manner that seems trustworthy (Shardlow, 2004). In my experiences with clients and interactions with people, I have always acted in line with the mission, ethical principles, values, and ethical standards of social work. I have acted responsibly and honestly; I have achieved this by promoting ethical principles and practices of the profession. In my human service experiences and interactions with people, I have recognized the significance of human relationships. I have assisted clients to understand that the relationships they have with people play an essential role in change. Moreover, I have strived to strengthen the relationships between people. This has allowed me to enhance, restore, and promote the wellbeing of families, individuals, and social groups. In my interactions with people and human service experience, I have successfully become competent in the field of social service. This has allowed me to enhance and develop the professi onal practice of my profession. Competence has increased my professional skills as well as knowledge; I plan to apply these in practice. I have had significant life experiences and relationships in giving help; these experiences motivated me to pursue social work. Social work entails working with clients at various levels, especially the needy, in order to improve their

Case Study Essay Example | Topics and Well Written Essays - 1250 words - 4

Case Study - Essay Example Starting with the establishment of the first store in 1962 in Rogers, Arkansas, Sam Walton together with his brother had managed to grow the firm to 32 stores spread across four states by 1969, when Wal-Mart Stores, Inc was incorporated, and subsequently to 330 stores spread across 11 states by 1980, culminating in 1,402 Wal-Mart Stores and 123 Sam’s Wholesale Club outlets covering 29 states by Jan 1990 with Sales of over $25.8 billion. In fact, back in 1977, Forbes magazine had ranked Wal-Mart first in the discount retailing industry based on parameters such as return on equity, return on capital, sales growth, and earnings growth. To understand the reasons behind such phenomenal performance it will be prudent to look at some financial performance parameters of Wal-Mart and its competitors, and then to look at how competitive forces act in this industry using Porter’s Five forces model. b) During the same period, the performance figures of other major competitors as given in Exhibit 5 of the case show that Sears and Kmart had recorded an average annual sales growth rate of just 7.8% and 7.9% respectively, while Target had recorded 12.9%. This indicates that Wal-Mart was way ahead of competition in sales growth. c) Wal-Mart also ensured that this sales growth was accompanied by excellent returns to stockholders by maintaining the profitability despite such growth in sales. Thus net earnings increased from $0.55 billion in 1981 to $1.90 billion in 1990, with EPS growing from $0.11 million to $1.90 million d) On this count again Wal-Mart was way above competitors clocking an average growth rate of 30.3% on Return on Equity (ROE), and 32.9% on EPS as against Sears (11.1%; 8.0%), Kmart (13.5%; 12.6%), and Target (15.2%; 14%). e) Wal-Mart had also managed its working capital very well with a current ratio ranging from a low of 1.66 to a high of 2.07 during this decade, primarily through excellent management of inventories, achieving an

Encouragement Essay Example | Topics and Well Written Essays - 500 words

Encouragement - Essay Example So let me clarify once and for all; your objectives are to attain and execute the highest level of scholarship, character, community service, and leadership. When I say scholarship, I do not mean a Fulbright Scholarship. Well, it’s nothing less than a privilege to have one, but i mean to talk about scholarship in a more generic and holistic sense. You need to be a scholar, or at least act out as one till you become one. As they say, â€Å"Fake it till you make it.† It’s not THAT difficult, you’ve got to trust me on that one. When it comes to achieving big goals, it’s the little things that matter. Sleep less, workout more, eat moderately, think positively†¦so remotely connected to scholarship as all this appears, it is just as much intrinsically linked with scholarship. And not just with scholarship, but also with character building. To build your character, you need to reflect. Make it a regular practice. Don’t go to sleep until you have reflected upon your day’s experiences. You’d realize and learn more. And hopefully, you would be able to apply more. You’d literally s ense the process of becoming a more responsible son/daughter, sibling, citizen, and in the long run, spouse, and parent. â€Å"Service to others is the rent you pay for your room here on earth† (Ali cited in Rivanna Natural Designs, 2013). You would be a living legend many would cherish and adore. But all this would not come just from character building, you would actually have to do some community service to be there. And when I say â€Å"some community service†, that means â€Å"a lot of it†. Community service can be done even by sowing a seed, by watering a plant, and by sharing the fruit of your own grown tree with others. You can get motivation to do community service by having a firm belief that you would receive what you send around. â€Å"We make a living by what we get, but we make a life by what we give† (Churchill cited in Lycoming College, 2011). Whether or not

