Medical Billing Process Essay

The medical billing process is when claims are filed to insurance companies requesting payment to providers who rendered the services to a patient. There are ten steps to make this process that we went over earlier in the class. Those ten steps include preregistering the patients, establish financial responsibilities for visits, check in patients, check out patients, review coding compliance, check billing compliance, prepare and transmit claims, monitor payer adjudication, generate patient statements, and follow up patient payments and collections. I think it goes along with the first step and all throughout. We use HIPAA to get insurance information from the patients and their demographic information to schedule appointments. HIPAA is there to protect the patient’s information. When you get ready to check out the ICD code book and the CPT codes would be used to get the diagnosis, treatment, and procedures. For the HCPCS codes, they do not provide any information about the diagnosis, just about what procedure was performed. The HCPCS codes are used to process outpatient services and professional services. ICD codes are required by HIPAA for inpatient services. The coding is done by the coding team that codes based on the information provided by the doctor. The people handle the medical billing process have to make sure they keep the patient information confidential because of HIPAA regulations. All the coding must be documented correctly so that you will not have any issues with payments.

A Love Letter

Dear Chanel; In this letter, I would like to express my love for your products. I have always been a fan of just about everything that your company has to offer, but in particular, I love your handbags and your shoes. They have always been a big part of my life and I am a fan for a number of reasons. When compared to other companies out there, it is clear that Chanel makes the finest handbags and shoes on the market.I love your products because they are both stylish and classic. They combine the best of modern style with the old time classic feel that all of your customers demand. When I wear a pair of your shoes or carry one of your handbags, I feel like I am combining the old with the new. I am indulging my tendencies to set new trends, while remaining classy and traditional. This is why I love Chanel and their products. They are just better than any other shoes and handbags that you will find out on the market.I love Chanel shoes because they always feature the newest style. They are always setting trends and looking to do new things that other companies have not been able to do before. When I go out in a pair of Chanel shoes, I know that people are going to turn and look. I like that about their shoes.I love Chanel handbags for the same reason. While they are trendsetting and they stay up with the times, they still allow me to look as classy as I possibly can. This is a really cool part of wearing Chanel products. They make all of the other companies out there look silly.

Christology Essay Example | Topics and Well Written Essays - 750 words - 1

Christology - Essay Example Acts 2:32-32 says, â€Å"This Jesus hath God raised up, whereof we all are witnesses. Therefore being by the right hand of God exalted, and having received of the Father the promise of the Holy Ghost, He hath shed forth this, which ye now see and hear†. Some other instances where this resurrection is the central theme are Acts 3:13-18; 4:10-12; 5:29-32; 10:37-43, and so on. Similarly, one can find this resurrection as the main theme in the Epistles. To illustrate, in 1 Corinthians 15, Paul provides a number of reasons why this resurrection is the basis of Christian faith. When some people in Corinth fail to believe in the resurrection of the dead, Paul explains the various dire consequences in the absence of resurrection. First, the act of preaching Christ will be futile, and hence, even faith in Christ will be useless. If Jesus were not resurrected from the dead, no one would be redeemed from sin as promised. That means all the preachers would be liars and Christians would be come a pitiable lot on the earth. Thus, one can see that it is this resurrection which gave the disciples enough courage and faith in what they preached. Secondly, the late 60s AD witnessed persecution of Christians by the Nero-led Roman government. In 62 AD, both Peter and Paul were executed, and this persecution continued till the early 4th century. In order to make the early Christians face the cruelties boldly, and to sacrifice their own life for this great cause, Jesus’ success over death acted as a catalyst (Vinzent 143). With this spirit, Romans 12:1 says, â€Å"I appeal to you therefore, brothers, by the mercies of God, to present your bodies as a living sacrifice, holy and acceptable to God, which is your spiritual worship†. Moreover, the Old Testament is full of prophesy about the resurrection, and for those who believed in Scriptures, the saviour is the one who would win over death. To illustrate, Hosea 5:15 reads, â€Å"I will go and return to my place, till they

Vodun and African culture Essay Example | Topics and Well Written Essays - 250 words

Vodun and African culture - Essay Example They believe there exists a hierarchy of inferior creations, the vodun that vary in strength from Superior deities that govern nature forces and societies of men to the individual streams’ spirits, rocks and trees, an expression considered sacred. Another belief is that God cannot contend with the humans, which makes the Vodun the core of religious life. This element of Vodun religion bears a resemblance to Trinity and angles and saints intercession-making Vodun very compatible with Catholicism and generally Christianity. A strong syncretistic Haitian Vodou was conceived as a result. Tying of souls is another phenomenon in Vodun. They believe in tying a soul in something tangible and physical (Robinson, pg. 72). A person is linked to another person using a soul tie, which commonly links the living and the dead and it is a form of a curse. The key and core Vodun aspect is performing healing to the people from illnesses. Houngans and Mambo arguably have a dominant role in healing. Healing performed in Vodun is a combination of faith healing (using Iwa’s help and some other spirits), herbal medicine, and the western medicine is gaining popularity in many Vodun healing practices (McGee. pg. 28

Critically evaluate Direct payments in relation to Personalisation Essay

Critically evaluate Direct payments in relation to Personalisation - Essay Example When one has the power of choosing and the power of control, it will hence lead to the life of a person to be in the best state (Barron 2010, p.57). Moreover, due to pay down assists in the privatisation policy, many other critical factors are brought into the light. Factors such as trying to ensure a proper and global proximity to both the societal and services that are termed as free by the government are considered (Bornat 2008, p.67). Others such as the intervening and also the early processes of intervening, the growth and also the continuous producing of services in social societies, and also the sector that does involve social care, trying to improve the levels of access to vital information, and also the guidance of all persons, who do utilise this primary social care amenities. This is irrespective of how they are planned to get their funding, and achieving recognition and other supportive aspects of this field (Hazel 2011, p.34). Direct payments which in short form are termed as DPs, are payments in cash form, that are paid to a person, for which they are now able to manage and also make designs of customized help so as to be able to obtain their various needs that are pertain able to social care (Glasby 2009, p.23). Therefore, the channel that submits funds for direct payments, originates from the authorities locally. Even though direct payments have always been present since the year 1996, they are currently one of the many choices that persons who are hence availed for a personal budget (Rogowski 2010, p.87). It is hence evident and without argument that, the number of persons who utilise direct payments as a want, has with time grown constantly from 50 to 3373, from the years 2002 to the year 2008. It is also observable that, the numbers of persons who utilise direct payments, from the year 2007 to 2008, have increased in terms of per cent, roughly rising by 61%. This is indeed one of the largest

