Dispencing a contraceptive pills for minors without parental Research Proposal

Dispencing a contraceptive pills for minors without parental permission - Research Proposal Example Providing access to contraceptive pills has its pros and cons. It can be considered a good thing as it reduces the risk of pregnancy, however at the same time if parents do not know about their child’s activities it can be harmful to the child in the future. Taking contraceptive pills can have long term effects like hypertension and abnormalities in glucose tolerance. In my research I propose to answer question as whether parental control is necessary or not for the provision of contraceptive pills. During I research I came across several journals and articles which answer my questions. Article like ‘Adolescent Contraception’ by Rochelle A. Turetsky, M.D., Victor C. Strasburger, M.D., and ‘Fertility Effects of Abortion and Birth Control Pill Access for Minors’ by Melanie Guldi are some of the articles which talk about the different options available for contraception. These articles also discuss the laws related to confidentiality and access to contraceptive pills to minors. In my research I have used these articles and many others to help me provide strong argument for my

Access control Essay Example for Free

Access control Essay The purpose of this policy is to define standards for connecting to Richman Investments network from any host. These standards are designed to minimize the potential exposure to Richman Investments from damages which may result from unauthorized use of Richman Investments resources. Damages include the loss of sensitive or company confidential data, intellectual property, damage to public image, damage to critical Richman Investments internal systems, etc. Scope This policy applies to all Richman Investments employees, contractors, vendors and agents with a Richman Investments owned or personally-owned computer or workstation used to connect to the Richman Investments network. This policy applies to remote access connections used to do work on behalf of Richman Investments including reading or sending email and viewing intranet web resources and wireless devices. Remote access implementations that are covered by this policy include, but are not limited to, dial-in Modems, frame relay, ISDN, DSL, VPN, SSH, and cable modems, etc. VPN access control model for a large scale company. This policy will support remote access control for systems, applications, and data access. Remote access Defined Remote access for employees is deployed by using remote access VPN connections across the Internet based on the settings configured for the VPN Server, and the following additional settings. The following diagram shows the VPN server that provides remote access VPN connections. Domain/Network Config: For each employee that is allowed VPN access: * The network access permission on the dial-in properties of the user account is set to Control access through NPS Network Policy. The user account is added to the VPN_Users group in Active Directory. To define the authentication and encryption settings for remote access VPN clients, the following remote access network policy is created in Network Policy Server (NPS): * Policy name: Remote Access VPN Clients * Conditions: * NAS Port Type is set to Virtual (VPN) * Windows Groups is set to VPN_Users * Calling Station ID is set to 207. 209. 68. 1 * Permission is set to Grant access. NPS policy settings: * On the Constraints tab, under Authentication Methods, for EAP Types select Microsoft: Smart Card or other certificate. Also enable Microsoft Encrypted Authentication version 2 (MS-CHAP v2). * Or SSTP, L2tp/IPsec, PPTP, IKEv2 Access control model/ policy: This model would support Role based access controls and allow mandatory access control to be governed by remote access. The IS Dept. is responsible for maintaining the access and access rights and provides and restricted as needed by user roles in the organization. All data is encrypted and transmitted via remote and encrypted and used by the VPN tunnel. VPN access will be terminated on a 3 month basis and must be renewed by revisiting based on your access role and permissions

The Myth Of Birth Orders and Personality :: Parenting Parenthood

Does birth order really influence personal traits? Many researchers believe that the first-born child is parental, responsible, hardworking and intelligent. The middle-born child is more competitive, tends to be a people-pleaser and usually hates quarrel. Youngest are social, less capable of doing things. But I have found different traits comparing to researchers findings. Defining ones personality through their birth order can be a lot like horoscopes. Horoscopes are so sweeping that they can apply to anyone. The same can go for birth order. While I do have many of the traits first-borns are said to have, I also have a lot of the characteristics that the youngest have. The author in the passage tried to give logical reasons to prove it, but I saw many examples in real life which has no connection with the author’s logic. Let me share some of those relating with the author’s logic. The firstborn child is not parental at all. In many families we can see that the younger brother’s are dominating the older sister. For example, one of my friends, Shanila, likes to talk with her friends at night. Most of the times her parents stay outside home so there is suppose to be no one to stop her. But she faces many troubles for her younger brother, Akash. He always tries to be parental and take care of Shanila by scolding her if she talks too much in phone. Sometimes Akash read SMS in her mobile and take numbers from her mobile to call and check the guy with whom she was talking the whole night. Sometimes younger brother also helps older ones with academic problems. Shanila is not a good student neither she have any interest with her study. She always faces problems with her assignments. So most of the time her brother force her like a parent to study. Therefore, I think it is the situation and parents influence which makes a people parental. Shanila’s parents give full right to Akash to take care of Shanila because her parents think boys are more capable than girls. So if any younger brother falls in a situation where he needs to be parental it can force him to be parental. The firstborn children are more social. I have seen in absence of parents in the house the oldest child communicate with different neighbor for various reasons. For instance, when Rajiv’s parents stay outside home Rajiv serve the guests who come to their home.

Resources in market and command economies Essay

In a market economy, decisions on how resources are to be allocated are usually taken by millions of households and thousands of firms the exact number depends on the size of the economy. They interact as buyers and sellers in the market for goods and services. The government has a very restricted part to play. However, in a Command economy the government has a central role in all decisions that are made and unlike the market economy, the emphasis is on centralization. Decision making is taken by central planning boards and organizations to enterprises that are state-owned or under state regulation and control. Whereas in a market economy consumer sovereignty influences resource allocation, in a command economy it is central planners who have to determine the collective preferences of consumers and manufacturing enterprises. In a market economy, prices and the operation of the price system underpin this interaction; in turn prices act to indicate the likely market value or particular resources. For example, a commodity in short supply but which has a high demand attached to it will have a high price. Alternatively, one which has a high supply and low demand will have a much lower price attached to it. Prices and the self-interest of people and businesses therefore act as a guide to the decisions that have to be taken. The self interest which drives suppliers to allocate resources is called the invisible hand. This invisible hand brings together private and social interests in a harmonious way: this is the fundamental philosophy underpinning the workings of the market economy. Central planning tends to set numerous goals for the economy that differ from those in a market economy. In a command economy, the scarce resource of human labour in employment is generally greater in proportion when compared to humans employed in market economies. This is because central planning institutions opt for the even distribution of wealth. This is in high contrast to the phenomenon of self-interest of suppliers in a market economy.

