Head Chef Essay Example for Free

period Chef EssayIf I wasnt told to choose a line of achievement now, I wouldnt have. Although Ive had the question what do you want to be when you grow up constantly in the back of my mind for the past 4 years, I never re completelyy came up with a definite answer. Last September I cash in ones chipsed the culinary arts program at the North exceptional Peninsula Skills Center and since then Ive realized that I really enjoy cooking so I started to consider being a chef as a c ber. In order to become an executive or head chef you must have a relevant education, training, and be willing to work hard. With all these attributes acquiring a position as a chef in a nice restraint is not difficult, and is very rewarding.After doing much research and talking to a few chefs I found out that higher education is not required to become a head chef, but it wouldnt hurt either. many a(prenominal) people considering becoming a chef as a career decided to go to a culinary college. One of the approximately well-known culinary institutes is the culinary Institute of America in Hyde Park, New York. A full academic year at the CIA in 2011-2012 cost $39,440 (CCIA). There is no GPA indispensableness in order to apply to the CIA but you must have your high school diploma. According to the CIAs web site before you merchant ship start classes it is required that you gain relevant experience in one of two ways before enrolling by working in a non-fast food origination with a professional kitchen for six months or by completing culinary classes at either the high school or college level (AR).Although education is important, prudish training is even more essential. Some training a chef is expected to have are glossa skills, food preparation and sanitation. Training of a chef commonly consists of an internship, apprenticeship, or externship, during which time the aspiring chef will work in all areas of the kitchen, mastering all aspects of food preparation. Many culinary colleges have an internship program in place to experience the culinary industry while gaining skills and on the job experience. On expire of education and training if you expect to go far as a chef there are certain skills you should have such as high stamina, organization, flexibility, teamwork, customer focus, and the desire to learn (SPCTP). Chefs work really long old age under high bosom and should be able to maintain a clear mind and continue to be productive.A really big bump of being a chef has to do with the customers after all, without them you wouldnt have a job. A good chef knows that customers want fresh, delicious food thats presented attractively, and does his or her trounce to fuddle sure that happens for every customer that enters the restaurant (SPCTP). I did my job shadow with the head chef, Julie, at St. Andrews Place in Port Angeles, WA. When I asked her what the most important skill needed to be good at her job was she said, besides from knowing how to coo k, time management. Having been in the culinary arts program and experiencing the pressure of getting done to get what needs to be done, I agree. Time management is a very important skill to have in the culinary industry.Most high schools have a culinary program that you could attend in order to obtain these skills, or you could simply learn through on the job training. A typical day for a head chef is different than that of an executive chef. An executive chef works in more of an office style tip other chefs, doing more meal planning, and a lot of paperwork. Executive chefs are hardly on the line cooking except occasionally during dinner rush. Head chefs may be involved with the meal planning and some paper work but mostly work in the kitchen the majority of the time. Being a chef means working mornings, nights, weekends, and holidays. Depending on the size of the restaurant or establishment, a head chef may arrive as early as 9 a.m. to gravel planning the days menus and not leav e until the dinner rush is over, sometimes at 10 p.m. or 11 p.m.Most chefs work at least 12-hour days and many times six days a week (Buchan). Not only is the workday long, but the work itself is hard as well almost the whole day is spent walking or standing. In order to be a chef you have to love what you do. Passion. This is what is release to make all the sacrifice, low pay, and long hours worth it. You have to have a defined, passionate goal something you want to work towards. And you need to have passion active food and someday being a professional chef. Without true passion, you will never succeed in a restaurant kitchen. (WIAPK) Being a chef can be a very stressful job and take quite a mental toll as well as physical. Although the work is difficult, the rewards are well worth it.The level of pay for head chefs varies depending on where you work and who you work for. Those who get paid most often work in upscale restaurants and hotels. According to the Bureau of Labor Statis tics, the median annual wage of chefs and head cooks was $40,630 in May 2010. The lowest 10 percent earned less than $23,260, and the top 10 percent earned more than $70,960 (CHCP). Seventy percent of chefs working for employers reported receiving health care benefits 69 percent received medical care, 51 percent received dental care and 36 percent received vision care (SBC). This does not apply to self-employed chefs. Although the pay is decent, if you are going to pursue a career as a chef you shouldnt do it simply for the money. Being a chef has personally gratifying rewards as well as financial, such as the satisfaction you feel when people love the food youve created.The culinary industry is only expected to grow 14% in all occupations between now and 2020 (CHCJO). Although the projected growth isnt a lot, the culinary industry is always in need of new employees. I feel care this would be a good fit for me because I have many of the skills needed to be successful in the industr y already. I have been eruditeness these skills though the Culinary Arts program I have been taking at the North Olympic Skills Center. I have been exposed to customer service, knife skills, food preparation, sanitation, HACCP logs, dish-pit, and have been told by my instructor that I have great time management skills.As you can see, with a proper education, training, and hard work, a career as a chef can be an extremely rewarding experience. The preparation of food is not only a job that satisfies peoples hunger, it is also an art, and the chefs are the artists.