Developing and using power and influence tactics to influence people Article

Developing and using power and influence tactics to influence people - Article Example Different leadership techniques have to be adopted under different circumstances and for different purposes. For instance, to get a project through, people need the support of others. The first action taken by the leaders is to adopt the project as their own and show personal commitment to it. They then work towards generating support from others in the organization. They have knowledge about the company and know how to use the company’s informal system of relationships. Markham (1998) indicates that some types of influence tactics are more successful like the logical argument. Some prefer to use the coercive and persuasive techniques rather than confrontive influence strategies even when they expect resistance although threatening tactics are unsuccessful influencing people. Use of personal power or positional power would depend upon target commitment. Expert power has been more useful than reward or legitimate power sources. Although leaders may use enthusiasm and drive to make their projects successful, these have a detrimental effect on projects and targets according to Markham. This requires influencing many people who may not wish to be influenced and the end result may be tension and conflicts. The project leaders may not be trained enough in interpersonal relations, which imply that being a project leader does not give an individual the power or ability to influence, although Carson and King (2006) believe that empowerment leads to self-leadership. Today’s work environment call for self-leadership, say Carson and King. Empowerment implies to delegate power from the higher organizational levels to the lower ones. Employees must be given the power to take decisions rather than just making suggestions. This leads to self-leadership which involves an analysis of how and why a task should be completed. It is the process of influencing oneself. This helps to improve direction and motivation within

Functionalist and Intentionalist Explanations of the Rwanda and Essay

Functionalist and Intentionalist Explanations of the Rwanda and Holocaust Mass Murders - Essay Example The mass murder in Rwanda is a perfect example of the modern time genocide born of ethnic hatred. As compared to the Holocaust genocide, the events unfolding in Rwanda in 1994 gave birth to the systematic slaughter of more than eight hundred thousand Moderate Hutu and Tutsi. This aspect position the Rwandese massacre to being a massacre of the modern phenomenon, absorbed by rationalism, bureaucracy and technology. The massacre of the European Jews, commonly referred to by a majority of scholars as the Holocaust, on the other hand is among the genocides known to the greater percentage of the educated in the society. Between the years 1941 and 1945, European Jews ranging between five and xix million were systematically massacred by the Nazi regime (under the leadership of Adolf Hitler) in collaboration with its allies and other surrogates in the Nazi-occupied territories. Irrespective of the astonishing intensity and scale of the genocide, the prominence of the Holocaust in the recent couple of years has been far from being preordained. Having given a brief preamble of both the Rwandese and the Holocaust genocides, this paper therefore, gears towards availing an in-depth comparison between the two genocides. In addition, this paper also does evaluate both the functionalist and the intentionalists explanation of the two cases of mass murder based on the principal areas of focus such as uniqueness, precedent and generality in either case as drawn from different theoretical quarters. Comparison and Evaluation of the Holocaust and Rwanda Mass Murders When it comes to the definition of what genocide is, it somehow proves to be challenging. Nevertheless, massacres have over and again been repeated in different parts of the world. The most imperative thing to keep in remembrance is that a mass murder remains to be not only a controversial, but also a contested debate among politicians, historians, academics, fascists and nationalists. Irrespective of the noticeable differences in the context of a mass murder, neither of th e sides presents a different opinion or even repudiates the authenticity of the Rwanda and the Holocaust, nor is there sombre rejection over the principle that the Hutus and Adolf Hitler were responsible for the crimes they set off. In this event therefore, it is imperative finding a mechanism of gauging the reality beyond the Rwanda and the Holocaust massacres (Christopher 2004, p.34). As thus, there arise two schools of thought as regards to the historiography of these genocides. These schools of thought are the functionalist and the intentionalist explanations of the genocides. Intenionalist versus Functionalist Explanation of the two Mass Murders Over the past two or so decades, the most heated debate has been revolving around an erudite predisposition by and large referred to as intentionalist and an antagonistic functionalist explanation. Arguably, a great percentage of the interpretation and data so gathered on the Rwanda and the Holocaust massacres relate in one way or the o ther either in the functionalist or the intentionalist perspectives. To begin with the Holocaust genocide it is even derivable from the word itself, the intenionalists’ explanation lays more accents on the intention that the Nazis had; and from the kick off, it is undeniable that these Nazis had their minds made up to eliminate the European Jews in whichever manner, including carrying a mass slaughter on them. An approach of this kind puts emphasis on the figure of Adolf Hitler and his monomaniacal passion to do away with what he referred to as the Jewish cancer from Germany and Europe as a whole (Tom 2010, p.25). Adolf’s stance of facilitating an elimination of the European Jews is clearly evidenced by the statement he makes when addressing a journalist. He confidently declares that in the event that he assumes power, his first priority

Business assingment Essay Example | Topics and Well Written Essays - 750 words

Business assingment - Essay Example Ethics is â€Å"the branch of moral philosophy that deals with moral judgments, standards, and rules of conduct† (Gundlach and Murphy, 1993, p.36). With this in mind, the basic business concept is ethically flawed at Monsters, Inc in terms of how the needs of humans are not considered when the business is seeking to scare them in the pursuit of gathering needed electricity. This is a form of emotional ethics and would be represented today, in real-time business, as an issue with corporate social responsibility. Several business experts identify that corporate social responsibility (CSR) involves â€Å"having a solid concern for the welfare of society† (Nickels, McHugh and McHugh, 2005, p.110). Concern for society is not only charity work, but involves the ethics of corporate policy as well. At Monsters, Inc., there is no such CSR as the monsters have a rather unified social belief that humans are dangerous to touch and contact with them should be avoided. This represent s an organizational culture which is not geared toward considering the needs of the stakeholder (the child). If the children are being emotionally-damaged due to business practices, this is an unethical business climate. In this ethical situation, virtually all of the monsters are guilty and few believe that scaring children for power generation is unethical. This unethical behavior impacted the organization positively, however, as this lack of corporate social responsibility has served as the only means to keep the business operating and profitable. At Monsters, Inc., new relationships with children made the monster workers believe that their scaring tactics were not good, ethical business practices and they eventually changed corporate policy to make children laugh instead of scream. This is the new focus on corporate social responsibility at Monsters, Inc. Of course, this lesson was learned only after meeting

