Professional Wrestling A Trend among Children - 1263 Words

Professional Wrestling has become one of the trends among people especially children. Leng et al in a literature review from their article their article (pg 45) explain profession wrestling as more of a source of entertainment than a sport where there is a portrayal and dramatization of good versus evil. My paper will focus extensively on television violence with respect to professional wrestling and its effects on children; it will also assert sexuality with in professional wrestling. According to statistics from Monday Cable Ratings, WWE Raw on Monday nights have been on top of the charts in the between January 28th and April 29th this year with the April 29th show having 4652 viewers leaving NBA playoffs- Round 1 L with 3921 viewers. However, there was a tie in the adult 18-49 ratings with both shows getting 1.8 views (BIBEL,2014). One cannot talk about professional wrestling and its violent effect on children without talking or focusing on television violence. Professional wrestling is a type of entertainment which some people will describe as â€Å"a soap opera for men†. This type of entertainment can be justified as not the only type to depict violence as most of its storyline involve talking (mostly humorous) more so than fighting. Most people may suggest that professional wrestling is not real and children and adolescents are aware of that by stating in most of their shows that stunts should not be tried at home or in school but what is the assuranc e to this in thisShow MoreRelated violence on tv Essay855 Words   |  4 Pageslead to aggressive behavior by children and teenagers who watch those programs. As adults we think that watching TV won’t effect us since we are older, but for younger children when they see someone die or get beat up they think it is cool. Children are very easy to mold into what you want, how many times have you noticed a younger brother or sister imitate their older sibling. TV can have the same effect, for example a 10 year old boys favorite show was WWF wrestling and one day after watching heRead MoreEssay on Body Art543 Words   |  3 Pagesbody art really a pop culture? Our dissatisfaction with the human body and its covering is expressed in endless change. This results in the desire and adoption of a trend, these trends are shown through ways such as piercing, body painting, and tattoos, Body piercing has grown in popularity over the past five years especially among American teenagers who pierce just about anything that can be pierced: ears, noses, tongues, and navels. The most conventional form of piercing in the United StatesRead MoreEssay on Sports Specialization1822 Words   |  8 Pagespopular pastime among all ages and types of people. People not only participate in them for fun, but also for money, physical fitness, rush of competition, and for many other personal reasons. Playing sports is especially common among young people in schools. Athletics are great and enjoyable for many reasons, but there can be a point where sports participation can go too far and become negative for children and adults. Sports specialization for young people is an increasing trend that results inRead MoreDescriptive Essay About Sports And Football1054 Words   |  5 Pagesdefines the noun sport as an activity engaged in for relaxation and amusement with synonyms including diversion and recreation.[11] Nomenclature The singular term sport is used in most English dialects to describe the overall concept (e.g. children taking part in sport), with sports used to describe multiple activities (e.g. football and rugby are the most popular sports in England). American English uses sports for both terms. Definition See also: Game  § Definitions The InternationalRead MoreViolence on Television Does Not Impact Behavior Essay3474 Words   |  14 Pagesroom, and pocket radios the size of a basic calculator have all taken their toll on American society. In a furious outburst reflecting the contemporary society in which we live, television has come to represent all that is evil and wicked for our children. Through gruesome, explicit, and often unrealistic portrayals of death and violence, the impressionable clay of our childrens minds are being molded into vicious statues incapable of comprehending the gap between what is real and what is injuriousRead MoreConverse Hits the Shoe Industry1602 Words   |  6 PagesBackground In 1908 Marquis Mills Converse opened the Converse Rubber Shoe Company in Malden, Massachusetts. The manufacturing company made rubber shoe, providing winter rubber soled footwear for men, women, and children. By 1910, Converse was creating 4,000 shoes daily, but it was not until 1915 that the company began making athletic shoes for sports. In 1917 Converse All-Star basketball shoe was introduced. Then in 1921, a basketball player named Charles H. Chuck Taylor walked into Converse complainingRead MoreThe Effects Of Concussions On Youth And Concussions1876 Words   |  8 Pages Youth and Concussions Many children enjoy sports more than life itself. To love a sports with that amount of significance is not a horrible thing, but to love oneself should be the first priority in life. Especially adolescents who play the sport with lots of passion and emotion by imitating their favorite athletes to fight an injury so they would be able to continue their action. The youth as a whole need to realize that injuries are capable of affecting people’s lives around them. For exampleRead MoreChild Abuse Prevention2380 Words   |  10 Pagesneeds to by carefully handled. Child abuse is defined as a no accidental injury or pattern of injures to a child for which there is no reasonable explanation. Child abuse consists of different types of harmful acts directed toward children. In physical abuse, children are slapped, hit, kicked or pushed, or have objects thrown at them causing wounds, broken bones, or other injuries. Severe abuse may result in major injury, permanent physical or developmental damage, or even death. Emotional abuseRead MoreThe Pressure of Reducing Weight on Athletes3847 Words   |  15 Pages Introduction Pressure to reduce weight has been the common explanation for the increased prevalence of eating-related problems among athletes and dancers. One of the reasons that ballet dancers may be at risk for developing eating disorders is that they may have to diet in order to maintain the sylph-like bodies that are required for the discipline of ballet. Lowenkopf and Vincent (1982) have suggested that female adolescent dancers run eight times the risk of developing eating disorders comparedRead MoreSummary Article Nikes Dispute with the University of Oregon9247 Words   |  37 Pagesstrength, victory, nakht. Nike markets its products under its own brand as well as Nike Golf, Nike Pro, Nike+, Air Jordan Air Jordan Air Jordan, or simply Jordans are a brand of shoes produced by Nike originally designed for and endorsed by professional NBA basketball player Michael Jordan. The Air Jordan line is now sold by Jordan Brand, a sub-division of Nike... , Nike Skateboarding Nike Skateboarding Nike Skateboarding is the Nike brand for its line of shoes, clothing, and equipment for

Teaching And Learning Of The 21st Century - 1098 Words

Teaching and learning in the 21st century Introduction Things are changing in this modern society at an epidemic rate. The world is starting to become much more interconnected and technology is constantly changing the world. We now live in an increasingly different, globalized, and complicated media saturated culture. So this Technological overthrow will have a greater change in education. Our students are facing many difficulties like increased population, climate change, health deficiency, primary poverty and other environmental changes. Therefore, this technological revolution, social, economic and globalization changes have intended for new changes and developments in 21st century teaching and learning. Knowledge and understanding: 21st century teaching and learning: 21st century learning means that students are connected to other learners and resources throughout the world, where they prepare themselves as a problem solver. They build their learning around relevant issues, collaborate through effective communication in an ever evolving economy driven world. Students explore the ways to be creative and quickly adapt to the world’s changing trends. They develop themselves as masters of the task in hand and as world leaders. Preparing students for the 21st century is not just about technology or skill for the global economy. Today teachers must be innovator, mentors, entrepreneurs, motivator, illuminators and catalysts. Supporting future-orientedShow MoreRelatedLearning And Teaching Of The 21st Century1289 Words   |  6 PagesLearning and teaching in the 21st century is evolving. The 21st century society is calling for different skills and capabilities of its members. Creativity, problem solving, and high level critical thinking skills are requirements employers are seeking as technology modifies the job environment. Schools must also adapt to this cultural shift. To help students become productive and competent members of a digital age, schools need to be informed of technological terminology, uses, and benefitsRead More21st Century Learning And Teaching902 Words   |  4 Pages21st century learning is a rapidly changing idea, both teachers and students are adapting and learning new ways to teach and learn respectively. A teacher’s pedagogy must evolve to incorporate new technology and new methods of teaching, putting focus on student centred learning and giving pupils the tools needed to create their own learning. Education must incorporate diversity to cope with the ever changing landscape of our society. Learners need to feel safe, secure and equal to each other andRead MoreTeaching And Learning During The 21st Century1733 Words   |  7 PagesTeaching and learning in the 21st century has changed dramatically from a traditional education. There has been a major paradigm shift to effectively support and prepare students for current and future work, social and school expectations. 19th century traditional education was designed to devel op industry based workers that required basic skills and performed menial tasks. However, students need new skills and capabilities to ensure their success in the global market. Teachers roles have also beenRead More21st Century Teaching and Learning Culture Provides Trust, Collaboration, Respect817 Words   |  4 PagesThe developed approach of the 21st century teaching and learning environment provides a good model for other public schools with low performance and non-adequate yearly progress (AYP) to apply. This model is considered to deal with different issues by developing specific concepts such as trust, collaboration, respect, and other positive relationships between school members. It gives the urban high school a solid foundation to overcome its problems and be prepared to adopt a change. The traditionalRead MoreCritical Thinking And Problem Solving Skills1648 Words   |  7 Pagesproblem solving skills have epitomised education throughout history. As time has passed; the education system has become increasingly complex with the integration of learning theories, pedagogies, transformative learning spaces, behavioural management and most importantly; the evolution and role of technology. 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Teachers need to be prepared for new pedagogical approaches that fit theRead MoreCurrent Force That Impact Curriculum Design And Program1207 Words   |  5 PagesCurrent force that impact curriculum design and program in the 21st century education, and developing an internationally-minded learner in a globalized era. Technology is manoeuvred into our everyday life, and it is evolving rapidly which urge educators to redefine the students’ potentials, and learning to know will never be the same. Technology calls for a change in learning and teaching for the 21st century education. The vast change and innovation of new technologies offer changeRead MoreEvaluate How To Communicate And Integrated Case Study991 Words   |  4 Pagesimplement the use of technology to create a blended professional learning community across districts within our state to share knowledge with fellow faculty on how a deeper understanding of subject matter can enhance problem- solving, critical thinking, and other 21st-century skills. Goal: The goal of our research study was to understand how the incorporation and implementation of the use of technology to create a blended professional learning community across districts within our state to share knowledgeRead MoreTeaching A New Generation Of Students815 Words   |  4 PagesSynthesis Paper 1 - Teaching a New Generation of Students We need to prepare students for THEIR future not OUR past – Ian Jukes The above quote by Ian Jukes resounds in the ears of our present day educators in the United States and around the world. Our world is rapidly changing due in part to the growth of technological innovations and the globalization of the world economy. However, how much of our educational system has changed to meet the demands of the 21st century? Are we preparing studentsRead MoreThe Nature Of Teaching And Learning1682 Words   |  7 PagesThe nature of teaching and learning in senior secondary schools is undergoing change. The Australian curriculum has set new priorities for learning in the final years of school. These priorities continue to emphasise learning in the disciplines, but they also include the development of a broader range of skills and attributes considered necessary for life, study and work in the 21st Century. This report builds on that foundation by examining how to assess 21st century competencies. The Queensland