Internet Browser Essay Example for Free

mesh browser EssayDespite the fact that Internet Explorer 5. 5 is matchless of the most popular in companies, Id like to recommend another one Maxthon Browser 2. 0, because it is much more than convenient for office working. Maxthon Internet Browser 2. 0 is a powerful tabbed browser nowadays. Its main advantage is a highly customizable interface. Although Maxthon Browser is based on the engine of Internet Explorer, it has many a(prenominal) an(prenominal) additional efficient features. What works in Internet Explorer works as well in Maxthon Browser and even better and faster. (Maxthon).Maxthon Browser includes many new features involving full customization of layout, new clean interface, multi-tab workspace, better security and improved rss/podcast reader. Until nowadays a big inconvenient was bookmarklet, toolbar and 3rd party plugins. Maxthon 2. 0 supports on the whole of the functions compared with Internet Explorer, Opera, etc. Additionally Maxthon has few exclusiv e screenshots below. Nevertheless the most interesting feature of new Maxthon is its possibility to create an account and to store all necessary information and settings online.The function is simply used just by logging in. Although Opera, Internet Explorer and FireFox are more sophisticated and have got more market share, Maxthon is swiftly gaining popularity. (Maxthon) Today is the era of Internet and application functionality is able to expand beyond the operating system into the desktops and the web. Personalization and delivery is very important and Maxthon Browser with its organic growth is a serious representative of such trend.In several years Maxthon will become a key player in the Internet market, because it has serious investors such as Morten Lund, CRV, and WI Harper, growing community and actually beautiful product. I recommend Maxthon, because it differs from other browsers and makes working process with Internet easier as it includes the visible gestures and customiz able Tab handling. But the most useful is if the browser is closed accidentally with ten tabs open, the next time it is opened, they are still there. (Maxthon).References Maxthon the Browser that Rocks. (2006, February 28) Retried September, from http//www. techcrunch. com.

Effects of Paraneoplastic LEMS on Neuromuscular Junction

Effects of Paraneoplastic LEMS on Neuromuscular JunctionQing Zhi TanEffects of ParaneoplasticLambert-Eaton Myasthenic Syndrome on the Neuromuscular JunctionIntroductionThe Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disease. It is characterised by muscle failing of the proximal lowerlimbs as a result of auto-antibodies produced against the voltage-gated calcium channels (VGCC) found on the presynaptic membrane of the neuromuscular junction(1). Most of the time, LEMS is classified as a paraneoplastic syndrome as it is often associated with cancer ( pure cell lung cancer in particular) (2, 3).One of the earliest descriptions of this disease was reported by Anderson and his colleagues in the year 1953, describing a 47-year-old patient with bronchial carcinoma presenting with progressive muscle weakness(4). Upon examining this patient, Anderson wroteHis (the patients) muscle power was generally weaker than his muscle bulk would suggest, especially the muscles of the should er girdle, hip girdle, trunk, and anterior compartments of the legs.(4)Since then, much research has been done to project out more about this disease. It is now known that the auto-antibodies are primarily directed against the P/Q-type VGCCs at the neuromuscular junction (1-3, 5, 6). This report will debate the effects of LEMS on the neuromuscular junction.Voltage-Gated Calcium ChannelsIt would be useful to first understand the structure of the voltage-gated calcium channels (VGCC). In general, VGCCs are made up of 5 subunits (1, 2, , , ) and can be divided, according to the electrophysiological and pharmacological properties of their 1 subunit, into 5 different subtypes (L, N, P/Q, R and T-type)(2, 7). The structure of a typical VGCC is shown in come across 1 below.As mentioned before, the LEMS auto-antibodies are mainly directed against the P/Q-type VGCCs (1-3, 5, 6). The 1 subunit of the P/Q-type VGCCs is known as 1A(8). This 1A subunit forms the channel which allows the movem ent of Ca2+ ions into the synaptic knob(8), and can be further broken down into 4 identical domains (I, II, III, IV), each possessing 6 transmembrane segments (S1-S6)(2, 8) (see Figure 2).What Happens at The Neuromuscular Junction?Now that we give birth understood the basic structure of the VGCCs, let us move on to its consumption and how it is affected by the pathogenesis of LEMS. The neuromuscular junction is made up of the pre-synaptic membrane, the synaptic cleft and the post-synaptic membrane (5, 9, 10). P/Q-type VGCCs present on the surface of the pre-synaptic membrane play a vital role in allowing synaptic transmissions to cross the neuromuscular junction (7, 9).In studies conducted by multiple different researchers, anti-P/Q-type VGCC auto-antibodies were found in more than 85% of LEMS patients (3, 6, 11). Japanese researchers Masaharu Takamori and his colleagues even went a step further to make up ones mind the specific immunodominant sites within the P/Q-type VGCC in wh ich the auto-antibodies would bind. In their study, they found that majority of their test subjects had auto-antibodies directed against domains II and IV of the 1A subunit in the P/Q-type VGCC(12)(highlighted in red in Figure 2).Depolarisation of the pre-synaptic membrane occurs when stimulated by an action potential initiated by a nerve impulse(13). This membrane depolarisation causes the VGCCs to open, allowing the local anaesthetic influx of calcium ions (Ca2+)into the synaptic knob(13). The increase in Ca2+ concentration will stimulate the exocytosis of vesicles containing the neurotransmitter Acetylcholine (ACh) into the synaptic cleft(13). ACh then goes on to bind to the nicotinic acetylcholine receptors found on the move end plate which will trigger an action potential and subsequently causing muscle contraction.