Assignment Essay Example | Topics and Well Written Essays - 500 words - 67

Assignment - Essay Example It has a clear unity of purpose and each of the members values these objectives. There is collective participation of the group members in the group discussions. There is also freedom of expression of the varied opinions of the members, and they are considered in the decision-making process. The members also value the differences between themselves, and they are managed effectively (Woodcock and Dave 14). An ineffective team presents with the absence of trust between the members that is presented by the perception of vulnerability of some members. There are also conflicts that arise due to the inability to engage all the aspects of a passionate discussion. There is also a lack of commitment towards the achievement of the goals and the objectives of the group. There is also a need of accountability of the parties towards the achievement of the goals. The members are inattentive to the results, by placing their individual considerations above the objectives. Before the teams come together, the goals of the members must be clearly defined by the allocating personnel. The group will have to meet and familiarize with themselves, and choose a leader for the group. The members should then be open to the suggestion of each of the members in order to accommodate all the opinions (Woodcock and Dave 14). The leader is central in enforcing these considerations, because they unite all the members. The team leader provides the guide to the members about the need to achieve the goals of the group. They should motivate the team members, and make them understand the essence of the team. In case of conflicts, the leader requires to counsel the members, and reinforce unity. Any miscommunications should be addressed by the leaders, and apologies made where necessary (Woodcock and Dave 14). The members should also be able to listen and understand the greater dimension of their objectives. They should enhance emotional compatibility, in order to

.Northwest Airlines Essay Example for Free

.Northwest Airlines Essay 1).Northwest Airlines applied mathematical models to determine which customers in its database were currently responsible for most of its profitability and which customers were not currently profitable but had similar characteristics to the most profitable customers. Northwest Airlines utilized _____ to identify these customers. 2) Minute Maid sees research as the fundamental first step in any business decision, and it created proprietary methods for conducting research. At what level of the hierarchy of business decision makers does Minute Maid operate 3) Which of the following questions is considered first when discussing a management dilemma 4) The goal of ethics in research is to _____. 5) _____ occurs when the participants are told only part of the truth or when the truth is fully compromised. 6) The process of stating the basic dilemma and then developing other questions by progressively breaking down the original question into more specific ones is called the _____. 7) The fundamental weakness in the research process is _____. 8) Which type of management question asks what do we want to achieve 9) In the Southeast, the potato chip market share held by the Lays brand is 46. This is an example of _____. 10) An increase in hours of television viewing leads to increases in the sales of snack foods. This is an example of a _____. 11) To be categorized as a customer, an individual must have a history of shopping at the establishment at least twice before the start of the study with expenditures of more than 10. RES/351 Final Exam. This is an example of _____. 12) James is entering data on client gender. Because the values entered reflect male or female, this variable is _____. 13) Which variable in an experiment is the variable expected to be affected by the manipulation 14) Qualitative research seeks to _____ theory while quantitative research _____ it. 15) Which of the following is true of quantitative research 16) The use of a control group in experimentation _____. 17) What is the first step in conducting an experiment 18) Data originating from studies that are conducted by others and created for a purpose different from the purpose of the study for which the data are being reviewed are called _____ data. Res 351 final exam 19) The goal of a formal study is to _____. 20) A _____ scale is a scale that scores an object or property without making a direct comparison to another object or property. 21).What type of data is produced by simple category scales