Poland Business Cycle Free Essays

This Country Focus analyses and interprets the statistical characteristics of the Polish business cycle. It also identifies leading and lagging variables and shows that the economic fluctuations in Poland differ to some extent from those in other emerging and mature economies, with Polish growth notably more volatile and government expenditure highly erratic. The available data on GDP growth suggest that the Polish economy is approaching the peak of the second business cycle since the start of economic transformation from a centrally planned to a market economy. We will write a custom essay sample on Poland Business Cycle or any similar topic only for you Order Now The current upswing is to some extent similar to the one of 1995-1997 which ended in large macroeconomic imbalances (increasing unemployment, spare capacity, widening fiscal and current account deficits). However, Poland now appears to be better positioned than after the last cycle and should be able to avoid a repeat of that outcome. Business cycles in emerging market economies Although the economic literature on business cycles is vast, only recently have some papers on business cycles in emerging market economies appeared. Usually they analyse economic fluctuations within particular countries (e. g. Benczur and Ratfai, 2005) or make some cross-country comparisons (e. g. Aguayo et al. , 2004 or Carmignani, 2005). A common methodology used in the analysis of business cycles (based on observations of mature economies and economic theory) distinguishes pro-cyclical, counter-cyclical and a-cyclical variables. Pro-cyclical variables fluctuate together with GDP (e. g. industrial production, investment, employment, inflation), countercyclical variables against GDP (e. g. nemployment, net exports) and a-cyclical variables independently of GDP (e. g. real interest rates). 1 With respect to timing, the ‘stylised facts’ of the business cycle identify leading, lagging and coincident variables: leading variables move ahead of GDP (e. g. average labour productivity, inventory investment, money supply), lagging variables follow GDP (e. g. inflation, nominal interest rates) and coincident variables, as the name suggests, move coincidentally with GDP (e. g. industrial production, consumption, employment) (Snowdon Vane, 2005, p. 306). Overall, business cycles in emerging market economies (Carmignani, 2005)2 are not much different from those in mature economies (Snowdon and Vane, 2005, p. 306), By Michal Narozny* The business cycle in Poland: where do we stand? Highlights in this issue: †¢ While on the whole not different from mature economies, the properties of the business cycle in Poland display some special characteristics †¢ The current cycle seems to have reached a peak but the slowdown is likely not to be as pronounced as in the previous cycle Volume IV, Issue 9 03. 08. 2007 ECFIN COUNTRY FOCUS Directorate for the Economies of the Member States. The views expressed in the ECFIN Country Focus belong to the authors only and do not necessarily correspond to those of the Directorate-General for Economic and Financial Affairs or the European Commission. Economic analysis from the European Commission’s Directorate-General for Economic and Financial Affairs Identification of direction and timing is key in business cycle analysis ECFIN Country Focus Volume IV, Issue 9 Page 2 but economies in transition (though they do not constitute a homogeneous group) display some specific characteristics: overall, the economy is much more volatile than in the euro area, which is the consequence of structural changes and catching-up, †¢ shocks are slightly less persistent than in the euro area, and fluctuations consequently more frequent, †¢ government consumption is more erratic than in the euro area, suggesting a significant discretionary element in fiscal policies, but not one that is necessarily aimed at cyclical stabilisation, †¢ employment is a-cyclical in some, but pro-cyclical in other emerging economies, †¢ inflation in emerging economies is volatile and not clearly pro-cyclical. Table 1 shows some tentative analysis of the key macroeconomic variables in the Polish business cycle. All variables (except for inflation and net exports) were logtransformed, de-seasonalised by means of the X. 12 method and later de-trended using the HP filter. Net exports were expressed as a ratio to GDP and deseasonalised by means of the multiplicative X. 11 method before being de-trended. Volatility of cyclical fluctuations, and hence the magnitude of the business cycle, is measured by the standard deviation. Polish GDP volatility is about 0. 015, compared to 0. 08 for the euro area. The persistence of cyclical fluctuations is measured by the auto-correlation coefficient: the closer to 1, the more persistent the shock (and the longer it takes to absorb it) and therefore the less fluctuation in the business cycle. Testing for the Polish business cycle persistence yields a coefficient of 0. 55 compared to 0. 85 for the euro area. Table 1. Summary statistics of business cycle fluct uations in Poland Correlations with the cyclical component of GDP Poland Standard Autodeviation correlation -4 -3 -2 -1 0 1 2 3 4 GDP 0. 015 0. 550 1 Industrial production 3. 317 0. 730 -0. 018 0. 154 0. 314 0. 515 0. 771 0. 599 0. 444 0. 229 0. 113 Private consumption 0. 013 0. 269 0. 015 0. 079 0. 283 0. 433 0. 434 0. 385 0. 463 0. 380 0. 037 Government consumption 0. 020 0. 001 -0. 200 0. 007 0. 230 0. 022 -0. 211 0. 175 0. 282 0. 199 0. 051 GFCF 0. 070 0. 717 0. 357 0. 399 0. 403 0. 484 0. 824 0. 585 0. 371 0. 313 0. 344 Inventories 1. 189 -0. 072 -0. 139 0. 044 0. 021 0. 074 0. 199 0. 187 0. 150 0. 177 0. 230 Net exports 0. 012 0. 574 -0. 061 -0. 174 -0. 386 -0. 373 -0. 326 -0. 513 -0. 497 -0. 389 -0. 452 Exports 0. 58 -0. 005 0. 098 0. 199 0. 177 0. 225 0. 594 -0. 018 0. 030 -0. 016 -0. 193 Imports 0. 063 0. 378 0. 097 0. 252 0. 350 0. 408 0. 672 0. 377 0. 384 0. 258 0. 175 Employment 0. 017 0. 857 0. 291 0. 372 0. 411 0. 452 0. 545 0. 409 0. 333 0. 355 0. 344 Labour productivity 0. 354 0. 512 0. 120 0. 090 0. 056 0. 070 0. 133 0. 257 0. 109 0. 026 -0. 142 Money supply (M1) 0. 041 0. 776 -0. 078 -0. 060 0. 092 0. 260 0. 475 0. 472 0. 535 0. 505 0. 432 Inflation 1. 819 0. 779 0. 092 0. 321 0. 511 0. 596 0. 473 0. 290 0. 082 -0. 082 -0. 146 CPI 1. 737 0. 777 0. 086 0. 255 0. 411 0. 422 0. 00 0. 082 -0. 075 -0. 167 -0. 184 Real interest rate 0. 655 0. 942 0. 226 0. 279 0. 302 0. 263 0. 135 0. 132 0. 120 0. 092 0. 088 Source: Own estimates. Data source: Eurostat. Sample: 1995Q3 – 2007Q1 Summary statistics Lags Leads Business cycles in Poland – what is different and what is alike The analysis of the Polish cycle yields a number stylised facts, which are to some degree typical for emerging economies. Table 2 summarises a number of stylised facts on business cycles in mature economies and in Poland (bearing in mind the relatively short time span for the latter). It shows that some of the usual characteristics of business cycles in mature economies (or even in emerging economies) are not seen in Poland. Where this is the case, some interpretation is offered. Industrial production is usually pro-cyclical and coincident in both mature and emerging economies, but in Poland it has a slightly leading property, which indicates the importance of industrial production as a driver of the business cycle. In the aggregate demand components, private consumption seems to be procyclical in Poland. However, it is not coincident as in mature economies, and has a lead-lag profile that is not typical: it is almost flat over four quarters with some lead. Hence, although private consumption is the largest component of GDP, the dynamic relation over time between the two variables is erratic, possibly indicating consumption smoothing, which is characteristic of low-income economies. However, the ratio of the standard deviation of private consumption to the standard deviation of GDP (by which consumption smoothing is usually judged) is estimated at 0. 8, i. e. higher than the upper bound of the normal range reported in the literature. 3 This suggests that consumption smoothing is not present in Poland, which might indicate lower risk aversion and/or underdevelopment of financial markets. The Polish business cycle displays some characteristic properties Business fluctuations in Poland are highly volatile and persistent ECFIN Country Focus Volume IV, Issue 9 Page 3 Table 2. The ‘st ylised facts’ about business cycles in mature economies and Poland Variable Mature economies* Poland** category Variable Direction Timing Direction Timing Supply side Industrial production pro-cyclical coincident pro-cyclical coincident/leading Private consumption pro-cyclical coincident pro-cyclical erratic Government consumption pro-cyclical erratic counter-cyclical /erratic erratic GFCF pro-cyclical coincident pro-cyclical coincident Inventories pro-cyclical leading pro-cyclical leading Net exports counter-cyclical coincident/ lagging counter-cyclical erratic Exports pro-cyclical coincident pro-cyclical coincident Demand components Imports pro-cyclical coincident pro-cyclical coincident Labour Employment pro-cyclical coincident pro-cyclical coincident/lagging market Labour productivity pro-cyclical leading pro-cyclical leading Money supply pro-cyclical leading pro-cyclical leading Monetary Inflation pro-cyclical lagging pro-cyclical lagging variables Real Interest rates a-cyclical erratic pro-cyclical lagging * Features commonly found in the literature. Main source: Snowdon ; Vane (2005) ** See Table 1 Source: Own calculations (see Table 1) and Snowdon ; Vane (2005) Government consumption seems to be neither systematically counter- nor procyclical. High volatility and a very low persistence (i. e. frequent fluctuations of sizeable magnitude) point to an irregular pattern of government consumption, suggesting an important role of discretionary fiscal policies, which is a distinctive feature of emerging economies (Carmignani, 2005) and possibly related to the existence of a political cycle in public finances. Gross fixed capital formation appears to be coincident, highly pro-cyclical and persistent (auto-correlation of 0. 