Negligence

IntroductionNegligence is a branch of civil law known as tort .tort is defined as a civil wrong in the form of breach of duty from which the legal remedy is an award of damage. Negligence is the doing of something which a reasonable person would not do or the failure to do something that a reasonable person would do which inflicts harm. Negligence covers wide area this meaning that it does not only involve careless conduct and involves a combination of the concepts of duty, breach and sufficient connection in law. The plaintiff does not have to prove that the defendant either intended his act or its consequences. Negligence is based on three essentials which the plaintiff must prove on the base of probability in order to succeed in an action in negligence, this are(i) Duty of care (ii) Standard of care (iii) Sufficient connection in lawDuty of care (dongue v Stevenson)Did the defendant owe the plaintiff a duty of care? This is the question we ask, which the plaintiff must prove on th e balance of probabilities. if no duty of care is owed the plaintiff calm must fail .the judge has the responsibility for deciding whether or not a duty of care exists as the issue is a question of law having regard to the fact of the case . The method used to test the duty of care will differ depending on whether this case involves negligence advice or negligence act Negligence acts are based on the doctrine of-Reasonable foresees ability -Proximity.Reasonable foreseeability Where in reasonable foresee ability we get to ask was the defendant able to foresee that his action or omission would cause harm or injury to the plaintiff? . plaintiff must prove that a reasonable person in similar circumstance to the defendant would be aware that their conduct may create a risk of harming the other person .breach of duty at this stage the concept of reasonable foresbility is concerned with the nature of the risk that has been created by the defendants conduct .in other words how would a  re asonable person respond to what exact type of risk.This is concerned with setting standards of acceptable conduct that will be determined with reference to range of factors including the likely consequences on the plaintiff if the risk eventuates and the burden that would be imposed on the defendant to remove the risk (Sullivan v moody ) (2001) 207 CLR 562 . The following steps are the once the court broad approach seems to involve in determining duty of care3.1Analogies –recognized duties of careDetermine whether there was a reasonably foreseeable risk of injury without that they can be never a duty of care .Determine whether the case is closely analogous to other cases in which duty of care has a ready been established .If not look to the salient features of the case to determine whether they reveal a sufficiently close neighbor relationship to warrant finding a duty of care3.2.2Neighborhood factorThe friend had brought a bottle of ginger beer after she had drunk some of th e ginger beer she poured the remaining onto a dish and decomposed remains of a snail floated out of the bottle .she suffered shock and gastroenteritis .she sued the ginger beer manufacture. Was the manufacture liable to her negligence? The manufacture was reliable.The court held the manufacturers have general duty to entire consuming public to ensure their products do not contain potentially dangerous effects that can be discovered on a reasonable inspection lord Atkins said that you must take reasonable care to avoid acts or omission which you can reasonably foresee would be likely to injure your neighbor. Who the in law is your neighbor? The answer seems to be persons who are closely and directly affected by my act that I ought reasonably to have them in contemplation as being so affected when I am directing my mind to act or omission3.2 .3 Social policyDuty of care will not generally be found if doing so would subject the defendants to an intermediate liability. policy considerat ion also apply in wide range of other cases where they allow the court to weigh competing consideration of legal policy to determine whether despite proof of foreseeability and neighbor hood duty should not be imposed either a tall the party need to succeed in his action. What this means is that general  policy issues are only taken into account where it would have been unreasonable to have expected the defendant to have done what would have been nesecassary to prevent the harm that occurred (stovin v wise)3.2.4ProximityWas the defendant so close that the plaintiff had to have him in mind? We have three ways to determine this (i) By physical proximity between the person or property of the plaintiff and the person or property of the defendant (ii) By circumstantial proximity that which exists in particular circumstances (iii) By causal proximity in the sense of closeness of directness of the relationship between the defendant particular act or omission and injury that the plaintiff sustained4.0 Duty of care for negligence advicesThere are clear differences between negligence word and negligence advice. Negligence words cannot cause loss by themselves. They cause loss only because persons act on them in reliance. second it is uncommon for people in social or informal context to make statements less carefully than if they were given advice in business or professionally the last words may be foreseeable receive such a coverage or circulation that application of (dongue v Stevenson) might lead to many claims for large amounts damages in the case (shaddock and associates v Parramatta city council {1981} 150 CLR 225) developed the following test of question4.1 Development of the law(i)Was the advice given on a serious matter? (ii)Did the speaker realize that or ought to have realized that his advice would be acted upon (iii)Was it reasonable for the recipient to act on the advice? Once the fact of the case supports the test it can be concluded that the advisor owed the plaintiff a duty of care4.2 Shaddock test, reliance and assumption of responsibility Shaddock and associate were interested in purchasing some land for development before they made enquires with the local council to ensure there were no plans that would affect they development the Parramatta city council issued a statement saying that there were no plans that would affect the block of land.Soon after purchasing the Parramatta council widened the road making the block smaller .shaddock could  not develop the land as planned because the block had become smaller .if they sold the land shaddock would lose the money because the value had dropped If someone gives information that they know will be relied upon and it is reasonable for others to rely upon it then there is duty to take reasonable care that the information is correct The advisor owed the plaintiff a duty of care in the case of shaddock associate v Parramatta city council5.0 Sufficient connection in lawThe plaintiff mus t prove that there was sufficient connection in law between the injury and the conduct. To satisfy this plaintiff must show that the breach actually caused the injury suffered which was due to reasonably foreseeable consequences’ of the breach. Sufficient connection in law has two components Causation -the defendant acts caused the plaintiff injury or loses Remoteness –if the defendant’s conducts did cause damage to the plaintiff is the defendant liable for the damage suffered by the plaintiff resulting from his negligence conductThe plaintiff must suffer actual damage recognized in law .the injury suffered by the plaintiff may fall in one of this classification personal physical injury loss of eye in mechanical injury, loss of hand in construction injury Property damage –involve actual physical damage to property Monetary or financial lose –involve lose of moneyLoses of wages5.1 Causation We ask the question on a balance of probability. Did the de fendant cause the plaintiff injury or lose? And to answer this we have some case test that we use5.1.1 But for test The but for test formulated by lord denning in cork v Kirby MacLean is useful for determining causation although it has limitations If you say damage would not have happened but for a particular fault then that fault is in fact a cause of the damage, but if you say the damage would have happened just the same fault or not, then the fault is not the cause of the damage when this happens you find both parties say but for your a fault it would not have happened but it’s both faults are the cause.In other words if the damage would not have happened without a particular fault then that  fault was the cause .the damage would have happened just the same way with or without the fault then the fault was not the cause (cork v Kirby Maclean ltd) The but for test to have some limitation for example say A and B light a fire independently each other in different places and meet up and burns down some house. Under the but for test neither B nor A is reliable as the house would still have burned by the other fire if he hadn’t lit a fire however in particular both would be held equally liable5.1.2 The common sense testThe high court has expressed dissatisfaction with the† but for test† and its limitation .pentony graw, lennard and parker (2003,p. 386) a preferred approach is to ask on the balance of probability the defendants acts or omission caused or materially contributed to the plaintiff loss damage or injury. The common sense test ask a question of fact (March v stramare (E&MH) pty ltd (1991)171CLR 506)5.1.3 Novus actus intervenesCertain activities or action may happen to prevent or break a chain of events or procedures and render the defendant not liable for particular losses suffered by the plaintiff. Consider an employee injured at work due negligence of his employer. they are been rushed to the hospital and the car he is in is involved in another accident causing further injuries to the patient .is the employer liable for this other accident suffered? Under this act it intervenes and rules that perhaps it carelessness of the other road users so the employer is not the cause and is not liable (knightly v johns {1982})5.2 REMOTNESSIn remoteness we look at the amount of damages the defendant is liable for. The defendant is not necessary liable for all the damages cause as the law must draw the line somewhere. In the case of wagon mound the defendant is not liable only for the kind of damage that were reasonably foreseeable that is damage suffered was not too remote. Example the defendant carelessly places a wooden plank which falls into a plaintiff ship hold and to unknown in both parties is full of vapors. The falling plank strikes and ignites the vapors with serious damages results with remoteness the defendant was not able to foresee that so the defendant is only liable for those type or kind  of injur y that are necessary foreseeable5.2.1 TEST OF REASONABLE FORESEEBILITYClearly personal injury or physical damages to property from impact are the kind or type of injury are reasonably foreseeable as the results of being hit by the plank, whilst an explosion is arguably to farfetched to be reasonably foreseeable .however if the defendant had known that the hold was full of vapor then the explosion may then be seen as reasonably foreseeable as a consequence of the plank5.2.2 EGG SHELL SKULL RULEEgg shell skull rule qualifies remoteness the issue of reasonable foreseebility in relation to personal injury .once the type of damage that is reasonably foreseeable is personal injury then the defendant is liable for all of that kind of injury actually suffered that s why the rule says that you must take you victim as you find him (egg shell skull rule )hence once some personal injury is reasonable foreseeable example if a person has some heart problem the you tell him to go and work in place where his heart will be affected and he collapses the egg shell rule applies (smith v leech brain &co ltd {1962})6.0 SIGNIFICANCE OF THE ESSENTIAL ON DEFENDANT LIABILITYThe requirement that a plaintiff establish that a duty is owed by the defendant places a limit on the situation in which liability can arise in the first place . once the existence of duty care and its breach has been established , the requirement the plaintiff damages actually suffered not be too remote (that is reasonably foreseeable )place a limit on the extent of the defendant s liability .that is a duty of care limits when liability can rise in the first place ,and once establish ,remoteness limits its extent6.1 DAMAGESDefinition Damages is the sum of money payable by a defendant found the main purpose of an award of damage is fair compensation rather than punishment or retribution loss means the damage or loss suffered and can be in personal  property or pure economic terms damage is the sum of money awarded for loss or damage suffered 6.2CLASSIFICATION OF LOSSLosses for damage are awarded in negligence fall into two categories pecuniary And non pecuniary   Pecuniary loss is defined as loss which can be valued or determined by monetary value an award of damage for pecuniary loss aims to return the plaintiff as close as possible to the position he would have been in had the injury not occurred Non pecuniary – is defined as loss which is difficult to asses or determine precisely in money term. Award of damage for non pecuniary loss aim to compensate the plaintiff for their pain and suffering loss of amenity, expectation of life and so on as a result of the injury7.0ConclusionIn negligence we have to proof that duty off care was owed to the plaintiff by the defendant so that we can have been able to connect it with the law. If no duty of care is owed the plaintiff clam must fail. The judge has the responsibility to decide whether or not duty of care exists. If there are clear fac ts about it then duty of care is owed to the plaintiff. After establishing duty of care was owed the plaintiff must show that there was sufficient connection in law between the injury and the conduct to satisfy this the plaintiff must show that the breach actually caused the injury suffered which was type was a reasonable foreseeable

Can one person in an organisation make a difference A Discussion of the attribution of an individual that can make a difference in an organization.

Can one person in an organisation make a difference A Discussion of the attribution of an individual that can make a difference in an organization. Introduction In the modern day business environment, organizations are constantly forced to exhibit innovation and enhanced performance so as to remain relevant and profitable in an ever increasingly competitive arena.Advertising We will write a custom essay sample on Can one person in an organisation make a difference? A Discussion of the attribution of an individual that can make a difference in an organization. specifically for you for only $16.05 $11/page Learn More The input of both the individuals and groups in the organization is invaluable to the achievement of organizational goals. Whereas the potential of groups and teams is monumental and crucial and as such indispensible to the organization, there comes a time when the fate of the organization may hang on the very shoulders of an individual. This paper argues that the effort of one person can make a significant difference in the life of an organization albeit with the unreserved involvement and c ooperation of the other key members of the organization. This paper will begin by giving a brief outlook of the environment in which this individual is to function. It will then proceed to define the traits that may make this one person turn around the fate of the organization. A discussion articulating the conditions under which the person may fail in his attempts to impact the organization will also be given. This will be in an effort to elaborate that good leadership ability is mandatory for the one person to make a difference. The organizational context Morgan (2006) defines an organization as an institute, group or an association which has a specific purpose and goals. In order for a group to deem itself as an organization, there must be observable elements of cooperation and coordination within the members of the group in accordance to a pre-prescribed format. As such, key to the establishment of any organization is the presence of some common and quantifiable goals which are to be pursued collectively. In an organization, the role that an individual plays must be looked at against the background of the overall effects that his actions may have on the entire organization. Traditional organizations have been characterized by rigidity and structural form whereby emphasis on an individuals input has not been as pronounced. The traditional organization is modeled around pre-defined plans and set goals which are all directed towards the optimization of performance by the organization (Malhotra 2000, p.1). Most of the activities are designed such that they adhere to organizational routines that are inherent to a well established structure.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Present conditions have called for a restructuring to the manner in which organizations function. Nadlers study (cited in Malhotra 2000, p.1) indicates that the traditional o rganizational structure was build for a relatively stable and predictable environment. This is contrary to the present day environment which is characterized by an increased level of instability and the risk of unforeseen changes in the business environment for organizations. This new environment in which the organizations find themselves calls for a reassessment of organizational practices. One of the reassessments made is the placement of even greater emphasis and value on the input of the individual so as to ensure that the organization survives the various competitive forces that constantly threaten its existence. The role of the individual Bearing in mind the factors discussed above, the organizational structure is constantly being modified so as to be aligned with the various realities that arise in the business environment. As such, the role of the individual has been propelled to the forefront and may indeed act as the last line of defense in instances where the tradition me ans of relying on group achievements has failed. For a person to make difference, he must possess some particular character traits. A study on leadership skills and traits by Stogdill (cited in Bolden et.al. 2003, p. 7) highlights the various traits and skills. This traits include; innovation, charisma, confidence, diplomacy, ability to take responsibility among other traits. Most of this attributes are a prerequisite for an individual to make a positive impact in the organization. Creativity is one of the skills in an individual that can be used to make a difference to the organization. Over the last decades, creativity and innovation has progressively become the defining factor of successful and failing organizations. Shavinina (2003, p. 607) asserts that this innovation has become paramount to the survival of organizations. She goes on to note that in most occasions, innovation springs from an individual’s initiative. It can thus be argued out that an individual possessing creativity and innovation can use this ability to positively impact the organization. This can be through the proposal of novel ideas or through the reinventing or discovering of more efficient ways of running certain aspects of the organization. In certain circumstances, the preserving of the corporate culture of the organization can make the difference in the organization. This is especially so when the culture has been responsible for the successful execution of tasks in the organization over a long period of time. This being the case, it is obvious that the success of an organization can be jeopardized by any move that threatens to weaken the corporate culture of the organization.Advertising We will write a custom essay sample on Can one person in an organisation make a difference? A Discussion of the attribution of an individual that can make a difference in an organization. specifically for you for only $16.05 $11/page Learn More Morgan (2006, p.128) states that corporate cultures develop â€Å"as an ethos created and sustained by social processes so as to bury out differences. This means that the culture is a means by which the various disparate members of the organization can forge some form of alliance and thus work towards. Jenster and Hussey (2001) assert that a strong culture may be further reinforced in an organization by a strong charismatic figure. Key to making a difference in the organization is the ability of the sole figure to ensure that everyone involved buys into the ideas and concepts that they are trying to advance. Sahskin (2003, p.178) articulates that actions that produce a feeling of charisma towards a leader figure will invariably lead to an increase in the likelihood of the followers to ape the actions of the leader. However, it should be noted that making the people follow a â€Å"model individual† may only be effective for a short term basis. The Education of key people in the organization abou t the assets and issues associated with the work environment may be a more effective and long term measure (Huszczo 2004, p.212). An individual who embraces the more encompassing role of an ambassador is therefore more likely to make a difference to the organization rather than relying solely on charisma. At the present, most economies in the world are working towards recovering from the credit crunch that hit almost all countries in the world. It is a reasonable assumption that most organizations were forced to make changes that included cutting on costs or laying off employees so as to remain profitable. In such times, there is need for a flame of optimism to be fanned in the organization. Bolden et. al (2003, p.16) state that an optimistic nature is one of the defining behaviors associated with a transformational leader. A person who can enthusiastically talk about the needs of the organization and draw a compelling image of the bright future that all in the organization can look forward to is capable of making a difference in the organization. In all organizations, there arise contentious issues which elicit different reactions at some point in time. How these issues are diffused may spell out the difference between the subsequent success or failure of the organization. The presence of a person who can manage the crises in a diplomatic fashion may be crucial to the success of the organization. Diplomacy entails the using of power and authority carefully so as to achieve positive outcomes by being unanimous or arriving at a consensus (London 2002, p.259). Failure of the individual Whereas the individual can be seen to be a potent force acting for the good of the organization, there may be instances whereby this individual can lead to the failure of the organization. Cyert and March (1992, p.31) present the organization as a coalition of individuals who have goals.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More There therefore exists the potential for internal goal conflict due to the diverse individuals that make up the organization. An individual may be tempted to project the goals that reflect on his/her personal values. Solo (2000, p.69) asserts that the economy in place favours the collective goals and those values that reflect the needs of groups rather than personal groups. This being the case, any emphasis on the individuals values may negatively impact the organization. Ambition and an achievement-oriented nature are some of the traits that are inherent in a person who set out to make a difference in the organization (Bolden et al. 2003, p.7). Whereas these traits are desirable and necessary for this task, they may have detrimental effects if they are exhibited in an exaggerated form. If an individual is overly ambitious, he may be tempted to act in ways that are beneficial to him/her at the expense of other members of the organization. This may alienate him/her to the other membe rs of the organization who may then proceed to sabotage his activities thus negatively impacting the organization. Conclusion This paper has argued that the role of an individual can make a difference in the organization if properly directed. The paper has discussed the prominent aspects in present day organizations that make the role of the individual more pronounced as compared to past times. It has been proposed that an individual possessing certain character traits that are mostly attributed to leaders can make a difference in an organization. However, it has been articulated that some of this traits can be detrimental to the organizations well beings. As such, a compromise should be struck to ensure that those skills and traits which yield positive trends are capitalized on while the traits which are negative are minimized. From the discussions presented in this paper, it can be authoritatively stated that while the role of the individual is crucial to the success of the organi zation, it should always be looked at in respect to its effect on the entire team since the organizational goals can only be effectively achieved with the support of all the members of the organization. References Bolden, R, Gosling, J, Marturano, A Dennison, P 2003, A Review of Leadership Theory and Competency Frameworks. Web. Cyert, M R March, G J 1992, A behavioral Theory of the Firm, 2nd edn, Wiley-Blackwell. Huszczo, G 2004, Tools for Team Leadership: Delivering the X-factor in Team Excellence, Davies-Black Publishing. Jenster, P V Hussey, D 2001, Company Analysis: Determining Strategic Capability. Wiley. London, M 2002, Leadership Development: Paths to Self-insight and Professional Growth, Routledge. Malhotra, Y 2000, Knowledge Management New Organization Forms: A Framework for Business Model Innovation, Information Resources Management Journal, 13(1), 5-14. Morgan, G 2006, Images of Organization, USA: Sage. Sashkin, G 2003. Leadership that matters: the critical factors fo r making a difference in peoples lives and organizations success, Berrett-Koehler Publishers. Shavinina, V 2003, The International Handbook on Innovation, Elsevier. Solo, A R 2000, Economic Organizations and Social System, 2nd edn, University of Michigan Press, USA.