Respecting Client Autonomy: Facilitated Suicide

Respecting Client Autonomy: Facilitated Suicide Respecting client’s autonomy is the most important principle for a mental health nurse to follow The clinical entity of suicide is generally subdivided into the three sub-categories of unassisted suicide, facilitated suicide and assisted suicide. (Pabst Battin, M., 1996). The bioethical model considers each of these entities separately. The first category includes all cases where the individual has made an autonomous decision to end their life without the knowledge or assistance of any other person. The facilitated suicide is a very specific group where the victim undertakes suicide in a situation where they have been under the care of a healthcare professional who had knowledge of the potential risk and that means of either suicide prevention or intervention were available but either not used or not considered. There is a clear distinction between this group and the next to be considered, as there is not a suggestion that the healthcare professional did anything positive to assist the suicide attempt, but there is an element or suggestion of neglect or failure of duty on the part of the healthcare professional to protect the patient. (Kupfer J 1990). The assisted suicide is where either a healthcare professional or another person actively assists, either in terms of providing the actual means of death or the knowledge and guidance as to its use, in the death of another. Most arguments aimed at supporting this situation are based on an assumption of rationality and competency on the part of the victim. The majority of such situations, if analysed critically, involve severe pain, disability or occasionally stress, each element has the ability to substantially impair rational thought and decision making. (Salvatore A 2000) Bioethics is the study of value judgements pertaining to human conduct in the area of biology and medicine. It espouses a number of ethical principles which are central to the field but are overlapping, occasionally contradictory and, in the field of suicide in particular, are frankly capable of producing considerable confusion. (Donnelly, J., 1998) We shall briefly consider the main principles that are relevant to this consideration. Perhaps the most central ethical principle to consider is that of autonomy. John Stuart Mill (Mill 1982) produced on of the most celebrated treatises on autonomy, which, taken on face value, allows any individual the right to self-determination of all his actions. In most fields of medical practice the principle of autonomy is considered virtually sacrosanct and explicit personal consent is required for most procedures. (Gillon. R. 1997). The practical difficulty arises when the patient is not â€Å"competent† (a legal term – not an ethical one). The arguments that surround the issue of autonomy in relation to suicide effectively turn on this issue. Those who support the autonomous right to suicide arguing that JS Mill was right, and on the other extreme there are those who oppose it pointing out that anyone who comes to the decision to take their life is, by definition, incompetent (legal definition again) (Coulter A. 2002). Other principles help us further. The Principle of Beneficence (often referred to as the First Principle of Morality), at its most basic level requires the doing of goodness and of being good. This immediately presents the analyst with a problem because the definition of â€Å"goodness† is dependent on both environment and culture. What is considered good in one circumstance may not necessarily be good in another. Critically, beneficence implies that the healthcare professional will have carried out his duties, obligations and responsibilities in a spirit of goodness. (McMillan J 2005) If we also consider the principle of Non-maleficence. Primum non nocere, which literally means â€Å"no malice†. Carrick (P 2000) points to the fact that Hippocrates encapsulated this Principle in his dictum â€Å"first do no harm†. In its more modern interpretation, it means that not only must the healthcare professional do no harm to the patient, but, critically in this regard, they must take all necessary steps to see that no harm comes to the patient. (Dimond. B. 1999). The World Health Organisation widens this interpretation to one which includes a duty to try to minimise any harm which is unintended or accidental. (WHO 1996). There are some circumstances, and these certainly have a bearing on consideration of suicide , where, if a clinician or healthcare professional feels that they cannot do good without the possibility of doing harm, then they should take no action at all. We should note that this is primarily a theorist‘s view and, in the real world it is almost impossible to take any action that does not have the possibility of doing harm to a patient. In conclusion one can agree that, in general terms, autonomy is indeed an important principle for mental health nurse to follow but, in the case of suicide, it is not the most important principle. Mills felt that autonomy required the exhibition of respect, dignity, and choice with the latter being considered generally the most important. Healthcare professionals have to have