An audit looking at how many patients are with thyroid dysfunction

An audit looking at how many patients are with thyroid dysfunction What is the function of thyroid gland and thyroid hormones The thyroid gland is located in the anterior part of the neck, attached to the thyroid cartilage. It consists of two lobes, approximately 5 cm each, that lie either side of the trachea joined in the middle by an isthmus. The thyroid gland is responsible for the production of three thyroid hormones: Calcitonin (involved with calcium homeostasis), Thyroxine (T4) and Triiodothyronine (T3). Everyday, approximately 100  ¿Ã‚ ½g of T3 and T4 are secreted 90% of which are in the form T4. Most of T4 is later converted to T3 in the liver and Kidneys. T3 is 10 times more active than T4. [1] The thyroid hormones are responsible for the control of basal metabolic rate. Expand? How is Thyroid hormone regulated The functional unit of the thyroid is the follicle. A spherical arrangement of secretory epithelial cells around a protein rich colloid. It is at this cell-colloid boundary that thyroid hormones are formed by iodination of thyroglobulin formed from tyrosine.[1] The follicular cells are involved in active absorption of iodine from the plasma which is required for thyroglobulin synthesis. The formed thyroid hormone is stored in the colloid until its secretion is triggered by thyroid stimulating hormone from the anterior pituitary which triggers the degradation of thyroglobulin in the follicular cells to release thyroid hormone. Thyroid hormone secretion is under the control of the hypothalamic-pituitary axis. The hypothalamus releases Thyrotrophin Releasing Hormone (TRH) which stimulates the anterior pituitary to secrete Thyroid Stimulating Hormone (TSH). The TSH reaches the thyroid where it binds to the TSH receptors on the surface of the follicular cell, stimulating it to produce and release thyroid hormones. The homeostasis of thyroid hormone concentration is maintained by a negative feedback loop whereby increased concentration of thyroid hormone inhibits Thyroid Stimulating Hormone release from the anterior pituitary by decreasing the affinity for TRH. This leads to a decrease in TSH causing reduced amount of thyroid hormone to be released by the thyroid gland. This feedback loop enables us to monitor patients on thyroid hormone replacement therapy (such as Levothyroxine) by measuring TSH levels. If for instance the prescribed dose is insufficient, it would lead to inadequate inhibition of the pituitar y gland and a raised serum TSH level. The reverse would occur with levothyroxine excess. () This cannot be done in patients with secondary hypothyroidism. So what do we do then? Common pathologies Thyroid disease is the second most common endocrine disorder after diabetes.  ¿Ã‚ ½ Hypothyroidism Hypothyroidism is defined as an underactive thyroid gland leading to decreased levels of T3 and T4. The annual incidence of hypothyroidism in the UK is 4 per 1000 in women and 0.6 per 1000 in men.[3] Symptomatic hypothyroidism is known as myxodema. Hypothyroidism is categorised into primary and secondary. Primary hypothyroidism results from disease processes affecting the thyroid gland itself, slowly decreasing thyroid function and thyroid hormone production. Onset of symptoms is therefore gradual, developing over months or even years. Secondary hypothyroidism is relatively uncommon. Secondary hypothyroidism develops when the pituitary is unable to produce enough TSH to induce enough T3 and T4 production from the thyroid gland. The causes of secondary hypothyroidism can include a pituitary tumour. Patients with hypothyroidism could present with a number of signs and symptoms including:  ¿Ã‚ ½ Tiredness  ¿Ã‚ ½ Somnolence  ¿Ã‚ ½ Slow cognition  ¿Ã‚ ½ Cold Intolerance  ¿Ã‚ ½ Depression  ¿Ã‚ ½ Bradycardia  ¿Ã‚ ½ Weight gain  ¿Ã‚ ½ Calf stiffness  ¿Ã‚ ½ Menstrual disturbance  ¿Ã‚ ½ Carpal tunnel syndrome  ¿Ã‚ ½ Hearing impairment  ¿Ã‚ ½ Dry, thin and pale skin  ¿Ã‚ ½ Puffiness below the eyes  ¿Ã‚ ½ Bradycardia The most common cause of primary hypothyroidism in the UK is autoimmune thyroiditis. In Hashimoto ¿Ã‚ ½s thyroiditis autoantibodies are produced against thyroglobulin. This leads to inflammation of the thyroid gland as it is infiltrated by lymphocytes causing goitre formation. Hashimoto ¿Ã‚ ½s thyroiditis is remarkable in this respect that it initially causes hyperthyroidism as inflammation of the thyroid gland releases stored thyroxine. Once this released thyroid hormone is metabolised the patient progresses to normal and then a hypothyroid state. [1] Other notable causes of hypothyroidism include:[4]  ¿Ã‚ ½ Iatrogenic: Radioiodine ablation or thyroidectomy as a treatment for hyperthyroidism  ¿Ã‚ ½ Thyroiditis: Subacute (de Quervain ¿Ã‚ ½s) thyroiditis  ¿Ã‚ ½ Drugs: Lithium, Amiodarone, thalidomide, rifampicin and sutinib as well as drugs used in the treatment of hyperthyroidism  ¿Ã‚ ½ Iodine deficiency: common in some developing countries but very rare in the western world At the opposite end of the spectrum lies Hyperthyroidism where there is increased Free T4 and a reduced level of TSH and has the opposite effect on the body than the one noticed in hypothyroidism e.g. tachycardia, heat intolerance etc. Hyperthyroidism is not covered further as this audit focuses on hypothyroidism. Diagnosis and treatment Symptoms of hypothyroidism are quite non-specific and can commonly occur with other medical conditions not related to the thyroid. Diagnosis of hypothyroidism therefore should not be made on clinical symptoms alone and it is essential to test thyroid function biochemically. This is done by measuring Thyroid Stimulating Hormone and Free Thyroxine (T4) in blood. The normal reference range for TSH is 0.4  ¿Ã‚ ½ 4.0 mU/Litre.[4] A TSH level within the normal reference range has over a 99% predicted value to rule out primary hypothyroidism or hyperthyroidism.[5] In hypothyroidism the patient would have a high Thyroid Stimulating Hormone level, with or without a low Thyroxine level. Depending on thyroid function tests hypothyroidism is further divided into: a) Overt hypothyroidism: patients with a high Thyroid Stimulating hormone level and a Low serum free Thyroxine (T4) b) Subclinical hypothyroidism: Patients with a high Thyroid Stimulating Hormone but a normal Thyroxine (T4) level Treatment depends on whether the patient has overt or subclinical hypothyroidism. Patients with overt hypothyroidism should be treated with Levothyroxine to render them  ¿Ã‚ ½euthyroid ¿Ã‚ ½.[5] According to NHS statistics 12 million Levothyroxine prescriptions were issued during 2006.[6] The goal of the treatment is to reduce the TSH back to within the reference range. The dose of Levothyroxine is usually titrated up from 25-50  ¿Ã‚ ½g daily however a recent trial has shown that this is unnecessary for most patients.[7] The study recommended that patients with no cardiac symptoms should be started on the full dose of 1.6  ¿Ã‚ ½g/kg. The following figure illustrates the algorithm for treatment of -pregnant adults with primary hypothyroidism:[4] Algorithm for management of non-pregnant adults with primary hypothyroidism [4] It is very important to monitor levothyroxine therapy as over or under prescription can be dangerous. Thyroid Stimulating Hormone (TSH) is the key method of monitoring levothyroxine therapy in patients with primary hypothyroidism. Unlike the thyroid function tests used to diagnose thyroid disease, free T3 and T4 levels are not very useful in monitoring treatment as their levels are influenced by the prescribed dosage of thyroid replacement hormone and are not accurate indicators of the individual ¿Ã‚ ½s requirement. TSH without T3 and T4 is also a cheaper test to carry out in General Practice. Current guidelines state that patients should have their Thyroid Stimulating Hormone level tested eight to twelve weeks after starting levothyroxine.[4] The dose can later be fine tuned accordingly to get the TSH level in the lower half of the reference range.[5] Besides monitoring TSH levels, an assessment of the patient ¿Ã‚ ½s symptoms should also be made as some younger patients may need higher doses to relieve their symptoms in which case it is acceptable to have the TSH between 0.1-0.4 mU/Litre. The Quality and Outomes Framework (QOF) guidance suggests that all Patients on long term thyroid hormone replacement therapy should have their TSH levels tested yearly to make sure their replacement dose remains optimal.