Medical Information Management Essay Example

Medical Information Management Essay Example Medical Information Management Paper Medical Information Management Paper Medical communication firms have a direct obligation to fulfill customer’s rights, maintenance of firms brand equity and fulfillment of customary obligations. All these are part of improved tactics for regulatory information compliance. To maintain brand equity, medical communication firms are in touch with the community to observe the performance of their healthcare and marketing professionals. In spite of the size of the medical communication organization, there is always a requirement for an efficient medical information management system that has to be considered with high regards (Medical Information Management). Adopting the paperless system has brought many changes within the doctors group. The time to attend patients by the doctors has also increased, due to elimination of paper works. In spite of the negative blows given against the paperless system or the Electronic Medical Records (EMR), it has improved the services provided to the patients. Though the software implementation and training of staff incurs huge expenditure still, all these investments in future improve the patients care. With the new EMR the communication is done without difficulty. There is no need for writing the report, dictating the matter and not even the help of the staff. All these could be done automatically by the new system. From the view of a patient, they are able to fix their appointment, maintain and share their medical records with other physicians with out carrying the stacks of files. It would be a burden than opportunity, if the right required software is not installed for an automated system (Rottinghaus). The OmniMD, one of the Electronic Medical Record (EMR) Software, computerizes and makes easy the process of recording, storing and recovery process of patient’s medical records. This software offer ideal patient care and brings a professional touch of fulfilling customary obligation. OmniMD protects customer data and information using HIPAA complaint communication etiquette. The norms of HIPAA ensures tough grade of encryption and verification, were by the company meets all the regular requirements allowing protection and privacy. It is regarded as an user-friendly software that can be accessible from any location. The recording of the patient’s details through EMR will assist in the instant retrieval of the documents. OmniMD software ensures coordination of the workflow. It provides the features for each user, which in turn helps them to have a proper workflow with coordination (Electronic Medical Records). Spring Charts Electronic Medical Record Software claims to be the number one in the EMR market. They state that the Medical Record Software can help in lowering the cost by improving the quality. To stand along their statement they provide better-quality documentation and increased efficiency in medical field. Due to their fast documentation and retrieval process the charting procedure is fast and easy. The software improves efficiency of the office by providing convenience to patient’s medical records. It also supports the documentation of the billing claims. Due to the easiness in charting and retrieval procedure, it is easier for the physicians to attend more patients’ per day. The implementation of this software more or less by small and large concerns is practicable while considering the cost factor. After implementation of the software there is a constructive return on the investment with in a short span (Electronic Medical RecordsSoftware). Yet another software company that provides variety of services in the healthcare industry is Health Quist. It is a unique versatile company that provides automated health care services. Health Quist are in to assisting the hospitals, health care suppliers and individual healthcare offices equally. They help in achieving the maximum ability among various aspects of the business model. Health Quist claims that, they are the novel and faithful partners who delivers high class services to health care organizations in serving the patients. The medical billing service of Health Quist is an absolute full service medical billing solution. Starting from an absolute outsourced billing solution to subdivision of various other specific functions, the companies customized strategies are planned to allow the customers to continue function their business on a usual basis without hassle. The company has provided better solution that helps in lowering the cost, maximizing the efficiency and thereby improves the revenue. Health Quist have taken special concern on the proper management of human life cycle, and their effect on the firms’ revenue. It provides an onsite and remote coding support to meet the hospitals demands in time bound manner. The range of services offered by the company software is on an outsourcing basis, whereas those services relating to the resource personnel, they focus on the contract management techniques. It ensures the selection of the right candidate with proper qualification, skill and required training. Altogether the services provided by the company are full service solutions. Their motto is quality and efficiency in serving the customers (HealthQuist). Technology should be to make life much easier not hassle. The use of technology with its multi facet services reduces the costs. This can be regarded as one of the reason for going paperless. Infact an efficient paperless EMR that is reasonable while considering all the aspects is a plus point for the health care institution (Rottinghaus). Electronic Medical Records (EMR) and Practice Management (PMS). (online). Available: omnimd. com/html/aboutus. html . Accessed on October 27, 2008 Electronic Medical Records Software. (online). Available: 2kmedicalrecords. com/ HealthQuist. (online). Available: healthquist. com/index. html. Accessed on October 27, 2008 Medical Information Management. Meeting The Demands Of Medical Inquiries. (online). Available: arisglobal. com/products/medical_information. php . Accessed on October 27, 2008 Rottinghaus, Dean. Electronic Medical Records: The Future of Private-Practice Documentation. 2008. (online). Available: chiroweb. com/mpacms/dc/article. php? id=52423 . Accessed on October 27, 2008

