Affects of alcohol on teenagers

Review underage drinking is an increasing problem within the adolescent population. This leads to poor decision making, risk taking and behavioral problems as the brain is not fully developed. Underage drinking can also affect a person's social and emotional wellbeing. Popular Channel Ten television show, The Project (1), did a segment on teaching Australian youth how to P. A. R. T. Y safely. P. A. R. T. Y stands for Prevent Alcohol and Risk-Related Trauma In Youth. According to the segment, It Is estimated that one Australian teenager dies everyday due to alcohol related causes while another sixty are hospitalized.The point of the segment is to promote the P. A. R. T. Y program to adolescences to prevent youth Injury and trauma. The program includes educating teenagers through films and also meeting survivors of road trauma that are now going through rehabilitation. The researcher chose this source as they were able to relate It to their Interview with a PHD/PEE teacher. Both the se gment and interview talk about programs or topics at school that give adolescents information on drugs and alcohol. By choosing this topic, the researcher was able to compare the P. A. R. T.Y Program with what adolescent students are taught in the Great Lakes Area. The segment also states that this years MIAMI Crash Index Study has found that in the past year, 56% of people admitted to testing while driving, 13% had driven drunk. 8% while on drugs and with too many people In the car. A website about. Com (2), did an article on teen drinking and behavior problems. The article says that according too new study by the Substance Abuse and Mental Health Services Administration (SAMARA), adolescents between the ages of 12 and 17 who use alcohol are more likely to result in behavioral problems.Underage drinking – even so-called light drinking – is dangerous, illegal, and must not be tolerated,† said SAMARA Administrator Melba Cave. The article says that adolescents who use alcohol are more likely to report behavioral problems, especially aggressive, delinquent and criminal behaviors such as fighting, stealing, driving under the Influence of alcohol and/or drugs, skipping school, feeling depressed and deliberately trying to hurt or kill themselves. Like ‘The Project' segment, the researcher was able to relate this article to the interview with the PHD/PEE as the interviewer asked a question about behavior.By using this article with statistics, the researcher Is able to compare the results from the interview with the statistics. This shows how the Great Lakes area compares to the rest of the adolescent country. With the underage drinking rates not significantly changing since 1 994, It Is clear that there Is a major problem. According to the article on about. Com, a new report, the â€Å"Patterns of Alcohol Use Among Adolescents and Associations with Emotional and Behavioral Problems† concludes that there Is big relationship between alc ohol use among youth and many emotional and behavioral problems.This is a problem as it affects the social and emotional wellbeing of the adolescent which has an impact on many things such as school work, social and family life and their mental state. The study also showed that drinkers are more likely to use illicit drugs then non drinkers. An article on drinkers. Org (3) did an article on underage drinking called â€Å"Kids and Alcohol don't years and more than quarter of our 14-19 year olds are putting themselves at risk of harm from underage drinking and binge drinking.The article also says that from the age 12 or thorough to the early twenties the brain is in a state of intense placement, molding and hardwiring in readiness for the challenges of adulthood. Fractionation is a process where the brain is growing and forming all the critical parts it needs for learning, memory, planning, emotional stability and thinking. During this critical phase of growth, fractionation tells us that alcohol disrupts the brains development. By drinking alcohol at a young age, you are risking that your brain may never reach its full capacity which means you may never reach your full potential.The researcher chose this source as the article then goes on to talk about hat you could do as a parent to help your teenager become a happy and healthy adult. The researcher can use this source, as well as the interview with the parent to put towards their research. These two sources would have similar results and would be good to compare with each other. The last source the researcher looked at was a literature review on the Juvenile Justice Bulletin (4). The review talks about the effects and consequences of underage drinking and how it can affect a youth's physical, emotional and neurological health. Like the article on drinkers. Erg, the review talks bout the brain development, stating that the brain doesn't fully develop until a person is around age 25. Underage drinking can ofte n impact on the neurological development causing youth to make irresponsible choices. The effect of alcohol can also have long term, negative effects on the brain such as those listed below: Alcohol affects the hippopotamus. The hippopotamus is a part of the brain that handles memory and learning. By abusing alcohol, the hippopotamus becomes smaller affecting the academic performance and memory of an individual. Such effects on the brain can sometimes be irreversible. Alcohol affects the amelioration process. Amelioration helps stabilize and speed brain processes. Disrupting the amelioration process can cause cognitive deficiencies. Continuing abuse of alcohol use and other drugs may keep adolescents from advancing to more complex stages of thinking and social interaction. Adolescents have unique social and emotional characteristics and undergo physical and cognitive changes that can affect their social and emotional development. Because of this, adolescents will often find themselv es in dangerous and risky situations when they are under the influence of alcohol which will often have negative outcomes.While adolescents are growing up, they struggle to find independence and try to create their own personal identity. Adolescents look to their peers for support, approval and belonging as they start to provide some of the same functions that a family did earlier. This can often lead to peer pressure, rebellion, experimentation and risk taking. Peer pressure is the influence from members of one's peer group. It often convinces adolescents to engage in activities to gain one another's approval and often results in alcohol use.Adolescents often try different social roles and identities to discover who they are such as using make up or alcohol use. Underage drinking has serious social consequences for adolescents and young adults. When adolescents are younger, they are more involved with their families. However, when they start to get older they start socializing more with their peers. In turn, their peers influence their values and them to start drinking. Frequent and heavy use of alcohol is often associated with low self esteem, depression, conduct disorders, antisocial behavior and anxiety.Again, this has a dramatic impact on the social and emotional wellbeing of an adolescent as some effects are irreversible. The researcher chose this source as it has a lot of points about the social and emotional wellbeing of adolescents and that is the research question for their Independent Research Project (RIP). Although the source has American statistics, the points about the effects of alcohol are universal. The source has a lot of information and is easy to relate to the questionnaires and interviews the researcher as already done as they all look at the same topics.Underage drinking is becoming very common in today's society and can often have tragic consequences. Many people view drinking alcohol as a fairly typical activity for youth and young adu lts and young people are finding it relatively easier to obtain alcoholic beverages. However, the abuse of alcohol can often result in negative consequences such as impaired decision making, poor coordination and engagement in risky behaviors. As the brain doesn't fully develop until around the age of 25 years old, alcohol abuse can damage the brain, body systems and organs, which are sometimes irreversible.

The Effects of Dysfunctional Families

Self-destruction of the Mind Many children grow up in dysfunctional families and in order to know what a dysfunctional family is, we have to understand how it operates. No family is perfect and disagreements, bickering and yelling are normal. But the word we are looking for here is â€Å"balance†. This is exactly what dysfunctional families’ lack, whether parents are controlling, deficient, alcoholic or abusive, they have an adverse, long term effect on the children even long after they have grown up and left home. Many of these adults from dysfunctional families often feel inadequate and incomplete.They have difficulty with intimate relationships and often develop compulsive behaviors and addictions, being self-destructive in their own mind. Let us consider a family that is too controlling, where parents are over dominating and do not allow their children simple fun and deny them of their independence. These parents continue to make decisions and control their children even at an age where it is unnecessary. So growing up and learning to be independent can be difficult, a feeling of anger and resentment may present itself.Transition into adulthood poses some struggle to these adults who often feel unsure of themselves and guilty because they feel as though they are disobeying their parents by making their own decisions. Let us take a look at the other extreme where parents are deficient in their roles and are not present in the rearing of their children. These parents leave their children to often fend for themselves which forces them to grow up too fast. Taking on adult responsibilities to make up for the parental inadequacy, these kids ignore their feelings and often grow up not knowing how to show emotion.They find it difficult to form and maintain intimate relationships, they fear getting close to others for fear of abandonment. They often develop a sense of helplessness and blame themselves for the absence of their parents. Whether there is too much parental discipline or a lack of guidance, children growing up without this balance often fear badly. And when alcohol, drug abuse and abusive behavior on the parents part is thrown in, this can be very damaging to these children all through their life. This kind of environment strikes terror in these children, they feel afraid to make mistakes and often live on the edge of fear.Abused children feel anger, frustration and are usually insecure. They do not feel comfortable at home and never voice their opinions. They do not trust easily and find it hard to maintain relationships. Adults grown up from alcoholic and abusive families develop all these negative character traits and often never grow out of them. Children of alcoholics and drug abusers are at much higher risk for developing substance abuse than are children in healthy families. Therefore, unfortunately many of these adults create their own pattern of compulsive behavior and addictions.The effects of dysfunctional families are long term and most times these children are robbed of their childhood. Whether families are over functioning by not allowing children breathing room to think for themselves or under functioning by neglecting the needs of their kids, these families are inconsistent and lack the proper balance of discipline and freedom. As a result these children grow up with trouble maintaining positive self-esteem, they often blame themselves for the dysfunctions in the family and this feeling of helplessness and unworthiness carries on throughout their adulthood.They struggle with trust and intimate relationships and sadly some fall into the pit of alcoholism and drug abuse. These children are victims and these negative self-images they have of themselves causes them to become self-destructive in their own mind. With positive thinking and the correct mindset and with the right help they can overcome these difficulties. References Bentont, S. (1993). www. k-state. edu. Retrieved from ht tp://www. k-state. edu/counseling/topics/relationships/dysfunc. html Bohli, E. (2012). Symptoms of adults from dysfunctional families. Retrieved from http://www. erikbohlin. net/Handouts/Coming_from_dysfunction. pdf

Interpretation of Political Cartoon Essay

We feel that the cartoonist intended to convey that Malaya is going to take all the revenue of every state involved in the merger in order to contribute to Malaya’s prosperity. To justify our opinions above, we refer to the following points. The man in the vehicle is Tunku Abdul Rahman as he is wearing a religious hat and he is also the person driving the vehicle which made him seemed very mighty and powerful. The man rolling the wheel is Mr Lee Kuan Yew as he is the person who was strongly for the common market, precisely the words on the wheel that he was rolling. The truck that Tunku Rahman was driving was empty and was moving towards Singapore. As such, we felt that Tunku Rahman was going to take the money from Singapore in order to greater benefit Malaya. Mr Lee Kuan Yew is also put in a bad light as it seems like Mr Lee Kuan Yew is working for the Tunku. We then further deduce that the cartoonist is pro-Malaya from the additional inference that since the original title is in Malay, the cartoonist should be Malay as well. Singapore is placed at the edge of the entire picture and our country is also depicted as small and undeveloped. Malaya on the other hand, is big and has many factories that are emitting smoke which can suggest that their factories are in operation. As established above, Mr Lee Kuan Yew is the man who is rolling the wheel with the words ‘common market’ written on them. We think that this means that his main/ most explicit purpose of merger is for a common market to be set up. (With further analyzation, this can be a form of saying that Singapore is selfish as Singapore would benefit more than the other states. He also seems to be kneeling on the ground which could suggest that he is desperate for a common market. On the other wheel of the vehicle, there are the words ‘rural development’ written on them. We feel that this means that the Tunku is pushing forward the idea of developing the rural areas. (With analysation, this can also be hinting that Malaya is very gracious who is thinking about developing the other not as advanced states unlike Singapore who only thinks about her own benefits. ) We believe that these respectively are the high hopes of each country.

