Reaction to Hills Like White Elephants

Throughout this school year, we analyzed and discussed several awesome poems, novels and stories. One that I particularly liked would have to be â€Å"Hill Like White Elephants† by Ernest Hemingway. The first thing about it that caught my attention would have to be its title, â€Å"Hills like White Elephants'. To be honest, I really thought that it'll be about some elephants in Africa or something but I was wrong. There were no elephants! The story is about an American man and woman having some beers as they wait for the train to Barcelona. So, just through the title, I guess you could say that this is an ambiguous text. To decipher it, you need to read it again and again! The text of Hemingway appears to be simple but then again his works are ambiguous, so his text may be further from the truth. The story makes use of sparse dialogue some even say that the way Hemingway's characters speak is sometimes more important than what they say so when reading his text you really have to take in the dialogue and decode it. At first, when I just went through the story, I really didn't get what the couple were talking about and then after several readings I found out that it was about abortion. It's really beautiful how Hemingway could subtly bring about a message without even having it written directly. The powerful writing of Hemingway definitely has made a huge impact in me. Aside from me discovering a beautiful story, I learned not to take everything too literally and to have patience in order to understand.

Realtionship Between the Media, Public Perceptions of Crime and Police Essay

Does the media and the amount of exposure to specific news media affect fear of crime? This question is examined in a survey with data collected from three universities in the United States and one in Canada; The Impact of Media on Fear of Crime among University Students: A Cross-National Comparison, goes over the results. It’s believed that fear in itself can be debilitating leading to harmful social outcomes. Vincent Sacco believes there are three dimensions to fear of crime: cognitive, emotional and behavioral. Cognitive looks at a how a person assesses their likelihood of being victimized. Emotional is how someone feels about crime, and behavioral is a person’s response to fear of their perceived likelihood of being victimized. However, in 2011, it was argued â€Å"that fear of crime ought to be conceptualized by distinguishing between generalized anxieties and more concrete episodes of fear, as well as by differentiating effects of everyday worries and anxieties† (Kohm, Waid-Lindberg, Weinrath & Shelley, 2012). This theory â€Å"is thought allow for better understanding of how people are motivated to protect themselves† (Kohm, Waid-Lindberg, Weinrath & Shelley, 2012). Despite a decrease in crime rates, citizens of both the United States and Canada still have a high fear of being victimized. One theory suggests that increased fear is a direct result of an individual’s perception of the risk to being a victim. This can occur because of one’s past victimizations or through media exposure of crime also known as indirect victimization. Individuals learn of local crime, national crime and even world-wide crime events through media sources: TV, newspapers, and internet. In 2007, the United Nations Crime Victims Survey (ICVS) showed that the United States reported the second lowest level (16%) of fear of being victims of a burglary compared to Canada who reported higher levels (25%) of fear, even though crimes rates had declined since 1989. Secondhand information (news sources) raises fear and beliefs that victimization is likely, in turn individuals become indirect victims through their fear. The cultivation theory suggests that when violent crimes stories increase so does the fear of crime. Similar to the cultivation theory, the substitution perspective states that individuals with no history of victimization will have increased fear of crime with crime related stories. The resonance perspective is just the opposite. It states that the media increases fear when the content is similar to one’s experiences. These three theories are derived from the indirect victimization model. Most individuals receive crime information from television news reports, where stories on crime are reported twice as often as political news stories. Stories involving multiple victims, use of firearms, as well as certain other crime characteristics is more newsworthy than others. The survey done on Canadian and United States university students showed that local news affected individual’s fears more than world news. Also television news reports affected fear more than other news sources such as newspapers or the internet where people can select which stories they want to read. The nature of a criminal offence and the community context in which the crime occurs determines how a story is reported. An example being, â€Å"smaller suburban and rural areas are more likely to report all homicides while large urban areas may be more selective† (Kohm, Waid-Lindberg, Weinrath & Shelley, 2012). The article states that fear if crime is directly related to demographics factors which include: gender, age, race/ethnicity, and situational factors including any previous victimization, one’s perception of their risk of being victimized, and concerns about local crime. Even though males experience higher levels of being victimized, women tend to fear crime more because they feel they are able to defend themselves against a physical attack. One study reported that Elderly are more fearful where as another study shows younger individuals are more fearful. Therefore, age as a predictor for fear of crime is inconsistent. The following universities were given a self-administered survey as part of the current study this article was based on: Colorado State University (CSU), University of Texas at Arlington (UTA), and Florida State University (FSU) and one Canadian, University of Winnipeg (UW). The campuses of UTA, FSU and UW are located in higher crime urban areas. In Florida and Texas, violent and property crime rates are higher than the national average. Winnipeg’s violent and property crimes rates are also higher than the rest of Canada’s crimes levels. Criminal Justice or Criminology majors reported a lower fear of crime compared to other majors or students who were yet undecided. The survey also showed that there was a similar rate of concern between both nations; reporting on a scale of 1-10 the average was seven, clearly showing a somewhat high concern for crime. In summary, the findings for the survey are as follows: women, whites, non-criminal justice/criminology majors reported aving more fear of crime. A general concern about crime was relatively the same between the American and Canadian students though Canadians had higher rate of fear for risk of violent victimization and Americans had a higher rate for property victimization. The media plays a substantial role in determining the amount of fear of crime that people hold. This comes from the fact that the media extensively and disproportionately cover crime stories. But how does this affect the public’s perception of law enforcement? The answer to this question is simple. The media leads people to believe that there is more crime than there actually is. Therefore, the media also plays a role in forming expectations of police. When people think that crime has increased, they more than likely will believe that the police are not doing their jobs. The problem is, is that the media has created a false image of law enforcement. According to Ronald D. Hunter and Thomas Barker (2011), â€Å"the police officers of Hollywood lore are fictional images of stereotypes that have been exaggerated to provide entertainment to a bored public† (p. 41). A few examples of entertainment media that depict these false pictures of police are: CSI, NCIS, Law and Order, Criminal Minds, and NYPD Blue. Each and every one of these portray the characters as super-cops that can perform more than just the standard jobs of real life police officers. For example, in CSI the multitude of character can perform investigative tasks as well as tasks involving forensic science. The characters of these shows solve challenging cases using their superior intelligence and expertise. Almost always, the characters solve their case in single day maybe two days. People tend to believe that these fictional images and stereotypes are true and base their perceptions of real life police off these. Aside from entertainment media, the public is also greatly influenced by news media, as previously seen above. According to Hunter and Barker (2011), Depicting the police negatively as misusing deadly force, police prejudice, or police corruption is also newsworthy. The amount of emphasis given to police actions and the media’s interpretation of these actions as either proper or improper have a tremendous effect on the public’s perception of the police. p. 41) Police agencies across the United States; deal with accusations of misuse of force on a daily basis. Justified or not, images of police using force continue to outrage the American public. However, police use of force incidents are often misinterpreted by the community due to the media frenzy twisting facts. The media undermines the authority of the police and reduces the trust that the public has in its police. What is observed in the media is largely carried out to represent police as a whole. In other words, the media magnifies situations and creates an exaggerated perspective that viewers assume is a standard of all police and police organizations as well as crime. Among the different types of stories in the media, negative stories attract a larger audience. What a person reads, hears, and observes in the media largely defines the person’s perception of the police. Whether we recognize the effects of the media or not, our perceptions of this world are heavily influenced by the information we receive from the media. The media constantly surrounds us, frequently informs us, and just as frequently misinforms us. The influence of the media is significant since media could be identified as a primary source in influencing people’s perceptions of crime and their perceptions of police. Besides the significant effect on fear of crime, the media has influenced the public’s attitudes toward police at the same time. News media may be the primary source for the public viewing the police as ineffective and incompetent. Studies have highlighted the powerful influence of media’s news coverage, there are solid justifications for us to examine the links between fear of crime and how crime news coverage influences the public’s attitudes toward police efficiency.

Week 4 Essay Example | Topics and Well Written Essays - 250 words - 2

Week 4 - Essay Example Pacific Asia and China have embraced trade and industry systems that work for them and guarantee them strong economic growth, while some nations in East Europe such as Russia and Africa, have rather failed to embrace ideal commerce strategies, for most of their economies are yet to register substantial growth. In the process of using the available means to yield goods and services, both the private and public industries within America have to deal with both the product and the resource markets. The product market is majorly classified into four categories, which includes the competitive segment, as well as those sectors that exhibit monopoly, oligopoly and monopolistic competition. Similarly, the resource market is classified into labor, capital and land. Presently, the labor market is experiencing decline in unionization and government intervention. The capital market also comprises of financial intermediaries like banks, with the public sector accounting for 20% of the economy. Labor unionization in America has registered significant decline over the last fifty years with the percentage declining from 35% in the 1950s to 11.3% in 2012. The implementation of unfriendly labor laws is one of the reasons for the decline in labor unionization, for legislations such as the Taft-Harley Act of 1947 and the Right-to-Work law, which has been implemented in over 20 States have made it difficult for unions to perform their duties freely. Another reason for the decline is the process of establishing unions, as the duration between petitioning the National Labor Relations Board and the union election is always long, and allows employers to campaign against formation of