2) and inventories behave according to the ‘stylised facts’: they are pro-cyclical and leading (though less so than in mature economies). Finally, both exports and imports can be seen as pro-cyclical, but imports slightly more so than exports, which is in line with the features of mature, but not emerging economies where exports are a-cyclical on average. Moreover, imports seem to be quite persistent (following persistent GFCF), unlike exports (which depend on external demand); both variables are hi ghly volatile (standard deviations are more than the double of the euro-area). Net exports are moderately counter-cyclical with an erratic pattern over time (due to persistent imports), whereas in mature economies net exports are also counter-cyclical, but usually coincident or lagging. With respect to the labour market, employment shows up as pro-cyclical and coincident, with some evidence of lagging, which places Poland somewhere in the middle between mature and emerging economies in this respect. Labour productivity appears to be pro-cyclical and leading, in line with the ‘stylised facts’, though the leading property is less pronounced than in mature economies. Pro-cyclicality of employment with its smooth and slightly lagged correlation profile suggests labour hoarding (Burnside et al. , 1993). Among the monetary variables, the money supply apears to be pro-cyclical and leading. Inflation seems to be pro-cyclical and to follow GDP as in mature economies, which is not the case in most emerging economies (where inflation is acyclical – see Carmignani, 2005). This is probably due to the fact that at the beginning of the transformation process all emerging economies had very high inflation rates that systematically decreased. Thus, it is hard to discern a clear cyclical pattern. Poland managed to achieve relatively low inflation sooner than other emerging countries, allowing this pro-cyclicality to be revealed earlier. Contrary to the ‘stylised facts’ for mature (but also emerging) economies, where real interest rates are a-cyclical with no clear pattern with respect to timing, real interest rates in Poland show up as being pro-cyclical and lagging, implying a countercyclical monetary policy (coefficient of correlation with GDP is 0. 4 and there is a clear lagging pattern). Smooth and lagged correlation profile of pro-cyclical employment suggests labour hoarding The irregular pattern of government consumption suggests that discretionary fiscal policies play an important role ECFIN Country Focus Volume IV, Issue 9 Page 4 Troughs, peaks and the drivers of growth The first economic cycle since the beginning of economic transition lasted about 10 years, with the expansion and slowdown phases each spanning about 5 years; the cycle ended in the second quarter of 2001. The current upswing has already lasted 6 years, which suggests that the peak is imminent if the length of the current cycle is similar to the previous one. Decelerating leading variables (industrial production, net exports and labour productivity) may also be signs of a turning point. Chart 1. Developments of basic economic variables in Poland in 1991-2008 -10 -8 -6 -4 -2 0 2 4 6 8 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 % 0 5 10 15 20 25 30 35 % CA deficit (% of GDP) Unemployment rate (rhs) CPI inflation (rhs) GDP growth Fiscal deficit (lhs) Source: Commission services In both the early 1990s and in 2001, when the economy was at its trough, there was a large unutilised labour supply and substantial reserves in enterprises’ capacity utilisation. The fiscal deficit was also substantial. In the first cycle, ample supply of resources was a consequence of transition to a market economy which caused a recession in 1990-1991. In 2001-2002 it followed from the world economic slowdown and a restrictive monetary policy, which forced Polish enterprises to reorganise to raise their competitiveness and efficiency. Poland got out of the trough twice hanks to exogenous impulses to investment: the restructuring of the London Club debt in 1994 (which brought the first major wave of FDI) and entry into the EU in 2004 (which led to an inflow of EU funds). The external circumstances were also favourable as the world economy expanded in the nineties until 1998 and has been on a stable growth path since 2003. Chart 2. Contributions to GDP growth in Poland in 1991-2008 -8 -6 -4 -2 0 2 4 6 8 10 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 % total consumption GFCF Inventories Net exports GDP growth Source: Commission services The main factor that drove real GDP growth in 1995-1997 to about 7% was dynamic domestic demand growth of 8? % on average, supported by robust consumption (about 5 percentage points contribution to GDP growth on average). Despite the fact that the economy was growing above potential and domestic demand was growing significantly faster than GDP, a strong zloty appreciation (with a temporary blip in 2000) ensured that the disinflation process was not disturbed. However, this There are indications that the Polish business cycle has approached a peak Large acroeconomic imbalance during the troughs ECFIN Country Focus Volume IV, Issue 9 Page 5 situation led to a fast-growing imbalance on the current account: the 2% of GDP surplus in 1994 fell to a deficit of 6% of GDP in 1999 (to which the Russian crisis also contributed). Growth outlook based on solid foundations for now It is estimated that the Polish economy is currently expanding at a pace close to its pote ntial (approximated at 5. 9% in 2007), on the back of rising domestic demand, which is likely to be followed by increasing imports and a deteriorating current account balance. The growth of gross fixed capital formation accelerated to 17% in 2006 and to nearly 30% y-o-y in the first quarter of 2007. Private consumption increased at 5. 2% in 2006 and stepped up to 6. 9% y-o-y in the first quarter of 2007, which is significantly higher than the 2. 7% average growth in 2000-2003. So far, this expansion of consumption has not led to a rapid increase in the current account deficit (which rose from 1. 7% in 2005 to 2. 3% of GDP in 2006) or a rise in inflation (which has come in below the central bank’s medium-term inflation target of 2. % for eight quarters in a row), mainly thanks to moderate real wage growth. However, with a tightening labour market, emerging skill mismatches and workforce emigration the pressure on wages is expected to become more significant, contributing to a further increase of consumption. In consequence, it might lead to an escalation of the external imbalance and/or increased inflation. Nevertheless, GDP growth in the current pha se seems to be based on more solid foundations than in the late 1990s: †¢ Firstly, the share of exports in GDP has nearly tripled in 1992-2006 to about 40%; the number of exporters has also increased considerably. The structure of exports has improved, with a bigger share of processed goods and a higher value added. Foreign direct investment has helped increase the production capacity of the Polish economy, which enables the domestic market to better meet increased private demand, and makes the balance of payments less prone to fluctuations in domestic demand. In addition, increased investment-driven imports are largely balanced by increased exports on account of a good situation in the external environment. †¢ Secondly, the floating exchange rate is likely to act as a buffer against imported inflation. However, even without a strong zloty appreciation, inflation in Poland during the coming years is expected to stay relatively low: below or around the central bank’s medium-term inflation target of 2. 5%. As the Polish economy is now more open than 10 years ago, inflation is more influenced by global factors. Increased exposure of Polish enterprises to international competition limits their ability to freely increase prices and wages. They are forced to increase labour productivity faster than wages to maintain their market position. Thus, even with growing wage demands, enterprises are more willing to decrease mark-ups than to raise prices. Thirdly, increased household incomes acquired as a result of higher wages and an improved labour market situation may not translate into consumption to the same extent as in the previous economic cycle. There is evidence that households are now more saturated with basic durable and consumption goods which they lacked before4 and are more e ager to spend additional income on holidays abroad owing to a more mature service sector. Financial markets are more developed than 10 years ago, giving an opportunity for financial investments. Conclusions The business cycle in Poland exhibits similar properties to cycles in mature economies, but there are some notable differences for government consumption, net exports and real interest rates (although for the last variable the picture may be blurred by its very high level at the beginning of the transformation process). However, because the data series are short, the results should be interpreted with caution. The irregular behaviour of government consumption in Poland with respect to influence on the business cycle could be related to a discretionary fiscal policy implemented within a political business cycle. GDP growth is based on more solid foundations in the current cycle ECFIN Country Focus Volume IV, Issue 9 Page 6 The analysis of the previous upswing in Poland, the identification of variables with leading properties with respect to GDP, and the latest developments all seem to suggest that the Polish economy might have reached the peak of the current cycle in the first quarter of 2007. Nevertheless, thanks to the ongoing process of restructuring of the economy, the slowdown phase is not likely to be as pronounced as in the previous cycle and should not lead to major imbalances. How to cite Poland Business Cycle, Papers