Spiritual Beliefs as a Factor in the Performance of Nursing Staff Research Paper

Spiritual Beliefs as a Factor in the Performance of Nursing Staff - Research Paper Example These questions are significant to nursing practice; in order to meet the demands of the population and increase both patient chances of survival and patient satisfaction the role of spiritualism as a factor considered motivational has been studied to evaluate its efficiency. Following a literature review nursing practices have been identified which contribute to better patient outcomes and advanced education has been noted to increase the ability of the nurse to provide spiritual care. Those nurse’s with more experience and those working at a higher grade have a greater understanding of spirituality (Noble, & Jones, 2010). The value of communication with non-verbal cues is necessary and spiritual care must be guided by the patients themselves. Communication has been identified as a strong factor in the ability to deliver appropriate spiritual care in Milligan, 2004; McSherry, 2006; and Ross, 2006 by Noble and Jones. A lack of time is also considered a barrier to providing spi ritual care and the need for better education and training would be welcome by many. Spirituality among nurse’s is related positively to education levels and those having a Master’s degree. It is also related to 11-19 years clinical experience and having received spiritual education and training (Wu, & Lin, 2011). In Lind, Sendelbach, & Steen, (2011) nurses were described as feeling unprepared and unable to meet the spiritual needs of patients. Patient satisfaction surveys in a Minnesota cardiovascular progressive care unit determined that meeting the spiritual needs of patients in the unit was an area that needed improvement. The unit first analyzed the 2001 Joint Commission of 2001Press Ganey national inpatient data which indicated that there is a high value placed on emotional and spiritual care while patient’s are hospitalized. Second, there is a very strong correlation between meeting a patient’s emotional and spiritual needs to their overall satisfa ction and third, this is area in most hospitals that provides opportunity for a significant improvement. Spiritual distress has been named as an appropriate nursing diagnosis by The North American Nursing Diagnosis Association and it is a recommendation of the American Association of Colleges of Nursing that spiritual care is included in all education programs. Despite this fact education and training seems to be lacking to many nurses. Only a small number of nurses feel that they are able to meet the spiritual and emotional needs of patients. The unit began offering a two hour voluntary education program to the nurses with time paid and which 37 or 70% of the nurses attended over the period of a year. The instructor who taught the class was from a local faith affiliated University and the hospital Chaplain participated in each training class. This education program included concepts such as defining spirituality, what spiritual care is, what prevents spiritual care, when to call th e Chaplain and nursing interventions for spiritual care. Sessions were based on literature and staff surveys. The unit implemented a new survey, the HOPE survey, in order to provide spiritual assessment. The survey was taken from a teaching tool that was developed for Physicians. Likert type survey scores which measured patient satisfaction with spiritual and emotional care went up from 65% and 62% to 74% and 71% the two months following implementation of the training program. Pastoral care consultancies were increased from 16 to 27 per month and spiritual care plans were increased from 1 to 4 per month. The success of this program in the

The Influence of Islam on GCC Businesses and their Ethical Behavior Essay

The Influence of Islam on GCC Businesses and their Ethical Behavior - Essay Example It is evidently clear from the discussion that all Islamic countries within the GCC are expected to be ethical in ways alike to their conformist counterparts.   As mentioned in their associations, these ethics include additional working operations with skills and integrity, diligence, care, avoiding the conflict of interest just to mention but a few. As ethics and values link to the ideas of what is wrong and right in the organizational context, for Islamic countries it will also be impacted by the Islamic principles of morality and legality. As such, Islamic states of the GCC will have extra ethical dimensions coming from their adherence to the morals and laws of Shari’ah. Though major Islamic businesses have discussed problems linked to the application of laws and rules to ethical practice, the association between ethics and morality has at some limit been neglected. In GCC business transactions, when the legal and ethical values are presumed to exist, some might argue, as particular Shari’ah scholars do, that as long as the needs and stipulations of the agreement are satisfied, the business deal will be both ethical and legal. Nevertheless, this argument might not have credence as the result of business transactions can cause adverse effects on the moral and social welfare of the citizens. A particular way of relating ethics to morals is in examining the impacts of actions of companies on the society. As mentioned by Carroll and Schwartz: â€Å"a business will be ethical only if it encourages good in the society.† That same logic is used to determine the ethical activities and transactions of the GCC. Precisely, activities of the GCC business will be ethical when it enables welfare (maslahah) and morality of persons within the society. On the contrary, a particular business that poses adverse effects on either Islamic morals or welfare of the people would be seen as unethical.

The value of leadership in the contemporary healthcare organisations Essay

The value of leadership in the contemporary healthcare organisations - Essay Example The research paper â€Å"The value of leadership in the contemporary healthcare organizations† highlights the leadership issues of human resource management and the leadership of clinicians and other stakeholders. The National Health Service (NHS) in the UK is faced daily with issues that make service delivery more and more challenging. These problems bare a direct effect on the health of every individual, because if the Healthcare organs function in a strain it would transcend into less quality services provided. Healthcare workers include various professionals from Doctors, nurses, administrators and sundry other stakeholders who are relevant to the delivery of good Healthcare are affected by the issues of funding, inadequate or shortage of manpower. However in the NHS one major clog in the wheel of adequate, humane healthcare delivery is the issue of personnel. Due to the nature of synergistic collaboration needed to provide adequate services at these organisations, human r esources management must be at the most efficient level. Bickering among stakeholders from Government agents to Medical staff has escalated, assuming alarming proportions. Therefore the importance of rightly qualified persons to handle all aspects of healthcare institutions is all too clear. Every healthcare worker should know what values they are supposed to believe in and strive for. Leadership will be seen to be failing if it is not setting the right examples. A good manager must know how and when to use any style of Leadership.

Employment Law Compliance Plan Essay Example | Topics and Well Written Essays - 1000 words

Employment Law Compliance Plan - Essay Example Any form of business should follow the compliance laws that have been set specifically to regulate the way the customers and the clients are interacting with it (Fox, 2013). These laws are also important in stating categorically how employers ought to deal with their employees, their responsibilities and the duties that they should perform. Compliance laws are found both at the state level and in the lower levels and the businesses that are run in a given location should adhere to both. The rights of the employees are very important and the cries and pleas made to the government have made the laws to be followed stringently and the violators handled mercilessly. In the next part I will put across some of the laws that need to be considered in the handling of employees and that can lead to confrontations if not addressed well. This law states that all businesses that are formed must adhere to it. No employee should be shown any form of discrimination on the basis of his or her race, gender or color. This means that an employee that feels his rights were infringed into by the organization or the business that he is working for can forward his claim to the related authorities and a legal act taken against the employer. The three form the basis of many cases of discrimination and with their address it means that employees rights’ are safe guarded and hence improving the relations in the working environment. Abbreviated ADEA, this act states that the rights of an employee who is beyond forty years must be safe guarded. No employee should therefore be subjected to any form of discrimination whether physical or otherwise by virtue of his age. Those people who are seeking employment at their advanced ages are also amply covered by the act as it seeks a fair platform where all the people wanting to be employed can be given a chance to present their reasons why they should be employed. In many circumstances organizations

Must Internet purchases be subject to sales tax Essay

Must Internet purchases be subject to sales tax - Essay Example According to Engler and Cellucci, "Ernst & Young concluded that 63% of total e-commerce sales to consumers are sales not taxable in most states". As for the taxable sales, "that same study also found that 60% of the taxable business-to-consumer Internet sales are substitutes for other types of sales, such as mail-order catalog sales by out-of state vendors, that do not currently generate sales or use tax revenue". Proponents for Internet tax also argue that "it is not a new tax" but the enforcement of existing laws that give mail order stores the right to collect sales tax (Senate Nixes Sales Tax on Catalogue, Internet Sales 1). Moreover, sales of the brick and mortar store continue to grow despite the flourishing of online stores (Engler and Cellucci 1-3). A brick-and-mortar store is able to provide consumers with service that the online store is unable to offer, such as getting to try the goods or see it physically before deciding to buy it. Furthermore, Internet taxes would require the electronic tracking of purchases (Engler and Cellucci 3).

What effects does parental involvement have on low income families or Annotated Bibliography

What effects does parental involvement have on low income families or Does parental involement have an effect on educational achievement - Annotated Bibliography Example including economic demographics, genetic predispositions, overall intelligence, and social factors, like parental involvement. The latter is a fascinating element. A parent’s active involvement in their children’s schooling can have a profound positive impact. There is however, a balance that needs to be achieved; after all too much parental involvement can be detrimental, depending on how that involvement is applied. The articles reviewed for this discussion allow for a thorough and balanced perspective on the topic. These sources, as a whole, were not particularly difficult to obtain. Google search provided a number of online accessible journal sources, simply, by applying the keywords, â€Å"parental involvement and student achievement.† Combined together these sources give a broader area of research and contributes to understanding of the relevant facts and allow for an unbiased viewpoint to answer the applicable questions of this issue. This article intended to determine how relevant parental involvement, or lack of, truly has on elementary school age children in the 1st, 3rd and 5th grades. The authors propose that, although, the immense amount of research has shown that parental involvement is imperative, hugely impactful, and should be encouraged, most research cannot say with absolutely certainty that involvement effects overall academic achievement.(El Nokali, Bachman & Votruba-Drzal, 2010) There is a definite correlation between less â€Å"bad† classroom behavior due to parental involvement and can aid in social development, but not directly on academic achievement. This article is a very interesting source. It is useful in that it approaches the correlation between parental involvement and academic achievement with a skeptical eye. Parental involvement is important and should be recommended, but it may not be a guarantor that it will ensure a

Canada Food Guide Essay Example | Topics and Well Written Essays - 2000 words - 1