(10, 13)In patients with LEMS, the LEMS auto-antibodies would bind to the VGCC present on the pre-synaptic membrane of the neuromuscular junction(5). This causes t he VGCC to lose its ability to function as an ion channel, thus inhibiting the influx of Ca2+ into the synaptic knob during membrane depolarisation(5). Since the exocytosis of synaptic vesicles are dependent on Ca2+ (14), it is believed that a devolve in Ca2+ influx would result in a reduction in synaptic vesicle exocytosis(5, 13, 15).A recent study conducted in 2015 confirmed the phenomenon in which the LEMS immunoglobulin G directly causes a reduction in the exocytosis of synaptic vesicles (16). They did this by using fluorescence imaging techniques to observe the exocytosis of synaptic vesicles in rat neurons incubated with LEMS IgG (16). Pooled IgG from healthy individuals were used in comparison and as a control (16).Hence, it is evident that the muscle weakness seen in LEMS patients is a direct consequence of cut exocytosis of ACh-containing synaptic vesicles.In summary, the Lambert-Eaton myasthenic syndrome is an autoimmune disease that causes muscle weakness in patients. T he reduction in muscle power is due to insufficient ACh release at the neuromuscular junction. In 85% of these patients, this is caused by auto-antibodies inactivating the P/Q-type VGCCs on the presynaptic membrane.Going Beyond VGCCsSo, what happens in the remaining 10-15% of LEMS patients that do not drop anti-P/Q-type VGCC antibodies? Many scientists have asked the aforementioned(prenominal) question and investigations have been carried out to find alternative mechanisms in the pathogenesis of LEMS in seronegative patients. (The term seronegative is used to describe patients with undetectable anti-P/Q-type antibodies.)In the absence of anti-P/Q-type VGCC antibodies, it is more or less impossible that LEMS would have the same pathogenesis in seronegative patients. Yet, it is found that there are no significant differences in the electrophysiological and clinical characteristics between the seronegative and seropositive patients(17, 18).One possible history for this phenomenon i s that there might be auto-antibodies directed against a different molecule involved in the synaptic transmission hence causing seronegative patients to have the same clinical and electrophysical features albeit having no anti-P/Q-type VGCC antibodies.To date, many auto-antibodies with different target molecules have been found in LEMS patients. One of the earliest to be discovered is an auto-antibody to synaptotagmin, which is a protein involved in synaptic vesicle exocytosis (2, 5, 13, 15, 19).Furthermore, antibodies to the M1-type presynaptic muscarinic ACh receptor (M1-mAChR) have also been discovered(20). The M1-mAChR is a G-protein coupled receptor that regulates ACh release at the neuromuscular junction(5, 20). We will not be going into the specifics of these antibodies in this report as the mechanisms involved are largely complicated.ConclusionEven though LEMS is a rare autoimmune disease, the prevalence of LEMS as a paraneoplastic syndrome in patients with small cell lung cancer (SCLC) is extremely high. More than half of LEMS patients have SCLC and more often than not, the diagnosis of LEMS precedes the diagnosis of SCLC(21). Therefore, LEMS could potentially play a crucial role in allowing certain cancers to be detected at an earlier stage.Hence, understanding the pathophysiology of this disease would not only prove useful in discovering better treatments for LEMS patients scarcely also aid the early detection of cancer.References1.Weiss N, Koschak A. Pathologies of Calcium Channels. Weiss N, Koschak A, editors Berlin, Heidelberg Springer Berlin Heidelberg Imprint Springer 2014.2.Takamori M. An autoimmune channelopathy associated with cancer Lambert-Eaton myasthenic syndrome. Intern Med. 199938(2)86-96.3.Lennon VA, Kryzer TJ, Griesmann GE, OSuilleabhain PE, Windebank AJ, Woppmann A, et al. Calcium-Channel Antibodies in the Lambert-Eaton Syndrome and Other Paraneoplastic Syndromes. immature England diary of Medicine. 1995332(22)1467-75.4.Anders on HJ, Churchill-Davidson HC, Richardson AT. BRONCHIAL NEOPLASM WITH MYASTHENIA. The Lancet. 1953262(6799)1291-3.5.Hulsbrink R, Hashemolhosseini S. Lambert-Eaton myasthenic syndrome diagnosis, pathogenesis and therapy. Clin Neurophysiol. 2014125(12)2328-36.6.Motomura M, Lang B, Johnston I, Palace J, Vincent A, Newsom-Davis J. Incidence of serum anti-P/Q-type and anti-N-type calcium channel autoantibodies in the Lambert-Eaton myasthenic syndrome. Journal of the Neurological Sciences. 1997147(1)35-42.7.Catterall WA. Voltage-gated calcium channels. Cold Spring Harbor perspectives in biology. 20113(8)a003947.8.Structure and Regulation of Voltage-Gated Ca2+ Channels. Annual check of Cell and Developmental Biology. 200016(1)521-55.9.Hughes BW, Kusner LL, Kaminski HJ. Molecular architecture of the neuromuscular junction. Muscle Nerve. 200633(4)445-61.10.Martini F, Nath JL, Bartholomew EF. Fundamentals of anatomy physiology. San Francisco Benjamin Cummings 2012.11.Motomura M, Johnston I , Lang B, Vincent A, Newsom-Davis J. An improved diagnostic assay for Lambert-Eaton myasthenic syndrome. Journal of Neurology, Neurosurgery Psychiatry. 199558(1)85-7.12.Takamori M, Iwasa K, Komai K. Antigenic Sites of the Voltage-gated Calcium Channel in Lambert-Eaton Myasthenic Syndromea. Annals of the New York Academy of Sciences. 1998841(1)625-35.13.Lang B, Newsom-Davis J. Immunopathology of the Lambert-Eaton myasthenic syndrome. Springer seminars in immunopathology. 199517(1)3-15.14.Mechanisms of Synaptic Vesicle Exocytosis. Annual Review of Cell and Developmental Biology. 200016(1)19-49.15.Takamori M. Lambert-Eaton myasthenic syndrome as an autoimmune calcium channelopathy. Biochem Biophys Res Commun. 2004322(4)1347-51.16.Spillane J, Ermolyuk Y, Cano-Jaimez M, Lang B, Vincent A, Volynski KE, et al. Lambert-Eaton syndrome IgG inhibits transmitter release via P/Q Ca2+ channels. Neurology. 201584(6)575-9.17.Oh SJ, Hatanaka Y, Claussen GC, Sher E. Electrophysiological differences in seropositive and seronegative Lambert-Eaton myasthenic syndrome. Muscle Nerve. 200735(2)178-83.18.Nakao YK, Motomura M, Fukudome T, Fukuda T, Shiraishi H, Yoshimura T, et al. Seronegative Lambert-Eaton myasthenic syndrome study of 110 Japanese patients. Neurology. 200259(11)1773.19.Takamori M, Hamada T, Komai K, Takahashi M, Yoshida A. Synaptotagmin can cause an immune-mediated model of Lambert-Eaton myasthenic syndrome in rats. Annals of neurology. 199435(1)74-80.20.Takamori M. Lambert-Eaton myasthenic syndrome Search for alternative autoimmune targets and possible compensatory mechanisms based on presynaptic calcium homeostasis. Journal of Neuroimmunology. 2008201-202145-52.21.Titulaer MJ, Verschuuren JJGM. Lambert-Eaton Myasthenic Syndrome. Annals of the New York Academy of Sciences. 20081132(1)129-34.

The Story Of Josie King Health And Social Care Essay