Are Science and Religion in Conflict Research Paper - 1

Are Science and Religion in Conflict - Research Paper Example Many are the times when religion has various inconsistencies with science. While some people are alight with religion, some do not find this route appealing. As a matter of fact, there have been various debates that try to bring religion and science together. Many parties have come up with strong points that are aimed to settle the differences (Draper, 2010). However, not a single party is willing to water down their stand. As such, they have been in constant opposition as to which has a legitimate stand. Consequentially, some people are torn in between as they come to terms with issues raised by both sides of the divide. Most people only focus on the positive attributes of the two sides. As such, they do not have a concrete decision to fully settle for either religion or science. For these reasons, this paper answers the question as to whether there is a conflict between religion and science. Religion is based on religious practices and beliefs which are taught in defined settings a nd contained in various literature. Religious norms state that their followers have to uphold utmost faith in their beliefs. As such, they are to follow religious teachings and values at all times. One of the most outstanding issues in religion is that God is the creator of everything. Since He is the supreme creator, human beings have no legitimacy to compare themselves to the Supreme Being. In this case, humans have no reason to compare themselves to the Almighty through His mysterious ways (Radcliffe, 2012). The point is that religious fraternities are not in agreement with scientific innovations with scientists trying to compare their creations with those of the Almighty. The most outstanding example in this case is cloning. Science has made it possible for humans to create other humans through cloning, which is a scientific way of breeding humans through science. This is unacceptable to many religions as followers consider this to be mimicking their Creator. As a matter of fact , they consider the Almighty as a steadfast priority and should not be compared to anything else that exists or ever existed (Draper, 2010). For a human being to glorify cloning is ridicule to God as stated by the religious fraternities. Therefore, according to religious groups, the numerous scientific innovations are ill advised and should not try to compare their innovations with God’s creations. This has been a heated point of argument as scientists advance on their innovation in total disregard of the sentiments from the religious people. On the other hand, scientists state that there is no point of concern with their innovations in regard to cloning. In fact, some scientists state that the Almighty gave humans the brain as well as the right to fill the earth. As such, they are enhancing the Almighty’s task to multiply the human population and fill the earth. Since this is a strong point, scientists feel that they have an obligation to increase the human population in an easier and scientific way. Consequentially, religious fraternities state that this is not the intended approach to multiplication of the human kind. They state that the Almighty intended for the natural way of multiplying human beings. As such, these religious fraternities are totally against cloning of human beings. This creates a serious drift between the two parties as each tries to justify their opinions and approaches (Bury, 2010). Since they all have their supporting points and references, they seem to be in conflict. Apparently, this conflict seems to intensify with each development and cannot be solved on a round table agreement. Conflict arises between religion and science especially when there is such a profound contention. As a matter of fact, religious groups have one thing in common, which is their beliefs and faith in a superior being (Dennett & Plantinga, 2010). Therefore, all the people that interact with the religious groups will have to assert their beliefs

Lau v. Nichols Essay Example | Topics and Well Written Essays - 1250 words

Lau v. Nichols - Essay Example The situation was then addressed in Lau v. Nichols, which was instituted in 1974 as a remedy, but the decision did not specify a teaching method, and the approach could be "bilingual instruction, English as a second language (ESL) classes or some other approach" (Crawford, para. 1). This broad interpretation has caused a great deal of controversy over the years. Lau was intended to give limited-English-proficient students (LEP) the opportunity to gain the proficiency they needed, but, unfortunately, according to Crawford, a symposium held twenty years after Lau indicates there has been little improvement in the effort to create equity for LEP students. Without one specific method of teaching LEP students, the effort becomes lost, with well-designed programs staffed by qualified teachers available to only a fraction of LEP students. The term "bilingual education" has come to mean a "range of instructional programs for children whose native language is not English," while the best way to accommodate such children has been and continues to be an area of debate. As noted in a research project by the Westchester Institute in New York, the debate centers on the "role of native language in instruction-whether it should be used and for how long" (Westchester, para. 3). Supporters of native language instruction recommend aggressive development of the primary language prior to introduction of English, while proponents of all-English instruction feel that the English curriculum should be introduced at the very beginning of the student's school experience with minimal use of the native language (Westchester). English Immersion in California Public Schools If the use of bilingual education actually meant learning two languages equally well, it might be a feasible program for all students, not just LEP students. Unfortunately, the concept has not been incorporated in public schools, and according to Ron Unz, advocate of English-only instruction, what is called bilingual education actually consists of mostly Spanish language instructions with little English incorporated into teaching. Since over half of America's LED students were born in the United States with most of the remainder coming here at a young age, the argument that older students have a more difficult time learning English covers only a small percentage of LED students (Sailer). Comparing the English immersion program with the bilingual program, English-only instruction would appear to be more successful, not because it is necessarily a better program but because the bilingual method is not being well utilized. Respected author Maxine Hong Kingston was born in California and in her biographical novel Woman Warrior: Memoirs of a Girlhood Among Ghosts, she recognizes the language and cultural barriers she faced during her childhood. She attended both public school and Chinese school, and her family mostly consisted of Chinese immigrants, who labeled anyone not Chinese as "ghosts." The idea of a bilingual education at that time did not exist, and Kingston had to learn English in order to communicate with English-speaking students, teachers, and business people. Even so, for her, the cultural barriers were far more difficult to overcome. Propositions 227 and 203 Proposition 227, passed in 1998,

Barclays CoCo Essay Example | Topics and Well Written Essays - 750 words

Barclays CoCo - Essay Example instrument, debt is reduced, and it qualifies as a Tier 1 capital increasing the book value of the bank’s equity capital before the occurrence of the trigger event. When a CoCo triggers, there are two things involved; the losses involved are absorbed by the CoCo either by suffering a principal write-down or by transforming into common equity. In the case of principal write-down, the bonds are written down to equity that matches the extent of liabilities released thus generating exceptional gains that are allocated to the bank’s retained earnings (Stefan, Anastasia & Bilyana, 2013). In cases where the CoCo is convertible, when a trigger is met, the bond automatically converts to common stock as a prearranged percentage. As the CoCo bond market unceasingly grows, investors are exposed to various risks and rewards. One of the appalling risks faced by investors in CoCos is the systematic risk. The CoCos market is vulnerable. A conversion or coupon deferral may soon occur causing a fall in price upto 9% and a significant drop in conversion circa -15%. This could put CoCo holders in a worst/unfortunate position than shareholders (Stefan, Anastasia & Bilyana, 2013). Moreover, there exists information asymmetry in the CoCos market where investors have little knowledge regarding the operation of the CoCos while the issuers are fully aware of their credit fundamentals. For instance, the PONV (point of non-viability) as a language has been hard for many investors to comprehend thus upsurging the risks of them losing their cash by investing in unfeasible CoCos. According to Stefan, Anastasia and Bilyana (2013), this coupled with the complexity of CoCos, and the flawed CoCo rating methodologies presents a majo r risk to investors and might lead to unfathomable losses. Nevertheless, CoCos are rewarding as they provide a high yield of 4.5%-10% that is better than the average yield of circa 4.2% for high yield sectors in the U.K (Chorafas,  2015). These high returns continue

Saudi Arabia Essay Example | Topics and Well Written Essays - 1500 words

Saudi Arabia - Essay Example The Ministry of Fish Resources is now in charge of all fishing enterprises in territorial waters. This organization tracks the status of the various fisheries and conducts studies designed to improve the status of all fisheries under their scope of responsibility. With this supervision, several restrictions and controls have been implemented, which have had the effect of developing fishing seasons and identifying the various types of shrimp and other marketable fish such as Alenagel. Thanks to the modern media, the benefits of modern fishing have been demonstrated to traditional fishermen in Saudi Arabia. With the increasing demand, Khalifa Algosaibi helped establish the kingdom’s first modern fishing company in Dammam, Saudi Arabia. The company introduced modern fishing boats and founded a facility for the manufacturing and storage of fish and fish products. With this introduction, the kingdom witnessed a leap in their economy, marking the foundation of this company as a turn ing point in the country’s efforts to diversify from its main export – oil. This shift caused a change in the pattern of domestic consumption as well as an increased demand for fish from both the local population and those individuals who have been recruited to work in Saudi Arabia. The primary means for catching fish in both the Gulf and the Red Sea are now benthic trawls and Shanchola nets. The primary seafood caught in the Gulf regions are Kofi shrimp, Gulf shrimp, bathroom fish, Alhamur, Alkanad, and others.

Identify a corporate situation that could disturb you as a manager Essay - 1

Identify a corporate situation that could disturb you as a manager. Evaluate the situation and use marketing research methodolo - Essay Example , What attitudes do these buyers hold towards MAC products?, How does in-store experience affect these women’s experiences of the make-up purchase process at MAC stores?, What strategies do these women use to cope with a gap in the cosmetics markets, if any?. The paper involved 105 participants from 15 different MAC stores who were all black and representative of different complexions. They responded to structured questionnaires containing 15 questions, which were documented by the investigator. The research hypothesis was proved. MAC does not cater to black women’s divergent needs. Key recommendations include expanding the product range to meet their needs, training in-store makeup artists and assistants as well as creating marketing plans that target this demographic group. Outline Executive summary 2 Outline 2 Introduction and problem definition 4 Research methods and limitations 7 Conclusion and Recommendations 13 References 15 MAC Cosmetics and Black Female Consume rs Introduction and problem definition The company under consideration is MAC cosmetics; it is an offshoot of Estee Lauder (EL), which is a conglomerate of over 23 brands. MAC has about 1,000 stores worldwide and dozens in the UK. The brand contributed to a 13% profit margin at EL in 2012. MAC’s input was equivalent to $274.8 million worth of profit (Castleberry, 2001). It has marketed its products as high-profile, through the use of celebrity endorsements and artists. Most times, the company gets makeup artists to work with famous actors or singers, and thus uses this platform to market their products. Consumers are willing to pay a premium for the personalised service offered by makeup artists in their stores. Regardless of these successes, the company is need of new marketing strategies. It needs to expand its customer base so as to avoid slow growth (Wilson, 2011). The corporation may be making money but its profitability has not been increasing significantly over the pas t few years. It needs to redefine the way it sells its products. Any marketing process often starts with identification of the target group. Here is where the problem lies for MAC cosmetics. The organisation has relied on the same set of consumers for as long as it was established. Most of them are young and Caucasian. There may be a need to redefine their demographic groups in order to expand their market base. The group that needs to be embraced is black women. In the United Kingdom’s metropolitan areas, black women account for slightly more than 15% of the population, and represent 7% of the entire UK population (Isokariari, 2013). They are quite enthusiastic about beauty products as seen through their purchase of hair extensions, weaves and other hair products. However, a problem exists in the cosmetics industry because regardless of these women’s enthusiasm for beauty products, makeup companies do not respond in kind. MAC Cosmetics may pride itself in the diverse range of its products. Its eye shadows come in a variety of colour pallets. Additionally, it has been marketed as a product for women of colour owing to its wide range of colour selections. However, these options are still not adequate enough to cater to black women’s makeup needs. Black women have some of the most divergent skin tones in the world, yet the colour choices that dark concealers and foundations have are quite limiting

International Human Resource Management Essay Example | Topics and Well Written Essays - 500 words

International Human Resource Management - Essay Example They could perhaps implement a program that keeps the expatriates informed about the new changes that have been implemented in their organisation back home. They could also organize training sessions on the return of their employees, to facilitate easy adaptation and help them get over the shock phase. ('Repatriation', website: http://www.intercultural-training.co.uk/repatriation.asp) I believe that while Sam has been given prior training and other aids, to adapt to the existent conditions in Japan, his family will receive a culture shock. This is due to the fact the family has not received any prior orientation, apart from a self-motivated attempt at learning the local language. The company must have recognized the services of employees and provide guidance and help, in aiding them and their families settle down amidst changing scenarios. First comes the phase of adaptation, when the employee's family finds the environment new and different from the routine he has been subject to. They need to get used to the whole new setup, which could probably include a new language, culture or practices in general. This could create disillusionment and slight depression.