What Was the Open Door Policy in China

What Was the Open Door Policy in China SAT / ACT Prep Online Guides and Tips Looking to learn more about the Open Door Policy? The Open Door Policy was an important policy that affected Asian, European, and US trade for decades and even contributed to the Japanese/American conflict in WWII. What was the Open Door Policy definition? Why and when was the Open Door Policy created? What are the impacts of it? We answer all those questions and more in these open door notes. What Was the Open Door Policy? A brief Open Door Policy definition: The Open Door Policy was a trade agreement between the United States, China, Japan, and several European countries. US Secretary of State John Hay created the Open Door Policy in 1899/1900 in order to allow the US, Japan, and select European countries equal trade access to China, a country that previously had no trade agreements. The Open Door Policy lasted nearly 50 years, until the communist party’s 1949 victory in China’s civil war. In the rest of the guide, we’ll dive deeper into the specifics of the Open Door Policy. We’ll discuss why the Open Door Policy was created, how it was established and maintained, and what its impacts were. Why Was the Open Door Policy Created? Simply put, the United States was worried it was going to lose trading access with China, and it wanted a policy in place to protect its ability to continue trading with the Chinese.In this section, we’ll look more closely as to why the US cared so much about trading with China, and why there were worried their access would be cut off. The Open Door Policy was created during the Age of Imperialism, a period during the late 19th century and early 20th century when European powers, as well as countries like the US and Japan, were attempting to expand their global power through colonialism and territory expansion. China was particularly seen as a lucrative prize, so multiple countries built a large presence there, and they began setting up trading stations and deploying troops to different regions of the country in order to have the best access to China’s trade. The United States got into this game a little late. It wasn’t until after the Spanish American War ended in 1898 that the US began to take a deep interest in China. At the end of the war, the US ended up with a large amount of land in Asia, primarily the Philippine Islands. This newly-acquired land caused the US to look more closely at China, and they saw that trading with China could earn them a lot of money. However, multiple other countries had already realized this and had established large spheres of influence in China. European powers such as Great Britain, the Netherlands, France, and Belgium had well established colonies and influence in Asia and Africa. Japan was also exerting significant power in China. During the first Sino-Japanese War (1894-1895), Japan and China fought for control of Korea. After Japan won the war, it sharply increased its power in both Korea and China. The US’s sphere of influence in China was not nearly as well-established as those of the other foreign powers there, and US President McKinley worried that the other foreign powers would limit the US’s ability to trade with China and potentially block the US from trading with China at all. How Was the Open Door Policy Implemented? In 1898, US President William McKinley announced his desire for a policy that would allow countries equal access to trade with China. In effect, there’d be an â€Å"open door† to Chinese trade, and one country couldn’t close the door to another country.President McKinley was concerned the US would be forced out of the Chinese trade by Japan and other European countries, and he wanted a policy that explicitly protected the US’s right to continue trading with China. As a result, in 1899, US Secretary of State John Hay began circulating diplomatic notes among the major world powers (Great Britain, Germany, France, Italy, Japan, and Russia) at the time to get the Open Door Policy formally approved. Because of his work doing this, Hay is often seen as the author of the Open Door Policy. Hay’s diplomatic notes proposed that all countries should have equal trading access to the entirety of China and those foreign countries must allow Chinese officials to regulate the trade and collect taxes from it.The purpose of Hay’s notes was to grant all the major powers equal access to Chinese trade and reduce the influence of countries that already had an especially large hold in China (such as Japan and Russia) so they couldn’t force other countries (particularly the United States) out of the Chinese market. None of the countries Hay spoke with formally agreed to the Open Door Policy. However, none explicitly opposed it, and the European countries unofficially supported the plan, so Hay announced that an agreement had been reached, and the Open Door Policy became the de facto trade policy in China. In 1921/1922, after challenges to the Open Door Policy by Chinese nationalists as well as Japan (discussed more in the next section), the US attempted to make the Open Door Policy official at the Washington Naval Conference. During the war between China and Japan that began in 1937, the US continued to strenuously support the Open Door Policy and increased embargoes on many commodities to Japan as a result of Japan not following the policy. The Open Door Policy remained in effect until Japan’s defeat in WWII in 1945 and the end of the Chinese civil war in 1949. After these events China began to be recognized as a sovereign state with control over its own trade agreements. What Were the Effects of the Open Door Policy? What did the Open Door Policy do? The Open Door Policy was an important agreement that reflected the imperialist attitude of many global powers at the time and those countries’ intense desire to expand their global reach. The Open Door Policy had three main impacts. Increased Chinese Backlash Against Foreigners The creation of the Open Door Policy increased foreign influence in China, which led to a rise in anti-foreign and anti-colonial sentiment in the country.The backlash against foreigners led to widespread killings of missionaries working in China and an increase in nationalist feelings among the Chinese.The Boxer Rebellion was one of the most important events caused by this anti-foreign movement. The Boxer Rebellion started in 1899, when a Chinese group known as the Society of Righteous and Harmonious Fists (known as â€Å"Boxers† to the English) initiated an uprising against foreign influence.The US, Japan, and several European countries fought back and eventually defeated the Boxers in 1901. Even after the rebellion ended, foreign soldiers continued killing and looting in many villages. The Boxer Rebellion weakened the power of the Chinese ruling dynasty and contributed to the end of Europeans’ attempts to colonize China. Chinese and American Conflict With Japan Even though Japan did not reject the Open Door Policy when it was created, the country challenged and openly violated the policy multiple times, which led to conflict with China and the US.Japan first violated the Open Door Policy when it presented its Twenty-One Demands to China in 1915. During WWI, Japan sent the list to China demanding an expansion of Japanese control in the Chinese region of Manchuria, as well as significantly increased control of the Chinese economy. Japan gained little from the Twenty-One Demands, but sending them caused a deterioration in Japan’s relationship with the US and Great Britain, who resented the challenge to the Open Door Policy.In response to the Twenty-One Demands, China, the United States, Belgium, France, the UK, Italy, Japan, the Netherlands, and Portugal attended the Washington Naval Conference in 1922 and signed the Nine-Power Treaty which officially affirmed the Open Door Policy and the sovereignty of China. However, in 1931, Japan violated both the Nine-Power Treaty and the Open Door Policy when they invaded Manchuria, an event known as the Mukden Incident.The Mukden Incident led to Japan establishing a puppet government in Manchuria, becoming diplomatically isolated as other countries condemned its actions, and withdrawing from the League of Nations.The Mukden Incident also led to the second Sino-Japanese War between Japan and China, which lasted from 1937 to 1945. It was the largest Asian war of the 20th century. The US allied with China in the war and strenuously supported the Open Door Policy by increasing embargoes on exports of key commodities to Japan. These embargoes led to heightened tensions between Japan and the US and were one of the causes of Japan bombing Pearl Harbor in 1941 and going to war with the US in WWII. Increased US Interest in East Asia The Open Door Policy was one of the first major steps the US took to expand their influence in East Asia, and it was one of their most important footholds in the area.Once the US realized how lucrative trading with China could be, they pushed hard for the Open Door Policy, which would give them secure access to Chinese trade and expand their influence in the area. This increased influence in East Asia was lucrative for the US, but it also caused them to be drawn into conflicts in the region, such as the Boxer Rebellion and conflicts between Japan and China. The increased American influence in the area and its involvement in the area’s conflicts also led to rising tensions with Japan, which culminated with the bombing of Pearl Harbor. Summary: Open Door Notes What was the Open Door Policy definition? The Open Door Policy was a policy between China, the US, Japan, and several European powers that stated each of those countries should have equal access to Chinese trade.It was created in 1899 by US Secretary of State John Hay and lasted until 1949, when the Chinese civil war ended. Why was the Open Door Policy created? The US had recently gained a foothold in East Asia, and they were afraid they’d be forced out of the Chinese market by countries who had been there longer than them, so they created the policy to ensure they wouldn’t lose their ability to trade with China. Why was the Open Door Policy created? The US had recently gained a foothold in East Asia, and they were afraid they’d be forced out of the Chinese market by countries who had been there longer than them, so they created the policy to ensure they wouldn’t lose their ability to trade with China. What were the impacts of the Open Door Policy? The Open Door Policy’s impacts lasted for decades, and it had three major impacts: Increased Chinese backlash against foreigners Chinese and American conflict with Japan Increased US interest in East Asia What's Next? Writing a research paper for school but not sure what to write about?Our guide to research paper topicshas over 100 topics in ten categories so you can be sure to find the perfect topic for you. Learning about natural logs?We've compiled all the main natural log rules to make it easy for you to learn and understand them. Have trouble understanding what dynamic equilibrium is?We break this sometimes tricky concept down so it's easy to understand in our complete guide to dynamic equilibrium.

Evidence Based Health Essay Example | Topics and Well Written Essays - 500 words

Evidence Based Health - Essay Example The sample should be satisfactory in terms of size, representation of the whole population and relevance to the study. Selection of the wrong sample and sample size will lead to poor conclusions and results therefore leading to wrong implementation. The success of any research work depends highly on the selection of the participants and the participation level of the participants. The selection of the participants from those who were to join the university made the research a worthy activity to undertake. Participants selected should be from a group privy to the research outcome (Boyer, 1990, p34-37). The researcher selected participants from a vulnerable group. Though this was not a full representation of the group, the researcher was able to monitor the trends of the students as they continued with their studies. The research was aimed at investigating whether students’ anxieties and depressions increase after entering college, how much adverse life experiences lead to their increases, as well as the influence of adversity, depression and anxiety on test performance. The use of the sample data would enable the researcher establish the level of increase in the student depressions and anxiety and impacts on exam performance. However, the researcher should also have used the continuing students and those who had already completed their studies in order to reach at a conclusive decision and recommendations. The sample selected was to benefit from the research outcome as the recommendations made would impact their lives. The researcher ensured that the privacy of the students is maintained by use of questionnaires where the identity of the students was not to be revealed when answering them. The participants were briefed of the essence of the research but were not given the chance to state their position in participation. The participants were assured of confidentiality and anonymity. In my view,

Defining a line Essay Example | Topics and Well Written Essays - 1000 words

Defining a line - Essay Example These all correlate with the way we think and act as people. In these terms, a line can be a shallow mind, hatred, ignorance, segregation, and an arrogant person. In essence, the word â€Å"line† almost always implies dissimilarities, divisions, and opposition in our world. A line is something that delineates boundaries and sets limits on the ideas, beliefs and actions of humankind. A line is a shallow mind. Shallow minds are narrowly constricted and do not allow for any room for critical thinking and reasoning. They cannot see past one aspect of an idea, situation or problem. They could not comprehend the idea of a challenge thus they never really rise above that is asked of them. Their trend of thoughts is static and stale. If you feed a shallow mind with garbage information, then expect to get garbage information in return. A shallow mind is often restricted to living in a world without the more. Seeking the more is characteristic of a healthy, working mind that works off the beaten path. Therefore, a shallow mind lives in a world containing only the absence of the more. It recoils from the curvaceous and ever expanding path of deeper thought. Therefore, a shallow mind is a line. When we think of hatred, we do not normally think of it as a line. However, if we take a closer look into nature of things, hatred limits the capacity of the mind to understand. It narrows down our way of thinking, thus hatred is a line. When you are angry, you draw a line; you close down your mind and channel your energies into one direction. Prejudice exemplifies a type of hatred. It is the persistence of racism that has emanated from ways of recognizing and classifying strangers. In the Medical Dictionary, hatred is defined as â€Å"an affection of the mind awakened by something regarded as evil.† The word â€Å"evil† is the key word. It is the seed that cultivates hatred, the hatred that when grown, enshrouds a mind, and turn it into

A Concept Analysis of Anxiety Essay Example | Topics and Well Written Essays - 1000 words

A Concept Analysis of Anxiety - Essay Example The objective of the study undertaken is to present various perspectives of the different disciplines regarding the concept of anxiety. The perspectives include medical and non-medical fields. Anxiety is distinguished from fear as anxiety is the reaction to an unexpected, possible harmless scenario. On the other hand, fear pertains is the reaction to a verified danger. Anxiety and fear are related but they are two different kinds of emotions especially when behavioral response is used as a basis. From an evolutionary point of view, possible hazard is detected and behavioral, cognitive and emotional reactions occur to save the human being and escape the possible danger through the functioning of anxiety as a logical and functional effect (Sartori, Landgraf and Singewald, 2011). Some people avoid anxiety and develop phobia towards anxiety. The phobia towards anxiety is known as anxiety sensitivity and it pertains to fear of anxiety symptoms that lead to beliefs about the negative effec ts of the symptoms in terms of psychological, physiological, and social point-of-view. Anxiety sensitivity leads to panic disorder and other anxiety diseases according to the studies conducted on adults and have increasingly become the reason for the onset of anxiety in the early stages of life like in childhood and adolescence. Studies showed that anxiety sensitivity is identified as an indicator to predict the panic attacks among preteens. It is related to fears, anxiety, panic-like symptoms, and anxiety diseases based on the experiments done on children and adolescents in communities. Anxiety sensitivity has the possibility to be connected to anxiety symptoms above and it is not only a trait since it influences the lives of children and adolescents (Mc Laughlin and Hatzenbuehler, 2009). As the above explanations showed, childhood and adolescence are the main life stages where the onset of anxiety symptoms occurs. Symptoms may involve mild symptoms or the whole anxiety disorders. The reliable clinical validity of assessment in the perspective of research is needed to determine the prevalence and patterns of the onset of panic and anxiety. Deeper understanding of characteristics as solid symptoms for more malignant disorders is needed as it may have some relations to self-limiting patterns of course and outcome. Early detection is an advantage so people can recognize anxiety and make full preparations and preventions or treatment for the young people (Beesdo, Knappe and Pine, 2009). Previous studies showed the effect of unrelated emotions to tasks on a goal-oriented cognitive processing occurring simultaneously is connected to unlike patterns of activation in emotions and perceptions versus cognitive executive brain regions. Although little is known about the use of individual variations in the responses, a present study investigated deeper into the influence of anxiety on the neural responses controlling: †¦the effect of transient anxiety-inducing task- irrelevant distraction on cognitive performance, and on the neural correlates of coping with such distraction. We investigated whether activity in the brain regions sensitive to emotional distraction would show dissociable patterns of co-variation with measures indexing individual variations in trait anxiety and cognitive performance (Denkova et. al., 2010). Past studies on stress and anxiety disorders has considered factors like genetic, physiological, or behavioral phenomena in isolation. Separate studies had been conducted and results were not integrated. Recent studies changed the tradition since more comprehensive developmental studies have been done that are very important for their inclusion of discoveries from adult social and genetic