Highlight Upon The Impact Of The Technologyâ€Myassignmenthelp.Com

Question: Discuss About The Highlight Upon The Impact Of The Technology? Answer: Introduction The aim of the current report is to discuss about the importance and impact of technology in marketing research activity. With the fast changing world of business environment, it is important for all organization to collect the latest data in order to prepare the marketing plan. There are various effective tools and methods that are related to marketing research activities and it help to increase the level of accuracy of the marketing research. The conclusion that is drawn from this report will help the ResMarket Pty, which is the Sydney based marketing research firm to implement the application of Technology India investigation work. Hence, it will be possible for them to improve the data collection and analysis procedure. Advanced research method of marketing with technology As the scenario of business environment in the current days are undergoing Rapid change, it is only with the help of latest relevant data that are collected in huge amount that makes it possible for the marketing researchers to make better prediction (Winer and Neslin 2014). It is important to modify the marketing research method that is an essential part of Technology implementation. It is also important to modify the data collection and analysis plan in order to make best use of the implication of Technology. There are also different methods used in sampling of the market size. According to Norman and Verganti (2014), the method of online survey is believed to be the best effective techniques that are used by current day market researchers in order to collect maximum amount of data from the given sample size. The various online portals and platforms like the social media websites are few of the popular places, from where data from the online survey can be collected. Babin and Zikmund (2015), have mentioned that one of the major advantage of this online process of Data Collection is that it can help to save huge amount of time and expense that he is usually in the case of manual process. This is mainly possible due to the fact that the result is obtained automatically with the help of the coding software. The survey can also focus upon a larger size of target audience. It is also important to mention that the entire process of Data Collection is done automatically with the help of latest software that can help to store the data for further analysis. This sig nificantly reduces the chances of errors, which the surveyors have to encounter during the process of manual data collection. The online portal for the server can be accessed by the participants in any time. This provides them with the opportunity of providing better opinion about the subject area of marketing research. According to Henseler et al. (2016), high level of accuracy is one of the major advantages of the online survey method. As the market researchers can focus upon larger group of audience, it is possible for them to provide better accuracy results that are used in making advanced level of business plan. There are chances in many cases, where in the manual form of data collection, there is a chance of information being unethically manipulated by the surveyors. This can normally be avoided in the case of electronic forms, as it is possible to implement the monitoring process. Hence, there is high chance that the result of the research work will be neutral and completely reliable for further reference. The cost efficiency is another major advantage of the online survey. The overall cost that is involved in the process of printing the survey forms can be saved (Neuhofer et al. 2014). Advanced form of Data Analysis The tools and software that are used in the process of data analysis are believed to be one of the better ways that technology can help in the work of marketing research. SPSS, SAS and JMP are few of the popular forms of data analysis software that are used by the market researchers in order to deal with the complexity involved in the process of data calculation and processing. These commercial forms of the data analysis software are mainly used on in both quantitative and qualitative forms of data analysis that is aimed to provide better result of the data that are being collected in the overall process (Huang et al. 2016). There is also the chance of having to maintain high level of flexibility of data that are being processed. This will allow the market researcher to analyze the wide range of data that are being collected from wide groups of audience. Coding of the data is also possible that can be used in the process of identifying any particular parameter of the marketing terms. The coded section of the database of the marketing research can also extract for the purpose of making business plan. This can provide access to the project managers to use all forms of information. There is a significant chance that the data that has been collected in the overall process can have fake or irrelevant data. The coding software of the data analysis can identify the irrelevant data and hence is able to provide better and accurate result of the research (Mittelstaedt et al. 2015). Conclusion It can be said in the concluding note that the better level of accuracy and the high level of cost efficiency are the major advantages and impact of technology implication of the marketing research. With the fast changing scenario of the marketing environment, the use of the data analysis and coding software can help to save huge amount of time that is necessary in the overall process of business plan implementation. Hence, it is highly recommended for the ResMarket Pty to modify the overall process and activities related to the marketing research that can help them to make most use of the technology within the market investigation. System building process is one of the important components of Technology application in marketing research. It is essential to develop the overall business portfolio and infrastructure in order to make best use of the opportunity that is being provided by technology in including data analysis software. It is also essential to have proper distribution channels in the market, where the technology can be implicated in order to collect relevant data. Proper training should also be given to the market researchers to make best use of the available technological infrastructure. It may be the fact that the initial cost of setting up the technological infrastructure is high. Nevertheless, in the long run operational process, this can help the market research firm to save money. Reference Babin, B.J. and Zikmund, W.G., 2015. Exploring marketing research.Cengage Learning. Henseler, J., Hubona, G. and Ray, P.A., 2016. Using PLS path modeling in new technology research: updated guidelines.Industrial management data systems, 116(1), pp.2-20. Huang, Y.C., Backman, K.F., Backman, S.J. and Chang, L.L., 2016. Exploring the implications of virtual reality technology in tourism marketing: An integrated research framework.International Journal of Tourism Research, 18(2), pp.116-128. Mittelstaedt, J.D., Kilbourne, W.E. and Shultz, C.J., 2015. Macromarketing approaches to thought development in positive marketing: Two perspectives on a research agenda for positive marketing scholars. Journal of Business Research, 68(12), pp.2513-2516. Neuhofer, B., Buhalis, D. and Ladkin, A., 2014. A typology of technology?enhanced tourism experiences.International Journal of Tourism Research, 16(4), pp.340-350. Norman, D.A. and Verganti, R., 2014. Incremental and radical innovation: Design research vs. technology and meaning change. Design issues, 30(1), pp.78-96. Winer, R.S. and Neslin, S.A. eds., 2014.The history of marketing science (Vol. 17).World Scientific.

American Beauty2 essays

American Beauty2 essays American Beauty tells the story of one man's search for happiness. The film introduces the audience to Lester Burnham, an ordinary- looking married man and father in his forties. Lester is in a loveless marriage. Lester's wife, Carolyn, is so wrapped-up in her real estate career that Lester often claims that Carolyn doesn't even acknowledge him. Furthermore, Lester's daughter, Jane, is completely distant, often claiming how "pathetic" she thinks her father is. Moreover, Lester has dedicated fourteen years to his occupation, and suddenly, he is in danger of losing his job due to downsizing. All of these factors dramatically effect Lester and culminate into feelings of desperation and vulnerability for him. Lester is therefore in search of an escape and a rebirth. He is seeking the slightest possibility of happiness. Throughout the story Lester is consistently reminiscing on his past; wishing he could have it back. In the beginning portions of the story, Lester, as the narrator, states that "it is never too late to regain your past." The catalyst to this frame of thought is Jane's friend, Angela. Lester feels excited by the thought that a teen-age girl thinks he is "hot." Lester overhears Angela state that she would have sex with him if Lester would start working-out and build-up his body. This drives Lester to change himself completely. Lester, in desperate search of happiness , finds an escape in Angela. Much like a hormone-driven teenage boy, Lester thinks that if he can "score" with a "bombshell" like Angela, then he will be reborn. Lester's mission for happiness and escape is further perpetuated by his eighteen year old neighbor, Ricky. In Ricky, Lester sees his model for rebirth. Lester calls Ricky his "hero" and is in awe of Ricky's confidence. Lester, then begins a transformation back to his stereotypical understanding of what a teenager is. Lester begins to work-out, smoke pot, and drink beer. Much like a teen, he...