respect for personal rights. Suicide has to be seen (generally) as the outcome of a number of processes which result in psychological debilitation. The extension of autonomy to such individuals facilitates suicide. It is generally accepted that respect for the individual patient in these circumstances is more usually demonstrated by recognising their vulnerability. It is a common finding that the principles of ethics can be antagonistic. Failure to observe one Principle in order to facilitate another does not render an action necessarily unethical. Beneficence must not be sacrificed for autonomy (Minois, G., 1999) Beneficence is about caring and not just treatment. Every attempt at intervention is warranted. The adoption of the Principle of Non-maleficence calls for the healthcare professional to do whatever is necessary to protect the patient from harm and for whatever it takes to assure the clients life. (Rich K et al. 2004) It is generally a mistake to consider that the ethical requirements and the legal requirements in these circumstances are the same. The law sets a minimum set of standards, ethics requires considerably more. We could conclude by considering the Socratic maxim which is particularly relevant here â€Å"Primum non tacere† (First, do not be silent) References Carrick P 2000 Medical Ethics in the Ancient World Georgetown University press 2000 ISBN: 0878408495 Coulter A. 2002 The autonomous patient. London: The Nuffield Trust, 2002. Dimond. B. 1999. Patients rights and responsibilities and the nurse. 2nd ed. Salisbury.: Quay Books 1999 Donnelly, J., 1998, Introduction, in Suicide:Right or Wrong?, J. Donnelly (ed.), Amherst, N.Y.: Prometheus. 1998 Gillon. R. 1997. Autonomy London: Blackwell 1997 Kupfer, Joseph, 1990, Suicide: Its Nature and Moral Evaluation, Journal of Value Inquiry, 24 : 67-81. McMillan J 2005 Doing whats best and best interests BMJ, May 2005 ; 330 : 1069 ; Mill JS 1982 On Liberty, 1982, Harmondsworth: Penguin, p 68. Minois, G., 1999, History of Suicide: Voluntary Death in Western Culture. Baltimore: Johns Hopkins University Press. 1999 Pabst Battin, M., 1996, The Death Debate. Ethical Issues in Suicide, Upper Saddle River, N.J.: Prentice-Hall 1996 Rich K Butts J (2004) Rational suicide: uncertain moral ground, Journal of Advanced nursing 46 (3) ; pp 270-283 Salvatore A 2000 Professional Ethics and Suicide: Toward an Ethical Typology Ethics, Law, and Ageing Review (6) pp. 257-269 WHO 1996 World Health Organisation. 1996 Ethics and health, and quality in health care–report by the director general. Geneva: WHO, 1996. (Document No. EB 97/16.) 25.4.06 PDG Word count 1,245

Vaccination: A Necessary Precaution Essay -- Health Medicine

The issue regarding vaccinations and their accompanying side effects has been a prevalent debate throughout society and medicine for a number of years. Some continue to believe that vaccinations are harmful and actually promote disease, but the truth is that the concept of immunization is one of the most significant advances in scientific history that has led to the prevention of countless diseases and epidemics throughout the world. Still, despite the overall improvement of public health, the usage of vaccinations remains a controversial concern that is constantly challenged. Vaccination critics argue that the serious side effects associated with vaccines have been underreported, underfunded, and rarely researched. This, however, is false. Vaccinations are a necessary part of society because they prevent the spread of major diseases, reduce the severity of illness, boost one’s immune system, and in turn, protect the populous from potential epidemics. The definition of a vaccination, as stated by the Encyclopedia Britannica, is â€Å"a suspension of weakened, killed, or fragmented microorganisms or toxins or of antibodies or lymphocytes that is administered primarily to prevent disease† (Encyclopedia Britannica). Vaccines stimulate the immune system to attack the specific harmful agent and then cause the anti-bodies to remain sensitized in case the agent should ever reappear in one’s system. Obviously, this can be helpful when trying to prevent disease, or any other illness for that matter, since the anti-bodies specific to that type of illness remain present in one’s body lest the illness returns. Since infants are extremely susceptible to infirmity, many are vaccinated as early as the first month of their life. This helps ... ...ed cases of measles reported, and less than one hundred reported cases of poliovirus. Also, studies performed in the United States have discovered that the diphtheria, pertussis, tetanus (DPT) vaccine is 90% effective in preventing the diseases (Zimmerman). Works Cited http://www.perfspot.com/docs/doc.asp?id=60286 Encyclopedia Britannica. "Science & Technology::Vaccine." Encyclopedia Britannica. Encyclopedia Britannica, Web. . http://internetreviewofbooks.com/sep10/the_pox_and_the_covenant.html http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/ http://www.vaccinateyourbaby.org/why/preventing.cfm Zimmerman, RK. (2000). Child vaccination, part 1:routine vaccinations. Journal of Family Practice, 49,(9), 22-33. Retrieved March 12, 2005, from EBSCOhost database. http://www.whale.to/a/moth.html