The Story Of Josie exponent Health And Social C are EssayThe story of Josie exponent is one that shook the hospital health compassionate system in 2001. Josie King was an 18 month-old that died from complications of treatment at Johns Hopkins Medical Center. Josie was originally admitted to the hospital with assist and third degree burns over 60 percent of her body. During trouble, Josie had received a lethal dose of methadone after which she died as a provide of a cardiac arrest. As a result of this sentinel event, the Kings were awarded a settlement which they ref put ond. Josies mother Sorrel wanted e genuinelyone to know what happened to her baby. Sorrel King has indite an inspiring memoir Josies Story and has created a patient-safety program at Hopkins in addition to a foundation devoted to reducing medical exam errors. Sorrel King now advocates for patient and families affected by medical errors, and provide lectures to medical professionals countrywide. (www.josieking .org.)Medical errors have and continue to be an enormous problem in health care. Patients die from the wrong do drugs or wrong dosage, or perhaps an infection that could have been prevent with better hygiene practices. More attention was pose on the issue of medical errors in 2000 when the Institute of Medicine made available the well-known report titled To Err is Human Building a Safer Health System. The report documented evidence of an estimated 44,000 people and as mevery as 98,000 people dying in hospitals from medical errors each year in the United States (IOM, 1999). Of the many medical errors, medicine errors happen to be one that can non be overemphasized. Medication use have been found to card for at least 20 percent of obstinate events in patients in hospitals. Out of every hundred medication orders, there is an occurrence of five unfavourable drug events (Tam, 2005).Malpractice claims due to adverse drug events can have negative effects on the hospital and the healt h care providers. The hospital and health care providers can have their reputation damaged, thousands of dollars are spent for the losses, there is time lost from work, not to mention the emotional stress involved (Rothschild et. al, 2002). The price of preventable medication errors has been estimated between 17 and 29 billion dollars annually (Strohecker, 2003). As such, due to these alarming statistics, this paper focuses on almost of the potential endangerments of medication errors, and some recommended interventions that can be implemented to help oneself curb the incidence of medication errors.What is a medication error?A medication error is defined as any preventable event that whitethorn cause or lead to inappropriate medication or patient harm while the medication is in the control of the health care professional, patient, or consumer (Oren, 2003). The terms adverse drug events and medication errors though used interchangeably do not necessarily imagine the same thing. An adverse drug event is an undesirable reaction after a drug administration that is not necessarily caused by the drug. Adverse drug events include adverse drug reactions and medication errors. Medication errors may lead to actual or potential adverse events. The potential adverse events are oft termed near misses. For example, if a medication overdose is administered accidentally, it would be a medication error and not described as an adverse drug reaction (Oren, 2003). electromotive force Risks of Medication ErrorsMany of the factors leading to medication error are unfortunately human related (Etchells, et. al, 2008). A survey of 983 sucks working in acute care hospitals reported that among the many factors that would contribute to medical errors, illegible hand create verbally prescriptions, distraction from the environment, exhaustion and stress happened to be the most weighted (Mayo Duncan, 2004). A cogitation by Hodgkinson et.al that sought strategies to reduce medication errors cited the most common reason of medication error was due to the lack of drug information by the multidisciplinary aggroup (2006). Inexperience and or lack of knowledge of the drug could lead to the physician say the wrong dose, the pharmacist incorrectly mixing the medication with the righteousness concentration, and the nurse administering the medication with the wrong route such as giving an intramuscular injection instead of subcutaneously (Etchells, et. al, 2008).While human error is very historic to consider, it is equally important to analyze the context in which errors can occur such as the clinical environment and patient population. The character reference of clinical mount in a hospital can be more prone to medication errors than others due to the patient population with respect to the severity of their illness, and number and type of medications needed to be administered. Critical care units for example, angle to be at a higher risk for medication errors. Critical care units provide for very sick patients who need to be attended to without delay, may require consults from various providers, and receive twice as many medications as compared to patients on general medical floors. Patients in intensive care experience an average of 1.7 medical errors each day. Medication errors are the most common type or error and greenback for 78 percent of serious medical errors in critical care (Camire et. al, 2009).In addition to the patients in critical care, pediatrics and the elderly also tend to be at high risk for medication errors since there require many medications when sick. Pediatric patients in particular tend to be very streake-ass to most medications hence the need to calculate most of their medication dosages by weight (King, 2003). The least miscalculation could lead to an adverse drug event. Older prominent populations, on the other hand, take many prescription medications for their chronic illnesses which need scrutiny to avoid contraindications (ANJ, 2009). However, regardless of whether the patient may be at risk of experiencing a medication error or not, all medication administration must ideally follow the seven rights which include the right patient, right medication, right dose, right time, right route, right reason, and right documentation (Schaeffer, 2009).Another factor which may influence the safety of medication administration involves medication reconciliation. When patients list of root word medications and allergies are not collected upon admission, a medication error can occur when a medication being taken regularly at internal is not continued during the hospital stay. If the patients medication reconciliation is not complete, the physician would not have full knowledge of the medications that the patients would need to be restarted on after being transferred or discharged from the hospital. At times there may be an oversight on the part of the prescribing