Canada Food Guide - Essay Example inst salty foods in the light of the increased heart disease and blood pressure related problems within the population.A major criticism of this advice is that it is still not clear whether there are any actual benefits or drawbacks of a balanced sodium diet.The last two decades have seen the discoveries of concepts like trans fats, and omega-3 fatty acids .The teenage population has been faced with growing rates of obesity .In the year 2002 alone the Statistics of Canada expressed its alarm at the degrading health of its population. The survey was based upon the information regarding 130,000 people aged 12 and older and the levels of obesity were at an all time high with an overall decrease in physical activity. â€Å"The survey found that between 1994-95 and 2000-01, the number of obese Canadians aged 20 to 64 grew by 24 per cent to almost 2.8 million. Increases in obesity rates were greatest among men and women aged between 45 and 54, who accounted for a quarter of all obese adults in Canada. Among children, nine per cent were considered obese. Another 20 per cent were considered overweight.†1 To inquire into the reasons for these alarming statistics the survey reviewed the consumption trends within the population and found that â€Å" children and adolescents who reported eating fruits and vegetables five or more times a day were substantially less likely to be overweight or obese than those who consumed them less frequently. Forty-one per cent of children and adolescents reported they ate at least five servings of fruit and vegetables a day.†2 In the light of these changes, the institution of Health Canada announced that the Food Guide would receive a makeover to â€Å"address changes in eating patterns, food supply and diets, as well as advances in nutritional science.† 3 The draft Food Guide was released in April 2006 with the draft recommending a daily number of servings of fruit and vegetables from a range of five-to-10 to four-to-eight. After a three

Race o racism Research Paper Example | Topics and Well Written Essays - 750 words

Race o racism - Research Paper Example The marathon race will feature numerous other activities apart from running. These include an avenue to interact among the participants and share ideas. It will also be a family affair where the children will be educated on the importance of stopping racism. The proceeds from the marathon will help the affected racism victims around the world through the organizations planning. This agency has numerous branches all over America and all over the world. The main theme of the marathon is creating awareness on racism. Through the marathon, people will also appreciate the importance of alleviating racism since it has numerous impacts to a society. To highlight on the impacts, racism cause disintegration in a society. The disunity of the society affects numerous other activities of the society especially the developmental projects. Societies cannot develop well since the members do not appreciate each other’s role and position based on racism. It is in this respect that the society lags behind in terms of development. Through having joint public initiatives like this marathon, everyone in the society understand the importance of forgetting the racial differences and working together as one people. This marathon, therefore, is necessary to attend for individuals who seek to debunk the racism problem in the society. In many instances, an individual can be faced with a situation involving racial prejudice. This can be at the workplace, school or even at the church. When the individual is judged base on their race, they get psychological torture. They might feel that they have no place in the society and in some cases commit suicide. The case of racial segregation also develops hatred among different people of the society. The individuals start judging others on ethnic lines. From that perspective, the hatred is likely to develop into conflict. The conflict can further escalate to unprecedented levels. Affect this means that not only will the individuals involved but the whole community as a whole. Through the marathon, you will get to understand how to evade such situations. This would be an available activity for individuals who do not want to participate in the race. Racism also causes uncertainty among the members of a society. Everyone lives not sure of the other persons intention towards them they might feel that any action an individual does is directed to them. The state on uncertainty is not appropriate for the social health of the society (Jackson et al 15). The members do not interact freely and in a mutual interest way. It is in line with this that the race is purposed to bring together members from different races. Participants will get the chance to overcome their racial differences and compete in the marathon. The interaction among these members is a vital step to achieve a racism free country. Through the marathon, the participants will get the chance to prove their competency outside the realm of racism. For the participants who do not wish to participate in the race, various activities are also available to suit their needs on understanding racism. There would be centers where talks are held about racism. Similarly, there would be discussions on racism and its effects. The participants in these discussions are also expected to give some of the possible solutions to racism. The International Agency against Racism hopes that, through this marathon, everyone will have a

The Great Awakening and Age of Enlightenment Essay Example for Free

The Great Awakening and Age of Enlightenment Essay The eighteenth century was a period of change for American colonists. They encountered new ways of life with the revival of religion and the introduction to science. The yearning for knowledge encouraged the colonists to partake in religious activities and explore the scientific world around them. The Great Awakening was a movement created by the Protestants and its purpose was to reestablish religious faith. The Age of Enlightenment was a movement concerning intellectuals all around the world. It was the culmination of old traditions and the beginning of new ideas and approaches. These two major movements significantly affected the growth of colonial America because it inspired people to work as a unified group and gain independence. The Great Awakening took place during the 1700s in colonial America and soon reached to European nations such as England, Scotland and Germany. The movement expressed how being truly religious required a person to trust the heart instead of the head and to depend on biblical beliefs more than human logic. Preaching was vital and had a great impact on the people who were listening. For instance, Jonathan Edwards tried to reform the Pilgrims and turn them back to their Calvinist roots and make them fear God once again. His emotional sermons talked about how all of mankind had sinfulness and hatefulness in their souls. Those who agreed to the message Edwards was sending were called the New Lights and those who opposed it were called the Old Lights. The conflict between them later resulted in the development of future universities and represented a small step towards the unity of all the colonies. The Age of Enlightenment started in Europe around the time of the Great Awakening. The goal was to develop knowledge based on logic and free- thinking. Scientific views and natural philosophy were replacements of religion and were the resources for understanding nature and human fate. There were advancements in mathematics with Sir Isaac Newton, who created physics. In addition, technology was a major achievement with an example of Ben Franklin and his invention of the lightning rod. Due to these successes, people of colonial America grew in their mental rather than their physical state. They were more aware of things around them, which was beneficial  because it created a sense of independence that they didnt have before. In conclusion, the Great Awakening and the Age of Enlightenment were two important movements of the eighteenth century. The movements inspired the American colonists to bond and become less dependent on others who usually take charge. The revival of religions brought people practicing the same belief together, which helped them unite and the Enlightenment period marked the basis on the journey to discover individual liberty. So as it is shown, both would certainly help colonial America grow into one independent nation.

different cultural beliefs about death

different cultural beliefs about death Person, Culture and Medicine Alexandra Lamb â€Å"Human Behaviour is essentially the same across groups and populations.† Biological death is inevitable. For all humans, death is the exclamation point marking the end of a life, the end of a journey; however it is approached and for however long. This is the universal biological condition for all humans. According to Benjamin Franklin, â€Å"†¦Everything appears to promise that it will last. But in this world nothing can be said to be certain except death and taxes.† (Curran 1975) It is in how we live our lives that we see the breadth of human cultural and psychological variation (Seeman, 2010), leading us to discover a great diversity of meanings regarding death and dying, spanning across all groups and populations (Charmaz, 1997). â€Å"Cross cultural [variation embodies] not just different opinions or beliefs, but different ways of everyday living and different systems.† (Jecker Carrese Pearlman, 1995, p. 6) At the most basic level we are all â€Å"built† the same. Death is a complicated process that is the result of the breakdown of the body’s systems. We all live, until the chaos in our body, caused by either natural causes or a forced external factor, is too much for all the intricate systems to work together as a coherent whole (Badham, 1996). Despite the advancement of technology and medical progress, there is no stopping everyone eventually facing death. Whilst biologically we are all essentially the same, from a cultural and psychological perspective, we all behave very differently. This can be seen by considering the bond between a parent and a child, which is said to be the most significant, powerful and enduring human relationship (Parkes Laungani Young, 2003,). Thus, the death of a child is acknowledged as the worst possible event, one that gives the deepest emotional impact. In this tragic event, we can see marked behavioural differences across and within cultures and so it is a good example to use to examine the differences in human behaviour in the face of death. Nations, as well as individuals, all live with very distinctive ideas and beliefs around how to deal with death (Charmaz, 1997). Most cultures are similar in that they attribute unique significance to a child’s death. Biologically many aspects of a parent-child relationship are pre-programmed from conception however, each of these characteristics are developed within a specific family, social and cultural context (Parkes Laungani Young, 2003,). These wider influences are what greatly shape the meaning and experience of the relationship for both parent and child and thus influence the meaning of death. This makes the emotional impact of parental bereavement unique. For example, in Western Societies, parents are expected to grieve in private and return to normal activities soon after the child’s death, where as in Egypt, a mother may be withdrawn and mute up to seven years after the child’s death and this is considered normal. A Balinese mother would be considere d normal if she remained cheerful and calm after her child’s death, as her culture believes that emotional upset makes one vulnerable to illness (Parkes Laungani Young, 2003,). â€Å"Grieving and death rituals vary across cultures and are often heavily influenced by religion† (Lobar Youngblut Brooten 2006, p. 45). For example whilst the traditional burial is common around the world, the rituals that are associated with it vary. In areas influenced by Islamic and Jewish faiths, the corpse is washed and dressed in a shroud and placed in a simple wooden coffin (in areas where coffins are used). In China, where Confucian beliefs dominate, thick wooden coffins packed with clothing and shrouds are used to delay decay and in Christian-dominated regions, bodies are dressed in normal clothing and placed in a coffin made of either chipboard, wood or metal. (Canning Szmigin 2010) The combination of both structural (cultural) and individual factors that impacts the experience of death is dynamic. (Howarth, 2007) Not every member of a particular ethnic group will share the same beliefs and values and other aspects such as social status, economic position, gender, sexuality, age will also have an impact on experiences and beliefs which when combined give meaning to the experiences of death and dying (Howarth, 2007). For example, the prevalence of child mortality also influences the experience of death. In developed countries, where changes to nutrition and sanitation and the evolution of medicine have made childhood mortality rare, a death of a child is more likely to be perceived as tragic. Whereas in developing countries, where the death of a child occurs much more often and thus is considered inevitable, mourning may only last a few days (Parkes Laungani Young, 2003,). Each person has their own beliefs about death, which are generated through experiences at a social, cultural and individual level. Universally, there is a level of respect shown for the dead and there are different â€Å"accepted† practices depending on the age, gender, social status and cause of death of the individual. (Bradbury, 1999) However, all of the beliefs around death are determined by the way the individual lives, which is why there is such diversity with regards to the biological condition that is an inevitable human fact. Just in this discussion of how different people across different groups and populations approach death and dying, a lack of conformity with the statement â€Å"Human Behaviour is essentially the same across groups and populations,† has been shown. Parallels can be drawn between people, but vast differences can also be highlighted. (Seeman, 2010) We begin and we end in much the same way, but the way we live our lives is remarkably different . Much can be learned about the breadth of human variation by examining the way we approach death and dying: â€Å"Our ways of dying are our ways of living. Or should I say our ways of living are our ways of dying?† -Toloki the Professional Mourner (Seeman, 2010, p. 1) References Badham, P. Ballard, P. (1996) Facing Death- An Interdisciplinary Approach. Cardiff, University of Wales Press. Bradbury, M. (1999) Representations of Death- A Social Psychological Perspective. New York, Routledge. Canning, L. Szmigin, I. 2010, ‘Death and disposal: The universal, environmental dilemma,’ Journal of Marketing Management, vol. 26, viewed 28 August 2014, (electronic Scopus). Charmaz, K. Howarth, G. Kellehear, A. 1997, The Unknown Country: Death in Australia, Britain and the USA. Great Britain, Macmillan Press Ltd. Curran, C. 1975, ‘Death and Dying’, Journal of Religion and Health, vol. 14, viewed 28 August 2014, (electronic Scopus). Howarth, G. 2007, Death and Dying- A Sociological Introduction. Cambridge, Polity Press. Jecker, N. Carrese, J. Pearlman, R. 1995, ‘Caring for Patients in Cross-Cultural Settings’, The Hastings Center Report, vol. 25, p.6, viewed 28 August 2014, (electronic Scopus). Lobar, S. Youngblut, J. Brooten, D. 2006, ‘Cross-cultural beliefs, ceremonies, and rituals surrounding death of a loved one,’ Peadiatric Nursin, vol. 32, p. 44, viewed 28 August 2014, (electronic Scopus). Parkes, C. Laungani, P. Young, W. 2003, Death and Bereavement Across Cultures. Routledge. Seeman, E. (2010) Death in the New World- Cross Cultural Encounters. Philadelphia, University of Pennsylvania Press.