[8] Audit 1. Reason for audit move it to the top to include the rest of the study Despite the yearly TSH tests, studies have shown that a considerable number of hypothyroid patients managed in primary care have TSH levels outside of the reference range. Okosieme et al reported that in 2009 data collected from 11 GP practices showed that 37.2% of the 1037 patients on the hypothyroidism register were inadequately managed.[9] When we take into account the high prevalence of hypothyroidism (9.3% in women and 1.3% in men)[3] the results of the Okosieme et al study suggests that the total number of patients with suboptimal thyroid hormone replacement is significantly large. Imperfect thyroid hormone replacement could have damaging repercussions for health. It may adversely affect blood pressure, body weight and lipid profile. Since the basal metabolic rate of the body is controlled by thyroid hormones it is perhaps not surprising that a decrease in thyroid hormone levels leads to a decrease in metabolic rate and thus can cause weight gain. Even in euthyroid subjects there is a negative correlation between free T4 and Body Mass Index (BMI).[10] This suggests that even a small under-prescription of thyroid hormones could, over a period of time, lead to obesity. Reduced Thyroxine levels also cause a dyslipidemia characterised by increased Low Density Lipoproteins (LDL) and a decrease in High Density Lipoproteins (HDL) with normal or slightly raised cholesterol levels.[11] Such a lipid profile is associated with a higher risk of atherosclerosis. The thyroid hormones also seem to have a role in blood pressure homeostasis as hypothyroid patients recorded a higher systolic and diastolic blood pressure after stopping thyroid replacement therapy.[12] Thus inadequate replacement may cause hypertension which, together with the dyslipidemia described above adds to the risk of atherosclerosis and its subsequent cardiovascular complications. Conversely, excessive thyroid hormone replacement has its own perils, having enhanced risk of atrial fibrillation, osteoporosis and fractures linked to it. Excessive thyroid hormone increases the risk of developing atrial fibrillation especially in older patients. Studies have shown that a low TSH level in patients over 60 years old have a threefold higher risk of developing atrial fibrillation.[13] Patients over treated with levothyroxine also show increased loss of bone mineral putting them at increased risk of osteoporosis.[14] Subsequent studies have shown that patients with a suppressed TSH i.e. = 0.03 mU/Litre also had an increased risk of fractures however this was not observed in patients with low but unsuppressed TSH (0.04  ¿Ã‚ ½ 0.4 mU/Litre).[15] This highlights the need for maintaining optimal thyroid hormone replacement in primary hypothyroid patients in the General Practice setting to reduce the above mentioned risk factors. The 11 GP practices used by Okosieme et al showed that there is significant room for improvement as one third of the patient population on levothyroxine had TSH levels outside the reference range.[0.11] Thus this is a worthwhile area for audit to establish current standards of care in our practice, Dr Dean Partners, Heald Green Health Centre. Since this audit has not been carried out before in the practice it would give an idea of how well the practice manages patients on thyroid hormone replacement therapy. The suggestions for improvement would be beneficial to the patients of the practice and might also help with obtaining QOF points. This audit would also be beneficial to me personally introducing me to the concept of audit cycles and giving me the opportunity to conduct my very first audit. It would also help me get a better understanding of management of hypothyroid patients which is the second most common endocrine disease in the UK after diabetes mellitus. 2. Criteria to be measured Serum Thyroid Stimulating Hormone is used as the gold standard for biochemically diagnosing hypothyroidism and monitoring thyroid hormone replacement therapy.[4] The reference range indicating adequate replacement is usually around 0.4  ¿Ã‚ ½ 4.0 mU/Litre.[4, 9] However this figure slightly varies according to local guidelines. For this I have chosen to use TSH between 0.1  ¿Ã‚ ½ 4.0 mU/Litre as a reference range for adequate thyroid hormone replacement as this is the reference range used by the local Primary Care Trust (Stepping Hill Hospital) and the practice. Patients with primary hypothyroidism on thyroid hormone replacement therapy should have a TSH level between 0.1  ¿Ã‚ ½ 4.0 mU/Litre. 3. Setting standards For setting the standard I have found that there are no specific guidelines stating what proportion of patients should be achieving the above mentioned criteria. There are no NICE guidelines for the treatment of hypothyroidism. The QOF guidance states that patients should have their TSH levels tested yearly but it does not state the standard of care required. Having discussed this with GP at the practice I have decided that a theoretically ideal standard i.e. 100% of patients meeting the above criteria would be very impractical in theory from a resources perspective. Given the fact that suboptimal thyroid hormone replacement could be harmful, it is nonetheless important to achieve a high standard of care. Therefore I have decided on an optimum standard: 90% of patients with primary hypothyroidism on thyroid hormone replacement therapy should have a TSH level between 0.1  ¿Ã‚ ½ 4.0 mU/Litre. 4. Preparation planning Before starting the audit I had a discussion with the GP tutor about worthwhile areas for audit. As I had never conducted an audit before he explained the audit cycle. As thyroid dysfunction was an area of interest for me I suggested undertaking this audit. The GP tutor agreed that this would be a useful area for audit and advised to me to review the literature to find out if it would be an appropriate audit from a clinical point of view and was an area where practice could be improved. After preliminary reading clinical reviews I formulated a step by step template of the things I felt should be covered and got the GP tutor ¿Ã‚ ½s approval to go ahead. The data was collected with the help of the GP tutor. As the practice keeps electronic records of all patients, EMIS Population manger search function. Using the search function we identified all patients who had been prescribed thyroid hormone replacement medication for the past 12 months. We then identified patients who in the past 12 months had had their TSH levels tested. We then selected patients who had a TSH =0.1 mU/Litre and TSH =4. Subtracting the number of patients which meet the TSH search parameters from the total number of patients on thyroid hormone replacement would give us the number of patients who were outside the reference range of TSH. 5. Initial data collection Criterion Number of Patients taking thyroid hormone replacement medication (n) Number of Patients with TSH levels within reference range Standard (%) Patients with primary hypothyroidism on thyroid replacement therapy should have a TSH level between 0.1  ¿Ã‚ ½ 4.0 mU/Litre. 206 167/206 (81%) 90% Discussion Results: what they are. How close to the standard. Are they good enough? (no, didn ¿Ã‚ ½t meet the standards). Why didn ¿Ã‚ ½t they meet the standard? Merge results discussion with limitations discussion The data collected shows that the current practice is 9% below the standard set. The standard required i.e. 90% of patients with primary hypothyroidism on thyroid hormone replacement therapy should have a TSH level between 0.1  ¿Ã‚ ½ 4.0 mU/Litre. However this was the case with only 167 patients (81%). This means that 39 patients (19%) did not meet the standard set. There could be several reasons why the results did not meet the standards set. One factor influencing TSH levels is the use of medicines which interact with thyroid function. Due to the limitations of the software used in data collection (as discussed below) we were unable to exclude patients who were on medication known to interact with thyroid function such as Amiodarone, Lithium, etc. Amiodarone, a fairly commonly prescribed drug to prevent arrhythmias, can cause deranged thyroid function as it contains iodine (37mg of iodine in 100mg of Amiodarone). This can cause a severe iodine overload and can lead to hypothyroidism as well as thyrotoxicosis.