Cinderella and EverAfter essays

Cinderella and EverAfter essays When most people think of the movie, Cinderella, they think of the animated Disney version with the little mice and the happy ending where Cinderella marries the prince and they live happily ever after. While the movie Ever After is based on Cinderella, it is not animated, but still has many of the same characteristics as the Disney version. Of course it is not exactly the same, and since it is not animated there are many differences. In Ever After, Drew Barrymore portrays the character Cinderella, who in the beginning of this movie is called Danielle. In the very beginning, it shows how Danielles father died and how she went off to live with her wicked stepmother and stepsisters. In Cinderella, both of the stepsisters are wicked, but in Ever After, her sister Jacqueline is not so wicked and usually sides with Danielle. In Ever After, Jacqueline is the not so pretty and quiet sister and Marguerite is the loud obnoxious pretty one. One similarity is that in both movies, Cinderella and Danielle are servants to their stepmother and stepsisters. They are also not allowed to eat with them, only serve them. In Ever After, Danielles only friends are the other servants of the house, this is similar to how Cinderella is friends with the mice that live in her house. In both cases their friends are always protective and willing to help. In Cinderella, Cinderella doesnt meet the prince before the ball, she doesnt even really expect to be going to the ball. In Ever After, Danielle meets the prince in a confrontation where the prince was actually stealing one of their horses. Danielle starts pegging him with apples, but just as she realizes that he is the prince, she kneels down before him. She apologizes, but the prince is lenient and s...

The middle East countries Assignment Example | Topics and Well Written Essays - 1500 words

The middle East countries - Assignment Example The infrastructural developments in these countries especially in UAE and Saudi Arabia have been commendable. This paper aims to critically analyze one of the projects that has been successfully executed and completed, and in this process, the world famous project, Burj?Khalifa of Dubai has been selected. Burj?Khalifa is the tallest building in the word (828m/2716.5ft) architected by Skidmore, Owings and Merrill. The world’s tallest building was inaugurated on January 4, 2010. The primary aim of UAE behind construct9ing such giant building was to position itself as major tourist and business hub center in the world (Smith and Architects, n.d.). The project for building the tallest tower of the world was constructed by the largest Dubai based real estate company, Emaar Properties. However, during the development if this giant towers, there were a number of challenges including technical was faced and the management efficiently coped up with all the constraints for the successfu l competition of this project (Tata Steel UK Limited, 2011). A project stakeholder analysis Burj Khalifa is one the best mega projects in the world and the government of UAE has offered its full support as this tower was about to become one of the most popular landmark for the country’s tourism and business center. Therefore, it can be claimed that the government itself was the major stakeholders of this project. It is quite notable that the name of this tower was named after the President of UEA, Khalifa Bin Zayed and was inaugurated by Mohammed Bin Rashid, the ruler of Dubai indicating the instrumental role played by UAE government. However, the major stakeholder of this project was its constructor group, Emaar Properties who spent more than US$1.5  billion. This project was one of major part of flagship project in Dubai by Emaar Properties, called Downtown  Dubai. The project Downtown Dubai is meant to reposition the tourism of UEA in a new avatar and Burj Khalifa is t he most vital attraction (Emaar PJSC, 2009). Emaar Properties PJSC is the largest and multinational property developer was found in 1997. This property developer has better technical expertise and financial strength and also has been awarded for its high quality services. The Downtown  Dubai is one the best work done by Emaar Properties (Emaar PJSC-a, 2009). A brief description of how the project was managed The imagination of building the tallest tower in the world is itself a big challenge and Emaar Properties has been able to execute their plan successfully. As it has been already discussed that primary aim of UEA was to reposition itself as major tourist destination, the Burj Khalifa have fulfilled this aim to a large extent. Basically, the building with 208 floors includes commercial and residential spaces where hotels, restaurants, offices, residents and a mosque are present. Therefore, this building is for multi-purpose usages. On the other hand, beautification, and safety were major factors and in all these respect, Burj Khalifa has scored efficiently (Merritt, n.d.). The planning of constructing the tallest building in the world started prior to 2004 and by the January 2004, the excavation started. Developing such skyscraper building was a challenging task and for the Emaar Properties, it became more challenging as it was

The Sarbanes-Act of 2002 and its Effects on Businesses Essay

The Sarbanes-Act of 2002 and its Effects on Businesses - Essay Example The Sarbanes-Oxley Act of 2002 was created in order to raise investor confidence in the market. The SOX regulation applies only to publicly traded companies. The act increased the accountability and transparency of the financial information that public companies release. The implementation of SOX was able to reform accounting practices by improving accountability, internal controls, auditor independence, and executive responsibility. The Sarbanes-Oxley Act attended a variety of accounting issues that were of great concern for the investor community. One of the first issues that the Sarbanes-Oxley Act attended was auditor independence. In the Enron scandal, the firm was able to get away with the con due to the fact that its auditor, Author Anderson, was an accomplice in the fraud. In order to deal with a potential situation of conflict of interest between the public firm and the auditors SOX created the Public Company Accounting Oversight Board (PCAOB). All companies that perform audi ts on public companies must be registered with the PCAOB (Pcaobox). Auditor independence was achieved by SOX because since its inception accounting firms that perform audits cannot have other accounting contracts with the audited firm. Public firms are mandated to include an independent’s auditors report within the annual report of the company. Another measure that the Sarbanes-Oxley Act created was mandatory rotations of auditing firms. Companies auditing a public company can only realize the job for four years, at that time a new auditor must take over the role. A great measure that the Sarbanes-Oxley mandated was the requirement of public companies to create internal control measures.

Dutch Artwork Essay Example | Topics and Well Written Essays - 250 words

Dutch Artwork - Essay Example Also, the woman’s pregnancy is readily noticeable showing that a significant amount of time has passed symbolizing the beginning of new life. Her lowered gaze and left hand gently resting on the table beside the sparkling gold and pearls, suggest that she’s serenely waiting for the empty balance to come to a rest. The woman’s calm, still posture and peaceful face along with the illuminated painting of the â€Å"Last Judgment† illustrate that she’s weighing much more than worldly objects. This mundane, everyday act signifies a larger, more eternal action. The woman’s pensive posture, thoughtful expression, empty illuminated balance, and the stillness of this brief moment all possibly suggest the need to balance the worldly and the spiritual life. Rachel Ruysch's "Flower Still Life" is a striking painting of a bouquet of colorful flowers blossoming beautifully amidst a swirl of leaves and buds. The dark background and tabletop emphasize the viv id brightness and lifelike hues of the flowers, stems, and leaves. The warm and cool tones of the blossoms highlight each flower, making every small bud visible from between the twisted stems and dark leaves.