Quantitative Critique of Research Paper Effect of Nursing Rounds on Essay

Quantitative Critique of Research Paper Effect of Nursing Rounds on Patients - Essay Example Background to the study The call light is very significant with regards to patient care in hospitals but it can be noted that this same call light can pose a challenge to nurses given that the demand for their time may also be increased. Various studies have revealed that the patients’ frequent use of the call light have unfavourable effects especially on patient care management units which is compounded by issues such as shortages of staff as well as general dissatisfaction among the nursing staff. However, there is little empirical research about rounding which is concerned about conducting bedside rounds among the patients. Therefore, this study has been significantly influenced by mainly two factors: to find out more about the observations made with regards to the amount of time spent by nurses responding to call lights and the impact of this practice on patient care management and measures that can be taken in order to assist nurses as well as hospitals to improve their d aily operations as well as the safety of the patients. Research has shown that patients mainly use call lights mainly for other non medical purposes such as the need to use toilets or other aspects related to food. However, there is need to research is needed to determine the best way of reducing call light use and burnout and fatigue among the people involved in this particular task in hospitals as well as increase the safety and satisfaction of the patients. Other studies have observed that an interdisciplinary rounding exercise is effective since it can positively improve patient care as well as operational efficiency while at the same time guaranteeing satisfaction of the health care personnel. Normally, the patients derive their satisfaction from their perceptions about the nurses especially with regards to the care they receive and in most cases, the call light is used for various purposes to determine the level of satisfaction of the patients. Therefore, the crux of this stud y has been to investigate the effectiveness of the use of the call light on patient satisfaction with regards to falls and its impact on the performance of the nurses. Problem statement In the study above, the problem statement can be summarised as: to what extent is there a correlation between the use of call light in nursing rounds as well as improved satisfaction of the customers and reduced workload on nurses? It has been observed that unscheduled use of call light negatively impacts on the nurses while on the other hand their failure to respond to the patients’ needs often results in reduced satisfaction. Therefore, it can be noted that this research is a twofold process which affects both parties involved in either a positive way or negative manner. In my own view, I think this problem statement is a researchable topic given that it is closely related to the nursing profession. The study also focuses on a population on a population sample collected from different hospit als to show that this problem identified is common in different healthcare centres. Given such a scenario, it can be seen that there is need to address this problem in order to improve the welfare of the nursing professionals as well as satisfaction of the customers from the services they get from the hospitals. It can also be seen that the

International Personality Essay Example | Topics and Well Written Essays - 1250 words

International Personality - Essay Example This is legal systems that regulate action by states. Sine 1945 the international legal system has been used in the world to arbitrate different conflicts and to bring conflicting sides to the table. The UN has played a pivotal role in the development of an internal legal system. However the principle subject that has been emphasized on the international law has been states rather than individuals. Individual have been placed under the municipal law. The international court of Justice had acknowledged in the repartition case which types of the international personality other than the statehood could be in existence which has seen an expansion of the subjects of the international law. But apart from the mention states, there have also been concerns that personality is also possessed by other bodies like international organization and human beings. The non-governmental organization and national liberation movement are also showing a great possession of international personality. (Nijman 2004, p. 2) In right to this we can therefore see that international personality is therefore bench marked on the power that is given to the entity. If the entity does not have the power to force the power that has been granted under the international laws, therefore it cannot be said to be an international person. This is the reason why the definition of an internal individual may not be the same as the normal definition since it will be referring to a specific entity rather those specific human beings. This means that the international community is taken as a being made up of "persons" who posses powers to act on behalf of the international community. This definition hence takes in the factors of power that is granted to the specific individual to implement the powers for the international community. While in our normal definition we may be referring to specific humans, the international community recognizes the states alone. But the non-governmental organization has also been given the same power of recognition in the international community as states. While the international law clearly defines an international person as "an entity that has the capacity to bear legal rights and duties under the international law" non governmental organizations have been able to bear the foresaid legal right and duties. (Greig 1996, p. 32) International organizations are also given legal

Quantitative Critique of Research Paper Effect of Nursing Rounds on Essay

Quantitative Critique of Research Paper Effect of Nursing Rounds on Patients - Essay Example Background to the study The call light is very significant with regards to patient care in hospitals but it can be noted that this same call light can pose a challenge to nurses given that the demand for their time may also be increased. Various studies have revealed that the patients’ frequent use of the call light have unfavourable effects especially on patient care management units which is compounded by issues such as shortages of staff as well as general dissatisfaction among the nursing staff. However, there is little empirical research about rounding which is concerned about conducting bedside rounds among the patients. Therefore, this study has been significantly influenced by mainly two factors: to find out more about the observations made with regards to the amount of time spent by nurses responding to call lights and the impact of this practice on patient care management and measures that can be taken in order to assist nurses as well as hospitals to improve their d aily operations as well as the safety of the patients. Research has shown that patients mainly use call lights mainly for other non medical purposes such as the need to use toilets or other aspects related to food. However, there is need to research is needed to determine the best way of reducing call light use and burnout and fatigue among the people involved in this particular task in hospitals as well as increase the safety and satisfaction of the patients. Other studies have observed that an interdisciplinary rounding exercise is effective since it can positively improve patient care as well as operational efficiency while at the same time guaranteeing satisfaction of the health care personnel. Normally, the patients derive their satisfaction from their perceptions about the nurses especially with regards to the care they receive and in most cases, the call light is used for various purposes to determine the level of satisfaction of the patients. Therefore, the crux of this stud y has been to investigate the effectiveness of the use of the call light on patient satisfaction with regards to falls and its impact on the performance of the nurses. Problem statement In the study above, the problem statement can be summarised as: to what extent is there a correlation between the use of call light in nursing rounds as well as improved satisfaction of the customers and reduced workload on nurses? It has been observed that unscheduled use of call light negatively impacts on the nurses while on the other hand their failure to respond to the patients’ needs often results in reduced satisfaction. Therefore, it can be noted that this research is a twofold process which affects both parties involved in either a positive way or negative manner. In my own view, I think this problem statement is a researchable topic given that it is closely related to the nursing profession. The study also focuses on a population on a population sample collected from different hospit als to show that this problem identified is common in different healthcare centres. Given such a scenario, it can be seen that there is need to address this problem in order to improve the welfare of the nursing professionals as well as satisfaction of the customers from the services they get from the hospitals. It can also be seen that the

Crime Prevention Through Environmental Design Assignment Research Paper

Crime Prevention Through Environmental Design Assignment - Research Paper Example Concrete and productive strategies are therefore necessary to compact the crime related complications. Crime Prevention Approaches To achieve the entire goal of crime prevention in any society, all stakeholders should be exclusively involved. Policy makers, community members, developers and law enforcers have to work collectively in the battle against criminal activities. Traditionally, crime prevention was the obligation of the police officers and the judicially. Community members and other community key players were not involved. With the modern technology and complexity of criminal activities in the society, the contribution of all informers in society is paramount. Crime prevention through environmental design (CPTED) has incorporated all stakeholders in addressing criminal activities in the society. According to Crime prevention through environmental design strategy, profound designs and inclusive use of the general environment reduces tremendously the level of criminal activiti es in the society. The strategy works directly and indirectly in fettering notorious criminal activities in a society. CPTED encourages business people, neighbors and community organizations to combine their effort in preventing crime. The guiding principle in crime prevention through environmental design is time to time community consultation (Crowe 209). The constituents of CPTED are divided into two generations, the first generation and the second generation. The first generation entails components of physical designs. In this case physical designs include territoriality, natural surveillance, access control and image. The second generation is composed of social variables of the neighborhoods. Thunder Bay is one of the biggest cities in northern Ontario Canada. The city is mostly occupied by miners. There are very many idlers in the city due to job scarcity (Zimmerman 200). The city accommodates one of the most attractive tourist sceneries in Canada. The city is known for its hig h level of criminal activities. Crime is very rampant in Thunder Bay city. The most apparent criminal activities in Thunder Bay city include, rape, and drug trafficking, murder, prostitution, and theft (Zimmerman 200). The security agencies have tried to reduce this criminal activities but their effort is futile. The criminal activities in the city have discouraged tourist in the area. The crimes activities have also developed fear among the city residents. With proper utilization of the crime prevention through environment design principles, criminal activities in the country can be a thing of the past (Zimmerman 200). There is dire need for intensive inclusion of the available resources in the fight against criminal activities. Proper integration of the crime prevention through environmental design principles by the city planners, community, home owners, and developers is the only apparent solution to criminal activities in Thunder Bay city. There most relevant CPTED principles in the city includes The Natural Surveillance Principle The principle is based on the notion that, criminals do not wish to be observed when doing their criminal activities (Jeffrey 140). The legitimate users of the city or any residential place are expected to be in touch with what is happening on the street. Through this principle suspicious visitors are easily identified .The basic aim of the natural surveillance is to eliminate all the obstacles in the streets, providing adequate lights in

Mary Barton Essay Example for Free

Mary Barton Essay Elizabeth Gaskell’s â€Å"Mary Barton† is a novel of social reform that explores injustice, abuse and inequality. The novel is especially concerned with the societal condition of England at the time. In her â€Å"Preface† Mrs. Gaskell asserted, â€Å"I know nothing of Political Economy, or the theories of the trade. I have tried to write truthfully†. The â€Å"truth† of â€Å"Mary Barton† is not political or economic but the truth of the human heart. The novel is not about industrial conditions but about people living in those conditions. Mrs. Gaskell’s social aim in writing is to inform rather than to reform. Her aim in writing is to give â€Å"utterance to the agony† and to explicate the consequences of â€Å"the seeming injustice of the inequalities of fortune†. In â€Å"Mary Barton†, the protagonist John Barton asks with bitter vehemence about the injustice of the massive gulf between the upper and lower classes: â€Å"Why are they so separate, so distinct, when God has made them all? [ ] We are their slaves as long as we can work; we pile up fortunes with the sweat of our brows; and yet we are to live as separate as Dives and Lazarus, with a great gulf betwixt us†. John Barton is ultimately driven to the act of murder by his outrage at the gulf fixed between the rich and the poor. John Barton is ultimately a victim of society and an example of how a man full of human kindness is hardened into hatred and violence. As the author tells the reader his wife’s death meant that â€Å"one of the ties which bound him down to the gentle humanities of earth was loosened†. The string of events that followed – the strike, the Davenports’ starvation and fever, the employees’ arrogant isolation and the failure of the petition, seem to purposely show that the world reckons the poor folk no account. And as John Barton lies on his deathbed his enemy Mr. Carson sits in his library quite unable to hate his son’s murderer. At the end Mr. Carson forgives John Barton and the murderer dies in the arms of the man whose son he has murdered and this image explicates the novel’s pivotal theme in the hope of human heartedness. In her novel Mrs. Gaskell presents men and women at the extreme of suffering at which point only the most radical of human actions remain be they despair and hatred or alternatively human compassion and forgiveness.