physicians where brand and gene ric medication name calling are concerned. A physician may also duplicate order a medication that the patient may already be taking at home, and at times order an incorrect dosage (Landro, 2006).In recent times, there have been technological influences in health care, where there has been an effort to take down rid of the paper documentation but the transition is not that complete. Many hospitals still document on paper and still creating the risk of medication errors by the use of error prone medication abbreviations. During transcription of written orders, the use of abbreviations can cause errors if not interpreted correctly. American Health Association intelligence service mentions a study discussed in the Joint Commission Journal on Quality and Patient Safety, medication errors that were reported to the national entropybase made up 5 percent of all errors that occurred as a result of incorrect interpretation of abbreviations used during prescribing (2007). In this same study , an analysis of 30,000 abbreviations related- medication errors reported to the United States Pharmacopeias database was made. intimately of the errors consisting 81 percent were made during the writing of prescriptions. The abbreviation QD used in place of once daily was found to have caused more errors 43.1 percent than any other abbreviation. The Joint Commission has a national safety goals report that include a do not use list of abbreviations that hospitals and other health care organizations can use as a reference (AHA News, 2007)Medication Error Risk Reduction StrategiesIn addition to the modified traditional seven rights for medication administration, hospitals are instituting additional evidence-based practices. According to an article in the ACCN monthly publication, the implementation of six best practice procedures for medication administration designed by the atomic number 20 Nursing Outcomes Coalition (CalNOC) significantly improved accuracy (2010). In this study, p articipating hospitals showed an 80.5 percent improvement in adherence to CalNOC best practices and an 81.4 percent score for unite administration accuracy and best practice improvements. The CalNOC six best practices include compare medication to medical record, keep medication labeled until administration, check both forms of patient identification, immediately record medication administration in the chart, explain the medication to the patient, and minimize distractions and disruptions during the administration process (ACCN, 2010).Another technological invention to help reduce medication errors are the smart infusion pumps. These smart pumps have built-in danger alerts, clinical calculators, and drug libraries including information on the standardized concentrations of commonly used drugs. Though smart pumps have been designed to prevent mistakes, it only works for high alert intravenous medications. In cases where the smart pumps are not used appropriately, its purpose is not served. In a controlled trial study of smart infusion pumps, nurses were found to routinely ignore danger alerts and drug libraries as much as 25 percent of the time, sometimes administrating medications such as propofol, insulin, and heparin at rates 10 times as high as those ordered (Rothschild et.al, 2005). Smart pumps can work exceptionally and prevent errors if alerts are paid attention to used appropriately.The computerized physician order entry (CPOE) system is another(prenominal) technology that has been found to significantly decrease the danger of illegible handwritten orders and the need for transcription. According to Bates et. al, out of the approximately 28 percent of preventable adverse drug events are associated with medication errors, 56 percent occurred during prescribing (Bates, et. al, 1998).The computerized physician order entry (CPOE), computer based system where all orders are electronically written helps to ensure accuracy of writing orders. Most of these CP OE are accompanied by a Clinical Decision Support System (CDSS) which provides automatic alert to prescriber on drugs or doses that are contraindicated with the patients age, allergies, condition, and or diagnosis. Review of a systematic study by Kaushal et. al on the effects of CPOE with CDSS showed a considerable decline in the rates of medication errors (2003).A study at the Brigham and Womens Hospital in Boston on the effect of CPOE on prevention of serious medication errors showed that the use of the CPOE system caught on to half the possible errors that may have lead to deleterious effects. The study showed a reduction in all the stages of the process from ordering to dispensing to administration (Bates et.al, 1998). CPOE therefore proven to hold some promise as an intervention to improve patient safety but would require further data of the benefits of costs before implementation.Bar coding is another technological intervention that has been shown to decrease the rate of medic ation administration errors. Bar coding can cede the possibility of nurses administrating medications without having a documented order. With bar coding, each time a physician ordered a medication, the order is automatically transmitted to the pharmacy where a unique bar code is generated. After verification of the order by the pharmacist, the labeled medications are sent to the floor/unit. The nurses who have to administer the medication would then(prenominal) have to scan the bar code on the patient identification band against the labels on the medications for comparison.Bar coding has shown to reduce medication errors by more than 50 percent, thus preventing preventable adverse drug events (Wright et.al, 2005). The Veterans Affairs hospital led the way in 1999 instituting a national bar coding program. at heart a year of initiation the VA hospital documented a 24 percent decrease in the rate of medication-administration errors (Wright et. al, 2005). Although the ultimate goal is to protect patients, bar coding could also save hospitals lots of money. The average adverse event costs extra hospital days and additional services, not to mention the cost of litigation. Like every other measure there would be disadvantages for using bar coding, but once more investigate can show that the benefits surpass the costs, more hospitals can join the increasing number of institutions that have embraced this technology.With medication errors responsible for many lost lives yearly, new national patient-safety standards require hospitals to have a mandatory formal medication reconciliation process for every patient admitted into the hospital. Medication reconciliation