Suprascapular Neuropathy in Overhead Athletes

Suprascapular Neuropathy in Overhead Athletes SUPRASCAPULAR NEUROPATHY IN OVERHEAD ATHLETES: A SYSTEMATIC REVIEW ON AETIOLOGY AND TREATMENT OPTIONS Surya.P, Pankhania. R, Funk.L ABSTRACT Suprascapular neuropathy is often overlooked as a cause for shoulder pain in overhead athletes. However, with recent advancements in the understanding of the condition as well as its treatment methods, suprascapular neuropathy is now diagnosed more frequently. Consistent overhead activities, rotator cuff tear and direct compression of the nerve, by space occupying lesion are important etiologies for suprascapular neuropathy. While MRI is widely used to identify space-occupying lesions and rotator cuff injury; Electromyography (EMG) and Nerve Conduction Velocity (NCV) remains gold standards for confirming injury to the nerve. Conservative physical therapy, nerve blocks and arthroscopic and open surgical interventions are the main treatment plans for suprascapular neuropathy. 1. INTRODUCTION AND BACKGROUND The posterosuperior aspect of shoulder receives its sensory innervation from the suprascapular nerve. The suprascapular nerve also provides motor innervation to supraspinatus and infraspinatus muscles. Compression or traction of nerve and rotator cuff diseases are found to be associated with suprascapular nerve damage and neuropathy. Clinical symptoms of the condition include pain in the posterior shoulder, feeble forward flexion, and weak external rotation. It is also noteworthy that the multiple presentations for suprascapular nerve neuropathy vary greatly in different patients and thus diagnosis of the condition is often challenging. This kind of nerve damage is a less common reason for shoulder pain and dysfunction in the general population, however is widely observed in athletes who play overhead sports such as volleyball, tennis, badminton, and baseball. Such sports expose the athletes hands to overhead, abducted and externally rotated positions for prolonged periods of time. ( Cummins Schneider, 2008). Observational studies have identified that players involved in overhead sports are at higher risk of injuries related to overuse of the shoulder such as rotator cuff tendinopathy and tearing of glenoid labrum (Pillai et al. 2011). On the other hand, shoulder pain due to suprascapular neuropathy is observed in only 1-2% of cases and therefore, the condition is often overlooked during diagnosis for shoulder pain (Boykin et al. 2010). Among the overhead sports athletes, incidences of suprascapular neuropathy are maximum in volleyball players. Around 33% of volleyball players suffer from this condition at some instance in their career (Boykin et al. 2010). Traditionally, suprascapular neuropathy has always been regarded as a diagnosis of exclusion. However, now with further understanding of the etiology and advanced diagnostic options, the condition is being recognised by physicians from an earlier onset. 2. AETIOLOGY FOR SUPRASCAPULAR NEUROPATHY Rotator cuff tear is considered as a prime cause for suprascapular neuropathy. Studies show that suprascapular neuropathy can also develop secondary to traction and microtrauma, especially in overhead athletes, particularly due to tightening of the spinoglenoid ligament during the overhead throwing position. The risk for the development of suprascapular neuropathy also increases in patients with ossification of the transverse scapular ligament or spinoglenoid ligament. Other causes such as; compression of the nerve at spinoglenoid notch due to the presence of a bone tumor, cyst due to labral, soft tissue or capsular injury tissue can also lead to the condition. Suprascapular neuropathy is also rarely seen following brachial neuritis, glenohumeral dislocation, fracture of the shoulder girdle, and penetrating or iatrogenic injury to the nerve (Lewis et al. 2012). All these etiological factors for suprascapular neuropathy are discussed in detail in the following section. 2.1 Rotator Cuff Injury: Anatomically, the suprascapular nerve branches from the upper trunk of the brachial plexus. From there, it travels posterior to the clavicle, passes below the transverse scapular ligament and then enters the suprascapular notch. The motor branches innervate the supraspinatus, and the nerve continues past the spinoglenoid notch and innervates the infraspinatus. Injury due to traction or compression of the nerve at any point in this path can lead to suprascapular neuropathy. Retracted superior or posterior rotator cuff tear is the most common cause for suprascapular nerve traction injury. Tension on the suprascapular nerve lying at a suprascapular notch or spinoglenoid notch increases with the retraction of supraspinatus and infraspinatus tendons. Studies on cadavers by Gosk et al (2007) showed that as the retraction of supraspinatus tendon increases, it reduces the angle between the suprascapular nerve and its first motor branch, which leads to an increase in tension and thus causes t raction injury. Gosk et al. (2007) also found that massive rotator cuff tear was the main reason for suprascapular neuropathy in eight different overhead players. On the other hand, studies by Lajtai et al. (2009) found that rotator cuff tear and muscle atrophy were responsible for only 8% of suprascapular neuropathy cases. Expanding the knowledge on the topic, different studies also showed that the tension between rotator cuff, supraspinatus and infraspinatus tendons has a profound impact on the condition of the suprascapular nerve. Observations of cadaver showed that the tension on the neurovascular pedicle increases significantly once the lateral advancement of a retracted rotator cuff tear exceeds 3 cm (Greiner et al. 2003). Other studies suggest that if the rotator cuff extension increases by 3 cm, it lay significant tension on the motor branches of the suprascapular nerve. Also, the tension on the medial portion of the suprascapular nerve starts to increase only by 1 cm extension of the rotator cuff. Increased tension is one of the important reasons for traction injury to the nerve (Larissa et al. 2014). It has also been reported that following surgical repair of rotator cuff tear, the tendons can be advanced up to 3.5 cm without any significant risk to the health of suprascapular nerve. Various reports suggest that surgical repair of rotator cuff tear can help in either partially or completely resolving suprascapular neuropathy. Nerve recovery by reinnervation has been found in patients of suprascapular neuropathy following partial or complete arthroscopic rotator cuff repair (Petra et al. 2013). 2.2 Nerve injury: Sports Specific Etiology: Sports physiotherapists have proposed various etiological mechanisms for suprascapular neuropathy which includes repeated traction, microtrauma, ischaemia of the nerve and compression of the nerve by soft tissue, tumor or cyst. However, the majority of the healthcare professionals consider that nerve injury due to repetitive trauma is the main reason for the development of suprascapular neuropathy. Two main sites for suprascapular nerve injury are: the suprascapular notch and the spinoglenoid notch. The symptoms alongside clinical presentation for suprascapular neuropathy thus depend on the location of nerve injury. Injury of suprascapular nerve at the spinoglenoid notch has been found to cause isolated atrophy and weakness of the infraspinatus muscle. This condition is also known as infraspinatus syndrome. A systematic literature review by Lee et al. (2007) found that suprascapular neuropathy due to infraspinatus syndrome is common in overhead game athletes, particularly volleyball players. (https://www.shoulderdoc.co.uk/article/1250) One important reason for traction injury in volleyball players is the huge amount of motion occurring at the shoulder during throwing action. The role of the scapula in allowing throwing motion as well as other overhead sports activity is now well-researched. It has been observed that the movement of the scapula during the protraction and retraction of hands leads to significant trauma of suprascapular nerve at both the suprascapular and spinoglenoid notches. This phenomenon is known as the sling effect. The sling effect proposes that certain positioning of upper limb during overhead activity exposes the suprascapular nerve at the suprascapular notch to a significant amount of sheer stress and thus injury. Sling effect also suggests that the suprascapular nerve is exposed to high risk of traction injury when it bends around the spine of the scapula at the spinoglenoid notch (Arash et al. 2015). Chronic overuse of shoulder, as well as functional instability, may cause the suprascapular nerve to angle sharply at the spinoglenoid notch, as an adaptive response. This condition is known as SICK scapula which is an abbreviation to Scapular protraction, Inferior border prominence, Coracoid tightness, and Kinesis abnormalities of the scapula (Burkhart et al. 2003). While imaging for the shoulder injuries of volleyball players, Crema Murakami (2016) found that SICK scapula significantly contributes to increased tension on the suprascapular nerve and thus causes traumatic injury. https://www.shoulderdoc.co.uk/article/930 http://www.scielo.br The spinoglenoid ligament lays into the posterior glenohumeral capsule. Observations suggest that the ligament gets stretched and rigid with the abduction and internal rotation of the ipsilateral upper limb across the body. Such action leads to the traction of suprascapular nerve at the spinoglenoid notch (Crema Murakani, 2016). Sandow Ilic (1998) provided another proposal for traumatic injury to the suprascapular nerve. According to them, when the upper limb is abducted and externally rotated, the medial border of the spinatus tendon present at the spinoglenoid notch compresses the suprascapular nerve. Repeated upper limb action thus causes trauma to the nerve and injures it. Plancher Petterson (2016), recently supported this mechanism of nerve injury in their research paper. The injury to the posterior part of the suprascapular nerve is thought to occur due to multiple, abrupt, peculiar stretching of infraspinatus tendon during the deceleration phase of the floater serve (the most common type of overhead volleyball serve). Ferretti observed such injury in volleyball players while Arash et al. (2016) observed this in various overhead sports players as well as labourers. 2.3 Other etiologies: Nerve compression: According to Raddic Wallace (2016) direct compression of suprascapular nerve passing through spinoglenoid notch can occur due to ganglionic cysts arising from the glenohumeral joint. Such cysts are formed by synovial fluid leakage due to injury to the posterior glenoid labrum. Incidences of suprascapular nerve compression due to a bone tumor or the surrounding soft tissues are very rare but not absent. Nerve ischaemia: In very rare conditions, microemboli formed after any trauma gets trapped in the suprascapular artery and then migrate to the vasa nervorum thus hindering the blood and fluid supply to the suprascapular nerve. This leads to nerve ischemia and then neuropathy (Shin et al. 2016). 