[0.16] Inclusion of such patients would bring the percentage down unfairly because management of such patients is a lot more complex and the TSH levels are not always a good indication of the adequacy of their thyroid hormone dosage. Patients with hypothyroidism due to Amiodarone are monitored by their Free T4 levels instead of TSH. [0.16] Another factor which could have contributed to the high number of patients with TSH levels outside those defined in the criteria is the possibility that patients with abnormal TSH levels often don ¿Ã‚ ½t get their levothyroxine dose optimised. A study published in 1995 reported that at one GP practice in Suffolk 71% of patients with abnormal TSH levels did not have their medication dosage change as a result.[17] If patients do not have their thyroid hormone replacement optimised as a result of abnormal TSH not only does it defeat the purpose of carrying out yearly TSH tests, it also means that these patients would continue to have an abnormal TSH when tested again. Currently we do not have the data to find out how many of the patients in our practice with abnormal TSH had not had their dose changed after a previous abnormal TSH in an attempt to bring it within the reference range specified in the criteria. Ranging from poor patient compliance to the way the data has been collected Lack of dose adjustment after abnormal TSH The way results were collected. Limitations of software used. Limitations of the results collected ie things missed: how many patients actually had test done in the last 12 months (QOF points). How many were over and how many were under prescribed. This audit has limitations. The data was collected from electronic records using the EMIS Population Manager. The limited search algorithms of the software meant that we couldn ¿Ã‚ ½t distinguish patients with a TSH below the reference range from those above it. All we were able to obtain was a single figure of how many people were within the reference range. Due to the limitations of the EMIS Population Manager software we were also unable to test how many patients with hypothyroidism had actually had their TSH levels tested in the past 12 months as stated in the QOF guidance  ¿Ã‚ ½ 2004.[8] Thyroid Function Tests are done for a large number of patients whose symptoms are actually caused by a non-thyroid illness. Due to this reason we could not search for people who had their thyroid function tested in the past 12 months as that data would have included a lot of non-hypothyroid patients. Instead we had to search for patients who had been prescribed levothyroxine therapy in the past 12 months. And then further narrow the search parameters TSH levels in the past 12 months to obtain the data. This meant that the people who have not had their thyroid functions tested in the past 12 months were excluded from our data. The positive aspect of only testing people within the last 12 months is that the data reflects current level of care. The data collection software shows patients as being within the normal TSH range if they have had at least one TSH test within the normal range during the last 12 months. If the patient has been started on levothyroxine therapy recently their TSH levels wouldn ¿Ã‚ ½t have had enough time to return to normal. However this is likely to be statistically insignificant. The way to get round these limitations of the EMIS Population Manager would have been to study the clinical notes of all patients who were prescribed levothyroxine in the past year. By looking at the notes we would be able to exclude patients who are unsuitable for the purpose of this audit i.e. those patients in whom the TSH level is not a valid indicator of thyroid hormone requirement e.g. those on Amiodarone or lithium or patients with secondary hypothyroidism. Looking at the notes would also allow us to check the number of patients who had not had their TSH levels tested in the past year. Reading through the notes would also allow us to obtain more information such as age gender etc which might be helpful in indentifying some of the factors responsible for suboptimal thyroid hormone replacement. However reading the notes of over 206 patients would have taken a considerable amount of time. Since this was my first audit I decided to avoid gathering qualitative data and decided that the using electronic records would be sufficient for the purposes of this audit. Changes to practice to hit the target. Tietable to implement that change and when to re-audit? Practicality, why change? Positives and negatives of changing. There are a few approaches which could potentially be taken to improve the standard of care. In order to improve the standard of care to meet the goal of 90% all patients on the hypothyroidism register should have yearly or six monthly blood tests to measure their TSH levels. all patients with abnormal TSH levels should be invited for an appointment with the GP and should be considered for a change in their current dosage. This would be a good opportunity to assess why their TSH levels are abnormal and check that the patient is adhering to the prescribed treatment regimen. If the dose remains unchanged the reason should be recorded in the notes so that the information is available for the second cycle of the audit. Doing this will allow us to make sure that patients are kept at the optimum dose of levothyroxine to reduce the risks associated with under or over prescription. Seeing patients like this would however increase the workload placed on the surgery and its resources. However by talking the patients as and when they have their TSH levels tested the strain on the resources would be spread out over a year. Since the current audit identified 39 patients with abnormal TSH levels, this would mean an extra 3-4 patient appointments per month over the period of a 12 months. This should be discussed at the doctors ¿Ã‚ ½ meeting. Twelve months after the implementation of the change of practice a second data collection should be done to complete the audit cycle and evaluate the impact, if any, the change in practice has had on the management of hypothyroid patients. Write to the patients to invite them to come in for a dose adjustment? Consider collecting better data by reading the notes. That would take too long. Consider specialist referral if symptoms persist. What have I learned: 1 about the condition, 2 about auditing. Conducting this audit has given me the chance to take an in-depth look at all aspects of hypothyroidism which has been an area of interest for me for some time. In the course of researching for the audit I have been able to review various guidelines, clinical reviews and other journal articles. Not only has that improved my understanding of the management of thyroid disease in primary care immensely. It has given me a sense of how a condition is followed through in general practice from first presentation to treatment to long term management. I have also realised that management of chronic conditions such as hypothyroidism is an ongoing process as the patients ¿Ã‚ ½ condition and requirements change continuously for instance if their body mass index changes significantly their thyroid hormone requirements would also change and the dose would have to be altered. Also if a patient is planning on or has become pregnant they would need to be referred to specialist endocrinologists. I have been able to review the evidence which forms the basis of current practice. Researching this topic by reading clinical reviews has made me realise the advantages of using original literature and how much beneficial it can be in achieving a comprehensive understanding of a topic. Being involved in a general practice standard-based audit has enabled me to learn about the role and significance of audits in healthcare. I have become familiar with the audit cycle and its different steps. Having conducted an audit myself, I can see the important role audits have in measuring and improving practice. It is a systematic way of monitoring standards of care and is very useful in facilitating change of practice through an evidence based approach. It has also allowed me to learn how to quickly and efficiently find relevant papers using such resources as ISI Web of science and medline. Conclusion and summary Timetable change re-audit 6. Description of change 7. Data collection (2) 8. conclusions be almost impossible to achieve due to variables like poor patient compliance or use of interactive medications e.g. Amiodarone and Lithium. It would also be vastly impractical from a reasources point of view to aim for a 100% standard.