Additive Manufacturing of Medical Implants: A Review

Additive Manufacturing of Medical Implants: A Review E. Gordon Wayne State University College of Engineering Abstract Additive manufacturing has numerous applications and is gaining interest in the biomedical field. The quality of additively manufactured parts is constantly improving, which contributes to their increased use for medical implants in patients. This paper reviews the literature on surgical additive manufacturing applications used on patients, with a focus on the customization of 3D printed implants and the ability to incorporate scaffolds on the implant surface. Scholarly literature databases were used to find general information on the focus topics, as well as case studies of surgical applications of additive manufacturing implants in rodents and humans. The advantages of additive manufacturing medical implants include improved medical outcome, cost effectiveness, and reduced surgery time, as well as customization and incorporated scaffold. Overall, the most effective type of additive manufacturing for the medical implant application is electron beam melting using Ti-6Al-4V because it can produce a high quality, high purity biocompatible implant that has the required mechanical properties. Keywords: Additive Manufacturing, Customized implants, Scaffold, 3D Printing, Ti-6Al-4V Introduction In recent years, additive manufacturing technologies have improved significantly, thus expanding the fields and applications for which they can be used. These 3D printing technologies create physical models from digital models without the need for tool and die and process planning. Additive manufacturing can fabricate prototypes of complex shapes in a variety of materials such as metals, polymers, and nylon. Metal components, in particular, can be used for practical applications such as medical implants: devices manufactured to replace or support a biological structure. The biocompatibility of these metallic devices must be considered, creating rigorous requirements for the material selection and final material properties of the structure. Studies have shown that additive manufacturing successfully produces implants with biocompatible materials that meet the structural requirements [1-6]. 3D printing medical implants can provide many benefits such as the customization and personalization of the implants, cost-effectiveness, increased productivity, and the ability to incorporate scaffold. Using custom made implants, fixtures and surgical tools can help decrease surgery time and patient recovery time, while increasing the likelihood of a successful surgery [7]. Another benefit is the cost efficiency of 3D printing medial implants. Traditional manufacturing methods are cheaper for large quantities, but are more expensive for personalized designs and small production runs [8, 9]. 3D printing is especially cost effective for small-sized implants like spinal or dental implants. 3D printing is also faster than traditional manufacturing if a custom implant needs to be made; traditional methods require milling, forging, and a long delivery time while 3D printing may only take about a day [1]. Another notable benefit of additive manufacturing is the ability to share data files of designs. Files saved as an .STL can be downloaded and printed anywhere in the world. The National Institutes of Health established a 3D Print Exchange to promote open-source sharing of 3D print files for medical models [7]. The most significant benefits for the biomedical industry, however, are the ability to manufacture biocompatible materials, customize implants, and incorporate a porous scaffold surface. Types of Additive Manufacturing The additive manufacturing approach uses computer software to slice a complex 3D model into layers of 2D cross-sections with a minute thickness. The layers are then printed layer by layer depending on the particular method chosen for the application. There are dozens of types of additive manufacturing systems on the market, some of the most common being stereolithography (SLA), direct metal laser sintering (DMLS), selective laser sintering (SLS), selective laser melting (SLM), 3D printing (3DP), and electron beam melting (EBM). These systems are classified according to the form of the raw material, which can be powder, liquid, or solid form [8]. The two types of additive manufacturing that are most commonly used for medical implants are SLS and EBM. Figure 1: Process chain for SLM and EBM. The pre-processing before manufacturing includes 3D modeling, file preparation, and slicing of the 3D model into layers. Post-processing may include heat treatment and polishing of fabricated parts [10]. Selective Laser Sintering An SLS printer uses a powder form of material for printing objects. A laser fuses a single layer of powder by drawing the shape of the object according to the first 2D cross-section of the 3D model. Immediately, the build platform is lowered by the defined layer thickness and another layer of powder is rolled across [10]. The process repeats, fusing each layer one at a time to form the object. SLS can be used with metal, ceramic, and plastic powders. The precision of the laser and the diameter of the powder determines the degree of detail of the final object, so it is possible to create detailed structures with an SLS printer [11]. Figure 2: Schematic of SLS system. The key components of SLM include the laser system (a fiber laser, F-theta and galvanometer used to control the laser beam movement) and the mechanical system (movable build platform and powder roller) [10]. Electron Beam Melting An EBM printer uses a powder form of material for printing objects, similar to SLS. However, while SLS uses a laser to fuse each layer of the powder, EBM uses an electron beam. This energy is delivered through an electric circuit between a tungsten filament inside of the electron gun and the build platform [10]. An electric current heats the filament to emit a beam of electrons [1]. Electric energy is transformed to heat energy which melts the powder on the build platform. The process continues similarly to SLS, where powder is spread across the platform in a thin layer, the cross-section of the object is melted, and then the build platform lowers by the layer thickness. A key element of EBM is that the build chamber is kept under vacuum, which allows the object to be maintain great detail (70-100ÃŽÂ ¼m) [1]. Figure 3: Schematic of EBM system. The key components of EBM include an electron beam system (electron gun assembly, electron beam focusing lens and deflection coils used to control the electron beam) and the mechanical system (movable powder rake and fixed powder cassettes) [10]. Materials of Medical Implants The most common metals used for surgical implants are stainless steel 316L (ASTM F138), Cobalt based alloys (ASTM F75 and ASTM F799) and titanium alloy Ti-6Al-4V (ASTM F67 and F136) [12, 13]. However, these metals have disadvantages such as the potential release of toxic ions and particles due to corrosion that cause inflammation and allergic reactions, affecting biocompatibility [14]. Also, the materials that have an elastic modulus that is not similar to natural bone stimulate new bone growth poorly [12]. Despite this, the low Youngs modulus, high strength, and nonlinear elasticity of titanium-based alloys make it the least harmful choice [3]. The most commonly used titanium alloy is Ti-6Al-4V (Ti64) because it also has a better resistance to corrosion compared to stainless steels and cobalt-based alloys [15]. Additive manufacturing has also been done using Tantalum. Tantalum is biocompatible, hard, ductile, and chemically resistant, but it is expensive and difficult to machine [6] . Titanium based alloys are superior, thus Ti-6Al-V4 is the best material for additive manufacturing medical implants. Material Youngs modulus (GPa) Ultimate tensile strength (MPa) Yield strength (MPa) Elongation (%) TiTa 75.77  ± 4.04 924.64  ± 9.06 882.77  ± 19.60 11.72  ± 1.13 Ti6Al4V 131.51  ± 16.40 1165.69  ± 107.25 1055.59  ± 63.63 6.10  ± 2.57 cpTi 111.59  ± 2.65 703.05  ± 16.22 619.57  ± 20.25 5.19  ± 0.32 Table 1: Tensile properties of SLS produced TiTa, Ti6Al4V and commercially pure titanium samples (n = 5) [16]. Customized Implants Additive manufacturing allows for the design and fabrication of customized prosthetic implants that are created to meet the specific needs of a patient, such as the size, shape, and mechanical properties of the implant. Additive Manufacturing reduces design time as well as manufacturing time because the implant pattern is computer generated with CT and MRI scans, thus removing the need for a physical model [8]. The ability to produce custom implants quickly solves a common problem with orthopedics where standard implants do not always fit the needs of certain patients. Previously, surgeons had to manually modify implants to make them fit the patient [7]. These techniques can be used by professionals in a variety of specialties such as neurosurgery, orthopedics, craniofacial and plastic surgery, oncology, and implant dentistry [8]. One example of an application in which a customized implant is required is craniofacial reconstruction. Craniofacial abnormalities are a diverse group of congenital defects that affect a large number of people and can be acquired at birth or due to injuries or tumors [8]. Standard cranial implants rarely fit a patient precisely because skulls have irregular shapes [7]. The custom implant can be created by using a CT scan to create a 3D virtual model of the patients skull. Then the model can be used with CAD software to design an implant that would perfectly fit the patient [8]. Using custom implants has shown to improve the morphology for large and complex-shaped cranial abnormalities, and some researchers have observed a greater improvement in neurological functions than after similar surgeries using traditionally manufactured implants [17, 18]. Figure 4: Skull model and customized implant for craniofacial reconstruction surgery [8]. Scaffold Additive manufacturing medical implants allows the porosity of the surface to be designed, controlled, and interconnected, which provides better bone growth into implants, thus decreasing the chances of the body rejecting the implant. Additionally, the rough surface quality of 3D printed implants enhances bone-implant fixation [1]. Without scaffold, there is a risk of bone weakening and bone loss around the implant, which is a consequence of stress shielding due to high stiffness of materials [19]. The probability of this problem occurring is lessened when bone can grow into a porous surface of the implant [19]. Cellular lattice structures are classified by stochastic and non-stochastic geometries. The pores in stochastic structures have random variations in size and shape, while the pores in non-stochastic structures have repeating patterns of particular shapes and sizes [10]. The main challenge in additively manufacturing scaffolds is the difficulty to remove the loose powder from within the pores, but an advantage is that additive manufacturing technology allows for the manufacturing of different types of scaffolds if a design requires it; different regions of the implant could have different porosities [1, 10]. The procedure used to achieve the porous areas with traditional manufacturing methods includes coating a smooth surface with other materials such as plasma-sprayed titanium or a titanium wire mesh; however, combining different metals increases the risk of the body rejecting the implant. Additive manufacturing allows the smooth and porous surfaces to be fabricated with the same material, thus decreasing that risk. A variety of additive manufacturing techniques can be used to create the lattice structure, but scaffold can be fabricated by SLS or EBM without the need for support structures, thus making it the most effective method [5]. Figure 5: Acetabular cup with designedFigure 6: (a) Porous femoral stem on the building porous surface [10].platform, (b) post-processed femoral stem [5]. Conclusion There are many advantages to using additive manufacturing to fabricate surgical implants. These benefits include improved medical outcome, cost effectiveness, reduced surgery time, as well as customization and scaffold. Overall, the most effective type of additive manufacturing for the medical implant application is Electron Beam Melting because it can produce a high quality, high purity biocompatible implant that has the required mechanical properties. The recommended metal to use for most implants is the titanium-based alloy Ti-6Al-4V because of its low Youngs modulus, high strength, nonlinear elasticity, and corrosion resistance. Overall, additive manufacturing is an excellent production method for medical implants because it allows surgeons to customize implants and scaffold to the specific needs of the patient. References 1.Petrovic, V., et al., Additive manufacturing solutions for improved medical implants. 