Case Study: Patient With Shortness Of Breath

Case Study: Patient With Shortness Of Breath Patient Identity The patient is a 54 year old female, Mrs SK who is a housewife with a BMI of 25.7kg/m2. Presenting Complaints She was brought in to the Accident and Emergency (AE) department, complaining of shortness of breath (SOB) and a productive cough. History of Presenting Complaints The patient was experiencing SOB for the past 2-3 days, and was progressively worsening on the day on admission. It was not associated with chest tightness and she was able to sleep the night before. She was also having persistent productive cough with white sputum since she was last discharged 12 days ago. Past Medical History She was diagnosed with diabetes mellitus and hypertension 8 years ago and has history of gastritis for the past 5 years. She was newly diagnosed with bronchial asthma in her last admission two weeks ago. Social History The patient is a widow since 6 years ago and is a housewife with 3 children. She stays in a factory area and has a cat at home. She is a non-smoker and a non-alcoholic. Family History Her mother and father have no known medical illness, but she has a cousin who suffers from bronchial asthma and is frequently admitted to the wards. Drug History The patient was on Salbutamol and Budesonide inhalers, 200mcg when necessary and 200mcg once at night respectively for her bronchial asthma. For her hypertension, she was on 40mg Telmisartan tablets once at night. She was also taking Gliclazide tablets, 80mg twice daily and Metformin tablets, 500mg three times a day for her diabetes mellitus. For her hypercholestrolaemia, the patient was taking Lovastatin tablets 20mg once at night. Based on the Morisky Scale, she was compliant with her medication and she had no known drug allergy. Examination Details On examination, the patient was alert and conscious. She was pink and appeared to be fairly hydrated. She was also able to speak in full sentences, and was not tachypnoeic. A Chest X-ray showed that there was a pneumonic consolidation at the right lower lobe of her lungs. Her blood pressure (BP) was 152/82mmHg, pulse rate (PR) was 109 beats per minute (bpm) and was afebrile. Her oxygen saturation (SpO2) was 96% under 3 litres of oxygen and her blood glucose was measured to be 4.7mmol/L. Investigations Upon admission, standard laboratory investigations were carried out and were obtained. From the renal function test, it was seen that the patient had a low potassium level of 2.8mmol/l and her calculated creatinine clearance was 60.0ml/min which indicated that she had mild renal impairment. The liver function test showed that she had normal liver function. The following shows the results that were out of the reference values for her haematological tests. C-Reactive Protein (CRP) 31.1 à ¢Ã¢â‚¬  Ã¢â‚¬Ëœ Erythrocyte Sedimentation Rate (ESR) (0 15 mm/hr) 110 à ¢Ã¢â‚¬  Ã¢â‚¬Ëœ Haemoglobin (Hb) (13.5-18 g/dl) 10.3 à ¢Ã¢â‚¬  Ã¢â‚¬Å" Haematocrit (0.36-0.46 L/l) 0.303 à ¢Ã¢â‚¬  Ã¢â‚¬Å" Red Blood Count (RBC) (3.8-4.8 x 1012 /l) 3.45 à ¢Ã¢â‚¬  Ã¢â‚¬Å" White Cell Count (WCC) (4-11 x 109 /l) 15.1 à ¢Ã¢â‚¬  Ã¢â‚¬Ëœ Neutrophil (Neutro) (2 7.5 x 109 /l) 10.57 à ¢Ã¢â‚¬  Ã¢â‚¬Ëœ Diagnosis/Impression Patient was initially diagnosed with Acute Exacerbation of Bronchial Asthma (AEBA) secondary to an upper respiratory infection (URTI) to rule out pneumonia. However, later in the day when the chest X-ray came back, she was diagnosed with pneumonia with right parapneumonic effusion. Management Plan The patients current medication was continued and was given 3 litres of oxygen via a nasal prong (NP). She was commenced on prednisolone tablets, 30mg once a day and was given nebulised Combivent (Ipratropium 20mcg/salbutamol 100mcg), every 4 hours. Her peak expiratory flow rate (PEFR) and SpO2 was to be monitored. Antibiotics were kept in view to be started if necessary after the total white blood count results came back. Clinical Progress Upon admission, the patient was afebrile, was tolerating orally well, did not have any sorethroat but was having a non productive cough. An echocardiogram (ECG) was done and it showed that she had sinus rhythm with no ischaemic changes. As her chest x-ray showed a right lower zone consolidation, she was diagnosed with pneumonia. She was immediately commenced on 2g Ceftazidime intravenously, and then continued on 1g three times a day. She was also under nebulised combivent every 6 hours. Her metformin and gliclazide was stopped and she was started on subcutaneous 10 units of Humulin  ® three times a day and 12 units of Humulin N once at night. On Day 2 of her stay, her blood results came back and as she has low potassium levels, she was given 15mls of Mist KCl three times daily and two Slow K tablets once daily. She was still complaining of cough without sputum and was given 15mls of Benadryl (diphenhydramine) syrup three times a day. The patient did not have any major complaints on the third day and was tolerating orally well. There was no SOB seen and she had good inhaler technique. She was then taken off the nebulizer combivent and the oxygen. By day 4, the patient was comfortable, and her cough and sputum had decreased. Examination on her lungs showed that she had prolonged expiratory phase. She was stopped on the Benadryl as well as Mist KCl and Slow K. After reinforcement on the inhaler technique by the pharmacist, the patient was discharged on day 5 as she was afebrile and had minimal cough. On discharge, she was then switched back to her oral hypoglycaemics and her intravenous antibiotic was switched to oral Cefuroxime 500mg twice daily for the next 10 days. She was also given Neulin SR 250mg once at night. Table 1 shows the vital signs chart for Mrs SK throughout her hospital stay. Table 1: Vital Signs Chart Day Time BP (mmHg) PR (bpm) SpO2 Blood Glucose (mmol/l) 1 13.00 178/102 109 100% 6.9 14.00 152/82 109 98% à ¢Ã¢â‚¬  Ã¢â‚¬Å" NP 15.40 4.7 18.40 133/73 114 97% à ¢Ã¢â‚¬  Ã¢â‚¬Å" RA 21.15 6.2 23.05 151/82 119 2 03.15 143/81 106 06.00 6.3 08.30 119/67 94 100% 10.35 4.8 11.24 100/61 107 97% 15.20 112/82 100 16.30 128/70 100 6.2 22.00 3.6 23.50 118/59 66 98%à ¢Ã¢â‚¬  Ã¢â‚¬Å"3L O2 3 04.10 124/64 104 100%à ¢Ã¢â‚¬  Ã¢â‚¬Å"3L O2 06.15 8.2 09.40 100/60 96 11.50 8.5 15.30 108/67 94 17.20 7.4 20.00 121/75 86 4 04.00 110/56 62 06.00 7.9 08.00 110/70 63 4.2 16.00 105/75 91 96% 17.00 9.7 22.00 138/67 114 6.1 5 05.00 9.6 07.15 11.1 Pharmaceutical Care Issues The first care issue is to review the management of AEBA based on the British Guideline on the Management of Asthma. The dose of prednisolone should be increased to 50mg once a day for at least 5 days or until recovery. Since the patient is prescribed with theophylline on discharge, she should be counseled on the signs and symptoms of theophylline toxicity such as confusion, dizziness, diarrhoea, nausea, fatigue and headache. The second issue is regarding the choice of antibiotics for the treatment of community acquired pneumonia in this patient. A sputum full examination microscopic examination (FEME) should be requested to identify the causative microorganisms of the lung infection. If empirical treatment is to be started the preferred drugs of choice would be amoxicillin 500mg three times a day plus either erythromycin 500mg four times a day or clarithromycin 500mg twice daily. Alternative choices would be levofloxacin 500mg once daily or moxifloxacin 400mg once a day, should the patient be intolerant of the preferred regimen. Thirdly, there is no clear indication of the prescription of the diphenhydramine in the first place, as it would only suppress the patients cough, which is inappropriate. Hence it should be stopped immediately. Next, the patients updated blood cholesterol levels should be taken and the appropriate use of statins should be reviewed. As she is on long-term statin use, her liver enzymes should be monitored regularly and if is raised by three-fold, she should stop taking the Lovastatin. She should also be counseled on the symptoms of rhabdomyolysis which is related to the long term use of statins, such as unexplained muscle pain, stiffness, weakness and the darkening of urine colour. The following issue is regarding the patients diabetes management. A HbA1c test should be done to determine her glycated haemoglobin level to see how well her self-management has been. She should also be advised on diet and lifestyle to keep her diabetes under control. Lastly, as she has low red blood count, haemoglobin and haematocrit levels, it is suspected that she has anaemia. Further tests should be done to confirm this, and if it is diagnosed, she should be given ferrous supplements such as ferrous sulphate tablets 200mg twice daily. DISEASE OVERVIEW AND PHARMACOLOGICAL BASIS OF DRUG THERAPY Acute Exacerbation of Bronchial Asthma: An Overview Asthma is a chronic inflammatory disorder of the airways where many cells and cellular elements play a role. This leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the morning. These inflammatory symptoms are commonly associated with extensive but variable airflow obstruction within the lung as well as airway hyperresponsiveness and this is reversible either on its own or with treatment. 1 Asthma is a worldwide problem as it is estimated that about 4.5% of the worlds population is affected, which amounts to 300million individuals approximately. The global prevalence of asthma varies from 1-18% of populations in countries all over the world. Asthma has three distinguishing characteristics which are airflow limitation, airway hyperresponsiveness, and bronchial inflammation. Airflow limitation is usually resolved by itself with or without treatment but for individuals with chronic asthma, inflammation may result in irreversible airflow limitation. Stimuli such as irritants or allergens may pose as triggers in airway hyperresponsiveness and bronchial inflammation is associated with eosinophils, T-lymphocytes and mast cells which cause plasma exudation, smooth muscle hypertrophy, mucous plugging and epithelial changes. It is shown that inflammation of the airways play a major role in the pathology of asthma and this starts when allergens or irritant trigger the activation of cells such as epithelial cells, macrophages, lymphocytes and mast cells. This leads to cytokine or mediator release and smooth muscle contraction resulting in cellular infiltration of eosinophils and neutrophils causing airway inflammation including oede ma, epithelial permeability or injury, mucous secretion and vascular permeability which eventually leads to airway obstruction and hyperresponsiveness. The diagnosis of asthma is based on a collection of signs and symptoms without a reasonable explanation for them and spirometry is an early test which is easy to assess if there is any airflow obstruction present and its extent. For diagnosed patients with asthma, acute exacerbations may occur and because patients with severe asthma are at increased risk of death following exacerbations, assessments of exacerbations are crucial. Clinical features of acute asthma exacerbations include severe breathlessness, tachypnoea, tachycardia, silent chest, cyanosis, or syncope. Peak Expiratory Flow (PEF) or Forced Expiratory Volume in one second (FEV1) is also used to measure the lung capacity. Oxygen saturation (SpO2) is measured using a pulse oximetry and this aids oxygen therapy as oxygen therapy is given in order to keep SpO2 levels at 94-98%. Measurements of arterial blood gases (ABG) are usually not necessary unless patients present with features of life-threatening asthma or have SpO2 of less than 92% as there may be a risk of hypercapnea if SpO2 is lower than 92%. Chest X-rays are also not recommended unless patients are suspected of pneumonia or lung consolidations, suffering from life-threatening asthma, having unsatisfactory response to treatment or if they require ventilation. Pharmacological Intervention in the management of AEBA2 Oxygen Oxygen therapy is needed most of the time as patients who are having acute asthma usually present with hypoxia as well. Hence, all patients with hypoxia who are suffering from acute severe asthma should be given oxygen and their SpO2 levels should be kept at 94-98%. ÃŽÂ ²2 agonist bronchodilators As first line therapy, high dose inhaled ÃŽÂ ²2 agonist bronchodilators are used as soon as possible as rapid relievers of bronchospasm. For patients who are unable to use inhaled therapy, intravenous ÃŽÂ ²2-agonists are used instead. ÃŽÂ ²2 agonist bronchodilators work by stimulating the ÃŽÂ ²2 adrenoceptors in the lungs, thus causing relaxation of the airways. Examples of short acting ÃŽÂ ²2-agonist are salbutamol and terbutaline, and a long acting ÃŽÂ ²2-agonist is salmeterol. Glucocorticosteroids Steroids should always be given in all cases of acute asthma. Examples of these are prednisone, prednisolone, dexamethasone, and hydrocortisone. They exert an anti-inflammatory effect by inhibiting transcription of the genes for the cytokines implicated in asthmatic inflammation and hence reduce airway hyper-responsiveness. Anti-cholinergic agents Ipratropium bromide is one of the anti-cholinergic agents that is used widely in treatment of acute exacerbations of asthma. Nebulised ipratropium bromide is used in combination with a ÃŽÂ ²2-agonist bronchodilator as treatment for patients with severe acute or life-threatening asthma. Anti-cholinergic agents work by inhibit muscarinic receptors M1 and M3 which then reduces cGMP formation and decreases smooth muscle contractility in the lungs. This eventually results in bronchodilation and reduces mucus secretion. Other therapies Other therapies include the use of magnesium sulphate. A single bolus dose of intravenous magnesium sulphate is administered to patients with acute severe asthma with previous unsatisfactory response to inhaled bronchodilator therapy or for patients who are suffering from life-threatening or near