The Mass-marketing of Working Class Culture :: Exploratory Essays Research Papers

The Mass-marketing of Working Class Culture The fads of the father are visited on the son: we've all seen how adult fads are given down to children. We've seen how cargo pants have trickled down, thanks to the Gap, Baby Gap, and Old Navy (all corporations owned by The Limited, Inc.). Cargo pants have always been a mystery to me. The attractive thing about them is storage (which I'll get to later), blandness and personal appearance. I only considered wearing cargo pants because they'd hide how chunky my thighs are. And they're beige and boring--they thus go with anything. I also don't understand this fascination with looking working-class (In a recent copy of Vogue, there were ritzy, high-priced versions of lumberjack clothing). There's absolutely nothing wrong with that and I don't want to sound like an elitist, because I'm by no means not working-class. I just wonder why this a trend, why white collar workers want to look like they work with their hands. But this fascination with storage, with having so many products presents a problem. Cargo pants were designed so workers could essentially wear their toolbox. Today's kids wearing cargo pants don't need that space for hammers and nails. To avoid acknowledging that cargo pants are a silly trend, wearers unconsciously seek to fill their pockets. As Lacan might say, empty pockets remind us of our lacks. Cargo pants only encourage the reckless. The Gap, like any other capitalist corporation, wants consumers to spend oodles of money. Providing more storage space in a pair of pants allows for children and teens to spend even more money filling them. What the Gap has done is transformed the meaning of cargo pants. It is a redefinition: today's cargo pants wearers aren't laborers, they're spenders. Isn't that a glorious thing, the Gap may ask us. It's a way of showing how the upper class has always stepped all over the lower class, taking what aspects of its culture it likes and discarding the individuals involved. We've seen this over and over, but it usually has been a race's culture that has been used while the individuals are considered meaningless by the ruling classes. This is happening again today with Latin culture. White culture takes what few things it likes (namely Jennifer Lopez and Ricky Martin, maybe a salsa beat, and some Tex-Mex food), and celebrates it as all Latin culture has to offer, ignoring debates about the "Latinness" of such aspects anyway.

Analysis of the Nitrogen Content of Lawn Fertiliser Essay

Research Question: What is the percentage by mass of nitrogen (from the ammonium ion NH4+) in Bunnings Green Up brand of lawn fertilizer compared to the manufacturer’s specification of 12.3%? Aim: To determine the percentage by mass of available nitrogen, present as the ammonium ion, in Bunnings Green Up brand of lawn fertiliser, then comparing it with the one specified by the manufacturer. Hypothesis: Since the ammonium ion (NH4+) present in fertilisers is a weak acid, it is hard to obtain an exact end point. Hence, back titration can be used to determine the percentage by mass composition of nitrogen in the fertiliser. To deduce the amount of nitrogen in ammonia, the NH4+ ion is reacted with an excess of NaOH, and the amount of unreacted NaOH found by titration with HCl is used to deduce the amount of NH4+ ion present by subtracting it from the initial amount of NaOH to find the amount that reacted with it. From this, the percentage by mass of nitrogen present in the fertiliser can be found and subsequently compared to the manufacturer’s specification. It is hypothesized that the percentage by mass of nitrogen present in the fertiliser will be similar or close to that specified by the manufacturer (12.3%). Materials: * * 100 cm3 of 0.1 mol dm-3 NaOH * 100 cm3 of 0.1 mol dm-3 HCl * 1.5 grams of fertiliser * 250 cm3 volumetric flask * 3 à ¯Ã‚ ¿Ã‚ ½ 250 cm3 conical flasks * 20 cm3 pipette * Burette and retort stand * 50 cm3 measuring cylinder * Bunsen burner, tripod, gauze mat * Mortar and pestle * Electronic balance * White tile, bench mat * Funnel * Spatula * Red Litmus paper * Methyl red indicator * Safety Measures: * Safety goggles must be worn at all times. Sodium hydroxide can react with the proteins in the eye. * Wear a lab coat. Hydrochloric acid can cause severe skin irritation. If any is spilt on the skin, wash it off with water immediately. * Ammonia vapour irritates the skin, eyes, and respiratory system. Method: 1. Accurately weigh about 1.2 grams of fertilizer. Record the brand of the fertiliser and the nitrogen content as specified by the manufacturer. 2. Dissolve the fertiliser in 250 cm3 of distilled water in a volumetric flask. Add the fertiliser first using a funnel and then add the water, allowing it to take with it the fertiliser remaining on the funnel, to the calibration line, stopper, and swirl the contents to dissolve the ammonium compounds in the fertilizer. 3. Using a pipette, dispense 20 cm3 aliquots of the fertilizer solution into three conical flasks. 4. Thoroughly wash the pipette and rinse it with a small volume of standard NaOH solution. Place a 20 cm3 aliquot of NaOH solution in each of the flasks containing fertilizer solution. Record the concentration of the standard solution of NaOH. 5. To one of the flasks, add 50 cm3 of distilled water. Boil the mixture for about 10 minutes. If necessary, add more water to maintain a constant volume of solution whilst boiling. Test the vapour at the neck of the flask with a moist strip of red litmus paper. If ammonia is present the paper will turn blue and heating should be continued until the point where litmus paper does not detect the presence of ammonia. Once this point has been reached, cool the flask under running water. 6. Repeat Step 5 with each of the other two conical flasks. 7. Rinse and fill a burette with standard HCl. Record the concentration of the acid and the initial burette reading. 8. Add two to three drops of methyl red indicator to each conical flask containing the fertilizer mixture, and titrate. The end point occurs when the initially yellow solution becomes orange. For each flask, record the burette reading once the end point has been reached. Data Collection: Table 1: Titration of the excess NaOH (0.084 mol dm-3) against HCl using Methyl Red Indicator Conclusion/Evaluation: Fertiliser is a natural or synthetic chemical substance or mixture that is used to enrich soil in order to promote plant growth. It influences grass colour, ability to recover from stress, and helps prevent weed invasions and diseases. Plants require more than a dozen different chemical elements but nitrogen, phosphorus, and potassium are the three major nutrients needed by lawns; Nitrogen is the nutrient required most as it promotes growth and keeps the grass green, although too much nitrogen can have harmful effects on plants and crops, and on soil quality. In this investigation, the percentage by mass of nitrogen from the ammonium ion in the sample fertiliser is being determined. The manufacturer’s claim of the amount of nitrogen present in this type of fertiliser is 12.3%. The ammonium that is present in fertilisers is a weak acid, thus it is hard to identify a sharp end point in direct titrations with the naked eye. Back titration is used instead. It is an analytical chemistry technique in which the unknown concentration of a reactant can be found by reacting it with an excess volume of another reactant of known concentration. The resulting mixture is then titrated back, taking into account the molarity of the excess which was added. Before titration, the sodium hydroxide was reacted with ammonium in the fertiliser to produce ammonia and water: NH4+(aq) + OH-(aq) –> NH3(g) + H2O(l) The basic solution needed for titration was reached through heating the solution to remove the ammonium ions. By heating it, the rate of reaction between the ammonium ions and hydroxide ions increases, consequently producing water and ammonia. Since ammonia is an extremely volatile gas, boiling the solution will result the vaporization rate, which is the desired outcome. The ammonium ions are also the limiting reagent thus once completely reacted, ammonia production ceases. This is indicated when the red litmus paper, which tests for the presence of a base, no longer turns blue meaning the ammonia has completely evaporated and no longer present in the solution. By titrating the excess, unreacted hydroxide ions with standard hydrochloric acid, it allows us to calculate the amount of unreacted hydroxide ions since the molar ratio is equal, and from this the amount of reacted hydroxide ions with the fertiliser solution can be deduced. Subsequently, the amount of ammonium ions initially present in the 250 cm3 volumetric flask can be found and then the mass of nitrogen ions can be calculated. From this, the percentage by mass of nitrogen in the sample of fertiliser can be found. It was found that the percentage by mass of 1.209 g of fertiliser was 13.87% (? 1.00%). This is very close to the percentage of nitrogen present in the fertiliser as specified by the manufacturer – 12.3%. This discrepancy may be due to several errors and limitations encountered throughout the experiment. The percentage difference of 12.76% is greater than the percentage uncertainty of 6.34% and as a consequence random errors alone cannot alone account for the difference. There must be systematic errors inherent to the investigation or the apparatus. Measurement errors could be the main source of uncertainty. One source of error could be that the exact mass of the fertiliser sample as measured on the electronic balance is not the same as in the volumetric flask, consequently affecting the final result. The loss due to the transfer process into the flask which could be reduced by sufficiently rinsing the apparatus used to transfer, weigh and grind the fertiliser sample ? the funnel, weighing bottle, spatula and mortar and pestle ? so that all sample weighed is transferred into the volumetric flask. Another possible error is that the meniscus of solutions measured was not sitting exactly on the calibration line in the volumetric flask when preparing the standard solution. This may affect the results as the expected volume of the standard solution would differ from the actual volume measured. This can be overcome by allowing more than one individual to test whether or not the meniscus is positioned on the etched mark, making sure it’s at eye level, which will effectively limit this parallax error. The interpretation of the orange colour determined at the end point could also have been another error. Subjective judgment when determining the shade of orange is another factor which may have affected the titre volume, and thus the final outcome. This problem was exacerbated by the fact that the methyl red indicator does not provide a sharp and easily distinguishable end point, as the colour change from yellow to orange. This may be overcome by using another indicator that allows for a clearer colour contrast. Another possible limitation which may have impacted the results is that some ammonia may still have been present in the conical flask. Although the red litmus paper may have served its purpose, this may still occur as a result of not boiling the solution long enough and thus some ammonia may not have evaporated. The result of this is that the ammonia in the solution will react with the hydrochloric acid, and therefore more hydrochloric acid will be required for the equivalence point to be reached, affecting the titre volume. This can be easily overcome by ensuring that the fertiliser solution containing water and sodium hydroxide is boiled for long enough so that all ammonia can evaporate, while simultaneously ensuring that the solution remains at a constant 90mL. The use of tap water may also have affected the results. It may not have been at a pH of 7 or may contain other contaminants such as salts which may ultimately interfere with the results. To overcome this, the most effective way is to use deionised water. Conclusion: It was found that the percentage by mass of nitrogen from the ammonium ion in Bunnings Green Up brand of lawn fertilizer was 13.9% (? 1.00%). This was very close to the percentage of nitrogen in lawn fertiliser as specified by the manufacturer ? 12.3%. Bibliography: 1. Unknown Author, http://www.urbanext.uiuc.edu/lawntalk.htm 2. Chemistry for the International Baccalaureate, 2005, IBID Press