2012: INTECH Open Access Publisher. 2.Ahn, Y.K., et al., Mechanical and microstructural characteristics of commercial purity titanium implants fabricated by electron-beam additive manufacturing. Materials Letters, 2017. 187: p. 64-67. 3.Yan, L.M., et al., Improved mechanical properties of the new Ti-15Ta-xZr alloys fabricated by selective laser melting for biomedical application. Journal of Alloys and Compounds, 2016. 688: p. 156-162. 4.Caldarise, S., Hip joint prostheses and methods for manufacturing the same. 1996, Google Patents. 5.Simoneau, C., et al., Development of a porous metallic femoral stem: Design, manufacturing, simulation and mechanical testing. Materials Design, 2017. 114: p. 546-556. 6.Wauthle, R., et al., Additively manufactured porous tantalum implants. Acta Biomaterialia, 2015. 14: p. 217-225. 7.Ventola, C.L., Medical Applications for 3D Printing: Current and Projected Uses. Pharmacy and Therapeutics, 2014. 39(10): p. 704-711. 8.Jardini, A.L., et al., Cranial reconstruction: 3D biomodel and custom-built implant created using additive manufacturing. Journal of Cranio-Maxillofacial Surgery, 2014. 42(8): p. 1877-1884. 9.DUrso, P.S., et al., Custom cranioplasty using stereolithography and acrylic. British Journal of Plastic Surgery, 2000. 53(3): p. 200-204. 10.Sing, S.L., et al., Laser and electronà ¢Ã¢â€š ¬Ã‚ beam powderà ¢Ã¢â€š ¬Ã‚ bed additive manufacturing of metallic implants: A review on processes, materials and designs. Journal of Orthopaedic Research, 2016. 34(3): p. 369-385. 11.Hoy, M.B., 3D printing: making things at the library. Med Ref Serv Q, 2013. 32(1): p. 94-9. 12.Kokubo, T., et al., Bioactive metals: preparation and properties. J Mater Sci Mater Med, 2004. 15(2): p. 99-107. 13.Staiger, M.P., et al., Magnesium and its alloys as orthopedic biomaterials: A review. Biomaterials, 2006. 27(9): p. 1728-1734. 14.Polo-Corrales, L., M. Latorre-Esteves, and J.E. Ramirez-Vick, Scaffold Design for Bone Regeneration. Journal of nanoscience and nanotechnology, 2014. 14(1): p. 15-56. 15.Dinda, G.P., L. Song, and J. Mazumder, Fabrication of Ti-6Al-4V Scaffolds by Direct Metal Deposition. Metallurgical and Materials Transactions a-Physical Metallurgy and Materials Science, 2008. 39A(12): p. 2914-2922. 16.Sing, S.L., W.Y. Yeong, and F.E. Wiria, Selective laser melting of titanium alloy with 50 wt% tantalum: Microstructure and mechanical properties. Journal of Alloys and Compounds, 2016. 660: p. 461-470. 17.Rotaru, H., et al., Cranioplasty With Custom-Made Implants: Analyzing the Cases of 10 Patients. Journal of Oral and Maxillofacial Surgery, 2012. 70(2): p. e169-e176. 18.Agner, C., M. Dujovny, and M. Gaviria, Neurocognitive Assessment Before and after Cranioplasty. Acta Neurochirurgica, 2002. 144(10): p. 1033-1040. 19.Shah, F.A., et al., Long-term osseointegration of 3D printed CoCr constructs with an interconnected open-pore architecture prepared by electron beam melting. Acta Biomaterialia, 2016. 36: p. 296-309. Bacillus Thuringiensis: Distribution and Habitat Bacillus Thuringiensis: Distribution and Habitat LITERATURE REVIEW For several decades since its discovery, formulations of Bacillus thuringiensis (B. t.) have been seen as the ideal means of controlling Lepidoteran pests in agriculture because of the many attributes that differentiate this microbial insecticide from the synthetic chemical formulations. No toxicity to mammals, environmental friendliness, apparent immunity to the pesticide resistance phenomenon (no longer true), good integration with other pest control methods and the possibility of being mass produced at farm level at low cost, all made B. thuringiensis the much-needed tool for IPM programmes in developing countries. Research of almost 85 years reveals that Bacillus spp., especially B. thuringiensis and Bacillus sphaericus are the most potent biopesticides (Boucias Pendland, 1998). B. thuringiensis is a species of bacteria that has insecticidal properties that affects a specific range of insect orders. There are at least 34 subspecies of  B. thuringiensis (also called serotypes o r varieties) and possibly over 800 strain isolates (Swadener, 1994). B. thuringiensis accounts for about 5-8% of Bacillus spp. population in the environment (Hastowo et al., 1992). Till date more than 130 species of lepidopteran, dipteran and coleopteran insects are found to be controlled by  B. thuringiensis (Dean, 1984). Historical Background of B. thuringiensis B. thuringiensis are interesting and important bacteria used in the biological control of insect pest which form toxic crystal proteins at the time of sporulation. Perhaps the most well known and widely used biopesticide comes from B. thuringiensis, a bacterium that produces insecticidal proteins during its sporulation. This common soil bacterium, most abundantly found in grain dust from soil and other grain storage facilities, was discovered first in Japan in 1901 by Ishawata and then in 1911 in Germany by Berliner (Baum et al., 1999). It was subsequently found that thousands of strains of B. thuringiensis exist (Lereclus, 1993). The bacterium was isolated from diseased larvae of Anagasta kuehniella, and this finding led to the establishment of B. thuringiensis as microbial insecticide. The first record of its application to control insects was in Hungary at the end of 1920, and in Yugoslavia at the beginning of 1930s, it was applied to control the European corn borer (Lords, 2005). Sporine which was the first commercial product of B. thuringiensis was available in 1938 in France (Waiser, 1986) for the control of flour moth (Jacobs, 1951). Unfortunately, the product was used only for a very short time, due to World War II (Nester et al., 2002). Formation of transgenic plant was also observed. The first reports of insertion of genes encoding for B. thuringiensis delta-endotoxins into plants came in 1987 and the first transgenic plants to express B. thuringiensis toxins were tobacco and tomato plants (van Frankenhuyzen, 1993). In 1957 pacific yeast products commercialized the first strain on B. thuringiensis, named as Thuricide due to the increasing concern of biopesticide over the use of chemical insecticides. B. thuringiensis is a gram-positive spore-forming bacterium that produces crystalline proteins called deltaendotoxins during its stationary phase of growth (Schnepf et al., 1998). The crystal is released to the environment after analysis of the cell wall at the end of sporulation, and it can account for 20 to 30% of the dry weight of the sporulated cells (Schnepf et al., 1998) Distribution Habitat of B. thuringiensis This bacterium is distributed worldwide (Martin Travers, 1989). The soil has been described as its main habitat; however it has also been isolated from foliage, water, storage grains, and dead insects, etc (Iriarte Caballero, 2001). Isolation of strains from dead insects has been the main source for commercially used varieties, which include kurstaki, isolated from A. kuehniella; israelensis, isolated from mosquitoes, and tenebrionis, isolated from Tenebrio monitor larvae (Ninfa Rosas, 2009; Iriarte Caballero, 2001).. The spores of B. thuringiensis persist in soil, and vegetative growth occurs when nutrients are available (DeLucca et al., 1981; Akiba, 1986; Ohba Aizawa, 1986; Travers et al., 1987; Martin Travers, 1989). DeLucca et al., (1981) found that B. thuringiensis represented between 0.5% and 0.005% of all Bacillus species isolated from soil samples in the USA. Martin Travers (1989) recovered B. thuringiensis from soils globally. Meadows (1993) isolated B. thuringiensis from 785 of 1115 soil samples, and the percentage of samples that contained  B. thuringiensis ranged from 56% in New Zealand to 94% in samples from Asia and central and southern Africa. Ohba Aizawa (1986) isolated B. thuringiensis from 136 out of 189 soil samples in Japan. There are several theories on the ecological niche filled by B. thuringiensis. Unlike most insect pathogenic microbes, B. thuringiensis generally recycle poorly and rarely cause natural epizootics in insects, leading to speculation that B. thuringiensis is essentially a soil micro-organism that possesses incidental insecticidal activity (Martin Travers 1989). Evidence to support this view is that B. thuringiensis are commonly reported in the environment independent of insects and there is a lack of association between occurrence and insect activity (van Frankenhuyzen 1993). Meadows (1993) suggested four possible explanations for the presence of B. thuringiensis in soil: 1) rarely grows in soil but is deposited there by insects; 2) may be infective to soil-dwelling insects (as yet undiscovered); 3) may grow in soil when nutrients are available; and 4) an affinity with B. cereus. B. thuringiensis has been found extensively in the phylloplane. Numerous  B. thuringiensis subspecies have been recovered from coniferous trees, deciduous trees and vegetables, as well as from other herbs (Smith Couche, 1991; Damgaard et al., 1997). B. thuringiensis deposited on the upper side of leaves (exposed to the sun) may remain effective for only 1-2 days, but B. thuringiensis on the underside of leaves (i.e. protected from the sun) may remain active for 7-10 days (Swadner, 1994). B. thuringiensis kurstaki has been recovered from rivers and public water distribution systems after an aerial application of Thuricide 16B (Ohana, 1987). Crystal Composition and Morphology The existence of parasporal inclusions in B. thuringiensis was first noted in 1915 (Berliner, 1915), but their protein composition was not delineated until the 1950s (Angus, 1954). Hannay (1953) detected the crystalline fine structure that is a property of most of the parasporal inclusions. B. thuringiensis subspecies can synthesize more than one inclusion, which may contain different ICPs (Hannay, 1953). Depending on their ICP composition, the crystals have various forms (bipyramidal, cuboidal, flat rhomboid, or a composite with two or more crystal types) (Bulla et al., 1977; Hà ¶fte Whiteley, 1989). A partial correlation between crystal morphology, ICP composition, and bioactivity against target insects has been established (Bulla et al., 1977; Hà ¶fte Whiteley, 1989; Lynch Baumann, 1985). Classification of B. thuringiensis subspecies The classification of B. thuringiensis subspecies based on the serological analysis of the flagella (H) antigens was introduced in the early 1960s (de Barjac Bonnefoi, 1962). This classification by serotype has been supplemented by morphological and biochemical criteria (de Barjac, 1981). Until 1977, only 13 B. thuringiensis subspecies had been described, and at that time all subspecies were toxic to Lepidopteran larvae only. The discovery of other subspecies toxic to Diptera (Goldberg Margalit, 1977) and Coleoptera (Krieg et al., 1983) enlarged the host range and markedly increased the number of subspecies. Up to the end of 1998, over 67 subspecies based on flagellar H-serovars had been identified. Genetics of ICP In the early 1980s, it was established that most genes coding for the ICPs reside on large transmissible plasmids, of which most are readily exchanged between strains by conjugation (Gonzà ¡lez Carlton, 1980; Gonzà ¡lez et al., 1981). Since these initial studies, numerous ICP genes have been cloned, sequenced and used to construct  B. thuringiensis strains with novel insecticidal spectra (Hà ¶fte Whiteley, 1989). The currently known crystal (cry) gene types encode ICPs that are specific to either Lepidoptera (cryI), Diptera and Lepidoptera (cryII), Coleoptera (cryIII), Diptera (cryIV), or Coleoptera and Lepidoptera (cryV) (Hà ¶fte Whiteley, 1989). All ICPs described to date attack the insect gut upon ingestion. To date, each of the proteolytically activated ICP molecules with insecticidal activity has a variable C-terminal domain, which is responsible