3. PRESENTATION DIAGNOSIS OF SUPRASCAPULAR NEUROPATHY The peculiar clinical presentations of suprascapular neuropathy are as follows: Shoulder pain which worsens on cross body abduction or internal rotation of ipsilateral muscle. Atrophy of supraspinatus or/and infraspinatus muscle, observable on physical examination. The weakness of ipsilateral shoulder abduction observed during manual muscle testing. The weakness of external rotation of shoulder observed during manual muscle testing. Pain elicited by pressure application over the suprascapular and spinoglenoid notch. The tenderness between the clavicle and the spine of the scapula or deep and posterior to the acromioclavicular joint (Podgorski et al. 2014). Radiological examination using X-rays is the first step for diagnosis if suprascapular neuropathy is suspected. It is important to have a radiological view of a suprascapular notch and spinoglenoid notch along with a standard view of the shoulder area. However, no remarkable changes can be observed in the radiological images unless is a prominent trauma responsible for the condition. MRI of the shoulder helps in identifying muscle oedema, muscle atrophy, and ganglionic cyst, if present. These factors are responsible for suprascapular neuropathy due to direct compression. Three Tesla (3-T) MRI scan is another tool used in the diagnosis of suprascapular neuropathy as it helps to identify any nerve abnormality or any denervation changes in muscles. Ultrasound is also appliable for the diagnosis of cysts and other muscle abnormalities as it is an inexpensive and relatively accurate diagnostic tool (Ahlawat et al. 2015). Electrodiagnostic studies are gaining increasing popularity as an important diagnostic tool for suprascapular neuropathy. Positive sharp waves and fibrillation potentials indicated by electromyography can suggest denervation while polyphasic motor unit action potentials suggest motor innervation abnormalities. Larisa et al (2014) suggest that electromyography (EMG) and nerve conduction velocity (NCV) tests are the gold standards for the detection of suprascapular nerve injury. EMG and NCV are suggested in the following conditions: Consistent pain on the back upper side of the shoulder and no confirm diagnosis is found. Atrophy as well as the weakness of supraspinatus and infraspinatus tendons in the absence of rotator cuff injury. MRI observations show muscle edema. Massive rotator cuff tendons with retraction and traction on the nerve. There are published and examined normative values for electrodiagnostic studies. According to which, the normal distal motor latencies to the supraspinatus muscles during stimulation at the Erb point are 2.7 msec  ± 0.5 and to the infraspinatus muscles, 3.3 msec  ± 0.5. Side-to-side differences greater than 0.4 msec suggest focal entrapment of the SSN or another neural injury (Larisa et al. 2014). In some cases, where outcomes of these electrodiagnostic studies are negative or not specific; fluoroscopically guided local anesthetic injection is used. This injection is administered to the region of suprascapular nerve and related pain relief is evaluated. This method is very effective in confirming the involvement of suprascapular nerve injury in shoulder pain (Debbie et al. 2014). 4. TREATMENT MODALITIES FOR SUPRASCAPULAR NEUROPATHY Treatment for suprascapular neuropathy is selected on the basis of different factors like etiology of nerve damage, the severity of nerve damage, duration of pain and weakness in shoulder, degree of functional disability and patients choice. The three main types of treatment options are conservative physical therapy, nerve blocks and surgical repair. 4.1 Physical therapy: If the suprascapular neuropathy is caused due to rotator cuff tear or labral tear with paralabral cyst, the treatment selection is done with regards to the pathology. However, in the case of isolated nerve injury, the conservative treatment plan including activity modification, analgesic drugs, and conservative physical therapy is initiated. The patient is asked to avoid or stop overhead activity as soon as he/she is diagnosed with suprascapular neuropathy. Following which, a physical therapy program is initiated which focuses on the movement of shoulder and muscle strengthening. The therapy also includes scapular stabilisation (Trojian, 2015). Different studies on patients with isolated suprascapular neuropathy suggest that non operative treatment for 6 months to 1 year provides good to excellent outcomes in the majority of the patients while surgical intervention following physical therapy is required by only 20% patients (Lee et al. 2007). Boykin et al (2010) suggest that such non-operative treatments in the case of suprascapular neuropathy due to compression by mass or a cyst do not provide satisfactory results. It has been found that 53% of patients with suprascapular neuropathy due to spinoglenoid cyst get significant pain control and symptomatic relief with non-operative methods while 96% of such patients experienced positive outcomes with surgical treatment. 4.2 Surgical Treatment: In case the conservative physical therapy for isolated suprascapular neuropathy fails, the patient is switched to surgical intervention. Furthermore, surgical intervention is immediately offered if suprascapular neuropathy is concomitant to rotator cuff tear or labrum tears with paralabral cysts. However, literature review suggests that there are debates about the application of surgical intervention for correcting nerve decompression in case of concomitant pathology. Many researchers recommend only for the correction of the isolated rotator cuff or labral repair and avoid surgery for nerve decompression (Boykin et al. 2010). Nerve damage at the suprascapular notch is usually treated with the release of the transverse ligament by an open or arthroscopic technique. Fewer complications have been observed with the open technique. Patients are reported to have adequate pain management as well as improved muscle strength with the open technique. However, muscle atrophy cannot be reversed in all the cases using this technique. Improvement of supraspinatus muscle strength is observed among 90% of patients treated by open technique while no significant improvement of infraspinatus muscle is seen (Kim et al. 2005). While there are no specific indications for arthroscopic suprascapular nerve decompression, it has been found to be similarly effective in resolving pain. However, extensive data is not available to show the effectiveness of the technique in treating muscle atrophy and weakness (Boykin et al. 2010). Nerve damage at spinoglenoid notch is usually secondary to nerve compression by the space-occupying lesion. Surgical management of such lesions often requires open or arthroscopic approach and resection of the lesion. It is noteworthy that patients with suprascapular neuropathy at spinoglenoid notch show poor results with physical therapy alone and thus are suggested to have surgical intervention immediately. Cyst recurrence rates are very low with both the methods (Petra et al. 2013). Literature review suggests that ultrasound-guided paralabral cyst aspiration is a good alternative to surgical intervention for suprascapular neuropathy due to compression at spinoglenoid notch. While the majority of patients reported excellent pain relief with the technique, recurrence rates for cyst are found to be between 75 100% (Moen et al. 2012). 4.3 Nerve Block: Nerve blocks are non-surgical treatment options for suprascapular neuropathy. Nerve blocks are usually administered to manage shoulder pain in preoperative setups as well as in the case of painful shoulder conditions like adhesive capsulitis. Diagnostic usage and specificity of nerve blocks are widely debated, but the blocks are used to achieve rapid symptomatic relief so that the patient can properly participate in the rehabilitation physical therapy. Nerve blocks consist of an injection of an anaesthetic mixed with corticosteroid administered to the suprascapular notch (Blum et al. 2013). Newer techniques like radiofrequency ablation of suprascapular nerve or palliative treatment for pain due to suprascapular neuropathy are still under consistent research phase and are not yet widely applied. 5. CONCLUSION The incidences of suprascapular neuropathy can be more easily recognised now due to increased understanding of the condition and improved diagnostic methods. Overhead athletes presenting with vague posterosuperior shoulder pain, muscle atrophy, weakness of supraspinatus and infraspinatus tendons must be investigated for suprascapular neuropathy. The condition must also be investigated in all the athletes with rotator cuff tear, due to the high incidence. MRI and EMG are the most reliable diagnostic techniques to identify suprascapular neuropathy and rotator cuff health. Recently, fluoroscopically guided injections to the suprascapular notch are also gaining popularity as a diagnostic method for the condition. While conservative physical methods can be applied to treat the isolated suprascapular neuropathy, open or arthroscopic surgical corrections are compulsory to treat suprascapular neuropathy due to rotator cuff tear and cystic compression. REFERENCES:Ahlawat S, Wadhwa V, Belzberg AJ, Batra K, Chhabra A. (2015) Spectrum of suprascapular nerve lesions: normal and abnormal neuromuscular imaging appearances on 3-T MR neurography. AJR Am J Roentgenol. 204 (3), 589-601. Arash A., Michael J., and Felix H. (2015) Suprascapular Nerve Release: General Principles. In: Elite Techniques in Shoulder Arthroscopy. Switzerland: Springer International Publishing, 271-281. Blum A, Lecocq S, Louis M, Wassel J, Moisei A, Teixeira P. (2013) The nerves around the shoulder. Eur J Radiol., 82(1),2-16. Boykin RE, Friedman DJ, Higgins LD, Warner JJ. (2010) Suprascapular neuropathy. J Bone Joint Surg Am., 92(13), 2348-64. Burkhart SS, Morgan CD, Kibler WB. (2003) The disabled throwing shoulder: spectrum of pathology Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy, 19(6), 641-61. Crema M., and Murakami A. (2016) Imaging of volleyball injuries. In: Imaging in Sports-Specific Musculoskeletal Injuries. Switzerland: Springer International Publishing, 663-695. Cummins CA, Schneider DS. (2008) Peripheral nerve injuries in baseball players. Neurol Clin., 26(1), 195-215. Debbie L., Angel M., William E., Susan V., and Ambrose J. (2014) Optimization and Standardization of Technique for Fluoroscopically Guided Suprascapular Nerve Blocks. American Journal of Roentgenology, 202(3), 576-584, 2014. Gosk J, Urban M, Rutowski R. (2007) Entrapment of the suprascapular nerve: anatomy, etiology, diagnosis, treatment. Ortop Traumatol Rehabil, 9(1), 68-74. Greiner K., Golser M, Wambacher F, Kralinger G, and Sperner T. (2003) The course of the suprascapular nerve in the supraspinatus fossa and its vulnerability in muscle advancement. Journal of Shoulder and Elbow Surgery, 12(3), 256-259. Kim D, Murovic JA, Tiel R, and Kline D. (2005) Management and outcomes of 42 surgical suprascapular nerve injuries and entrapments. Neurosurgery, 57(1), 120-127, 2005. Lajtai G, Pfirrmann CW, Aitzetmà ¼ller G, Pirkl C, Gerber C, and Jost B. (2009) The shoulders of professional beach volleyball players: high prevalence of infraspinatus muscle atrophy. The American Journal of Sports Medicine, 37(7), 1375-1383. Larisa J., Elena J., Marisa J., and Jeffrey A. (2014) Evaluation, Treatment, and Outcomes of Suprascapular Neuropathy: A 5-Year Review. PM R, 6(9), 774-80. Lee BC, Yegappan M, Thiagarajan P. (2007) Suprascapular nerve neuropathy secondary to spinoglenoid notch ganglion cyst: case reports and review of literature. Ann Acad Med Singapore, 36(12),1032-5. Lewis L., Michael T., Paul Y., and Jon J. (2012) Suprascapular Nerve: Is It Important in Cuff Pathology? Advances in Orthopedics, Article ID 516985. Moen TC, Babatunde OM, Hsu SH, Ahmad CS, Levine WN. (2012) Suprascapular neuropathy: what does the literature show? J Shoulder Elbow Surg., 21(6), 835-46. Petra M, Gaspar S, Sven L, Peter H, and Mathias W. (2013) Results of Arthroscopic Partial Repair of Large Retracted Rotator Cuff Tears. Arthroscopy-The Journal of Arthroscopic and Related Surgery, 29(8), 1275-1282, 2013. Pillai G, Baynes JR, Gladstone J, Flatow EL. (2011) Greater strength increase with cyst decompression and SLAP repair than SLAP repair alone. Clin Orthop Relat Res., 469(4), 1056-60. Plancher K., and Petterson S. (2016) Distal Suprascapular Nerve Compression: Spinoglenoid Ligament Release. In: Elite Techniques in Shoulder Arthroscopy. Switzerland: Springer International Publishing, 283-302. Podgorski M, Miroslaw T, Marcin S, Piotr G, Ludomir S, and Michal P. (2014) New parameters describing morphological variations in the suprascapular notch region as potential predictors of suprascapular nerve entrapment. Bmc Musculoskeletal Disorders, 15. Raddic R Wallace A. (2016) Arthroscopic release and labral repair for bifocal compression of the suprascapular nerve. Shoulder Elbow, 8(1), 32-36. Trojian T. (2015, October 13) Suprascapular Neuropathy. Retrieved from: http://emedicine.medscape.com/article/92672-overview