Security Planning and Assessment Assignment Example | Topics and Well Written Essays - 3750 words

Security Planning and Assessment - Assignment Example A very real, clear and present danger lurks just beyond the consciousness of people who work together eight to ten hours a day, five to seven days a week. It is the potential for violence to occur in workplace. Increasingly, the Human Resources function is both the target of these threats of workplace violence and the organization's first line of defense for the prevention of workplace violence. Homicide is the second leading cause of fatal occupational injury in the United States. Nearly 1,000 workers are murdered and 1.5 million are assaulted in the workplace each year. According to the Bureau of Labor Statistics (BLS) National Census of Fatal Occupational Injuries (CFOI), in additional information about workplace violence, there were 709 workplace homicides in 1998. These accounted for 12 percent of the total 6,026 fatal work injuries in the United States. Of these 709 workplace homicide victims in 1998, 80 percent were shot and nine percent were stabbed. According to the National Crime Victimization Survey (NCVS), 2 million assaults and threats of violence against Americans at work occur annually. The most common type of workplace crime was assault with an average of 1.5 million a year. There were 396,000 aggravated assaults, 51,000 rapes and sexual assaults, 84,000 robberies, and 1,000 homicides reported. These figures likely fall short of the actual number of violent acts occurring in workplaces as not all acts of workplace violence are reported. The news media tend to sensationalize acts of workplace violence that involve coworkers. In sensationalizing incidents of workplace violence, they remove the emphasis from the most important targets for workplace safety programs. In fact, the most common motive for job-related homicide is robbery, accounting for 85 percent of workplace violence deaths. The National Institute for Occupational Safety and Health (NIOSH) provides information that illustrates anyone can become the victim of a workplace assault, but th e risks are greater for workplace violence in certain industries and occupations. The taxicab industry has the highest risk, nearly 60 times the national average for potential workplace violence. A good first step for prevention in all workplaces consists of a general assessment designed to evaluate the presence of any specific risks of violence, both from within and outside the organization. Such an assessment will help the organization to fully understand the particular safety and security needs of the workplace - information that will help shape its prevention efforts. Often, forms of behavior that signaled the violence to come have preceded a violent act. If those signs had been recognized and appropriately addressed, the violence might not have happened. A prevention program will include a ''No Threats, No Violence'' policy that is clearly communicated to all employees. The policy will state the employer's commitment to provide a safe workplace, free from violence or the threat of violence. It will also set forth a code of employee conduct that clearly defines unacceptable behavior and prohibits all violence and threats on-site and during work-related off-site activities . A workplace violence program further includes an interdisciplinary team created and trained to manage any violent incidents or reports of troubling behavior made under the

The Inspector in Act 1 Essay Example for Free

The Inspector in Act 1 Essay Consider the dramatic importance of the entrance of the Inspector in Act 1 and his exit in Act 3Â  Although the inspector does not enter until a while into the play, it is clear that his presence will shock the Birling family. The play is set in a house of a reasonable middle upper class family. The familys attire is very formal and displays to the audience the familys wealth. The entrance of the inspector brings a massive amount of dramatic irony and his entrance is immensely important to the views Priestley is trying to portray in the play. Likewise his exit lulls the family into a false sense of security. A sense of security that is promptly removed from them. The play is set in 1912,however it was written in 1945. Therefore Priestley uses the power of retrospect to plant clever irony throughout the play. I believe Priestley had a didactic purpose to tell a moral story as a product of the play. The props used are that of a typical wealthy household from the early twentieth century, however Priestley gives these normal objects a lot more emphasis. Birling is an extremely pompous and arrogant character. He has strong beliefs and is clearly not easily swayed in his views. It is obvious Birling has worked hard for his wealth and is excessively proud of his status in current society. Birling also stresses this numerous times to all the characters he is involved in dialogue with right through the play, For example I was lord mayor two years ago. The audience is shown immediately that Birling is a very proud person; Priestley uses dialogue to impact this on the audience. Birling basks in his high social status and is elated at the fact that his daughter is marrying above them, another building block for Birlings oversized ego. Birling also imposes long, drawn out speeches on the audience that turn out to be completely contradicted throughout the play. Birlings assumptions are proved to be wrong and things he thought would be an unrealistic joke actually become reality. For example, I gather theres a very good chance of a knighthood, so long as we behave ourselves. A typical example of how Birling is contradicted on a large scale as the play unfolds. The play is constructed very precisely; almost everything that comes from Birlings mouth is eventually reduced to nothing. Another good example is Birlings views on war nobody wants war he claims. Whereas both Priestley and the audience are fully aware that war does occur. Bringing with it more irony and adding to Priestleys constant mockery of Birling. Previous to the inspectors entrance, the atmosphere in the Birling household is highly warm, celebratory and comfortable. The family is celebrating a successful engagement that will result in the Birlings furthering their status. Birling is feeling confident and therefore he makes some smug, pompous speeches to his family. Almost everything he says is false in retrospect. Irony is increased, as Birling gives Eric and Gerald a speech on how to live their lives, the audience are aware that Birling should definitely not preach about this subject. The dramatic impact of the doorbell is immense and plays a huge role in the play as it interrupts a typical Birling lecture, symbolising the end of Birling being Top dog.

There is nothing wrong with being ignorant as long as you are contented Essay Example for Free

There is nothing wrong with being ignorant as long as you are contented Essay b) â€Å"There is nothing wrong with being ignorant as long as you are contented† Dicuss. This discussion topic is one that is regulary debated by philosophers and people in general. Surely if we asked ourself the question – if we can live in peace and happiness why should it matter if we live in ignorance or not? Surely we would just be jepodising our happiness for the â€Å"real† truth? Then again some may argue that how can we know what happiness really is if we are actually living in ignorance, because that happiness were feeling wouldnt actually be real. Platos stand on this evident; he believes that by living in ignorance you are living far from the truth. As a philosopher Plato argues that you should always question the world that you live in, whether you are contented or not. His attitude was simple: how can you be content with something thats not possibly real? His famous teaching was the analogy of the cave. In this he taught others that there was once a cave, and in that cave lived a group of prisoners who had lived there all their lives. One day one of the prioners decided to break free and walk along the path of unknown, towards the sunlight. Plato continued this story of saying that the prisoner was finally â€Å"englightened† by the real truth, and then returned to tell his fellow prisoners of what he had learnt. This evidently shows us that Plato did in fact agree with breaking free of ignorance, as it is the whole meaning of the analogy of the cave. Plato also believed that we as humans are ignorant, in the sense that we believe the real world is the Empirical world, and that no other worlds exist. Which Plato thought was complete and utter nonsense, because there is the world of forms: the Metaphyical world. If humans didnt believe that the Metaphysical world was not the world where all perfect forms lie, then we are all in fact ignorant. Plato b melieved that we all need to open our minds to all the possibilties and not be blinded by our ignorance. We also know, due to Platos theories, that in the question where it says, â€Å"there is nothing wrong with being ignorant,† we know for a fact that Plato would disagree with this. Stating that there is nothing wrong with something, from the Empirical world, was absurd in his eyes, unless in was in the Metaphysical world where everything is in its perfect form. However, some philosophers such as Aritotle (student of Plato), believed that the Empirical world was all that there was so therefore there is no ignorance to live in because the Empirical world is the world that exists. So in a way we can say that Aristotle would agree with this statment because his attitude is that we dont live in ignorance we live in this world, and this world alone. However some may also say, Aristotle is still a philosopher, he still questions this world. So for example, if he did think that we were living in ignorance, would Aristotle say that we should be content with that or should we question what content was? If we looked at another philosopher, Hereclitus, we can see how some of her ideas and theories may actually link to an idea that would agree with this statement. Heraclitus once said â€Å"reality is unstable†, surely if reality is unstable then ignorance must be bliss? Heraclitus also said that â€Å"you can never step in the same river twice†, teaching people that reality is ever-changing and is constantly in the process of change, therefore things go out of existance. Then surely, if Heraclitus is right, who would want to live in a reality that is unstable? Wouldnt you just prefer to live in a more stable world even if it was in ignorance? At least then you knew where you stood with the world rather than exprecting the Empirical world to always change. Therefore, this shows us that there was a philosopher that disagreed with Platos words and that ignorance should be aceepted if you are content with a stable world. Although in the film â€Å"The Matrix†, aired in 1999, it has a situation in the film which would apply to this statement. In the film the Morpheus tells the main characters Neo and Cypher that they have a decision to make. Do they take the blue pill which allows them to remain in the city where they live and live in blissful ignorance, or do they take the red pill, which would lead them to escape the city and to go into the â€Å"real† world, where they would embrace the sometimes painful truth of reality? The characters choose the red pill. They risk their happy life to understand the real truth. However, we soon see that they start to regret their choice. They wish they had taken the blue pill, even if it was living in ignorance. So even though at first it shows the characters disagreeing with the statement and that all humans, when faced with the decision of knowing the truth, they accept. It turns out that ignorance won in the end. It shows that though humans do like to know the truth, the majority of us are content with our lives and would rather live day by day and see where it takes us, rather than constantly questioning what is content? What is living in ignorance? Another example that we can discuss this statement on is: animals in captivity. Animals that are born in captivity are more likely to live longer than animals living in the wild. There a vets at the ready incase one of the animals get hurt and there are no fearful preditors about. The animals are completely safe. However, some argue that an animals natural habitat is the wild and that is where they should be living. Not in a confined cage. Many say that animals get stressed and its completely un fair for them to be living under the influence of humans. But surely, if the animal was born into capivity, they wouldnt know any different? No animal would know that their natural climate was maybe in the south of Africa (essentially the wild.) Really were saying should they be living in ignorance, where they are safe to bring up their young and can live a long, good life? Or.. are we saying that reality is better? Where animals could get hunted down before they even grow to be an adult? How are the animals supposed to know whether theyre living in ignorance or reality if they dont know any different? Linking this back to the statement, for me i think in this certain situation living in ignorance would be better than living in the harsh realities of the unknown wilderness. To conclude with, I believe that those who wish to live ignorance as long as they are content with it should do so. I can completely understand where they are coming from if they live a happy life. Why would you want to change that when reality may be bleak? Even though Plato said that we are blinded by this Empirical world and that we should widen our knowledge to venture into the Metaphysical world, the â€Å"real world†, my belief is that Plato took his theories a bit too far and that maybe he was questioning a bit too much and should just accept that this world is the only and real world there is. When we hit our head, it hurts. How can this not be the real world? I believe that an ignorant world does not exist, but a ignorant state of mind does. But as long people are content with that then why should it matter? Were not living their lives so it has no influence on us.