Bookbinders Book Club Essay

1. Before beginning any case, students should familiarize themselves with the model being used. Marketing Engineering for Excel comes with tutorials that demonstrate the capability of each model. The tutorial can be found under each model within the ME>XL menu after starting Excel. These tutorials are designed to work with our OfficeStar examples which are located in the My Marketing Engineering directory, usually installed in My Documents during software installation. The data required for this case is located in two files in the My Marketing Engineering directory (usually located within My Documents): Bookbinders Book Club Data (Customer Choice). xls Bookbinders Book Club Data (Customer Choice) Holdout Sample. xls 2. Introduction About 50,000 new titles, including new editions, are published in the United States each year, giving rise to a $20+ billion book publishing industry. About 10 percent of the books are sold through mail order. Book retailing in the 1970s was characterized by the growth of chain bookstore operations in concert with the development of shopping malls. Traffic in bookstores in the 1980s was enhanced by the spread of discounting. In the 1990s, the superstore concept of book retailing was responsible for the double-digit growth of the book industry. Generally situated near large shopping centers, superstores maintain large inventories of anywhere from 30,000 to 80,000 titles. Superstores are putting intense competitive pressure on book clubs, mail-order firms and retail outlets. Recently, online superstores, such as www. amazon. com, have emerged, carrying 1–2. 5 million titles and further intensifying the pressure on book clubs and mail-order firms. In response to these pressures, book clubs are starting to look at alternative business models that will make them more responsive to their customers’ preferences. Historically, book clubs offered their readers continuity and negative option programs that were based on an extended contractual relationship between the club and its subscribers. In a continuity program, popular in such genres as children’s books, a reader signs up for an offer of several books for a few dollars each (plus shipping and handling on each book) and agrees to receive Copyright  © 2008 by DecisionPro, Inc. To order copies or request permission to reproduce materials, go to www. decisionpro. biz. No part of this publication may be reproduced, stored in a retrieval system, used in a spreadsheet, or transmitted in any form or by any means – electronic, mechanical, photocopying, recording or otherwise – without the permission of DecisionPro, Inc. a shipment of one or two books each month thereafter. In a negative option program, subscribers get to choose which and how many additional books they will receive, but the default option is that the club’s selection will be delivered to them each month. The club informs them of the monthly selection and they must mark â€Å"no† on their order forms if they do not want to receive it. Some firms are now beginning to offer books on a positive-option basis, but only to selected segments of their customer lists that they deem receptive to specific offers. Book clubs are also beginning to use database marketing techniques to work smarter rather than expand the coverage of their mailings. According to Doubleday president Marcus Willhelm, â€Å"The database is the key to what we are doing†¦. We have to understand what our customers want and be more flexible. I doubt book clubs can survive if they offer the same 16 offers, the same fulfillment to everybody. †2 Doubleday uses modeling techniques to look at more than 80 variables, including geography and the types of books customers purchase, and selects three to five variables that are the most influential predictors. The Bookbinders Book Club The BBB Club was established in 1986 for the purpose of selling specialty books through direct marketing. BBBC is strictly a distributor and does not publish any of the books it sells. In anticipation of using database marketing, BBBC made a strategic decision right from the start to build and maintain a detailed database about its members containing all the relevant information about them. Readers fill out an insert and return it to BBBC which then enters the data into the database. The company currently has a database of 500,000 readers and sends out a mailing about once a month. BBBC is exploring whether to use predictive modeling approaches to improve the efficacy of its direct mail program. For a recent mailing, the company selected 20,000 customers in Pennsylvania, New York and Ohio from its database and included with their regular mailing a specially produced brochure for the book The Art History of Florence. This resulted in a 9. 03 percent response rate (1806 orders) for the purchase of the book. BBBC then developed a database to calibrate a response model to identify the factors that influenced these purchases. For this case analysis, we will use a subset of the database available to BBBC. It consists of data for 400 customers who purchased the book, and 1,200 customers who did not, thereby over-representing the response group. The dependent variable for the analysis is Choice — purchase or no purchase of The Art History of Florence. BBBC also selected several independent variables that it thought might explain the observed choice behavior. Below is a description of the variables used for the analysis: Choice: Whether the customer purchased the The Art History of Florence. 1 corresponds to a purchase and 0 corresponds to a nonpurchase. Gender: 0 = Female and 1 = Male. Amount purchased: Total money spent on BBBC books. Frequency: Total number of purchases in the chosen period (used as a proxy for frequency. ) Last purchase (recency of purchase): Months since last purchase. First purchase: Months since first purchase. P_Child: Number of children’s books purchased. BOOKBINDERS BOOK CLUB CASE 2/4 P_Youth: Number of youth books purchased. P_Cook: Number of cookbooks purchased. P_DIY: Number of do-it-yourself books purchased. P_Art: Number of art books purchased. To assess the performance of the model, the data set includes a second sheet with 2300 customers–a holdout sample representative of the entire target market. The use of such a validation sample is an appropriate way to compare alternative models. BOOKBINDERS BOOK CLUB CASE 3/4 EXERCISES BBBC is evaluating three different modeling methods to isolate the factors that most influenced customers to order The Art History of Florence: an RFM (Recency, Frequency and Monetary Value) model, an ordinary linear regression model, and a binary logit model. 1. Summarize the results of your analysis for all three models. Develop your models using the case data files and then assess them on the holdout data sample. Interpret the results of these models. In particular, highlight which factors most influenced the customers’ decision to buy or not to buy the book. Bookbinders is considering a similar mail campaign in the Midwest where it has data for 50,000 customers. Such mailings typically promote several books. The allocated cost of the mailing is $0. 65/addressee (including postage) for the art book, and the book costs Bookbinders $15 to purchase and mail. The company allocates overhead to each book at 45 percent of cost. The selling price of the book is $31. 95. Based on the model, which customers should Bookbinders target? How much more profit would you expect the company to generate using these models as compared to sending the mail offer to the entire list? Based on the insights you gained from this modeling exercise, summarize the advantages and limitations of each of the modeling approaches. Look at both similar and dissimilar results. As part of your recommendations to the company, indicate whether it should invest in developing expertise in any of these methods to develop an in-house capability to evaluate its direct mail campaigns. How would you simplify and automate your recommended method(s) for future modeling efforts at the company. 2. 3. 4. 5. 6. 1 The case and the database were developed by Professors Nissan Levin and Jacob Zahavi at Tel Aviv University. We have adapted these materials for use with our software, with their permission. 2 DM News, May 23, 1994. BOOKBINDERS BOOK CLUB CASE 4/4