Poems By Robert Frost And Leon :: essays research papers

Have you ever wondered what makes two places the same, but in two totally different areas? Throughout the poems â€Å"Stopping by the Woods on a Snowy Evening† by Robert Frost, and â€Å"The Bus† by Leonard Cohen, there are many similarities that take place. These similarities are the life in cities and towns, the escape into nature, and the consequences of such escapes. Throughout this essay these similarities will be explained in detail.In all cities and towns people always have obligations and responsibilities to perform. One example of this is when Robert Frost says â€Å"I have promises to keep†(pg 127). This quote proves that he has an obligation to the city and to the people at home.The Bus has it’s own similarities in the life in cities and towns. While reading the poem Leonard Cohen makes the reader feel that the bigger the city, the less homy it is. The is proven when Cohan states â€Å"Lets run away from the big city...† (pg 144). This qu ote shows that Cohan is trying to â€Å"run away† from his obligations and responsibilities.The similarities in cities and towns from â€Å"Stopping by the Woods on a Snowy Night† and â€Å"The Bus† are in both poems the character is effect by there obligations to the world. In â€Å"Stopping by the Woods on a Snowy Night† Frost’s character is honouring his responsibilities and obligations by leaving the wood to go home to his family. In â€Å"The Bus† the character wants run away from them.In both poems the author escapes into nature. At on point in â€Å"Stopping by the Woods on a Snowy Night† Frost’s character notices the beauty of the forest around him: â€Å"The woods are lovely, dark, and deep† (pg 127). This shows that the character has a deep feelings for the nature around him.Leonard Cohen also escapes into nature in his poem. When his character is riding the bus home he says to the bus driver â€Å"Lets find o urselves a tiny american fishing village, in unknown Florida† (pg144). With this quote he expresses that he is picturing a beautiful place out in the middle of no-where. A place the is beautiful and relaxing to him.In both poems the escape into nature is obvious. In â€Å"Stopping by the Woods on a Snowy Night† Frost is showing us how beautiful mother nature really is. Meanwhile in â€Å"The Bus† Cohan was dreaming of how beautiful and relaxing his tiny fishing village would be.

Logic, Imagination and Deduction Essays -- Logic Imagination Deductio

Logic, Imagination and Deduction "Quit your day dreaming" "Mr. Gies, are you still with us?" "Hello!" These are some of the common inquisitions I heard while trying my best to pay attention during elementary school classes. It seems that I had some issues with staying on task. Perhaps it was a problem that I would outgrow, or at least be able to control, but as the years went on by I found that time did not change me. What a break! It turns out that using my imagination has helped me numerous times in solving networking issues, writing code, troubleshooting electronic devices, and designing complex systems. So are critical thinking, logic and deduction, and problem solving learned skills? Or are they simply tied to ones ability to imagine. Although genetics may play a role in the degree to which an individual can imagine; I believe imagination can be a skill that is developed and is directly proportional to ones ability to use logic and deduction when solving complicated problems. So who does all this imagining anyway? Bronowski, in his essay, "The Reach of Imagination", states, "To imagine is the characteristic act, not of the poet’s mind, or the painter’s, or the scientist’s, but of the mind of man" (Bronowski 461). It seems that this act of imagining is for all mankind. You’ve probably heard the phrase "right brained people". These are the artsy, imaginative, creative types that seem to dominate media venues such as TV and radio, and because of this visibility it would be easy to assume that’s where all the creative people hang out. I think that assumption is way off track. Plenty of highly imaginative technical experts are discovering great solutions to all kind of problems. Architects designing buildings to... ...ion is controlled by conditioning and experiences. Life and its experiences have far more to do with ones ability to imagine then the physical makeup of your genes. I do, however, believe that problem-solving correlates directly to one’s ability to imagine. As I write the conclusion to this essay I find my self imagining a multitude of other things. I imagine how the essay will look printed, did I get the point across, and will it be received well. A quick reflection back in time and I hear a voice from the past saying "Mr. Zimmerman, are you with us?", "Mr. Zimmerman, stay on task", and only now can I safely say, "No. I think I’m just going to think for awhile". Imagine that. Works Cited Katherine Anne Ackley, Perspectives on Contemporary Issues Bronowski Jacob, The Reach of Imagination Hoffmann Roald, The Chemist Ridley Matt, The Year of the Genome

Living with Asthma :: Medical Medicine Respiratory Essays

Living with Asthma missing works cited The weather in Boston is just beginning to feel cooler as Maeve Vaillancourt, a Northeastern University sophomore rushes to her first class of the day. Although she is already behind schedule, she huddles in a corner to take a dose of her Abuterol inhaler, then finishes her ten-minute walk and slips into class late. â€Å"I hate taking my inhaler in public, because it is embarrassing, but after quick walks like that, I need to or else I feel as if I can’t breathe,† said Vaillancourt. Vaillancourt has been suffering from asthma since she was diagnosed at the age of 9. She is one of 18.2 million adults age 18 years and older with this illness according to the Agency for Healthcare Research and Quality. Over seven million children ages 0-17 have asthma. Asthma is a chronic disease of the respiratory system that leads to inflammation of the bronchial tubes, resulting in difficulty carrying air to the lungs. Asthma greatly affects an individual’s breathing, and can place severe restrictions on daily life. During asthma attacks, which may be triggered by weather, allergens, exercise, the individuals’ ability to breathe becomes difficult. As a young, active college student, Vaillancourt’s battle with asthma plays a role in her day-to-day life, beyond just her walks to class. â€Å"I don’t think of inhalers as medicine. I bring it out everywhere; itis like a wallet, or cash,† said Vaillancourt, who suffers from mild asthma. â€Å"If I don’t bring it out, I panic and actually make my asthma worse.† Like most who suffer mild asthma, Vaillancourt is prescribed two inhalers. One is a preventative inhaler, Advair; and the other is her emergency inhaler, Albuterol. Advair is used to prevent an attack from occurring. It contains the steroid, fluticasone, which prevents inflammation that leads to asthma attacks; and salmeterol, which is abronchodilator, to relax muscles to improve breathing.Albuterol is also a bronchodilator, used to treat bronchospasms as they are occurring. Vaillancourt takes Advair, her preventative inhaler, and once in the morning and once before she goes to bed, as well as before exercising. Although she knows it is important Vaillancourt said she â€Å"often has trouble remembering and keeping up with taking the inhaler.† Vaillancourt has noticed that since she has been living in Boston and consistently walking, especially in cool weather, she is more likely to remember her inhalers since she is more likely to need them.

Do Aliens exists Essay

Many people think that aliens exist, but others do not agree. We live in a world in which everything is possible. As far as I know, according to the statistics, the public in general tend to believe that the aliens do exist. As for me I tend to consider that the aliens really exist. Let us start by considering the facts. First and foremost, almost every day we watch TV and it is absolutely normal when channels transmits the program about the Unidentified Flying Object. I think if television transmits such programs, it means that these facts are scientifically proven and then people can choose whether believe in it or not. To draw the conclusion, one can say that â€Å"something† really exist. There are a great number of facts of the UFO existence in books, the Internet and TV programs. So it’s up to everybody to decide whether to believe in it or not. I think that in future people and the aliens will even be able to cooperate with each other and make new discoveries. â€Å"Not an encounter with aliens, no. I’ve seen a UFO, about 120 miles north of Toronto, over Lake Muskoka, where I have a cottage,† he admitted. Hellyer said he and his wife had been looking at the stars when they spotted a UFO. â€Å"We watched it until our necks almost broke for about 20 minutes, and it was definitely a UFO because it could change position in the sky by three or four degrees in three or four seconds,† he said. Hellyer went on to say that when he was minister, he received plenty of â€Å"sighting reports,† though about 80 percent of them were â€Å"sights of Venus or of plasma or a dozen other things.† â€Å"But there were 15 percent or 20 percent for which there was no explanation, and they were the genuine unidentified flying objects,† he added. Hellyer said he’s hopeful someone will crack the case and share their findings with the world that aliens do exist. â€Å"There’s just so much evidence, if anybody will take time off to do a little bit of research and  study†¦There’s just a lot of information out there and it doesn’t take very long to get your hands on it.† Lots of people believe in extraterrestrial life forms, but not many can give specific details about what they look like and where they’re living. But that’s just what Paul Hellyer, the now-90-year-old former defense minister of Canada, did in his recent interview with Russia Today, claiming there are 80 different species of alien life, from places like Andromeda, Pleiades and Zeta Reticuli, and some look just like us. â€Å"The latest reports that I’ve been getting from various sources are that there are about 80 different species and some of them look just like us and they could walk down the street and you wouldn’t know if you walked past one,† said Hellyer, who served during the Cold War, who went public with his theories on extraterrestrial life in 2005, The National Post reported. â€Å"They are what we call ‘Nordic Blondes’ and also the Tall Whites who were actually working with the U.S. air force in Nevada. They’re able to get away with that; they had a couple of their ladies dressed as nuns go into Las Vegas to shop and they weren’t detected. †¦ Then there’s the Short Greys as they are called, and they are the ones you see in most of the cartoons, they have very slim arms and legs, they are very short, just a little over 5 feet, and they have a great big head and great big brown eyes. But there are different species and you have to know that they are different species and know that they all are different. If you saw the Short Greys, you’d certainly know there’s something up that you’ve never seen before, but if you saw one of the Nordic Blondes, you’d probably say, â€Å"I wonder if she’s from Denmark or somewhere.† But fear not: Hellyer said most of the aliens who have â€Å"been visiting our planet for thousands of years† are â€Å"benign and benevolent, and they do want to help us, [but] there may be one or two species which do not.† However, he does believe that these species, who have a â€Å"long history† — he said he knows of 50 reports of UFOs during the Cold War — are concerned about unconventional warfare. â€Å"Since we invented the atomic bomb and they are very concerned about that and the fact that we might use it again, and because the Cosmos is a unity and it affects not just us but other people in the Cosmos, they are very much afraid that we might be stupid enough to start using atomic weapons again, and this would be very bad for us and for them as well,† he said.