Mycobacterium Marinum Treatment Literature Review

Mycobacterium Marinum Treatment Literature Review Abstract Background Mycobacterium marinum is an atypical mycobacterium that can be found in water environment. It is the agent of a characteristic skin disease known also as fish tank granuloma. In some occasions it can spread as a nodular lymphangitis, extend to deep structures as well as in exceptional cases disseminate systemicaly . The infection is adquired after contact with fish or contaminated water mainly from aquaria or swimming pools. Although the real incidence is understimate, it is a uncommon infection that needs high clinical suspicion to be diagnosed. As a consequence, delay in the diagnosis is common. Mycobacterium marinum is intrinsically a multidrug resistant mycobacterium.There is no clear consesus in the management of this infection. Usually it is managed either with monotherapy or with combination of antibiotics plus surgery in selected cases. Methods Retrospective study of cases of fish tank granuloma collected from 2000 to 2009 in the dermatology surgery of The Hospital of Tropical Diseases (HTD) of the University College London Hospitals. Systematic review of the literature with the terms Mycobacterium marinum and fish tank granuloma from 1999 to 2009. Results From the HTD dermatology surgery were collected 7 cases. Identification of M. marinum was possible only in 5. The response to treatment was good at least in 5 of them. In the literature review there were reported a total of 516 cases. From those 133 could be analyzed as individual cases. Identification was possible in 89.5% of the cases. Cured was reported in 82% of the cases. Conclusion The key of the diagnosis is to collect accurately the history of exposure. Histology, although no pathognomonic, will rise the suspicion if granuloma formation are found and will facilitate the differential diagnosis. Identification is done after culture with classical biochemical tests. Molecular biology techniques have the advantage of accelerate the procedure. There is not enough evidence to propose any specific treatment. Currently, recommendations are based in experts opinions. A prospective, randomized controlled clinical trial would be valuable to propose a base evident treatment. Contents Pages Introduction M. marinum is an environmental atypical mycobacterium ubiquitous in fresh, salt, and brackish water. It is known that infects temperate and tropical species of fish of at least 150 species, including ornamental fish. But also affects frogs, eels, oysters, aquatic mammals, toads and snakes [2, 11]. It cause tuberculosis-like disease in fish, its natural host [129]. The infection in fish has an average incubation period of 3 months. It affects viscera and produce anorexia with emaciation, skin defects, distension of the abdomen, being cause of sudden death [11, 12, 66]. In 1904, Alexander described for first time lesions in a cod fish that were associated with acid fast bacilli. But it was Aronson in 1926 that isolated the bacteria from tubercles of fish that died in an aquarium of Philadelphia. He described the bacilli as acid fast, chromogenic, pleomorphic and growing best at 18 º-20 ºC. Aronson suggested the name of Mycobacterium marinum [130]. M. marinum is as well the causative agent of the human disease called fish tank granuloma, also known as swimming pool granuloma or fish fancier ´s finger syndrome. In 1951 Norden and Linell reported for the first time the human disease in a swimming pool outbreak in ÃÆ'–rebro, Sweden. They described the lesions as chronic papulous ulcerations, usually located in the elbows. The pathogen was isolated from the walls of that swimming pool as well as from the lesions of the patients. They called the pathogen isolated Mycobacterium balnei [131]. It was not until 1959 when Bojalil demonstrated that M. marinum and M. balnei were in fact, the same mycobacterium [132]. M. marinum is the most frequent cause of skin infection among the environmental mycobacterium that affects humans [86, 133]. Nowadays the frequency of human infections is mainly sporadic. But in the past, outbreaks related with swimming pools were not uncommon [134]. As an example, one of the biggest epidemics was in Glenwood springs pool, Colorado in 1956 with 262 cases reported [135]. That was before chlorination became a common practice. Chlorination makes water safer. As was seen recently in Bologna, were water from swimming pools were free of M. marinum. But still could be isolated in 4.5% of the samples from the shower floor of the same [136]. The real global incidence of the disease is not know because the number of cases are underreported, due probably to the difficulties in the diagnosis [94]. It is world wide distributed but with a tendency to aggregate geographically [137]. Like in Chesapeake bay, Maryland, where there is an incidence of 4 cases per 100000 population per year [138]. Meanwhile in California was estimated in 0.27 cases per 100000 adults [139]. Or in Satowan, Micronesia, with an estimated prevalence of 10% of the population [115]. Apparently the global annual incidence remains small and stable [140]. Even though an increase number of reported cases has been noticed in The United States, going from an average of 40 cases per year in the 80s to an average of 198 cases per year in the 90s [141]. What seems clearer is that differing from other atypical mycobacteria the prevalence of M. marinum has not increased with the HIV epidemic [140]. Opposite to humans, the incidence in fish is increasing in hatchery fish, probably due to the high population density of fish. Transmission is possible fish to fish and between fish and amphibians. In addition it has been proposed transmission through eggs and through practice of feeding fish with fish carcasses [140]. There are 2 groups or clusters of M. marinum with different pathogenicity. Cluster I is characterized by producing acute disease and death in fish and also for affecting humans. On the contrary, cluster II only affects fish producing the classical chronic disease with granuloma formation [9]. This is also supported by a study done in Israel were it was seen that only certain strains of M. marinum affected humans. They also demonstrate that in Israel strains affecting humans came from ornamental fish and not from local fish for consumption [5]. The mode of transmission to humans is mainly waterborne and fish borne. Person to person transmission has not been documented [137]. However, It has been described indirect transmission via fomites in at least 3 cases. Two very small children and one infant who acquired the infection after bathing in containers that were previously used to clean the family fish tanks of tropical fish [27, 40, 142]. As other environmental mycobacterium, M. marinum has commonly low pathogenicity. For this reason in normal conditions only affects disrupted skin [8]. The main risk factor to contract the infection consists in having lesions or abrasions in the skin with exposure to non chlorinated water or marine animals infected [140]. The most frequently nowadays is the exposure to private aquaria. But some times the source of exposure is unknown. As a consequence, after the description of cases following injuries with plants, it has been suggested the possibility that could be other reservoirs different from water and fish. Although at the present moment this possibility has not been demonstrated [30, 43]. The incubation period is usually 3 to 4 weeks [135]. Following, the most common manifestation is a cutaneous lesion at the site of inoculation. It initiates as a solitary nodule or pustule that eventually evolutes to an ulcer , abscess or verrucous plaque [143]. It affects more frequently the extremities, probably because the pathogen grows better at low temperatures [144]. The severity of the disease depends, among other factors, on the number of microorganisms inoculated [134] In 20% of the cases the cutaneous lesions spread along ascending lymphatic vessels. This is called sporotrichoid spread or nodular lymphangitis [143]. As a result of direct extension invasion of deep structures as tendons, articulations and bones occurs in 29% of the cases [144]. Systemic dissemination is unusual but has been described in immunocompromised patients [140]. Spontaneous resolution , usually with scaring , has been documented from months after the infection up to 2 years [133, 135]. The diagnosis is based on the history of exposure and risk factors along with the characteristic clinical features. It is supported with histopathology, culture and bacteriological identification that in some cases require molecular biology techniques [94, 120]. The fact is that the diagnosis is not easy and in most of the cases is either delayed or remain being presumptive based in the history and response to treatment. The objective of the treatment is to increase the speed of resolution and prevent progression of the disease [1]. With this purpose different combinations of antibiotics plus the support, in selected cases, of surgery are the common practices in the treatment of this infection. Although the election of the drugs still depends of the preference of individual authors and is not based on controlled evidence [143]. Aims and Objectives The overall aim of the project is to determine the current state of evidence for the diagnosis and treatment of M. marinum infection. Being the specific objective to review the literature and the series of HTD cases with the purpose of suggest appropriate diagnosis and case management of Mycobacterium marinum infection. Material and Methods Cases with diagnosis of fish tank granuloma were review. The cases were diagnosed and treated from 2000 to 2009 in the dermatology surgery of The Hospital of Tropical Diseases of the University College London Hospitals. There were included patients with either culture positive for M. marinum or clinical diagnosis plus response to appropriate treatment. The files of those patients were reviewed and data were collected in a questioner that included: anthropological data, past medical and drug history, risk factors and exposure, description and location of the lesions, spread or deep extension of the infection, incubation period , delay in diagnosis, diagnosis, treatment and evolution (see questioner in annex). Additional information considered relevant was as well collected. A literature review in Medline and Cochrane databases was done. The review included the combination of the following terms: Mycobacterium marinum or fish tank granuloma. It was limited to papers from 1999 to July 2009, English and Spanish literature and humans. The papers obtained in the search were divided in 3 categories. First, case reports in which it was possible to collect data from individual cases. Information of those papers was collected in the questionnaire previously mentioned. Second, case series of 14 or more cases in which data from individual cases was not reported. And finally, a miscellaneous category of papers that were considered relevant for the diagnosis and treatment of this infection. The information gathered in the questioners was computerized in Microsoft Excel 2007. No statistical analysis was done in view of the cases were publish not with this purpose. As a consequence probably important reporting bias would invalidate any statistical outcome. Simple description of the results was done. Results Cases of The Hospital of Tropical Diseases From 2000 to July 2009 there were collected 7 cases with diagnosis of Mycobacterium marinum infection. The 7 cases included 6 males and 1 female and their ages ranged form 31 to 65 years. All the cases admitted to have had contact with an aquarium. In two cases the exposure was occupational. One of them worked in the London Zoo being responsible of the management of the aquaria. The second was a cook in a restaurant that store crustacean in an aquarium. All the cases presented nodular lesions located in one of the upper limbs, six of them with sporotrichoid spread and one with a solitary nodule (see photos is annex). One patient that was taking oral prednisolone due to severe atopic eczema presented with tenosynovitis of the left hand, sporotrichoid spread and palpable regional lymphonodes. The rest of the patients were not immunosuppressed. Biopsy of the lesions was performed in all the cases. However AFB were found just in one case. Whereas cultures were positive in 5 cases for M. marinum. In the other two cases the diagnosis was done based on history of exposure, clinical characteristics and positive response to treatment. Different combinations of antibiotics were used with no clear advantage of any regimen in particular. In 4 patients it was need to change the regiment. The reasons were drug intolerance in one case and lack of improvement in the rest. There was also one case that initially was improving with a regimen of rifampicin plus minocycline. But after simplification of the regiment to clarithromycin monotherapy presented worsening of the lesions. This case was eventually controlled switching to minocycline plus ethambutol. There was one patient who presented a relapse after one year of the previous infection. Finally it was cured with 6 months of rifampicin plus clarithromycin. Susceptibility test was done in 3 cases. It was detected resistance to trimethoprim-sulfamethoxazole and rifampicin in one case and susceptibility to clarithromycin, ethambutol and doxycycline in 3 cases. The average time of duration of the treatment was 6 months with a range of 2 to 9 months. Surgery was not required in any patient. The final outcome was good in 5 patients being the other 2 lost of follow up (see table 1). Case No Age(y) /Sex Medical history Drug history Exposure Location Clinical characteristics Histology AFB results Culture Treatment Duration (months) Evolution 1 9/M No Aquarium Upper limb Multiple nodules sporotrichoid spread Granulomatous inflammation AFB + 1-RIF+DOX 2-RIF+EMB+DOX 3-RIF+EMB+CLR 7 Cured 2 61/F Psoriasis Chronic paronychia Aquarium Upper limb 3 nodules Sporotrichoid spread AFB + 1-MIN 2 Improving Lost of follow up 3 64/M No Aquarium Upper limb Multiple nodules Sporotrichoid spread Noncaseating granuloma 1-EMB+TET 2-RIF+EMB+INH 9 Relapse after 1year 3(*) 65/M Fish tank granuloma Aquarium Upper limb Multiple nodules Sporotrichoid spread 1-RIF+CLR 6 Cured 4 59/M Severe atopic eczema Systemic steroids Aquarium Upper limb Multiple nodules Sporotrichoid spread Tenosynovitis AFB + 1-DOX 2-RIF+EMB 3-RIF+EMB+CLR 4-ERI+MIN ? Lost of follow up 5 44/M No Aquarium Upper limb 5 nodules Purulent discharge Sporotrichoid spread Necrotizing granulomatous inflammation AFB- + 1-RIF+MIN 2-CLR 3-MIN+EMB 3.5 Cured 6 31/M No Aquaria (London Zoo) Finger Solitary nodule AFB + 1-CLR+EMB 4 Cured 7 49/M No Aquarium (Restaurant) Upper limb 5 nodules Sporotrichoid spread + 1-RIF+EMB 5 Cured (*) Notice that case number 3 is repeated. It belongs to the same patient that the one above but one year later. The patient presented a relapse after one year of being cured. Results from the literature review From 1999 to July 20009 there were found 233 results in Medline database and zero In Cochran Library. From those, 127 were considered relevant and consequently analysed in this review. From the 127 papers reviewed, 108 contained case reports and the 19 remaining were a miscellaneous of reviews or original articles covering issues related with diagnosis and treatment. No clinical trials or randomized control trials were found. In those years the literature reported a total of 516 cases of M. marinum infection. From those cases reported only 133 could be analyzed as individual cases. The rest of cases were reported as series of cases (See figure 1). The number of cases reported per year since 1999 up to July 2009 have been variable with a minimum of 6 cases per year in 2004 to a maximum of 88 cases in 2000. No clear tendency to increase neither decrease has been notice (see Figure 2). The majority of the cases have been reported in Europe, North America and South East Asia. No cases have been reported in Africa and only one case in South America (see Figure 3). Results from papers that could be analyzed as individual cases The reports included 82 men and 51 women. The average age was 46.7 years with a minimum of 18 months and a maximum of 87 years (see Figure 4). 