Themes in To Kill a Mockingbird by Harper Lee :: To Kill a Mockingbird Essays

Some books are written to prove a point or some sort of idea. The novel, To Kill A Mockingbird by Harper Lee, is an excellent example of proving a point or a theme. Themes in the book include courage, lady, standing in another man's shoes, it's not time to worry, education, and trash. All the themes stand out, however, three in particular are exemplified in the book. The three main themes in To Kill a Mockingbird are courage, lady, and standing in another man's shoes. The first theme is courage. Courage is apparent in the seemingly wicked Mrs. Dubose. It is also courage for Jem to strive against Mrs Dubose. According to Atticus, the children's father courage is, "...when you know you're licked before you begin but you begin anyway and you see it through no matter what."(p112) Mrs. Dubose had great courage trying to get over her morphine addiction and, even though she would have trouble doing it, bumped the addiction for the rest of her life. In the beginning of the book, when Dill, Scout, and Jem were still hyped up over Boo Radley Jem showed the ultimate courage by venturing into the spooky dwelling place inhabited by Boo Radley. Jem went through the gate and touched the house. One time, all three went into the Radley yard to simply look inside Boo's window. However, the children were frightened near death by a warning shot from Nathan Radley. The real courage comes after that when Jem goes to reclaim his pants, facing a possible confrontation with Boo or Nathan. Another example of courage is Atticus defending Tom Robinson, a black man who is innocent of rape but is tried because Bob Ewell said Tom did it. Atticus knew he would be defeated but he tried to win the case anyway. Also, though the book doesn't really mention the way Scout is not happy in school, it requires great courage for Scout to continue to go to school even though she has to deal with a bad first grade teacher. Lee's point in courage is a person is not defeated until the person loses faith and gives up. The second theme in the book is lady. One of the people of this theme is Scout's Aunt Alexandra, who is constantly scolding Atticus for allowing Scout to do unladylike things. Miss Maudie, the town's resident botanist, is a lady who Scout's uncle is always after. Once when Scout is being asked what she thinks her occupation would be, she answers, "Just a lady."(p230) Being a lady also has to deal with the types of clothes worn by the lady.

Essay examples --

Archimedes was one of the last ancient Greek mathematicians, following in the footsteps of Plato, Socrates, and Euclid. Historians call him "the wise one," "the master" and "the great geometer". Although he was also a scientist and inventor, it was his work in mathematics that has ranked him as one of the three most important mathematicians in history, along with Sir Isaac Newton and Carl Friedrich Gauss. Further, he was one of the first scientists to perform experiments to prove his theories. Archimedes’ discoveries in mathematics continue to have an impact today. Historians do not know a great deal about Archimedes’ life. Archimedes was born around 287 B.C. in Syracuse, Sicily, which was part of Greece at that time. We know his father was an astronomer, which Archimedes mentioned in one of his works, "The Sand Reckoner". He had a close relationship with the royal family and was called upon by the king when he needed scientific advice. At 1...

AIDS and Society: The Growing Concern

Over the past centuries, the field of sociology has primarily focused on looking into various problems faced by different societies not just to understand more about this.   More importantly, the study of sociology is to be able to provide the needed knowledge in order to find a solution for what has been considered as a social problem.While there are some social problems that are isolated and merely experienced by certain societies, there are some issues and concerns that have greatly affected societies found all over the world.   The AIDS epidemic is one such problem.The fact that, to this day, there has yet to be an effective treatment that would successfully treat this disease has not just caused the number of individuals being infected to increase.   It has also greatly affected how other members within a particular society relate and associate with individuals infected with AIDS.This paper will discuss the different factors that have qualified the AIDS epidemic to become a social problem.   The paper would also provide relevant information regarding the background of AIDS as a disease and the various ways on how the AIDS epidemic has influenced society in general.The AIDS EpidemicIn order to fully understand why the AIDS epidemic is considered as a social problem, information regarding the disease must first be established.The AIDS epidemic was the primary area of discussion in the United Nations Security Council in January 2000.   The huge priority with regards to the AIDS epidemic was in part to the alarming statistics the council received the year before.By 1999 alone, about 34 million individuals living all over the world have contracted the AIDS virus with another 18.8 million of these individuals dying from the disease in the same year.The statistics have also shown that while the AIDS epidemic is most prevalent in Africa, the United States has been ranked as the number one country in the Western world with the highest number of individual s infected and succumbing to the AIDS virus (Young, Schvaneveldt, Lindauer & Schvaneveldt 2001).AIDS, which stands for Acquired Immune Deficiency Syndrome, is a virus which, as the name suggests, attacks the immune system of the human body.   While the virus itself is not fatal to human beings, it is the fact that the immune system of an individual who has contracted AIDS is no longer able to ward off infections and other diseases brought about by bacteria and other kinds of virus that causes the death of an individual afflicted with the AIDS virus.The virus has been traced to originate from Africa.   It is believed that the virus, which thrives in the bodies of monkeys have been able to mutate and once entered into the human body, begins to damage the immune system (Langone 1991).AIDS and Its Impact to SocietyFor an issue to be considered as a social problem, the problem must be seen as one that poses a severe and grave threat towards the members of a particular society (Drass, Gregware & Musheno 1997).   There is no doubt that the AIDS epidemic has now been recognized as a social problem that continues to grow to this day.Once believed to be a disease that only infected homosexuals engaging in sexual intercourse with members of the same sex (Langone 1991), recent studies have made societies all over the world view the AIDS epidemic in a different light.Apart from the fact that there are now individuals being inflicted with the AIDS virus as a result of unprotected sexual intercourse involving partners from the opposite sex, the AIDS virus has also been known to also inflict children.In the report provided to the United Nations Security Council in the year 2000, out of the 34.3 million individuals all over the world who have been infected with the AIDS virus, 1.3 million of these were children below the age of 15 years (Altman 1995; Young, Schvaneveldt, Lindauer & Schvaneveldt 2001).The general perception that the AIDS virus is a major social problem ha s greatly influenced other parts of society, primarily when it comes to equality and advocacy.   How the general public perceives a particular social problem would greatly affect the association and relations that they would eventually have to those that they perceive to be the instigators of the problem.In the case with the AIDS epidemic, individuals who have been discovered to carry the disease experience a number of various incidences for racism and prejudice to arise.The most profound example of this can be seen during case proceedings in litigation hearings conducted in the court houses of the United States.Studies with regards to the manner as to how legal decision making in the United State court houses are carried have determined that social influences, particularly those involving cultural dynamics and social dynamics have greatly influenced the outcomes of various court cases which involves at least one individual who has been diagnosed to be infected with the AIDS virus (Drass, Gregware & Musheno 1997).One particular social dynamics that play a crucial role in decision making process done in court houses in the United States is social status.   Studies have shown that individuals that have a higher social status ranking would be likely to experience the ruling of a court proceeding to be in their favor as opposed to those who have been considered to have a low social status.Individuals who have been infected with the AIDS virus have long been regarded as individuals with a low social status ranking primarily due to the fact that those who surround them view them as carriers of something that would definitely cause adverse harm to the individuals living with them.In effect, individuals who have been infected with the AIDS virus have been viewed within the same ranking just as how members of a particular society would view and individual indicted for committing a heinous crime (Drass, Gregware & Musheno 1997).The ideologies and beliefs upheld by a particular society is another dynamics that greatly influence legal proceedings involving an individual who has been inflicted by the AIDS virus.   The culture upheld by a particular society is based on the sharing of common beliefs, traditions and ideologies among each other.Discrimination based on the culture within a particular society normally occurs based on the gender, sexuality and ethnic background of an individual.   Recently, the status of an individual as to whether or not he or she is inflicted with the AIDS virus has also been included in the list.In fact, the culture within a society in the manner as to how they perceive individuals infected with the AIDS virus not only causes decisions made during court proceedings to rule against the individual who has been inflicted with the AIDS virus.An individual who has been diagnosed to be infected with the AIDS virus are often subjected to alienation, branding and other forms of oppression from other members within a part icular society (Altman 1995; Drass, Gregware & Musheno 1997).