would take effect during the patients admission process and involves the recording of a patients allergies and thorough collection of all the patients home medications including over the counter drugs. This routine has been found to reduce medication duplication and avoid the effects of contraindication w hile the patients are hospitalized. This also aids the physicians on what medications to discharge the patient with. During the medication reconciliation process the need to educate the patients and their families is also import. Patients and families have to understand the rationale rear end keeping handy a list of all their medications and being able to provide the list especially in emergent situations (Landro, 2006).SummaryThis paper has reviewed research on medication errors in hospitals with an emphasis on the prevalence, risk factors, and strategies to prevent errors from occurring. Although the immediate cause of medication errors is often as the result of human error, the bulk of errors can be attributed to system failures made worse by the increasing complexity of patient care. A medication error can cause desolate results, threaten patients lives, and affect a providers confidence and job security. Hospitals also tend loose lots of money in malpractice law suits. The wi de range of pharmaceutic products and dramatically changing technology adds to the complex situation. Many strategies including the CPOE and CDSS, smart pumps, and bar coding among other strategies have already been implemented by few hospitals. look shows that these strategies that have been implemented targeting the reduction of medication errors have been found to be promising. However, due to the complexity of patient care, both human and technological influence may be able to control but never be able to completely put to death medication errors.

Analysis of the UK Confectionery Industry: Thorntons

Analysis of the UK Confectionery Industry ThorntonsConfectionery Industry In The UK Contributes A Major Amount Of Revenue To The Countrys EconomyChapter 1 IntroductionConfectionery industry in the UK contributes a study amount of revenue to the countrys economy. Repeated case studies have revealed that the confectionery industry is ever ripening and the demand for creativity and innovation in the products in increasingly demanded by the consumers in the UK trade. Alongside, the growth in the confectionery industry has also resulted in the pie-eyed competition among the players in the securities industry with many global competitors like Cadbury and Nestle. The growth of more focused and niche market targeting companies have also grown tremendously in the UK, which includes companies like Thorntons, Ferroro UK ltd, etc. The stiff competition in the market and the increased penetration of the big players into various market segments has further disturbed the persuasion of compan ies like Thorntons. This circulate is focused on the analysis of the marketing strategies for Thorntons Plc and provides valu adapted suggestions for future expansion and strategies to understand competitive advantage in the UK chocolate market. The report aims to achieve the following objectivesTo effectively segment the target market for Thorntons and identify those segment(s) here the company piece of ass effectively develop its business.To identify the importance of purchaser behaviour and establish that the effective deployment of buyer behaviour would help the company understand its target market in detail so as to exculpate market share.Provide recommendation for an appropriate short-run promotional campaign in the UK for increasing the awareness on the companys products in the target market.Devise a sales or promotion campaign for the company in methodicalness to increase its sales through focusing on establishing the brand of Thorntons in the market as a strong compe titor.Present a critical analysis of the advertize strategy mentioned in the case study for Thorntons and device a advanced advertising strategy that would include a creative media based plan in order to increase the awareness among the customers in the target market in addition device a critical structure for the mail marketing plans in order to reach the over 50 years segment of customers in the UK market.Chapter OverviewChapter 1 IntroductionThis is the current chapter that introduces the reader to the objectives of the report and the flow of the report text.Chapter 2 Market Segmentation and buyer behaviourThis chapter first presents an analysis on the market segmentation and identifies those segments that the company should target upon for further market expansion. This is then followed by the overview of the buyer behaviour and the use of buyer behaviour by the company in order to gain competitive advantage in its target market.Chapter 3 Advertising and PromotionThis chapter first presents a discussion on a short-term promotional campaign for the company in order to increase the awareness of the products in the existing target market. This is then followed by a detailed overview of the advertising plan incorporating creative plans in the media based advertising in order to promote the products of the company. This is then followed by a critical analysis on the direct marketing strategy for over 50 years segment of customers in the UK in order to effectively reach that segment of the market so as to increase the sales as well as the market share.Chapter 4 ConclusionThe objectives of the chapter are reviewed against the research and analysis conducted in the previous chapters and then a conclusion is derived based on the results of the analysis.Chapter 2 Market Segmentation and Buyer Behaviour2.1 Market SegmentationFrom the case study of the company it is evident that the major segments in the Chocolate market includeCount linesMoulded BarsBoxed Chocolat esSeasonal Products andBagged Self linesIt is also evident that the company under debate i.e. Thorntons Plc nail down in the manufacture and sale of Boxed continental chocolates in the UK and global market. Hence the market segment that the company primarily operates is under the sub celestial sphere of the Boxed chocolates in the Chocolates industry of the UK. A further segmentation of the Boxed Chocolates market in the UK based on the price and quality is presented belowThe meter and One Nights Gender and Power DynamicsThe 1000 and One Nights Gender and Power DynamicsGENDER/POWER dynamics as suckn in The thousand and one nightsThe Thousand and one Nights are a collection of stories in the middle east/south asia in the golden Islamic age. The tales are relate around the people Shahrayar and