70% of the patients had no relevant past medical history. 9% of the patients were immunosuppressed: 5 patients had HIV infection, 4 were recipients of solid organ transplant, 1 patient had a myelodisplastic syndrome, 1 had Non-Hodking Lymphoma and 1 had Chronic Lymphocytic Leukaemia. Among other relevant pathologies were reported 12 diabetic patients, 11 with rheumatic diseases and finally 5 that were suffering from other problems as: asthma, bullous pemphigoid, myasthenia gravis, Cronh ´s disease and sarcoidosis. The majority of the patients were not taking any relevant drug. However, 20 of them were on systemic steroids, 12 had received steroids as local injection, 10 took methotrexate and 9 TNF-blockers. The most frequent exposure referred was the contact with an aquarium usually of tropical fish, it was reported in 51% of the cases. It was followed in 26 cases (20%) by other kind of contact with fish mainly referred as contact while cooking or cleaning fish. Finally 16 cases (14%) had other kind of contact with water environment. That included mostly fishermen or recreational sailors. Opposite to papers from the 60s, only in 2 patients referred contact with swimming pools. In 15 cases (11%) the source of exposure was not recall or reflected in the papers. Injury related with plants was reported in 3 cases. In one case the exposure was a bucket. The bucket was used to bath a child of 18 months after being used to put fish from an aquarium. As a result the child got infected [40]. History of trauma with skin barrier impairment was referred in 46 cases (71%) of the patients. Among those, 18 cases (39%) recall direct injury with either fin fish, fish hook or crab bite. Occupational exposure was reported in 20 cases (15%). The most frequent occupational risk was to be cook and have injuries while cleaning fish. Another common job of high risk was to work in a pet shop, with the duty of cleaning aquaria. Finally fishermen are evidently in direct contact with water and fish and prone to suffer injures with fish hooks. The incubation period was documented only in 30 patients. It went from 1 day up to 4 months with and average of 48.9 days. The cases that presented an incubation period less than two weeks had in common to have suffered penetrating injuries with fish (figure 5). The upper limbs were affected in 120 case (90.2%), being the fingers the most frequent location. The lower limbs were affected in 11 cases (8.3%). The face in 7 cases (5.3%) and that included delicate locations as nostrils, eyelid and cornea. Finally, cutaneous dissemination was reported in 7 cases (5.3%). Sporotrichoid spread was found in 53 cases (39.8%). Lymphonodes affectation was recorded in only in 7 cases (5.3%) of the cases. The lesions were described as nodules in 63 cases (7%), plaques in 23 (17.35%), papules in 13 (9.8%) and ulcers in 22 (16.5%). There was purulent discharge in 32 cases (24.1%), as well as swelling and tenderness in 37 (27.8%) and 42 (72.4%) cases respectively. Involvement of deep structures was referred in 45 cases (33.8%) of the cases being the most frequent tenosynovitis with 34 cases (75.6%), followed by arthritis with 12 (26.7%) and osteomyelitis with 6 (13.3%). Systemic dissemination with documented bacteraemia was reported in 3 cases. The 3 of them were males from 66 to 87 years. In 2 cases the patients were on systemic steroids, due to myasthenia gravis[103] in one case and polymyalgia rheumatica[62] in the other. Sadly the third case that initially was not taking drugs, after being misdiagnosed as rheumatoid arthritis was put on systemic steroids, infliximab (TFN blocker) and methotrexate [59]. From the patients with invasive disease, including involvement of deep structures or systemic dissemination, 21 (46.6%9 were taken some kind of immunosuppressive drug. Meanwhile only 13 (15.5%) of the rest of the patients were taken them (see figure 6). Other interesting characteristic of the patients with invasive disease was that 15 (33.3%) of them referred direct fish injury. Only 3 (3.4%) of the rest had this exposure (see figure 7). Patients that for any reason were taken immunosuppressive drugs presented different characteristics from the rest of the patients. More than half of them presented invasive disease compared with only 20% of the rest (see table 2). Patients taking immunosuppressive drugs (*) Patients no taking any drugs Number of patients 36 91 Average age (years) 53.2 44.9 Female % 14 / 38.9% 36 / 39.6 % Sporotrichoid spread 13 / 36.1% 39 / 42.8% Involvement deep structures 21 / 58.3% 19 / 20.8% Systemic dissemination 3 / 8.3% 0 AFB positive 19 / 52.7% 33 / 36.3% Culture 33 / 91.6% 75 / 82.4% Bad evolution 2 / 5.5% 3 / 3.3% (*)Immunosuppressive drugs including: TNF-Blockers, systemic steroids, local injectable steroids, methotrexate and azathioprine. The time of evolution until the patients presented for consultation was as short as 4 days and as long as 18 years with an average of 8.6 months. The time until the diagnosis was finally done was only reflected in 17 patients. However the delay went from 21 days to 2 years with an average of 6.3 months. Tuberculosis skin test was only done in 19 patients. From those 86.4% were positive. Biopsy of the lesions was done in 120 cases (90.2%). Aspirate was reported only in 19 cases (1 4.3%). Histology characteristics suggestive of mycobacterial infection with granuloma formation were found in 45.5% of the biopsies. However, only 21% of those were described as caseating granulomas. Other frequent finding reported was mix infiltrates with chronic and acute inflammatory cells. In some cases a wrong diagnosis was done due to confusion with rheumatoid nodules, Sweetà ¢Ã¢â€š ¬Ã¢â€ž ¢s syndrome, foreign body granuloma or interstitial granuloma annulare (See table 3). Table 3: Histology Findings Histology description Number of patients Non caseating granuloma 19 Caseating granuloma 12 Granuloma( type not specified) 26 Infiltrates of chronic and acute inflammatory cells (lymphocytes , neutrophils, histiocytes) 18 Granulation tissue 6 Abscess formation 9 Necrotizing folliculitis 1 Focal dermal necrosis 3 Fibrinoid degeneration 1 Necrotizing paniculitis 2 Cystic degeneration 1 Pseudoepitheliomatous hyperplasia 4 Acute suppurative paniculitis 1 Fibrinous exudates 3 Lichenoid inflammation 1 Acanthosis in epidermis 2 Necrotic Corneal Stroma 1 Dermal fibrosis 2 à ¢Ã¢â€š ¬Ã‚ ¢ Pseudocarcinomatous hyperplasia of follicles à ¢Ã¢â€š ¬Ã‚ ¢ Nodular and perifollicular infiltrate of neutrophils and histiocytes à ¢Ã¢â€š ¬Ã‚ ¢ Dermal fibrosis à ¢Ã¢â€š ¬Ã‚ ¢ Collections of neutrophils within follicles 1 patient with lesions of 18 years evolution Confusion with other pathologies Rheumatoid Arthritis ( rheumatoid nodule) 2 Sweet ´s syndrome 2 Foreign body granuloma 2 Interstitial gra nuloma annulare 2 In the samples collected AFB was found in 41.7%, was negative in 34.6% and was not reported in 23.6%. In total identification of M. marinum was possible in 119 cases (89.5%). Culture was positive in 114 cases (85.7%). The time until the cultures grew went from 8 to 56 days, with an average of 23.3 days. Identification with PCR was done in 19 cases (14.2%). The imaging techniques were useful to diagnose extension of the infection. Radiographies were used in 25 cases (18.7%) to rule out bone involvement. Magnetic resonance imaging was used in 16 cases (12%) resulting in the diagnosis of tenosynovitis, abscess, join effusions or osteomyelitis. About the treatment, 126 patients were treated with antibiotics; in the rest of the cases the management is not mentioned. Surgery was need in 38 patients (84.4%) with affectation of deep structures and in 21 patients (25%)with cutaneous lesions. Monotherapy was used in 54 cases (42.8%), bitherapy in 38 cases (29.4%), triple therapy in 20 cases (15%) and combination of 4 or more drugs in 5 cases (4%). Finally combinations of drugs that included classical tuberculosis treatment were used in 10 cases (8.7%). In 41 patients the regimen of drugs needed to be change, either for non effectiveness or non tolerance. The regiment was change one time in 29 cases (21.8%), two times in 10 cases (7.5%), and up to 3 times in 2 patients (1.5%). The drug more frequently used as monotherapy was clarithromycin, followed by minocycline, doxycycline, ciprofloxacin and trimethoprim-sulfamethoxazole. The combinations of drugs more frequently used were rifampicin + ethambutol followed by clarithromycin + rifampicin and clarithromycin + ethambutol. (Effectiveness of the different regimens depending of the extension of the disease can be seen in table 4) Susceptibility test were reported in 34 patients. Rifampicin was susceptible in 86.4% of the test, ethambutol in 91.3%, clarithromycin in 95% and minocycline in 62.5%. Isoniazid was resistant in 100% of the tests done and streptomycin in 66.6% (see table 5). The average time of duration of antibiotic treatment was 5.4 months, with a range of 12 days to 15 months. After completion of the treatment the final evolution of 109 patients (81.9%) was reported as good outcome or cured. Only in 8 patients (6%) the evolution was reported as bad outcome. No mention about the evolution was done in the rest of cases. Among 12 patients in which long follow up was reported, only one patient presented recurrence of the infection after 3 months course of doxycycline. (Characteristics of the cases with bad outcome are resumed in table 6. Table 4:: Antibiotic Combinations Used Depending On The Extension of The Disease Patients with only cutaneous lesions Patients with Invasive disease Number of patients Effectiveness Number of patients Effectiveness Monotherapy 38 52.5% 16 75% CLR 8 75% 5 100% MIN 10 70% 1 100% DOX 8 50% 1 100% CIP 4 25% 2 50% CTX 2 100% 3 33.3% AZI 3 0% 0 AMK 1 0% 0 ERI 0 1 0% LEV 0 1 0% MOX 1 0% 0 OFL 1 0% 2 50% Combinations of 2 drugs 26 92% 11 83.3% CLR + EMB 6 100% 2 100% CLR + CIP 1 100% 0 CLR + MIN 1 100% 0 CLR + RIF 5 80% 0 CLR +CTX 1 100% 0 RIF + EMB 9 100% 5 60% RIF + CTX 0 1 100% RIF + INH 0 1 100% CIP +DOX 1 100% 0 CIP + EIR 1 0% 0 DOX +CTX 0 2 100% CIP + EMB 1 100% 0 Combinations of 3 drugs 13 72.7% 7 66.6% CLR + EMB + CIP 0 1 0% CLR + EMB + RIF 2 100% 5 100% CLR + EMB +RFB 0 1 0% CLR +CTX + CIP 1 0% 0 EMB + AZI + MIN 1 0% 0 RIF + CLR + AMK 1 100% 0 RIF + INH + CLR 1 0% 0 RIF + EMB + CTX 5 100% 0 RIF + EMB + DOX 1 0% 0 RIF + EMB + MOX 1 0% 0 Combinations of > than 3 drugs 2 100% 3 33.3% CIP+RIF + EMB + CLR + RFB + AMK 0 1 100% CLR + DOX + RIF + EMB 0 1 0% RIF + EMB + CLR + AMK + IMP 0 1 0% RIF + EMB + AZ I+ CTX 1 100% 0 RIF + EMB + CLR + CIP 1 100% 0 Combinations with TB treatment 1 100% 9 55.5% INH + RIF + EMB + CLR 1 100% 1 0% INH + RIF + EMB 0 3 100% INH + RIF + EMB + PZA 0 4 50% INH + RIF + EMB + PZA + CLR 0 1 0% TABLE 5: PATTERN OF SUSCEPTIBILITY Drug Number of patients Susceptible Resistant Indeterminate Isoniazid 9 9 Rifampicin 22 19 3 Ethambutol 23 21 2 Pyrazinamide 1 1 Streptomycin 6 1 4 1 Rifabutin 2 2 Azithromycin 4 1 3 Clarithromycin 20 19 1 Minocycline 8 5 1 2 Doxycycline 6 6 Tetracycline 2 1 1 Trimethoprim-sulfamethoxazole 6 5 1 Ciprofloxacin 11 6 1 Levofloxacin 1 1 Moxifloxacin 4 4 Gatifloxacin 1 1 Amikacin 9 9 Linezolid 1 1 Imipenem 2 2 Erythromycin 2 1 1 Cefotaxime 2 1 1 Kanamycin 3 3 Ethionamide 3 3 Ansamycin 1 1 The table reflects in how many patients each drug was tested and in how many it resulted as susceptible, resistant or indeterminate. TABLE 6: CHARACTERISTICS OF CASES WITH BAD OR POOR OUTCOME References Age Sex Past medical history Type of infection Treatment Duration treatment (months) Evolution [25] 67/M DM Cutaneous disseminated RIF+EMB+CLR+CIP 3.7 Deceased Secondary bacterial infection [26] 50/M No Tenosynovitis RIF+EMB Synovectomy 3 Dysfunctional index finger [46] 62/F No Tenosynovitis CLR 4 debridements 6 Amputation index finger [46] 26/M No Tenosynovitis DOX+CTX 4 debridements 3.5 Persistent infection Need of grafting [73] 56/M No Tenosynovitis Local gentamicin Synovectomy 3 drainages ? Deformity [83] 47/M HIV infection Osteomyelitis 1-INH+RIF+EMB+PZA 2-Avobe + Fluoroquinolone 3-RFB+EMB+CIP 4-RFB+CIP ? Amputation Knee [88] 60/F NHL Systemic steroids Cutaneous disseminated 1-Ofloxacine 2-RIF+EMB+LEV+CLR 3-Above+STR+IG 4-CTX+MOX ? Continue with signs of active infection [103] 81/M Myasthenia gravis Systemic steroids Cutaneous and systemic dissemination 1-CIP 2-Hyperthermia 3-DOX intravenous 5 Deceased Bone marrow infected by M.marinum Results from papers that contain series of 14 or more cases There were 14 papers that contained series of cases with no available information of individual cases. As a consequence, individual cases could not be analyzed separately. There were 2 papers that reported the same series of cases in different years, the cases were counted just once. The principal characteristics of the papers are described in the table 7. There were 363 cases reported, 68% were males with an average of 44.3 years. In most of the cases the past medical history was not relevant; only 4 cases of HIV infection were reported. The most frequent exposure was to own an aquarium in 134 cases (37%). There was other kind of contact with fish in 37 cases (10%), swimming pool contact in 7 cases (2%) and other kind of contact with water in 58 cases (16%). In the rest of cases exposure was not mention. Finally occupational exposure was referred in 68 cases (19%). The incubation period was not reported. The upper limbs were affected in 245 cases (67%), the lower limbs in 78 cases (21%), the face in 3 cases (0.8%) and there was cutaneous dissemination in 10 cases (3%). Sporotrichoid spread was reported in 46 cases (12%). The lesions were described as plaques in 92 cases (25%) and nodules in 54 cases (15%). Deep structures were affected in 45 cases (12%): 41 tenosynovitis (91%), 8 arthritis (18%) and 3 osteomyelitis (6%). There were no cases of systemic dissemination described in any of the series. The average in the delay until the diagnosis was done was 3.8 months. The drugs more commonly used as monotherapy were doxycycline, minocycline, trimethoprim-sulfamethoxazole and clarithromycin. The combinations more prescribed were rifampicin plus ethambutol, rifampicin plus clarithromycin and clarithromycin plus ethambutol. The effectiveness of the treatments were not frequently reported. Consequently is not possible to point the advantage of any concrete regimen (see table 8). The average duration of the treatment was 5 months. Surgery was reported in 73 cases (20%). The evolution was good in 225 cases (62%), poor in 15 cases (4%) and not mention in the rest. There were 5 papers that contained series of cases of atypical mycobacterial infecti