Public Speaking Essay

PUBLIC SPEAKING INTRODUCTION When we heard the word, ‘public speaking’, what came to mind is standing in front of a crowded room packed with people and talking to them. The image alone sometimes create an enormous effect on most people, causing nervousness, and maybe even fear. Before we jump to that, let’s look at the definition of the word itself. According to Merriam Webster online dictionary, the words Public Speaking has a meaning of â€Å"the act or process of making speeches in public,† or â€Å"the art of effective oral communication with an audience.† Next, what is an audience? An audience is defined as â€Å"a group of listeners or spectators.† From the definitions, we can draw a conclusion that in public speaking, there is an act of both speaking and listening. So what differentiates public speaking from a conversation? While both public speaking and conversation involves a direct and face-to-face encounter, usually public speaking is more of a ‘one-wayâ €™ talking. Although nowadays most speakers claim that they want an interactive session, but usually the audience is given a specific time to do so. Next, in terms of language, public speaking uses a formal language. Because they are speaking in front of a group of people, speakers need to adress their audience in a more formal way. Third, and most importantly, public speaking needs to be structured. They need to have a tight grasp on their topic and do their research thoroughly. The reason the topic ‘Public Speaking’ is chosen is because it is something that everyone needs to do at some point of their lives. It is also based on the In conclusion, public speaking can be defined as the act of making a speech in front of a group of listeners, and is different from conversation in terms of approach, language, and structure. TYPES OF PUBLIC SPEAKING Naomi Rockler-Gladen, a former professor at Colorado State University, wrote on the website suite101 that there are three types of public speaking; informative, persuasive, and ceremonial. These types also defines the purposes, or the reasons the speech is made. More details on the three types of public speaking will be explained below. The first type, informative. Informative has the meaning of giving information, to inform. An informative speech has a purpose to inform, or give knowlegde to its audience about  something that they probably did not know of before. The end goal of an informative speech would be to equip the audience with a brand new knowledge that they can apply to a particular aspect of their lives. The important thing to watch about giving an informative speech is to not put in too much information. Imagine an empty bucket being filled with water. If being filled with too much water then the water will leak out for sure. The same thing applies to the audience. The ‘leaking’ must be avoided at all costs, so the information has to be kept simple, yet useful. The second type is persuasive speech. A speaker giving a persuasive speech needs to be able to persuade the audience to do, or believe in something. Usually, the speaker would try to change the mindset, perception, or behavior of the audience for their own good. Giving an informative speech is not an easy thing to do. The speaker needs to be really passionate about the cause they’re giving, in order to convince and persuade the audience to follow suit. The second thing that can be done is to look for common ground with the audience, try to relate to what they might agree on. Third, try to aim for a smaller scope of issue for a start. As mentioned before, a speaker is given a time limit to deliver his or her speech, and it will not be easy to change one’s mind in such a short time. Third, and last type is a ceremonial speech. There are so many ceremonies in our li ves, starting from graduation, engagement, wedding, to funeral. Usually this kind of speech is given to congratulate, or in the case of a funeral, remembering the dearly departed. Thus, the given speech tends to be less formal and more personal than the other types of speeches. The important thing to watch about giving a ceremonial speech is to be appropriate. No matter how well you know the person you are giving speech about, try to not say bad things about them, even if it is meant to be a joke. The point here is to make them feel special, not to bring them down, especially in front of a large group of people. From the three types of speeches mentioned above, we can draw a conclusion that all kinds of speeches will have have to cause some kind of an effect for the audience. Informative speech needs to result in the audience understanding or knowing something they did not know before. Persuasive speech is aimed to change someone’s perspective about something or to ask them t o do something, and ceremonial speech should be more personal, and make someone feel special and included in a certain ceremony. PREPARING The key of perfecting anything is through practice, and public speaking is no exception. However, merely practicing will not be sufficient to have a successful public speaking. Aside from practicing, there are also several things that can be done to prepare oneself for the often-dreaded experience. The first thing is to know who the audience will be. Try to get as much information as possible regarding this particular area. Age, gender, cultural brackground, sexual orientation, and religious views are among the most crucial things that a speaker needs to know. These informations will be very helpful to the speakers to determine their style of speaking, the approach that they are going to use, and to avoid offending a particular group. There are three questions that needs to be kept in mind when working on the speech: To whom am I speaking? What do I want them to know, believe, or do as a result of my speech? What is the most effective way to composing and presenting my speech to acco mplish that aim? (Lucas, 2004). The next thing that can be identified is the venue. Knowing the ‘battlefield’ in advance will give the speakers a huge advantage. They would be able to plan beforehand, for example, where they want to stand, and if they wish to walk around, what pattern would be best so the audience will not get too distracted, and how they are going to face the audience. Every speakers need to have a tight grasp on their topics. Therefore, they need to do a thorough research before they present their topic to their audience, especially if they are giving an informative speech. Speakers can acquire their materials from many different resources, whether it be the books from the library, the internet, or even their own knowledge and experiences. At the end of every session, usually the audience are given the time to ask questions regarding the topic, and the speaker needs to be able to answer them. There are two words that most speakers always have with the m during their seminar or presentation; visual aids. They are usually in the form of a Power Point presentation, which can include texts, audios, and videos. The essence of having a visual aid, aside from making the presentation more interesing, is so that the audience can have a better understanding of the topic. Speakers can include the main points of each of their ideas instead of the whole sentence in their slides, to keep the audience from getting bored. Last, as  mentioned above, practice is necessary. Sparing some time to practice will help build confidence, which is an important thing to have in delivering a speech or presentation in public. It will also help determine the length of the presentation, whether it is too long or too short from the given time. From the explanations above, it can be concluded that there are five things that needs to be prepared in public speaking, which are; knowing the audience, identifying the venue, doing a thorough research on the topic, ha ving a visual aid, and practicing. These five elements of preparation could be the key to ensuring the success of public speaking. PRESENTING When all the preparation has been done, comes the real challege; presenting. There are a few aspects speakers need to pay attention to while giving their speech. Language is the main aspect a speaker needs to pay attention to while giving a speech. Whether their purpose is to inform or persuade, language is their tool, their weapon. Therefore, how the use the language is crucial to the success of their speech. Language needs to be used clearly. Words are not limited to a universal meaning, which means that not everyone interprets a word in the same meaning or understanding. A speaker needs to choose their words carefully and make it clear to the audience what they mean of it. Language also needs to be used appropriately. When giving a speech, audience looks up to the speaker to give them something new, something useful. Thus, the speaker needs to know how to deliver their speech to fulfill the audiences’ expectation. Audience tends to prefer if their speaker can deliver their speech without any form of notes or texts. Speaking from the memory shows a great deal of confidence, and that will gain more respect from the audience. However, there is no harm from getting help from notes or flashcards. This can help the speaker remember and focus on their main points, and also keep their speech organized. Language and delivery alone will not be sufficient if the speaker does not have the right body language. Body language includes personal appearance, movement, gesture, and eye contact. The phrase â€Å"don’t judge a book by its cover† is often heard but rarely practiced. First impression will always matter in the way one person looks at another, so a speaker needs to dress appropriately. The movement and gesture of a speaker also affects the audience, for  example, if the speaker keeps pacing around the room, it willl distract the audience from the topic and confuses them. Sometimes, when a speaker is feeling nervous, he or she will tend to make move their hands around or play with their hair, etc. This should be avoided at all costs, as mentioned above, to avoid making the audience feels distracted. Eye contact needs to be maintained to hold the audience. Lucas explained in his book that when speaking in front of a small audience, you can look briefly from one person to another, but in a larger audience, it is better to just scan through the audience rather than look at each person directly. It has been mentioned above that it is best if the speaker could prepare visual aids beforehand. While presenting a visual aid, the speaker needs to be clear, but by doing so, they also need to still be connected to the audience, and not be too immersed in their own visual aids. The visual aid itself should be made as large and as intersting as possible. While closing the speech or presentation, speakers can restate their main points, just to remind the audience of the important things that has been said. They can also end it with a s pecial message and encourage the audience to ask questions. Speaking in public is all about confidence. Wearing the right clothes, movements, gesture, maintaining eye contact, and having visual aids can enhance the speakers’ confidence, and in return, will gain the respect and trust from the audience. BBIBLIOGRAPHY Lucas, Stephen. The Art of Public Speaking. 8th ed. Boston, MA: McGraw Hill, 2004. Print. Osborn, Michael, and Suzanne Osborn. Public Speaking. Boston: Houghton Mifflin, 2006. Print. Rockler-Gladen, Naomi. â€Å"Public Speaking Class Tips: Writing Great Speeches for Your Speech Course | Suite101.com.† Naomi Rockler-Gladen | Suite101.com. 13 Jan. 2007. Web. 10 Oct. 2011. .