Shahrazad. Sharazad uses her power of narration controling to King sharayar to keep her and others protected from existence executed. Throughout the floor we impinge on that women are scarcely exitn as objects of pleasure as women only can hold onto their power through sex,desire and beauty. Women in the stories in the thousand and one nights The thousand and one nights uses Sharazad to represent feminism as with her wisdom and her way of storytelling we see how she overpowers herself and change Shahrayar.This juxtaposing mood of womens role in society and Shahrazad set ups us the actual value that women possess as they are just get even to men. There is also an interesting correlation with gender/power dynamic and with class that is present in the thousand and one nights.There is this common stem rise in the stories Shahrazad tells sharayar the stories can be labeled as misogynistic as some of the stories told feature men who cause the downfall of women. An example being the short story The merchant and his wife. When reading this story readers might be quite surprised on the message the story is trying to convey that men should be able to beat their wiv es in order to control them. At first I was quite confused on why Shahrazad tells this specific story in order to change shahrayar but then I found that she tells this story in order to show a reflection of him and his actions. The actual intended message was to show that beating women wont force obedience. Telling this story surprisingly genuinely worked as she didnt get killed by the king the day after.In the Fisherman and the djinny we are introduced to a djinni and Fisherman as this story concerns on this idea of this power dynamic. In the story we are first introduced to this fisherman who we see that this fisherman is near the shores trying to catch fish for his family. We then see the fisherman reels in a golden jar which then a jinni comes out of. The Jinni then tries to kill the fisherman but fails to do so as the fisherman is then tricked to go back into the jar. We see this idea embedded in the advert Since I must die, he said, before I choose the manner of my death, I conjure you on your honour to tell me if you really were in that vase? This quote itself makes readers question the validity of status in society as this reveals us how a fisherman is trying/planning to outgo a Jinni. The fisherman is considered as a person of such low status and him being able to outsmart such a unchewable zoology must mean something . Status is just a social construct created by society and Shahrazad telling this story shows this.There is also this strong relation with Allah the story revolves around this idea that if you trust and believe in allah good will always come to you.In one of the stories The Woman Whose Hands Were Cut stumble For that She Gave Alms to the Poorwe see an interesting point regarding the gender dynamic commonly seen in the thousand and one nights. We see here a clear portrayal of how women can hold on their power other than things like sex,beauty and desire. Instead we see the women holding onto her power with her generosity. In the st ory we see here that a womans hit is cut off after giving food to a poor man. Later in the story this act of generosity is what proceeds her as the scene when she tries to save a baby from drowning the food that she gave to the old man comes and restores her hands. Seen in the story the power of generosity helps her keep her power as a woman. We see this standardised concept in another story in the thousand and one nights named The Miller and his Wife . Where the wife used her intelligence to retain her power. The wife in the story after finding out the millers dream about the treasure uses this to try to attract the attention of her real cheatr which is their neighbor. Having this attribute helps her both gain her actual lover and getting rid of her husband. But the exact thing women were valued during this time overcomes her and she fails to get what she wants. Instead of holding onto her power with her intelligence she lets her love and sexual desire for the neighbor get the best of her thus leading her both to lose her love and the treasure.In the Tale of Ala-al din and the wonderful lamp we see this aspect of gender/Power dynamic. Women are rarely given voices and are only to be desired by men. We are introduced to this character named Ala-al-din even is considered the adept is actually a character that is filled with greed. When Ala-al-din first meets with the genie and turns ala-al-din who is considered a low-life into a well-respected man only for his riches. When Ala-al din was transformed into this new man we see his undeniable greed as he only wanted to flaunt with what he wanted. His main desire was getting the sultans daughter despite her already being married he makes a plan to her. This idea shows one of the framings of women in the thousand and one nights as in this case we see the daughter performing as a desirable object. At the end of the story we are given this closing which states Aladdin had won the hearts of the people by his gentl e bearing. He was made captain of the Sultans armies, and won several battles for him, but remained as courteous as before, and lived thus in peace and content for several years. When reading this quote readers get a sense of this feeling of greed. The theme of Aladdin seems to focus on this idea that the whole rag to riches theme can be only achieved by the feeling of greed. That if you want a better life for yourself you will have to be greedy. Ala Al-Din also shows his power by outsmarting the genie Before meet the genie Ala al din is seen as a low life as he is very poor but we see this quickly turn around when he meets the genie and is then transformed into a wealthy respectable man. We see this interesting connection also within The fisherman and the Jinni how a person with low status is able to outsmart a being who is considered powerful. This shows how this idea of status is imaginary and means nothing. Ala-al din is actually powerful in his own terms and doesnt need societ y labelling him of such low status.Conclusively The thousand and one nights in a larger frame actually shows us the power and value that women possess regardless of the fact that the stories were labelled as misogynistic by many and the morals and virtues believed when the stories were made.. Women possess this power of intelligence that helps them retain their power which is clearly seen in numerous stories in the thousand and one nights. The thousand and one nights clearly act as a symbol of feministic publications pieces from many years to come.