buy custom Iranian Revolution essay

buy custom Iranian Revolution essay In Iran, Khomeinis aim was to take the political power. He strongly believed in the establishment of Allahs Government, which is founded on the principle that the concept of sovereignty finds its residence in Allah, and not on the people. He strongly believed that the sovereignty is exercised by Rahbar Imam on behalf of Allah. In addition, he had the goal of disabling, killing or imprisoning all rival political opponents or potential leaders who might threaten his political ambitions. In doing this, he would make use of imprisonment, selecting repression, executions or torture to disable and cripple any opposing groups. Moreover, he would concentrate power, prestige and authority as objects of emulation. In the Islamic World, Khomeini had a goal of creating, supporting, and encouraging Islamic military movements and groups in the entire Islamic World. He wanted also to engage in the exportation of Shia Islamist Revolution into other designated Islamic countries such as Iraq, Yemen, Afghanistan, Bahrain, Azerbaijan, and Lebanon among others. Besides, he had an aim of increasing political contacts as well as economic ties with other developing nations with the view of converting them into Shia Islam as well as making them join Shia Imamate. In the entire world, Khomeini had a goal of waging Planetary Jihad so as to enable him conquer, and probably subdue the remaining Infidel nations with the aim of bringing them under the rule and control of Shia Islamist. His major aim was to conquer and rule the world on behalf of Allah till the return of Imam Mahdi, who was believed to have hidden from the people. How did his anti-imperialist stance differ from Nasser's? It is very interesting to note that Khomeinis stance on anti-imperialism was more of a self-serving entity than a principled one witnessed with Nasser. He was strongly devoted to fighting the penetration of the western imperialism without necessary seeking support from other countries. In addition, he led strong Islamic force that were against the secular nationalism as well as the left. He fought the dictators who came to rule and influence the governing system of Iran with impunity. This rebellion was against both the economic and political systems that were linked with the imperialism. However, Nassers anti-imperialist stance was quite different since his ideology was not as powerful as that of Khomeini. In fact, Nassers ideological views on imperialism lacked both the religious agenda and the outlook of clerical leadership that were possessed by Khomeini. The latters views were so powerful that the concept swept aside the entire leftist arguments. Besides, Khomeinis view on the anti-imperialist revolution was very appealing due to its nationalist facets that were assimilated with little resistance from the Iranian people. Consider Marjane Satrapi's graphic novel. Persepolis: The Story of a Childhood. How does Satrapi remember and characterize the revolution? Satrapi uses both images and texts to remember and characterize the revolution. She argued that as a child she was not meant to have some political awareness since the dominant political ideology does not permit children due to their perceived innocence. The childhood narrator provides some unique insights concerning the events, which dominated the Iranian revolution. In her literary analysis, Satrapi argued that characters such Marji and Mehrri attended the Black Friday protest that was the bloodiest demonstration at the point of the Iranian revolution owing to their illiteracy and class. Though, they enjoyed this game, it portrayed the bloodiest revolution in the Iranian history. On their return home, Marjis mother slapped them, and this invoked a lot of anger. This echoed violence on top of the revolution witnessed, and sparked a strong reaction to the role of the state and parents authority. In the novel, Marji raised her hand declaiming her mothers dictatorship. This can as well be compared to the Iranian revolution that came as a result of autocracy, which domminated the countrys political landscape. The childs knowledge, as far as Satrapi could remember was often confined to the domestic atmosphere. Arguably, this limits the childs perspective on the national views, and it supports the view that state violence, as the one witnessed in the Iranian revolution, disrupts and reshapes the dynamics of the family. What do we learn from her narrative that we do not see in the more standard academic texts of Cleveland and Fischer? Satrapis narrative is more distinct in its literary analysis than other scholarly texts such those of Cleveland and Fischer since it carefully uses comic to portray the intended messages. The literary style challenges the expectations of the readers with the tactical use of both images and texts. With its simple style and use of child-focused narrative, it facilitates understanding of the literature, yet the text stimulates and forces the readers to analyze the meaning of the narrative. Contrary to other texts, Satrapis narrative comic requires the readers to engage in unpacking the books co-mixed images and words. In understanding the novel, it can be learned that the readers would be required to engage in working hard in order to successfully decode the co-mixed Western and Eastern cultural experiences. It can as well be learned that this piece of literary work composes of empty spaces, which are often referred to as gutters. These gutters in Satrapis literary narrative are very unique in their own kind, and they can be filled with answers that are provided by the narrators dominant ideology. These gutters between the literary texts are instrumental to the readers since they engage the audience in interacting with the narrator as well as interpreting historical, cultural, and political silence. Indeed, it is these spaces within the narrative texts that give new meanings, which help in deflating the over-determined classifications of both the West and the East potentials that can be generated, and this is lacking in the standard academic texts of Cleveland and Fischer. Buy custom Iranian Revolution essay