Info Systems

vary I True/False rating and Multiple-choice questions (0. 5 points/each question) 1. The overarching coating of information security measure is to ensure information integrity, availability, and confidentiality. 2. Managing security refers to a comprehensive flummox of activities that develop, implement, direct, and monitor the arrangings security strategy and activities. 3. The most expensive cybercrime are computer viruses. 4. Authentication is a actor of providing proof of data transmission or receipt so that the occurrence of a transaction cannot later be refused. . The curl in computer security is toward policy-based wariness. 6. The kernel challenge of security anxiety is ___________. a)Finding the compensate balance among shielding the organizations main assets from potential disability b)Enabling staff to do their jobs c)Both a) and b) 7. Which of the following political hack tricks involves launching software that monitors all relations looking for passwor ds or other precious information? a)Main-in-the middle b)Denial of service c)Trojan one dollar bill d)Network sniffing 8.Defining security policies and then managing and enforcing those policies via security management products and services is known as _______. a)Intrusion-based management b)Policy-based management c)Incident-based management 9. To protect against spoofing, firms withdraw a way to ____________. a)Authenticate the identity of an single b)Repudiate the identify of an psyche c)Dispute the identity of an individual 10. To protect against hacking, companies install ___________ which controls access between networks. a)Virtual private systems b)Encryption c)Firewalls

Ideal Student Essay

Quote: I realized that the only purpose to social revolution is to be able to love who you want, how you want, when you want and where you want†¦ Idle student: An ideal student is someone who is thirsty good for knowledge. Such a student will not be distracted in class. After all that is what every teacher desires. how This thirst for knowledge will ensure how that she is attentive and is committed to learn all that part she can about a particular subject so that how she can understand it fully.An best student is a patriot.She will consider also have a clear vision of what is necessary to attain how her goal. An ideal student will mutual respect her teachers but will not be afraid of them. She will have the courage to admit her ignorance and ask for advice wired and direction if she needs it.She will not be the kind of person who accepts  things blindly and learns by rote.Apart extract from studies, he knowingly gets involves in activities.

An ideal student will observe discipline. She free will be punctual and properly dressed.She will not absent herself from social class for silly reasons and will do her homework daily. She will be neat and tidy and observe decorum in class.He achieves success in life by using first time properly.These ideal students would go on to become ideal citizens. Who is an ideal student.?There isn’t one definite answer to that because there are many qualities deeds that together define an ideal student. The most important good quality of an ideal student is that for him.It unquestionably promotes economic economic status of the nation.

Apart from studies, an ideal young student actively gets involves in other activities.He is good in arts logical and sports and regularly participates in intra logical and inter school events. He is an active honorable member of various clubs in the school and helps in organizing events. But participating in competitions logical and winning events is not the only big thing in life, and an ideal student knows deeds that very well.Students wish to enhance their wisdom and mental ability with attending their classes on a regular basis.He is always cheerful logical and maintains a positive approach to life. He large spreads hope and happiness wherever he goes. In short his conduct is admired by everyone. An ideal student is a voracious reader.Thus, they can render services deeds that are invaluable to the reason for the nation.

He never wastes his parents’ hard-earned money and believes that common knowledge is the biggest wealth he can acquire. An ideal high students grows up to be an asset to his family, his society and the country. If only all our schools couls produce few more and more ideal students, our whole country could achieve tremendous progress and become the envy of the whole world..He is an physical embodiment of all of the virtues.Schools, on the flip side, attempt to select the ice cream of the crop in a bid to sign up the illusive teachers.If one sees their instructor outside what does not indicate they are able act rudely or to dismiss them and theyre not their great teacher beyond the campus.

Everybody wants to be an best student just a few are nearly ready to become one.Must be prepared to do sacrifices unlooked for causes and A student ought to how have a patriotic mind.Hes an perfect citizen in the making.Ideal student is well being great only facing the teacher but they need to have a behaviour among those that are around them.

An very best pupil is someone whos committed to great sacrifice their time and effort to grow into a practicing medical professional that is upcoming.Any student can grow into an student deeds that is perfect.Beneficial and good habits are cultivated by him.An medical student is the one whos an all-rounder.

Mark Sexton and Todd Story

vertical stabiliser 6130 several(prenominal) designation ( causa study) theatrical role cin one caseive secernate sexton and Todd base, the owners of a manufacturing community drive resolved to flourish their operations. They instructed you as their fresh hire pecuniary psychoanalyst to plight an in undis draw up commensu account-bodiedr to jockstrap mete out $35 one thousand meg in refreshful 10- course of instruction gets to finance construction. You keep af whole entered into natural bounce backingchat with Kim McKenzie, an insurance menage from the impregnable of Raines and warren roughly which wedge experiences your federation should stand and what verifier footstep the egression leave behind belike engender.Although your Bosses atomic number 18 conscious(predicate) of the splice causes, they argon non sure approximately the be and advances of whatever consumes speci every(prenominal)y how they ordain reckon the verifie r locate of the draw together prints. This is much so that your star sign is non a in public traded foreseeer. You nurture been asked to establish a memoranda on the deed of for each one of the quest attachment gives on the voucher count of the attach. It is evaluate that you volition furiousness on their perceived pull aheads. The adherence geldr/the starter/the bosses dog sacristan and Todd Story mystify pry $35 million trammel net certificate adulthood find era 10 historic menses finance scream constructionHired general agent Kim McKenzie (Raines and Warren) .Case plentyvass Memos 1. The credential of the stick with- that is, whether the mystify has a verifying. Secured deposit is with corroboratory, whereby the issuer plight proper(postnominal) tendernessmations in flake of failure or unable to tole pass judgment debt. A hold fast with validating pull up stakes feed a subvert verifier roam ( amour/return) and cut the bails lay on the line muchoer with high source ratings, which slight promising it is to default. exactly the issuer pick out to view that the corroboratory is in tidy operative place and fucking non be inter pitch until the mystify is matured.Considering stick to with verificatory is absoluted investment investment deposits to investors, during default, the investors whitethorn know solely or while of the corroborative in the evaluate of debt un give. Collateralized stick to is as hygienic as vendable to the substitute(prenominal) commercialize oddly if it is a non-publicly traded or listed comp nigh(prenominal) acknowledge among investors. In verge of outlining the particular(prenominal) certificate of collateral disposed to a join, its topper to ascribe pass water guideline of what secern of addition entitled to be put as collateral and learn sure form of how the pluss appraise merchant ship be sum up to secure the stay put maturity limit. 2.The oldity of the alliance In case of excreting or failure, of age(p) hold fast has high antecedence to be give earlier comp atomic number 18d to an some other(a)(prenominal) amaze that is considered jr. or the subordinated coheres. cured wedge gets adept return in bankruptcy which its plight whitethorn control the borrower from take any futurity stupefys old to the au consequentlytic attachs. A minor(postnominal) draws comfortive cover ranks turn down than other truss securities in bear on to the owners claims on as learns and income if the issuer becomes insolvent. beatholders of secured debt (with collateral) moldinessiness(prenominal)iness be compensable onward the holders of unlatched debt.Bondholders of unbolted debt essential be salaried sooner like sh atomic number 18holders, and finally, preferable sh beowners must be cheery originally commonplace shareholders. In general, a next-to-last credent ials entails majuscule assay exclusively vortexs high potence yields than securities with greater seniority. To be to a greater extent challenge to investors, the alignmentholders should place senior stand by in able to clear uper discredit verifier. 3. The straw man of a change posture feeling memory Bond drop down farm animal is a restricted as raise where the issuer is unavoidable to find out off coin for redeem back or buy back some of its fastening collectable by deposited specie with an nonsymbiotic trustee.Sinking blood line is a fond(p) stock warrant to beatholders that pass on discredit the voucher lever. By having drop inventory, it allows the issuer to render ad hoc alliances jimmy at a true achievement or fork over a portion of the truss every year until its matured. Its a great political platform plainly the issuer must be able to deliver currency flows to blade the meanwhile salarys into a sinking feeling f und or else, governance default. By having the battlefront of a sinking fund as collateral patronize of a impound, it promotes fiscal fosterive covering which go forth retract investors to accept stick by with freeze off stakes place.With the sinking fund, it ordain likewise do advances through with(predicate) tax and do it great(p) gain. It besides secured a nice charge of semipermanent debt in advance. 4. A bring up codetion with qualify holler out dates and think termss Adding supplying to a affixation with item constitute date and prices get out make the bail issuer more than the confederationholder provided it bequeath emphati bellyachey outgrowth the verifier place. adapted to buyback gets originally maturity (or at a qualify date fit to purvey) is chitchated recollectable fastening (or cashable confiscate) at a exceptional price (not obligated).every forthcoming tense honorarium to the chemical link upholder is str aight off and indefinitely turned once the sequester is diagnoseed. Re commerce a tie down with let down the debt and is consequently libe assess from remunerative quest on the roared adhere. Normally, the follow is augured be progress to the issuer no long-dated inevitably to borrow the specie, or because concern order obligate fall and the issuer motivation to issue new-fangled fond regards at a move by-line crop. In certification adjudicate of long-term benefit with indeterminate pecuniary forecast, it is not applicable to issue yell readiness. 5. A deferred put forward ac party the hollo formulationA chemical seize with bid training come with by a deferred battle cry leave alone genuinely command from wawling the bond onward a genuine date. It is constitute defend or finis of environ apology during the period of era which the bond whitethorn not be prematurely redeem. During the adjure saved period (the jar period), v erifier post payments are guaranteed besides not later. subsequently the rallying cry date, the bond may be redeemed by reversive headway to the bondholder and ceased the verifier sum up. The call readying go with by deferred call in a bond is to protect the bondholder from the locomote of come to grade forward the call date.A deferred callable bond may accept a around high verifier calculate compared to a convening bond collect to its callable brag as investors are clear to the reinvestment risk assume that the dominate please valuates thence is frown than the coupon paid by our bond on the callable date. 6. A grass- hale call provision A bond with a feign hale call (provision) allowing the issuer to pay off be debt early by making protuberance sinkhole payment ground on NPV (net personate honour) of future evoke payments that lead not be paid in cause of the call.This attri scarcee of call should tear down the coupon regularise than th e average call provision with unique(predicate) dates. Bondholders forget run across the mart value of the bond if it is a make social unit provision which then they set up reinvest in some other bond with corresponding criteria. The make building block call pass on be be in the indenture. Normally, an issuer doesnt put up to conduct to use this cause of provision, entirely if the issuer does, investors bequeath be compensated, or do whole. Because the live tole reckon oftentimes be significant, such nutrition are seldom invoked.Hence, it is recommended that the bond payoff should not have a make-whole call provision. 7. any verificatory arrangements. talk of any boilers suit plus concordats that your firm may consider. The strawmans of imperative concordats ( excessively called as favorable covenant) protect bondholders by forcing the caller-out to approach actions that benefit bondholders. A verificatory covenant would expurgate the coupon stray but allow ontogenesis the trust of bondholders. For instance, it requires the issuer to cover the corpus of the bond plentiful unruffled assets must be maintained.More commonly, a exacting covenant requires the issuer to have a sure touchstone of insurance or gift to periodic audits. 8. Any banish covenants. hash out any overall prejudicial covenants that your firm may consider. A ban covenant would snip the coupon value. Remember, the ter electronegative of a stack is to maximize shareholder wealth. The presence of negatively charged covenants protects bondholders from actions by the confederation that would injury the bondholders. This says nix closely bondholders. In typesetters case, the issuer cannot gain dividends, or at least increase dividends beyond a specify level.The downside of negative covenants is the barricade of the issuers actions. 9. A revolution sign The variety feature is a financial differential mover that is precious eac h from the be security. Therefore, an plant renewing feature adds to the overall value of the security. The innovation feature would tolerate bondholders to benefit if the confederacy does well and also goes public. redden though the union is not public, a transition feature would likely demean the coupon rate.The downside is that the company may be selling impartiality at a discounted price. standardised bond is an example of an asset that can put up with reincarnation. It gives the bondholder the excerption to supervene upon the bond for an issue forth ( predetermined) of the bond issuers equity. Typically, the bondholder will practice session the choice when the native value of the shares authorized from conversion exceeds the bonds worth. 10. A direction slight rate coupon planless rate coupon is a bond with aimless(a) coupon payments that are familiarized at specific intervals.It is all cognize as a inconstant rate bond which has a locomote or unce rtain rate engage, or coupon rate. The bond is due to the bondholder upon requirement by-line an interest rate change. The rate adjusts gibe to a predetermined formula sketch in the bonds course catalog or semiofficial statement. Generally, the ongoing money merchandise rate is what is apply to set the interest rate (plus or minus a set percentage). As a impression of this, the coupon payments can change over time. A floating rate coupon or protean rate bonds commercialise determine weave less than other bonds.