fatal asthma. It is believed that magnesium sulphate works by reducing calcium uptake by the bronchial smooth muscle cells, causing bronchodilation and also inhibits mast cells degranulation, thus reducing the release of inflammatory mediators such as histamines, and leukotrienes. EVIDENCE FOR TREATMENT OF THE CONDITION The management of asthma can be divided into two parts; acute treatment, and long term management. Management of acute asthma It has been shown that most patients suffering from acute severe asthma are hypoxaemic. Therefore it is essential that supplementary oxygen therapy be given to them.3-6 This is administered via a face mask or nasal prong with the patients SpO2 kept between 94-98%.7 Where nebulisers are needed in therapy, oxygen-driven nebulisers are favoured instead of those that are air-driven due to oxygen desaturation when driven by air alone.8-10 However, the lack of provision of supplemental oxygen should not pose as a factor in omitting nebulised therapy from administration if deemed appropriate.11 Referring to the case presented above, the patient was treated accordingly as she was immediately given supplemental oxygen and her SpO2 was maintained well above 96% throughout hospital stay. As acute asthma is associated with symptoms of bronchospasms such as wheezing and tachypnoea, the main aim of treatment is to quickly resolve these symptoms and most often, high doses of inhaled ÃŽÂ ²2 agonist bronchodilators are effective with minimum adverse effects.12-14 Salbutamol is usually the drug of choice although there is no significant differences in terms of efficacy as compared to Terbutaline. It is shown that there are no significant clinical benefits by using a non-selective ÃŽÂ ²2 agonist such as epinephrine instead of selective ÃŽÂ ²2 agonists.15 Based on a meta-analysis, it is seen that ÃŽÂ ²2 agonists administered via inhalation are more preferable and has similar efficacy with those administered intravenously in adult acute asthma.16 In ventilated patients or those in life-threatening conditions, parenteral ÃŽÂ ²2 agonists may be added to inhaled ÃŽÂ ²2 agonist treatment although there is little evidence supporting this treatment. Although a sing le bolus nebulisation may relieve most acute asthma cases, it is shown that continuous nebulised treatment of ÃŽÂ ²2 agonists is more effective in relieving acute asthma for those with unsatisfactory response to initial therapy.17, 18 Steroid therapy is always given in acute exacerbations of asthma and it is proven that it has better result if given earlier. It not only reduces mortality but it also reduces relapses and the number of hospital admissions as well.19, 20 Oral steroids given are seen to be equally as effective as parenteral treatment hence there is no need for the use of parenteral administration of steroids unless the patient is unable to tolerate orally.19 Prednisolone 40-50mg is given daily for at least five days or until recovery and this can be stopped abruptly after the patient has recovered.2 As long as the patient is on inhaled steroids, there is no need for the dose to be tapered down slowly prior to discontinuation.21 In the case presented, the patient was commenced on steroid therapy but was under-treated as she was only given prednisolone 30mg once daily for just one day. Hence, there is a need to increase the dose of prednisolone to 50mg and to continue is for at least another four days or until recovery before stopping this treatment. In hospital therapy, anticholinergic treatments are given to severe exacerbations of asthma and nebulised ipratropium bromide is always the drug of choice used in clinical settings. A combination of nebulised ipratropum bromide with a ÃŽÂ ²2 agonist bronchodilator is often given as treatment as it is proven that a combination of these two agents has a significant increase in bronchodilatation as compared to the use of a ÃŽÂ ²2 agonist alone. Hence, there is faster recovery and will reduce the length of hospital stay. However, it is also seen that anticholinergic treatment is not particularly effective and favourable for cases of mild exacerbations of asthma as well as after the patient has been stabilized, thus is not necessary in these cases.22-24 The patient in this case was seen to be having a mild exacerbation of acute asthma and hence nebulised ipratropium bromide treatment was not necessary. However, the use of nebulised Combivent, a combination of ipratropium bromide and salbutamol was justified since this patient was re-attending with a relapse and she was also suffering from pneumonia as well. Hence, there was probably a need for a quicker rate of bronchodilation as well as faster recovery for her. The use of magnesium sulphate in hospital treatment of AEBA is not widely seen, however there have been some evidence showing the bronchodilating effects of magnesium sulphate when used in adults.25 There are also studies which report that nebulised magnesium sulphate combined with a ÃŽÂ ²2 agonist shows positive outcomes and good clinical effectiveness in hospital settings.26, 27 The use of an intravenous bolus administration of magnesium sulphate is believed to promote lung function in patients who have severe asthma without harmful side effects.28 Nevertheless, there have been no studies on the repeated administrations of magnesium sulphate, though it is presumed that repeated use may lead to hypermagnesaemia, causing muscle weakness and respiratory failure. As further extensive studies need to be done to determine the most suitable route and dosing of magnesium sulphate, this treatment is reserved only for patients with acute severe asthma without satisfactory response to inha led bronchodilator therapy and patients with life-threatening of near fatal asthma. Monitoring should be carried out constantly throughout hospital stay and in acute asthma cases, monitoring of PEF is crucial. PEF readings should be measured and recorded every 30 minutes after treatment has been started. PEF should also be monitored pre- and post- nebulisation therapies as long as the patient is in hospital and until the asthma is well under control after discharge. It is seen that after hospital discharge, a relative amount of patients either experience relapse or are readmitted into the hospital with at least 15% within two weeks following discharge.29 Therefore it is essential that patient education such as proper inhaler technique, and well-documented PEF recordings with action plans depending on symptoms experienced should be instilled in order to reduce rate of relapses as well as minimize problems associated with exacerbations after discharge.30 Monitoring of the patients PEF was done consistently throughout her hospital stay and the patient was given sufficient counseling prior to discharge on her inhaler technique. However, there was no evidence that the patient was educated on self-documenting PEF recordings as well as action plans based on symptoms experienced following discharge and this should be done in this case to avoid another exacerbation of her condition. Long Term Management of Asthma The aim of management of asthma is to keep it well-controlled without the need of rescue medications, asymptomatic, no exacerbations, no hindrance to daily activities including exercise as well as normal lung function. A stepwise management approach is adopted for asthma patients and this is to acquire initial control and maintain it by stepping up treatment to improve control if necessary or stepping down treatment if there is good control over the condition to maintain the lowest step that will control the patients condition. As the patient is currently on regular preventer therapy with inhaled steroids, she is currently on step 2 of the management of asthma. There have been many studies being carried out to compare the different inhaled steroids that are being used for asthma and it is shown that beclomethasone diproprionate and budesonide are both similarly clinically effective although there may be different devices for delivery. It has also been seen that fluticasone and mometasone being administered at half the dosage of beclomethasone and budesonide shows equivalent clinical effectiveness, however there is somewhat inadequate evidence that fluticasone possesses fewer side effects and further studies need to be carried out on establishing the safety profile of mometasone.31 A new inhaled steroid has been introduced which is ciclesonide and clinical trials have shown evidence that it has more local activity than systemic and less oropharyngeal side effects as compared to the regular inhaled steroids.3 2-35 Although this seems promising, this clinical advantage is still controversial as its safety to efficacy ratio has yet to be established and compared with the conventional inhaled steroids. Inhaled steroids are recommended as preventer drug therapy for adults as they are most clinically effective in controlling asthma based on the treatment goals outlined.36-39 The frequency of dosing of inhaled steroids are generally twice daily and it is shown that there is slight clinical benefit obtained when taken twice a day than once daily, however a once daily dosing may suffice for those with milder asthma. There is also limited evidence of advantage with increased frequency of greater than twice a day.37 In addition to that, starting at higher than recommended doses have no significant effectiveness in management of mild to moderate asthma.40 Hence the recommended dosage for inhaled steroids would be 200-800mcg daily. This would be an add-on therapy to the step 1 management of using in haled short acting ÃŽÂ ²2 agonist bronchodilator as required. Based on the presented case, the patient was on budesonide 200mcg once at night prior to admission but this was immediately increased on admission and was in line with the recommended guidelines as she was continued on budesonide 400mcg twice a day together with salbutamol 200mcg as required following discharge. Other preventer therapies may be included for the patient despite inhaled steroids being the first choice of drugs for preventer therapy. These alternatives are less effective although they have shown some clinical benefit in patients who are on short acting ÃŽÂ ²2 agonists only. Chromones which act as mast cell stabilizers such as sodium cromoglicate and nedocromil sodium have shown to be beneficial in adults.41, 42 Apart from that, leukotriene receptor antagonists montelukast and zafirlukast too have clinical benefits.37, 43, 44 Theophylline also have some evidence in showing benefits in adults.36, 45 The patient in the case presented above was prescribed sustained-release theophylline on the last day of admission. Although it is another option that may be added to daily controller medications for step 2 management, there is very little evidence on the clinical efficacy of it as a long term controller. There is no reason to justify the use of theophylline in this case as the patient is responsive and can be controlled on inhaled steroids. Further more, theophylline has a narrow therapeutic index and close monitoring of plasma theophylline levels is necessary because at concentrations above 25 µg/ml, there is high risk of tachycardia and seizures may occur if concentrations exceed 35 µg/ml. CONCLUSION After reviewing the management of the patients condition throughout hospital stay, it can be concluded that SK was treated adequately based on the current guidelines and evidences attainable. She was given all necessary treatment at point of admission and there was no lacking of medications in all four days of her hospital admission. Apart from that, monitoring of her condition was carried out consistently and all data was updated, leaving no room for questioning and doubt. However, there were a few issues that came to attention which were the prescribing of several drugs that were unnecessary such as diphenhydramine and theophylline. There were little and no clear evidence that these drugs prescribed would be of benefit to the patient, and may also increase the risk of harmful effects to her as well. Alongside treatment of her acute condition, SKs controller medications were reviewed and subsequent changes were made as appropriate. Besides that, her other co-morbidities were also managed well as treatments for her hypertension and diabetes mellitus were given accordingly. PATIENT MEDICATION PROFILE PATIENT DETAILS Name S.K. Consultant Dr YKS General Practitioner Address Gender Female Weight 65kg Height 1.59m Community Pharmacist Date of Birth (Age) 54 years old Known Sensitivities NKDA Social History Widow of 6 years, Housewife, Non-smoker, Does not drink PATIENT HOSPITAL STAY Presenting complaint in primary care / reason for admission Admission date 17/04/09 Shortness of breath for the past two days, progressively Discharge Date Discharged to 21/04/09 Home worsening today and productive cough. RELEVANT MEDICAL HISTORY RELEVANT DRUG HISTORY Date Problem Description Date Medication Comments 2001 Diabetes Mellitus T. Diamicron 80mg BD 2001 Hypertension T. Metformin 500mg TDS 2004 Gastritis T. Telmisartan 40mg ON 2009 Bronchial Asthma MDI Salbutamol 200mcg PRN MDI Budesonide 200mcg ON T. Lovastatin 20mg ON RELEVANT NON DRUG TREATMENT Prescribed Medication Start Stop Clinical/Laboratory Tests Date Result 1 T. Telmisartan 40mg OD 18/04 21/04 2 T. Gliclazide 80mg BD 17/04 17/04 3 T. Metformin 500mg TDS 17/04 4 T. Lovastatin 20mg ON 17/04 19/04 5 MDI Salbutamol 200mcg 2 puffs PRN 17/04 6 MDI Budesonide 200mcg 2 puffs BD 17/04 7 T. Prednisolone 30mg OD 17/04 17/04 8 Neb. Combivent 6-hourly 17/04 19/04 9 IV Ceftazidime 2g STAT, then 1g TDS 17/04 21/04 10 S/C Humulin R 10units TDS 17/04 21/04 11 S/C Humulin N 12units ON 17/04 21/04 12 Syrup Diphenhydramine 15mls TDS 18/04 20/04 13 T. Slow K 2tabs BD 18/04 20/04 14 Mist KCl 15mls TDS 18/04 20/04 15 T. Theophylline 250mg OD 20/04 CLINCIAL MANAGEMENT Diagn