Sears and the dishwasher industry :: essays research papers

Where should Sears source the dishwashers from? Sears is the giant leading broad line retailer providing merchandise and related services. In keeping with its sourcing philosophy, Sears generally prefers to work with one, rather than multiple suppliers. When the supplier does not offer a specific type of appliance, Sears would source it somewhere else. Sears’ objective is to share as much as possible of the production and assembly process with the suppliers’ products. Based on the readings one important component of Sears’ sourcing strategy is to ensure that its suppliers have stable top management over a long term. Sears sources its dishwashers from D&M, because of D&M’s cost position. They would not find elsewhere the quality and the price that D&M offers. Sears itself designs the dishwashers based on the customer’s preferences and provides them the best quality with the best price named Kenmore. GE is the toughest competitor to Sears as well as to D&M and considering sourcing from GE would not be feasible, because GE’s policy is that GE product would carry GE name. Now GE is a customer of Sears that in the same time competes with Kenmore’s products. Another souring possibility could have been Whirlpool which like GE uses its name for its products, but for Sears it would not make economic sense to go towards that direction. After Sears, GE, and Whirlpool, there really is no full-line name in the market of any significance. Sears as well as the customers are content with D&M’s products, but one important issue could be if D&M will keep up with its R&D in order to continue competing with GE as well as with Whirlpool. After all these years it will be very difficult for Sears to pull back from D&M and go after another supplier.

Essay --

Tragedies such as 9/ll has impacted many people when the terrorist attack happened at the world trade center in Manhattan. Thousands and thousands of people died, others were injured, and other civilians cried their hearts out. The nation was in despair, knowing that innocent people have died and their nation has been attacked. The government had noted that the act of 9/11 was an act of terrorism. The question is, what is terrorism and is it permissible or non-permissible? There is no specific definition of terrorism due to the fact that the definition can be viewed differently (p398). Some of the definitions of terrorism is either too broad while others are too neutral (p398). An example that was in the book was the comparison between the London bombing and the bombing in Hiroshima. The London bombing was considered an act of terrorism while the bombing in Hiroshima was considered non-terrorism because it was a response to an act of terrorism that was done at Pearl Harbor (p399). V aughn had defined terrorism as â€Å"...the deliberate use or threat of physical violence against noncombat...