Outline

portray ledger entry Nowa long time, intimately bulk In the introduction wasting disease the meshwork. mess roll in the hay propose any kinds of education from to a hugeer extent(prenominal) than or less the domain finished the net profit and vitality in the world light to bunko gameduct with reinvigorated(prenominal)s. The meshwork convergems to be at prime(prenominal) survey romance likewisel. However, the mesh Is non eer a radiant side. It groundwork be termsful, when throng mapping it and petty(a) c atomic go for sense 18. dissertation regimen should modu posthumous the meshwork, thither be hardly a(prenominal) modestnesss here(predicate) that g e very(prenominal)wherening should flummox the mesh more strictly. be primary(prenominal) root 1 head fate The happen upon off of criminal offences on the net income at dangerous quicken is make up in the knightly hardly a(prenominal) years.Disgruntled employees and ha ckers draw galore(postnominal) cyber- crimes, and opposites are committed by con artists development the weathervane to perpetuate auction off artifice, identity operator errth and any(prenominal) other scams. (Hansen, B, 2002) We close to terms go over or so fraud when we do some obtain on the net income. In this case, we are doing procurance and they do not commit to the buyer, although the currency has been move to the seller. This Is re all toldy knotty to booster c equal fling off criminals beca procedure we shake al roughly no Iranians, who they are, what they do, however where they receive we withal dont know.If we hire the meshing for online shopping, our reference point neb number Is stolen then, the bullion In our swan key whitethorn be apply up. development the Internet to make our in- someone development is not safe, curiously those key documents In f toy, when we breakers the Web, shoot e-mail, and transfer software, a hush-hush class is expected a fifth column chat, idler pull to our computing machine with come in our knowing. It exit steal and modify all the teaching that we already saved. deepr on that, this person may make use of it to there. (Hansen, 8. 002) master(prenominal) approximation 2 take clock time indemnify of setoff earthation onset with with(predicate) unauthorized digital d makeloading, and commit share is another(prenominal) reason why the brass should control the meshwork. In reality, we gouge generate out a commode of bootleg work, such as medicament, movies, or books on the Internet. If volume download eject music, movies, or books without generate money, It pass on harm the economy. much than 2. 2 one million million hard-working, bourgeois large number In the US wager on the pleasure effort for their Jobs, and m either millions more ark in other industries that imprecate on bright property. Clammiest, M. , 2012) expel downl oading does sometimes deputize a music sale, nevertheless its misleading to count on each stark Internet download as an act of plagiarisation that deprives a procure proprietor of dollars. (Clammiest, M. , 2012) The emergence of freehanded downloading $58 jillion is befogged to the U. S. spa large number every year due to heart and soul theft, including more than 373,000 woolly-headed Ameri bottom Jobs, $16 million in baffled employees earnings, sum $3 billion in mischievously unavoidable federal, severalize and local anaesthetic anesthetic governments assess r howeverue. Worth,J and Amy, C. , 2012) briny whim 3 musical theme destine The security review of cyberspace sight sift the wrong nurture online and encourage tykeren from trouble weavesites, such as, child pornography, slashowshipable madness and detailed operating instructions In crime or medicate use. The unwarrantable Internet development may separate childrens honourable con sciousness and spoil childrens soul. water-loving result of children or even let teenaged crime. However, children are weak to speck indefensible net income in orchestrateation.Since parents empennagenot monitor lizard the web ages that children range in every time and at any place, the censo aura of cyberspace push aside dish out the parents to perk overweening websites for children and treasure them from the misguidance and banish enamour of internet. (Shears, R. , 2010). In endpoint The censorship of internet can nurse the look concealment of people, peoples economical come to and hold dear children from disturb websites. The censorship of internet can foster to bear the mainstream moral philosophy and value of the race and armed service the public to formula intelligent and logical internet victimization consciousness. lineDu elude the late eye Ages and the conversion (fourteenth to early 1 sixth centuries) 1 . France and England fought in a crushing 100 Years war (1337-1453) 2. bubonic governance ravished Europe. 3. snag indoors the church building 4. horse opera juxta blot seemed to be collapsing with the flack of the Turks and the total of Constantinople. 5. Scholars argued and pondered over the assumptions somewhat beau ideal and his nature. 6. Humanists cured unmingled knowledge and languages, generate-go ethnical changes that would blossom out through Europe. 7. at heart fencesitter nation-states, patriotism and patriotism rose. II. resurgence of the pudding stone,church building, and Towns A. Otto I and the revivification of the imperium I. The ancient pudding stone and the pontificates fortunes establish 1 . business leader Saxon heat content I and rebuilt princely personnel, passing his surrogate world world personnel Otto I in a capacious territorial position 2. magnate Otto Xis hold (936-973) a. Otto managed to get his own line of reasoning into power In Bavaria, S wab, and Franois. B. Invaded Italy and state himself king In 951. C. defeated the Magyar at Leeched In 955, securing borders against other baseless attacks. L. bring in him the agnomen the grand d. Enlisted the church building in a deliberate rebuild computer programme l. vest bishops and abbots purplish princes and agents of the king. Responded to a call of financial aid from pontiff toilet XII. L. pontiff hind end crowned Otto I emperor butterfly for aid him in 962. F. The church services power became stronger low Tots rule. B. The revitalising Catholic perform I. pansy Otto I shifted the royal centering from Germany to Italy. 1 . Successors were as well preoccupy with Italy, Germany cast off apart. Lie. church inclined(p) to harbour its freedom too new coerce as bring round empire began to separate. 1. regenerate inside the Church was coming. A. awkward tidy up forepart l. rectify reason natural In cut monastery 910 II. rejected se rvility of the clergy to royal stag authority.Separation of Church and demesne including the chastity of the Catholic clergy has its origins form this reform movement. V. The papacy embraced the reforms in the late ordinal century. Iii. investing contend Gregory septet and total heat IV 1 . pope Gregory vii condemned the limit enthronization of clergy at any take low the penalization of excommunication. A. The emperors custom-made of instalment bishops by gifting them the ring and stave ( typify apostolic office) was what Gregory had in mind. B. The emperor, hydrogen IV took this as a take exception to authority. C. territorial reserve princes support Surgerys edict, absentminded to see the emperor weakened. atomic number 1 amass his well-nigh true bishops, having them harbor independency from Gregory. E. Gregory excommunicated henry IV and clean-cut his subjects from their loyalty to him. F. Gregory begged for mildness by stand barefooted in the shock for some 3 days sooner the pontiff absolve him, symbolizing the lift of apostolical supremacy. 2. The investiture joust finally stop when emperor moth enthalpy V renounced his power to give bishops with the ring and module. A. In exchange, pope dragon II allowed for the emperors to be able to give the bishops fiefs forward or subsequently(prenominal) they were invested with the ring and staff by the church. emperor butterflys whitewash had the right to proscribe a candidate. 3. The expiry resulted in the pope strengthen his range of a function and place, at the appeal of decrease imperial authority. 4. In the end, local princes cease up profiting most from the finished controversy. C. The send-off constricts I. previous(a) in the seventeenth century, the gnarly Empire came under(a) intrusion and hale from the trafficker Turks. 1. Emperor Alexis I Comments appealed for booster from the West. A. pope urban II legitimate by origination the first milit ary campaign. L. Religion, hot-blood, and rapacity were authoritative in the creation of the bids. II.Planned out and penalise very conservatively by the revived papacy. Ill. Promised participants of the starting signal Crusade comprehensive daftness should they get out in battle. remotion of all soul sins, etc V. Sparked anti-Jewish riots and protests crosswise Europe. V. personate seller forces afterward regular army until capital of Israel fell to the Crusaders in 1099. 2. Latin charge in the tocopherol began to crumble after the basic Crusade. A. A secondment Crusade was a olive-drab ill. B. A tertiary Crusade was also a great failure and the sanctum sanctorum Lands remained Muslim. 3. The Crusades did tending fill again and grow western sandwich trade and heathenish presence in the East.