Shit I Do For Fun Essay -- essays research papers

To look into the mind of a television addict, we must look at the big picture†¦ First we recognize the voluntary slavery that makes up the majority of modern life. A I see it, people get up early, put on work clothes, and â€Å"work like machines for the rest of the day† getting no satisfaction from their repetitive day-jobs. Then come home around seven o’clock to their families who have already had dinner, and the kids already getting in bed. By that time there is almost no room left for quality family time or anything else to pursue that’s worthwhile. Thus the person turns to the television for that instant dose of friendship and gratification that could not be found anywhere else during his or her day. Once the person gets comfy on the lazy-boy, he becomes quickly stimulated and amazed by the intense sound and picture of thirty frames per second, and suddenly forgets thinking about the real world. Notice how some people become extremely annoyed when you talk to them or distract them when they are watching a program, or even a commercial. And might even yell at you for walking in front of the TV. As the hours of straight zombie-like watching go by, the person slips further into the fantasy world of television, and with you breaking that link between them and the tube comes as a shock to them. Someone can be so engulfed that it becomes a regular part of his/her daily routine. As a result of a lot of watching TV, studies have shown that the heart rate, and blink rate have slowed down dramatically and muscular function decreased down to the snap of a finger on the remote or the lift of a drink. The stimulation of the picture and sound shift so rapidly that they must become completely relaxed to soak it all up. Television is like an addiction, and like any addictive substance a moral message lies behind it†¦ The advertising and the programs are only they’re to keep the viewer coming back for more. But there are even deeper morals to the story. The televisions main purpose is to distract from what you really want to be doing. Than around the second line of commercials you realize that you could be doing far better things than this, but before that thought gets to you, another flashy commercial pops up that literally says â€Å"damnit stay in your seat, we’ve got more products to sell you†. And giving the viewer the sense that he/she cannot live without it. And this is... ...half its inorganic wastes. Television is where one must look to blame for this chaos. As it is the obvious driving force. With that in mind, how can it be possible for people to see past these views long enough before they realize what impact the media has on them, if they ever do, let them decide for themselves. In other words, how much TV must we watch before we realize what it is doing to us as people, and as a society. As you think about this, and wonder how we can change it all, obviously it is going to have to be a grass-roots effort. And since the message wont come to you through the TV or the government (since they fund some of it), it will only come from friends, and from other people showing the Tv-aholik that there is another way to live. Something like â€Å"hey come with me, I can be a real friend to you, make you laugh, and share the world together. The light bulb of the soul switches off as we switch on the TV. And I believe that the bulb can only flicker again from the wisdom of someone else that shares the same thoughts about the media. But ultimately, in the end people are searching for meaning, and that meaning can only come from within, and for each of us to find.