for receptrecognition (host susceptibility), and a conserved  N-terminal domain, which induces pore formation (toxicity) (Li et al., 1991). Most naturally occurring B. thuringiensis strains contain ICPs active against a single order of insects. However, conjugative transfer between B. thuringiensis strains or related species can occur, resulting in new strains with various plasmid contents (Gonzà ¡lez Carlton, 1980). Thus the mobility of the cry genes and the exchange of plasmids may explain the diverse and complex activity spectra observed in B. thuringiensis (Gonzà ¡lez Carlton, 1980; Gonzà ¡lez et al., 1981; Gonzà ¡lez et al., 1982; Reddy et al., 1987; Jarrett Stephenson, 1990). New B. thuringiensis strains have been developed by conjugation that is toxic to two insect orders. Nutritional status of B. thuringiensis Since sporulation and germination in bacilli are dependent on the nutritional status of the organism (Hardwick Foster, 1952), a study of the nutritional requirement of  B. thuringiensis var. thuringiensis is important for delineating the control mechanisms which regulate spore and parasporal crystal formation. Certain amino acids support growth, sporulation and crystal formation of B. thuringiensis var. thuringiensis, while others inhibit the growth (Singer et al., 1966; Singer Rogoff, 1968; Bulla et al., 1975; Nickerson Bulla, 1975; Rajalakshmi Shethna, 1977). A lower concentration of cystine (Nickerson Bulla, 1975) or cysteine (Rajalakshmi Shethna, 1977) promotes growth, sporulation and crystal formation in Î’. thuringiensis, while at a higher concentration of cys/cysSH, only the vegetative growth was observed, (Rajalakshmi Shethna, 1977). Classification of B. thuringiensis The classification of B. thuringiensis subspecies based on the serological analysis of the flagella (H) antigens was introduced in the early 1960s (de Barjac Bonnefoi, 1962). This classification by serotype has been supplemented by morphological and biochemical criteria (de Barjac, 1981). Many strains of B. thuringiensis have been isolated and classified within more than 20 different varieties by serological techniques. On the basis of their potency for insect these varieties have been grouped into five pathotypes: Lepidopteran-Specific (e.g. B. thuringiensis .var Kurstaki) Dipteran-Specific (e.g. B. thuringiensis . var israelensis) Coleopteran-Specific (e.g. B. thuringiensis .var. tenebrionis) Those active against Lepidoptera and Dipter(e.g. B. thuringiensis . var. aizawai) Those with no toxicity recorded in insects (e.g. B. thuringiensis . var. Dakota) Mode of Action The ICP structure and function have been reviewed in detail by Schnepf et al., (1998). Binding of the ICP to putative receptors is a major determinant of ICP specificity and the formation of pores in the midgut epithelial cells is a major mechanism of toxicity (Van Frankenhuyzen, 1993). After ingestion of B. thuringiensis by insect the crystal is dissolved in the insects alkaline gut. Then the digestive enzymes that are present in insects body break down the crystal structure and activate B. thuringiensiss insecticidal component, called the delta-endotoxin (Swadner, 1994). The delta-endotoxin binds to the cells lining the midgut membrane and creates pores in the membrane, upsetting the guts ion balance. The insect soon stops feeding and starves to death (Gill et al., 1992). Target Organisms In the past decades, B. thuringiensis Cry toxins were classified according to the target pest they attacked (Hofte Whiteley, 1998); however, due to the dual toxic activity exhibited by some cry genes and the inconsistencies in the original classification proposed by Hà ¶fte and Whiteley(1998), Crickmore et al., (1998) proposed a revision of the nomenclature for insecticidal crystal proteins, based on the ability of a crystal protein to exhibit some experimentally verifiable toxic effect in a target organism (Crickmore et al., 1998; Hà ¶fte Whiteley, 1998). The diversity of B. thuringiensis is demonstrated in the almost 70 serotypes and the 92 subspecies described to date (Galan-Wong et al., 2006). It is well known that many insects are susceptible to the toxic activity of  B. thuringiensis; among them, lepidopterans have been exceptionally well studied, and many toxins have shown activity against them (Jarret Stephens., 1990; Sefinejad et al., 2008). Order Lepidoptera encompasses the majority of susceptible species belonging to agriculturally important families such as Cossidae, Gelechiidae, Lymantriidae, Noctuidae, Pieridae, Pyralidae, Thaumetopoetidae, Tortricidae, and Yponomeutidae (Iriarte Caballero, 2001). General patterns of use: Commercial applications of B. thuringiensis have been directed mainly against lepidopteran pests of agricultural and forest crops; however, in recent years strains active against coleopteran pests have also been marketed (Tomlin, 1997). Strains of B. thuringiensis kurstaki active against dipteran vectors of parasitic disease organisms have been used in public health programmes (Tomlin, 1997). Applications in agriculture and forestry Commercial use of B. thuringiensis on agricultural and forest crops dates back nearly  30 years, when it became available in France (Van Frankenhuyzen, 1993). Use of  B. thuringiensis has increased greatly in recent years and the number of companies with a commercial interest in B. thuringiensis products has increased from four in 1980 to at least 18 (Van Frankenhuyzen, 1993). Several commercial B. thuringiensis products with B. thuringiensis aizawai, B. thuringiensis kuehniella or B. thuringiensis tenebrionise have been applied to crops using conventional spraying technology. Various formulations have been used on major crops such as cotton, maize, soybeans, potatoes, tomatoes, various crop trees and stored grains. Formulations have ranged from ultralow-volume oil to high-volume, wettable powder and aqueous suspensions (Tomlin, 1997). In the main, naturally occurring B. thuringiensis strains have been used, but transgenic microorganisms expressing B. thuringiensis toxins have been developed by conjugation and by genetic manipulation, and in some cases, these have reached the commercial market (Carlton et al., 1990). These modified organisms have been developed in order to increase host range, prolong field activity or improve delivery of toxins to target organisms. For example, the coleopteran-active cryIIIA gene has been transferred to a lepidopteran-active B. thuringiensis kuehniella (Carlton et al., 1 990). A plasmid bearing an ICP gene has been transferred from B. thuringiensis to a non-pathogenic leaf-colonizing isolate of Pseudomonas fluorescens; fixation of the transgenic cells produces ICP contained within a membrane which prolongs persistence (Gelernter, 1990). Applications in vector control B. thuringiensis Kurstaki has been used to control both mosquitos and blackflies in large-scale programmes (Lacey et al., 1982; Chilcott et al., 1983; Car, 1984; Car de Moor, 1984; Cibulsky Fusco, 1987; Becker Margalit, 1993; Bernhard Utz, 1993). For example, in Germany 23 tonnes of B. thuringiensis Kurstaki wettable powder and 19 000 litres of liquid concentrate were used to control mosquitos (Anopheles and Culex species) between 1981 and 1991 in the Upper Rhine Valley (Becker Margalit, 1993). In China, approximately 10 tonnes of B. thuringiensis Kurstaki have been used in recent years to control the malarial vector, Anopheles sinensis. Resistance of Insect Populations A number of insect populations of several different species with different levels of resistance to B. thuringiensis have been obtained by laboratory selection experiments during the last 15 years (Schnepf et al., 1998). The species include Plodia interpunctella, Cadra cautella, Leptinotarsa decemlineata, Chrysomela scripta, Tricholplusia ni, Spodoptera littoralis, Spodoptera exigua, Heliothis virescens, Ostrinia nubilalis and Culex quinquefasciatus (Schnepf et al., 1998). The Indian meal moth, a pest of grain storage areas, was the first insect to develop resistance to B. thuringiensis. Kurstaki (Swadner, 1994). Resistance progresses more quickly in laboratory experiments than under field conditions due to higher selection pressure in the laboratory (Tabashnik, 1991). No indications of insect resistance to B .thuringiensis were observed in the field, until the development of resistance was ob-served in the diamondback moth in crops where B. thuringiensis had been used repeatedly. Since then, resistance has been observed in the laboratory in the tobacco budworm, the Colorado potato beetle and other insect species (McGaughey, 1992) B. thuringiensiss Ecological Impacts Some of the most serious concerns about widespread use of B. thuringiensis as a pest control technique come from the effects it can have on animals other than the pest targeted for control. All B. thuringiensis products can kill organisms other than their intended targets. In turn, the animals that depend on these organisms for food are also impacted (Swadner, 1994). Effect on Beneficial insects: Many insects are not pests, and any pest management technique needs to be especially concerned about those that are called beneficials, the insects that feed or prey on pest species (Swadner, 1994). B. thuringiensis has impacts on a number of beneficial species. For example, studies of a wasp that is a parasite of the meal moth (Plodia interpunctella) found that treatment with B. thuringiensis reduced the number of eggs produced by the parasitic wasp, and the percentage of those eggs that hatched (Salama, 1993). Production and hatchability of eggs of a predatory bug were also decreased (Salama, 1991). Other insects: Many insects that do not have as directly beneficial importance to agriculture are important in the function and structure of ecosystems. A variety of studies have shown that B. thuringiensis applications can disturb insect communities (Swadner, 1994). Research following large-scale B. thuringiensis applications to kill gypsy moth larvae in Lane County, Oregon, found that the number of oak-feeding caterpillar species was reduced for three years following spraying, and the number of caterpillars was reduced for two years (Miller, 1990). Birds: Because many birds feed on the caterpillars and other insects affected by B. thuringiensis applications, it is not surprising that impacts of B. thuringiensis spraying on birds have been documented (Swadner, 1994). In New Hampshire, when B. thuringiensis-treatment reduced caterpillar abundance, black-throated blue warblers made fewer nesting attempts and also brought fewer caterpillars to their nestlings (Rodenhouse, 1992). Effects on Humans Eight human volunteers ingested 1 gram of a B. thuringiensis kuehniella formulation  (3 ÃÆ'- 109 spores/g of powder) daily for 5 days. Of the eight volunteers, five also inhaled 100 mg of the B. thuringiensis kuehniella powder daily for five days. Comprehensive medical examinations immediately before, after, and 4 to 5 weeks later failed to demonstrate any adverse health effects, and all the blood chemistry and urinalysis tests were negative (Fisher Rosner, 1959). Pivovarov et al., (1977) reported that ingestion of foods contaminated with  B. thuringiensis gastroenteitis at concentrations of 105 to 109 cells/g caused nausea, vomiting, diarrhoea and tenesmus, colic-like pains in the abdomen, and fever in three of the four volunteers studied. The toxicity of the B. thuringiensis gastroenteritis strain may have been due to beta-exotoxin (Ray, 1990). In a purified form, some of the proteins produced by B. thuringiensis are acutely toxic to mammals. However, in their natural form, acute toxicity of commonly-used  B. thuringiensis varieties is limited to caterpillars, mosquito larvae, and beetle larvae (Swadner, 1994). Special Concerns about B. thuringiensis Toxicity The earliest tests done regarding B. thuringiensiss toxicity were conducted using B. thuringiensis var. thuringiensis, a B. thuringiensis strain known to contain a second toxin called beta-exotoxin (Swadner, 1994). The beta-exotoxin is toxic to vertebrates, with an LD 50 (median lethal dose; the dose that kills 50 percent of a population of test animals) of 13-18 milligrams per kilogram of body weight (mg/kg) in mice when injected into the abdomen. An oral dose of 200 mg/kg per day killed mice after eight days (swadner, 1994) Beta-exotoxin also causes genetic damage to human blood cells (Meretoja, 1977).