Plymouth Plantation Essay Example | Topics and Well Written Essays - 1250 words

Plymouth Plantation - Essay Example The book describes the first Thanksgiving and about the brave pilgrims who were in search of religious liberty. The description of Mayflower is a new kind of telling a story that goes up through King Philip's War in 1675-76. The bloody war was fought between the English and the Native Americans that resulted in the death of hundreds of English and thousands of Native Americans. The Native Americans were the Indians and most of them were killed and the remaining were starved to death or deported or sold as slaves. After the war independence of native New England was broken. The next 250 years was repetition of the history between the English (white Americans too) and the Native Americans. The Indians weren't in a mood to accept the new visitors or the white Americans. As the number of white settlements increased the insecurity among the Indians also increased. Each day passing the whites were moving closer to the natives and were more powerful than the Indians. The whites were growing in number and stature. Since the two sides need different things and respect different values, grievances build up. They weren't in a mood to understand each other and stopped trying to understand each other's values, the result was bloodshed and finally the Indians lose. The Indians were illiterates and didn't make any effort to write their side of story and their own history. The Thanksgiving Day was declared a national holiday by the then president Abraham Lincoln. Lincoln describes the Pilgrims as national heroes who remind the Americans of their roots. Squanto was the Pilgrim's trusty English speaking interpreter; to take Massasoit's place he made every effort to turn the English against him. The result was a bloody preemptive attack on a Massachusetts band that was led by Miles Standish and was sanctioned by William Bradford. The raiders came back with the head of a warrior as a trophy to commemorate their victory and hanged it over the fort. This resulted in a shocking wave of fear amongst the natives that made them to flee their fields and villages. When the Rev John Robinson, Pilgrim's spiritual leader came to about the raid he condemned this kind of shocking and terrorized act and denounced it in a letter to William Bradford. The naives of different tribal groups and always had complexities amongst them. They were the Pokanokets, the Nausets of Cape Cod, the Rhode Island Narragansetts, the Massachusetts near Boston and several others. These tribal groups were collectively called as Wamponoags. The English and the Wamponoags were complicated in terms of psychologically and morally and were always under various pressures. The Pilgrim village museum in Plymouth contains description and artifacts of both cultures and represents as bicultural institution. It not only represents or tells the stories of European immigration but also the encounter between them that happened centuries ago. Mostly the Whites described the Mayflower by their writings and scriptures though both cultures were involved in the arrival of the Mayflower. Since the natives were not literate as the Whites they fell behind and little was known from them. Both the cultures have equal importance and played significant role in the evolving American history. They made us to realize the importance of both the cultures and to respect them. The Indians passed

False activation rates by EMS (Paramedics) and the ER doctors on STEMI Research Paper

False activation rates by EMS (Paramedics) and the ER doctors on STEMI patients - Research Paper Example In cases, when a patient experiences STEMI, it is the duty of the paramedics to detect the anomaly within the heart through the use of 12-lead electrocardiogram technique. Notably, the patients having STEMI gets examined in the ‘Cardiac Catheterization Laboratory (Cath Lab)’ setup within diverse medical facilities. However, within multiple medical facilities, the precision factor within the Cath Lab is not attained till date and as a result of which multiple cases of false activations regarding STEMI detection in patients have been addressed within the previous few years (National Center for Biotechnology Information, â€Å"Early cardiac catheterization laboratory activation by paramedics for patients with ST-segment elevation myocardial infarction on prehospital 12-lead electrocardiograms†). With this concern, the research paper will mainly focused on evaluating and understanding the trends as well as rates of false activations in relation to STEMI depending on which, effective strategies will be formulated as how to reverse the rise in the rates of such false activations. In addition, an assessment will also be conducted on the Emergency Room (ER) doctors and the EMS determining who should be held liable for the rising rates of such issue. Apart from these, the research paper will also focus towards elaborating the cases wherein the doctors have failed in detecting and activating the STEMI patients. Finally, a comparison will be made in the research paper regarding the data provided in opposition to national trends, elaborating the strategies that can be used in enhancing the provided data. Emergency services such as Reperfusion therapy is a high cost treatment against STEMI patients, which also results in multiple negative side-effects if practiced on the wrong patients. As a result, the EMS and the ER doctors remain highly cautious in terms of identifying the appropriate symptoms before declaring a patient to be suffering from