Two Personalities in My Last Duchess :: My Last Duchess Essays

Two Personalities in My Last Duchess The poem My Last Duchess is about a powerful Duke, and his beautiful, flirtatious wife who has deuce different personalities, one that was reality and the other was the lady in the painting. The poem begins and ends with him mourning the loss of his deceased Duchess, but from the way that the mighty Duke speaks, he knows much about her death than he leads us to believe. The Duke chooses his word very carefully, when he talks to his companion about the painting of his wife. He only drops small hints, to his friend about the death of his Duchess. Which leads me to believe that the Duke killed his wife, or had someone to put her to her death. As the Duke speaks of his Duchess, in the beginning, he sounds extremely compassionate and caring towards her. The Duke had an absolute love for his Duchess as most husbands and wives do. He sounded so proud of her and the beauty that she posed almost like she was a trophy. Despite all of the pride and exci tement that he showed towards her, in that respect was an element of distrust that lingered inside of his mind. The Duchess created the element of distrust that was bestowed into the marriage. The Duke explained that his wife was extremely flirtatious and easily impressed. The Duke said, Too easily impressed she liked whateer she looked on, and her looks went everywhere. This line is cogent about the Duchess, as she was when she was alive. The Duke believes that his Duchess is a cheat, and that she doesnt try to hide it either. A husband can tell when his wife is interested in another man, cause she at once looked upon him in that way she is looking upon her new male interest. The Duchess probably didnt know that her husband was watching her, while she was taking interest to her lovers. She may have mind that she and her male interest at the time were alone, cause not any woman, in that era would have been seen with another man besides their husbands. Given the item that th is poem dates back to the Duke and Duchess era, so they lived in an old fashioned world. The Duke believes his wife is not being faithful to him.

Great Gatsby 2 :: essays papers

slap-up Gatsby 2F. Scott Fitzgerald is an author who is distinguished for his use ofsymbolism in his literature, like in the novel The Great Gatsby. Heuses the image of Doctor T. J. Eckelburgs eyes to symbolize a godlikebeing. Fitzgerald uses the symbol of the two women in yellow atGatsbys party to represent the values of the 1920s. The sustenance providedat Gatsbys party symbolic bothy represents the members of 1920ssociety. F. Scott Fitzgerald uses Symbolism in the novel The GreatGatsby as an accurate reflection of brio in the American 1920s. InThe Great Gatsby the symbol of T. J. Eckelburgs eyes represent a godlybeing watching over society. Fitzgerald incorporates the eyes into hisnovel to represent a pair of all seeing, all knowing and judging eyes,which ar meant to intimidate. The character of George Wilson believesthat the eyes are the eyes of God.I spoke to her, he muttered, after a long silence. I toldher she capacity bait me but she couldnt fool God. I took her tothe window- With an effort he got up and walked to the rear windowand leaned his face pressed against it, -and I said God knows whatyouve been doing, everything youve been doing. You may fool me butyou cant fool God Standing behind him Michaelis saw with a shockthat he was looking at the eyes of Doctor T. J. Eckleburg, which hadjust emerged disgusted and enormous from the dissolving night. God seeseverything, repeated Wilson. (p.167) Through Wilsons beliefsFitzgerald explains that the eyes can see everything including Myrtlesinfidelities. Myrtle is a typical person of the 1920s. She has put herown life and interests ahead of everyone elses including herhusbands. The eyes of God are frowning down on the 1920s society.But above the grey land and the spasms of bleak dust whichdrift boundlessly over it, you perceive, after a moment, the eyes ofDoctor T. J. Eckleburg. The eyes of Doctor T. J. Eckleburg are blue andgigantic-their retinas are one yard high. The look out of no face but,ins tead, from a pair of enormous yellow spectacles which pass over anon-existent nose...his eyes, dimmed a little by many painless daysunder sun and rain, brood on over the solemn dumping ground.(p.27-28)Through Fitzgeralds wording in describing the image of Eckleburgseyes the reader develops a mental image of an omnipotent being who isconstantly watching over the land. The reader discerns that the eyesnot only see everything but that they eyes are morbidly unhappy.