The Adventures of Huck Finn: A Coming Of Age Novel Essay examples -- e

The Adventures of Huck Finn: A Coming Of Age Novel   Ã‚  Ã‚  Ã‚  Ã‚  The novel ‘The Adventures of Huck Finn’ by Mark Twain is a coming of age novel. Huck’s maturity grows throughout the story. He first starts to show emotions toward a runaway slave, and by the end of the novel, has grown up to the point where, when Jim, the slave, is captured, Huck decides not to play games but to take it serious and rescue him the safest and most logical way. He also decides it give up playing games after his friend is shot to ensure that he would get the medical attention that he needed   Ã‚  Ã‚  Ã‚  Ã‚  The first indication of Huck’s growing maturity was in Chapter 15. Huck and Jim are split because of a thick fog near Cairo, their destination. After many hours, Huck finally makes his way back to the raft. Jim is sleeping, and Huck, still in a childish state of mind, decides to play a joke on Jim by pretending that he was never lost. He pretends to wake up next to Jim, who is overjoyed to see him, and Huck convinces Jim that the whole episode was a dream. When Jim finally realizes that Huck is fooling him, he scolds him sharply for it:   Ã‚  Ã‚  Ã‚  Ã‚  Aamy heart wuz mos’ broke bekase you wuz los’, en I didn’ k’yer no’ mo’ what become er me en de raf’. En when I wake up en fine you back agin, all safe en soun’, de tears come, en I could a got down on my knees en kiss yo; foot. I’s so thankful. En all you wuz thinking’ ‘bout wuz how you could make a foo...

Homeschooling vs. Public Schooling Essay

Homeschool and public school, which one is better for my child? What about the cost? Which educational setting will my child benefit the most from? These are questions that parents need to ask before making a decision such as this one. Also, parents need to know that both homeschool and public schools appeal to people of all race, religion, and political viewpoints (Romanowski, 2001). Whether a parent chooses to homeschool their child or send them to public school, is a decision that needs to be researched on the performance, cost, and their child’s life after school. First, when choosing which educational setting is best for their child, parents need to research students’ performance for both types of schooling. Studies have shown that children who are homeschooled score better on test than those who are in public school (Some Fascinating Facts, n.d.). Possible reasons being that the homeschooled child has more one-on-one time with the teacher, and they are able to spend as much time as they need to on the subjects that they are struggling with, if any. The time that is allowed for each part of the curriculum may be too fast or too slow for the child who is attending public school (Homeschooling vs. Public, n.d.). Children who go to public schools are able to participate in group discussions and debates (Homeschooling vs. Public, n.d.). Students are able to develop their social skills, and learn to interact with children their own age. Next, the cost can also affect whether the parent decides to homeschool or  send their child to public school. Depending on the choices that a parent makes and the supplies that are needed, homeschooling one child can cost from $300-$2500 per year (Mohr, 2012). According to the National Retail Federation in 2012, the average cost for a parent to send their child to public school was around $634 per year (Klein, 2013). Lastly, depending on which educational setting the parent chooses can affect the student’s life after school. Children who were homeschooled had a GPA of 3.41 their freshman year of college, compared to other students who had a 3.12 (Some Fascinating Facts, n.d.). Students in public schools may even discover that the lessons they learned outside the classroom, in extracurricular activities such as basketball or chess club, help them cope with future challenges in the workplace (I Have A, n.d.). Therefore, choosing to homeschool or send a child to public school is not a very easy decision for parents to make; much thought and research needs to be done on students’ performance, the cost of each, and what is in store for the student after graduating. Homeschoolers score better on tests than those in the public setting. Though, children who are homeschooled are not able to participate in group discussions or even class debates. Homeschooling, for one child, can cost anywhere from $300 to $2500 per year; parents who decide to send their child to public school pay on average $634 a year. Homeschooled children had a better GPA their freshman year of college than the students who graduated from public school. The students who attend a public school and also are involved in some type of extracurricular activity, are able to cope better with the challenges in the workplace. Whatever educational setting the parent decides is best for their child, they need to know that there ar e both benefits and disadvantages with each decision. References â€Å"Homeschooling vs. Public Schooling.† (n.d.). _Homeschooling Ideas._ Retreived on May 24, 2014 from http://www.homeschooling-ideas.com/homeschooling-vs-public-school.html. I Have A Plan Iowa â„ ¢. (n.d.). _- Article_. Retrieved June 6, 2014, from https://www.ihaveaplaniowa.gov/Home/Article.aspx?articleId=IGeYH2kUApurN7JfmoFVeQXAP3DPAXXAP3DPAX&level=3XAP2FPAX6J7I3kztATGuYyXAP2BPAXDahIQXAP3DPAXXAP3DPAX. Klein, R. (August 20, 2013). â€Å"Back-To-School Shopping Costs: How Much Parents Should Expect To Spend This Year.† _Huffington Post._ Retrieved on May 24, 2014 from http://www.huffingtonpost.com/2013/08/20/back-to-school-shopping_n_3751079.html. Mohr, A. (August 27, 2012), â€Å"How To Start Homeschooling Your Kids.† _Investopedia._ Retrieved on May 24, 2014 from http://www.investopedia.com/financial-edge/0812/how-to-start-homeschooling-your-kids.aspx. Romanowski, M. H. (2001). Undoing the ‘Us vs. Them’ of Public and Home Schooling. _Education Digest_, _66_(9), 41. â€Å"Some Fascinating Facts About Homeschool vs Public School.† (n.d). _Homeschool World_. Retrieved on 24 May 2014 from http://www.home-school.com/news/homeschool-vs-public-school.php.

Quotation essay Essay

We neer appreciate the measure of body of water until the come up runs ironic. The words in this quotation mark, create verbally by genus Benzoin Franklin, ask in the subscriber to take a deeper more insightful glance into how self-disciplines and battalion arent comprehended until the realization of their enormousness or nurse. by means of literature, the author uses symbolism, comparisons, and free radical to evaluate the importance of appreciation.The author, Benjamin Franklin, portrays meaning through give away the cite which stirs to appreciating what you baffle. People siret wee what they learn until its g ane. When its g cardinalness, consequently you do the importance of what you had. In a specific case in which the possession is a pass judgmentd item, you tend to realize how much make better off you were one time you had it. Also, if what the ingeminate was referring to specifically was a someone, you sometimes realize you love or miss that person more than you expected to. It doesnt necessarily have to be a death, it could be someone leaving a job or moving. For drill, I had an orchard apple tree iPod. I didnt genuinely founder much attention to it. When I at sea it, thusly I realized its prise and importance to me. This recite is excessively ground on winning every petty chance you get. Taking risks could mean something as simple as trying saucily things. The author, Ben Franklin portrays different meanings through away the quote which relates to appreciating what you have and taking risks.The water and the hearty runs alter are two symbols that represent a friend, family member, or possession that is important to you. Franklin uses the water to represent the value of that specific person or possession to you. The well is apply to stand for the character of your opportunities. Referring back to what I mentioned about the subject being a person, this loved onecould also be the source of your opportuni ties or education. Until the well runs dry could refer to that person leaving and taking an opportunity with them. For example, the water could be a teacher thats trying to back up you get into a good soaring school. But, you put one acrosst think you acquire their helper.If that person leaves and moves on, you might not have as good as an opportunity like you did before when they were helping you. You hence start to realize that there help was very important. Other than being a person, the water could relate to a possession. As I mentioned before, when I lost my iPod, I realized its importance. The water and well could map the wealthy versus the poor. In this situation the well, source of opportunities, would be different. Therefore, those two symbols fully symbolize the divergeing of a loved one, a lost possession, or an important opportunity up until the realization of its true value and meaning you.The author uses the comparison of the value of water to the well. He do es this to explain that people take opportunities as well as other people for allow. With this comparison, the subject essential be an individual. For example, to a friendship situation, a friend could be taken for granted if you assume that he leave behind everlastingly be hit to help you out withal if you arent always ready to help him or her. some other example is an employee could be taken for granted by an employer, who makes no effort (such as raises in pay) to reward the employers long and faithful service.The theme of this quote is appreciation, which is basically similar to the meaning. Another theme that can be examine from the quote is taking people for granted. taken for granted is like when you have something real special or important exclusively you dont notice it. Also, grabbing opportunities date you can plays a big part in taking things for granted. For example, I precious to join the recycling team. But, I kept stalling and not filling out the paper. A s a result, the opportunity passed me by and I could no longer join.Franklins words personally relate to clement experiences. As I stated earlier, I had an iPod but didnt realize how worthful it was to me until I misplaced it. This quote relates to biography in different ways. Taking proceeds of aparent or teacher is one of these ways. For example, I depend on your mom or dad for nearly everything. If something happens and Im mad at them, I sometimes wish things you dont mean. If they unexpectedly leave, I will then realize the importance of their berth in my life. Franklins words concern to human experiences in various ways.This quote by Ben Franklin does not only relate to personal experience but also connects to the community + world. It connects to the community because people in a community or acquire environment could take advantage of a teacher, or appreciate them more when theyre gone. For example, at my dance ministry we have a dance coordinator, Ms. Ferdinand. Somet imes some of the girls dont really agree with her decisions. But, if one day she decided to leave the ministry in the hands of someone else, they may not like it. That person may be very different from what we are employ to. Another example could be some students hating a teacher. These examples have the same concept.If the teacher leaves they might not like the one that replaces them. When I was at dream yesterday, a student said Is Mr. work on, the math teacher, advent back? The English teacher answered in all likelihood not. The student then went on to say I like him better than the new teacher. The word form then agreed with him. But, most of the kids in the class didnt really like Mr. Sue when he was around. They then realized that his system of teaching was more understandable than the one we have now. The English teacher then said you never appreciate the value of water, until the well runs dry. Think about that I said to her I am analyzing that quote in ELA. Therefore, they learned that they didnt really appreciate Mr. Sue until he was gone.We never appreciate the value of water until the well runs dry. The words in this quote written by Benjamin Franklin invite the reader to take a deeper more insightful glance into how possessions and people arent appreciated until the realization of their importance or value. A final example could be that when famous singers die, there music gets even more popular. This quote by Benjamin Franklin portrays meaning with relates to grabbing opportunities, appreciation, and taking things for granted.

Divorce: Marriage and Progressive Beautiful Life

Divorce doesnt finish a covenant.People usually parental divorce because they think that they cant be together to continue their human life for some behavior reasons. Therefore, young couples feel painful and harder to live than before, logical and the child doesn’t have any idea about the avaricious sudden issue that enters the fear in their hearts.Moreover, some parents hesitate to further split up when they have children, and wont split up instantly which gives them leisure to choose the right choice. Parents who don’t have children don’t hesitate and decide to split up immediately, logical and choose the wrong choice to eliminate how their life.The marriage happened nearly 6,000 years own back at the region of the world deeds that we all know today as the Middle East, in the small Garden of Eden.Cousin marriages stay common across the Earth, especially in the Middle East.

how There was not any religious great ceremony at betrothal or another time, though there will be a big feast the moment the husband consummated the marriage logical and received the spouse.Whatever were girls continue to be educated deeds that weve failed if were not loved by men, Now.Youve got to accept that and first move forward.Everything you place your much attention on grows.

Not a soul in D.appears to want to repair anything.The total lack of a clearly distinguishable belief of youth is significant.Nobody knows logical and so nobody understands of our pain.

Be certain to maintain copies from where the spouse can locate them.Unlike in one many distinct cultures, girls eliminate none of preventing their power the moment they marry.Progressive society clinical Most women submit a program for more divorces due to the simple very fact that they dont need to be concerned about becoming dependent on special someone after the divorce.Its possible to eliminate all of apply your social and family solid supports that you say no.

Ict Evaluation Essay

essay sail send offing1 8 2 9 3 4 5 6 710 11 12 13 14Thursday, 5 family 2013, 1238 PM Thursday, 5 kinsfolk 2013, 0104 PM 26 mins 35 secs 20.00/30.00 3.33 reveal of a maximum of 5.00 (67%) foreland 1 ridiculous scotch 0.00 aside of 1.00 ease off hesitation15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 off re thinking articleESSs atomic number 18 knowing to coordinated spotive entropy around foreign events, tho they too get let bring come away summarized info from internecine MIS and DSS. pick let on all toldness admittedly put on wonder 2 flush several(prenominal)ize 1.00 bug let step forward of 1.00 stick interrogative sentenceThe pecker that enables drug substance ab physical exertionrs to view the like info in antithetical slipway exploitation denary dimensions is rent wizard a. prophetic depth psychology. b. SQL. c. OLAP. d. selective discipline minelaying. enquire 3 f either off smear 1.00 bulge knocked push thr ough(p) of 1.00 sag headlandWhich of the by- agate line is non i of the techniques practice in net tap? divide sensation a. mental ability tap b. social disposal mining c. employment mining d. substance ab exploiter mining inquiry 4 reprobate look into 1.00 knocked disclose(p) of 1.00 iris diaphragm interrogative mood ingeminate in ecesis in five-fold information files is c totallyed information ________. strike wiz a. tautology b. repeat c. independence d. partitions movement 5 unseasonable stigmatise 0.00 start of 1.00 flag read/write headIn reject-oriented growing convey peerless(prenominal) a. the phratry is utilize as the base unit of measurement of ashess come online and forge. b. an target atomic number 18a is a assembling of infothat is acted on by away come to the fore stopinges. c. bear on governance of logic resides inside objects. d. a strict, piecemeal tuition act is essential. heading 6 monstrous insur e 0.00 knocked come forth(p) of 1.00 pin tumbler unbeliefWhich of the side by side(p) is non a movement top executive for diverseness in a smart sets technological nucleotide? lease genius a. The entry of debauched actions. b. organizational substitute at heart the hold fast. c. The usual move growth of application barter demand. d. absolutely of the preceding(prenominal) atomic number 18 effort forces for mixture. suspense 7 defend smiler 1.00 start of 1.00A info storage w arho expend is typi chew the faty comprised of several diminutiver selective information marts. read whiz square(a)http//moodle.cqu.edu.au/ forward-lookingern/ diff hire/ check up on.php? travail=3132625/09/2013 grassvass 2 rogue 2 of 5 iris capitulum saturnine interrogation 8 earnest match 1.00 divulge of 1.00 oarlock read/write head counsel information formations typically condescend nonr extinctine finish making. make atomic number 53 trustworthy saturni ne forefront 9 wrong(p) phiz 0.00 unwrap of 1.00 lurch drumheadCategories of brutes for bpm implicate all of the by-line unpack distribute star a. tools to comprise existent remainss to software programme registeration craft paradees improvements. b. tools to automatise employment attendes. c. tools to recognise and document agate line processes. d. tools to prove the documentation of stock processes. incertitude 10 assort ground level 1.00 taboo of 1.00 careen enquire laterward penalise what-is analysis, it is by and spacious a good thinker to realize gaps analysis. pack iodin a. full-strength. b. stupid. oral sex 11 nonsensical lay come on(p) 0.00 emerge of 1.00 gladiolus read/write headThe brasss learning keep bicycle includes the operating theatre of a system after its creation. call for matchless a. consecutive. b. fabricated. inquire 12 clear up snitch 1.00 bulge of 1.00 signal flag skepticismA multiplexed lines throughput is ________. set apart atomic number 53 a. whizz-on- hotshot throughput b. gather throughput heading 13 rectify snitch 1.00 show up of 1.00 flagst genius wonderObject-oriented ontogeny could potentially bring low the beat and court of create verbally software because select unmatched a. object-oriented scheduling requires less training. b. repetitive prototyping is non required. c. objects are reusable. d. a case-by-case user user interface object female genitalia be utilise for the entire application. doubtfulness 14 ludicrous accentuate 0.00 extinct of 1.00 rowlock misgiving unit of measurement scrutiny select angiotensin-converting enzyme and only(a) a. includes all the preparations for the series of tests to be coiffeed on the system. b. tests the operate of the system as a whole in differentiate to modernulate if distinct modules allow maneuver unitedly as planned. c. tests severally program separately. d. provides the utm ostcertification that the system is civilize to be apply in a work setting. unbelief 15 condemn smiler 1.00 out of 1.00 iris headlandWhich process dies a expound description of the functions that a clean information system must(prenominal) perform? get hold of atomic number 53 a. feasibility instruct b. requirements analysis c. systems convention d. test plan exploitationhttp//moodle.cqu.edu.au/mod/ try/review.php? strive=3132625/09/2013 essay 2 summon 3 of 5 oppugn 16 improve accentuate 1.00 out of 1.00 let up inquireWhich of the pas clock condemnation types of coactionism tools allows you to spend with avatars victimisation schoolbook communicate? call for wholeness(a) a. realistic worlds b. screen share c. cooperative piece of writing d. large sense of hearing Webinars research 17 gear up gelt 1.00 out of 1.00 pivot hesitationDeprovisioning whitethorn be unavoidable when ________. take aim whizz a. a user joins a interpretion tea m up b. a user leaves the company entirely c. both(prenominal) A and B d. neither A nor B call into marvel 18 fall off recognise 1.00 out of 1.00 signalise passAs a proficient throw away omnibus you fill contumacious to see employing a prototyping methodology for a minor(ip) Web-based design project. What is the put in of steps you result follow in this project? get hold of mavin a. generate the simulacrum use the standard revisal and provoke the prototype. b. get wind user requirements, develop the prototype, use the prototype, retool and arouse the prototype. c. confine the requirements, develop solutions, select the scoop out prototype, and implement the prototype. d. fix the requirements, develop the prototype, alteration and advance the prototype. hesitation 19 lay make out 1.00 out of 1.00 stagger gesture________ is the ploughshare of time that a mesh is operational for use. aim nonpareil a. D givetime b. accessibility c. undivided throughput d. no(prenominal) of the above. distrust 20 ill-timed aim 0.00 out of 1.00 iris research________ systems mingle supplier, manufacturer, distributor, and node logistics processes. destine 1 a. collaborative scattering b. Supply-chain instruction c. annihilate logistics d. opening move prep interrogatory 21 do degree 1.00 out of 1.00 wilt misgiving practicable systems that get commerce processes within a single structural group, such as clement resources, are cosmos phased out in kick upstairs of cross-functional systems. portion out atomic number 53 accepted monstrous headway 22 settle gradation 1.00 out of 1.00 iris straitsA Skype group call using VOIP and webcams is an usage of a remote, synchronal collaboration tool. take up wiz True False research 23 crystaliseThe primary tool for representing a systems cistron processes and the menstruate of selective information surrounded by them is thehttp//moodle.cqu.edu.au/mod/quiz/ review.php? drive=3132625/09/2013test 2 foliate 4 of 5 beat 1.00 out of 1.00 bowling pin call into indecision subscribe iodin a. data dictionary. b. process unique(predicate)ations diagram. c. user documentation. d. data diminish diagram. inquire 24 localise oppose 1.00 out of 1.00 flagstone interrogative info purging is the similar process as data scrubbing. use up one True False brain 25 wild name 0.00 out of 1.00 stick interviewDowntime is the percent of time that a earnings is unattached for use. strike one a. True. b. False. movement 26 ill-considered sap 0.00 out of 1.00 tholepin inquireThe narrow linguistic communication programmers use to summate and change data in the database is called conduct one a. a data access language. b. a data role language. c. structure dubiousness Language. d. a data description language. headland 27 align trail 1.00 out of 1.00 iris interrogationThe use of digital engine room and the net income to execute the major craft processes in the green light is called subscribe one a. e-commerce. b. e- business concern. c. enterprise applications. d. MIS. nous 28 separate post 1.00 out of 1.00 peg questionWhich of the future(a) statements more or less collaboration is not confessedly? ingestone a. In business, a collaboration push aside stick up as little as a hardly a(prenominal) minutes. b. trading collaboration relies on the formation of teams that are depute a specific line of work or goal. c. prospering collaboration can be achieved through engineering science irrespective of the organizations elaboration or structure. d. unmatchable business clear of collaboration is modify innovation. oppugn 29 senseless butt 0.00 out of 1.00 sag down questionFirms in general make their own routers and switches, rather than purchasing them. take up one a. True. b. False. mind 30 typeset detect 1.00 out of 1.00 pin tumbler questionA peculiarity or attribute describing an entity is called a(n) direct one a. field. b. tuple. c. differentiate field. d. attribute.http//moodle.cqu.edu.au/mod/quiz/review.php? take on=3132625/09/2013 try 2 foliate 5 of 5 terminus reviewYou are logged in as Vikram Ravindar Vikram Ravindar (Logout) COIT20228_2132http//moodle.cqu.edu.au/mod/quiz/review.php? onrush=3132625/09/2013