Marketing Plan †Chancellor University Essay

Chancellor University is a for-profit secondary education institution located in Seven Hills, OH. Grounded in the traditions of business, it has multiple degrees in business and other select professions. Alumni of Chancellor University include John D. Rockefeller and Harvey Firestone. The degree selection ranges from certificates to Masters Programs focusing in business, healthcare management, global comparative studies, and criminal justice. In 2009, Chancellor switched from ground campus to an all-online format, with students spread across the United States and some countries around the world. Chancellor believes that students succeed later in life because they are taught to strive for excellence. Based on previous SWOT analysis, Chancellor has a chance to recover from the economic downturn and help it become viable as a premiere institution. STRENGTHS| WEAKNESS| SOCIAL MEDIA PROGRAM| LOSS OF JACK WELCH MGMNT TO STRAYER UNIVERSITY| COMMUNITY COLLEGE PARTNERSHIP| REPORTS OF LOSING ACCREDITATION| HISTORY| LOW STUDENT RETENTION| | | OPPORTUNITIES| THREATS| WORKING CLASS AND FIRST GENERATION COLLEGE ATTENDEES| BAD ECONOMY| CELEBRITY STUDENTS| LACK OF ALTERNATIVE FINANCING|. DEMAND FOR HIGHER EDUCATION| COMPETITORS OFFERING SIMILAR CLASSES AND FORMATS| Recently added to the Chancellor University degree offerings is the Masters and certificate program of Social Media. According to some, this addition as a Master’s Degree is not viable but the certificate program is seen as viable for specializations. The feeling is that most students would already be well versed in social media and that its best to follow a concentration in Marketing and use the social media classes within the Marketing program. The social media certificate program is great to have for the marketing major and will show a specialization of making social media relevant in the business realm. A lot of higher education facilities are starting to add courses and degrees with this specialization, Chancellor is seen as one of the firsts to make it available to their students. Chancellor recently began to offer a â€Å"Study Abroad† program that will aide in the students in getting a well-rounded education with global exposure. Chancellor has also partnered with community colleges to offer students a wider variety of courses and credits toward their Bachelor’s and Master’s Degrees. Chancellor stands to continually lose its footing as a premiere institution considering the lack of alternative education financing due to its for-profit status. It makes it difficult for students to pay or obtain alternative payment plans for their education. Pell Grant is the only grant offered to the students. States cannot award students grants because Chancellor is a for-profit institution, this means that the students will bear the weight of financing and increase their loan responsibility. Reports have been continually floating around of the schools accreditation being at risk from the Higher Learning Commission in Chicago due to poor leadership, financial health, and the quality of the academic programs. Losing accreditation would mean that students could no longer utilize the federal Pell grants for their education with Chancellor. The Jack Welch Management Institute was a top notch addition to the Chancellor curriculum. With its loss to Strayer, Chancellor loses the investment money that came from Jack Welch and the prestige that came with the famous managers name and contributions to their management program. The demand for higher education at an affordable rate continues to rise. Chancellor is not offering it in their current format. Time is taken away from the leadership team developing the curriculum or focusing on the needs of the students to prepare for the commission review. This can turn a lot of students away and the retention rate will decrease. The classes are moderately priced compared to University of Phoenix and Strayer University (based on Bachelor Degree programs). Opportunities exist for Chancellor to expand. Recommendations would include: * Branching out to offer campus sites within the community colleges that they have established partnerships with. This can be obtained by offering professors a stipend to teach courses that are more difficult for students to follow with the online formats, satellite campuses have contributed to the success of Strayer University and University of Phoenix. * Establish a larger presence with social media. Offer the current students the opportunity to blog about their experiences and link the blogs to their social mediums, this increases awareness of Chancellor and their presence on the Internet. * Increase information on the Wikipedia. org page. The article for Chancellor University is more so focused on the history instead of the offerings of the institution. The page describes several changes that Chancellor has been through starting with the Folsom’s Mercantile College and can turn potential students away with the constant changes. * Work out, within the partnerships of the community colleges, to offer Chancellor students the option to take their courses as electives. This will increase the amount of electives available for Chancellor students and contribute to the satisfaction of their education experience. * Chancellor should transition back to letting the students pick their own classes, giving them a selection in each category for the general education electives. This way, the students are responsible for their education and can still study subjects of interest to them. Works Cited Chancellor University. (n. d.). Retrieved from www. chancelloru. edu Chancellor University wikipedia. (n. d. ). Retrieved October 24-26, 2012, from Wikipedia: http://en. wikipedia. org/wiki/Chancellor_University Magaw, T. (2012, August 6). Crain’s Cleveland Business. Retrieved Octber 24-26, 2012, from Accrediting body again issues show-cause order for Chancellor U. : http://www. crainscleveland. com/article/20120806/FREE/308069957 Strayer University. (n. d. ). Retrieved October 25, 2012, from Wikipedia: http://en. wikipedia. org/wiki/Strayer_University Strayer University. (n. d. ). University Tuition Fees and Costs. Retrieved October 25, 2012, from Strayer University: http://www. strayer. edu/financial-support/tuition-and-fees University of Phoenix. (n. d. ). Bachelor of Science in Management. Retrieved October 25, 2012, from University of Phoenix: http://www. phoenix. edu/programs/degree-programs/business-and-management/bachelors/bsm. html#tab=tuition Wecker, M. (2012, March 1). US News – Education. Retrieved October 26, 2012, from Avoid Social Media M B A’s, Some Students Say : http://www. usnews. com/education/best-graduate-schools/top-business-schools/articles/2012/03/01/avoid-social-media-mbas-some-students-say.

How Muhammad Established Islam As A Major Political And Religious Force In The World Essay

While Muhammad was living with his wife Khadija, he often went to a cave outside Makkah called Hira, where he would reflect and pray. During one night in 610CE, when Muhammad was 40, he was in a cave on Mount Hira. God revealed himself to Muhammad. This was called the night of power, and it relates in Surah 95 of the Qur’an, which is entitled The Blood Clot. When Muhammad returned home, Khadija became his first believer. Then his cousin Ali, a freed slave called Zayd, and one of his closest friends, Abu Bakr, all became followers. There started one of the great religions of the world. Muhammad had a strong belief that there was only one God, the creator. He believed that all humans should be equal in their relationship with this creator. This undermined the tribes of Makkah who, especially the Quarish, rose up against Muhammad and his followers. All through his life, Muhammad fought to establish Islam, to gather followers, and to create a substantial political force. In the 22 years after the first revelation, until Muhammad died in 632CE, God delivered the Qu’ran to Muhammad, his messenger. By the time that God had finished revealing the Qu’ran, Muhammad had moved to Madinah. Hence we get Makkan and Medinan verses. The Makkan verses are usually shorter, more judgemental, and are found towards the end of the Qu’ran. After the second revelation, the night journey, Muhammad migrated to Yathrib, 40 miles north of Makkah, to settle disputes with the pilgrims from that town. He went there with family and followers in 622CE. When he arrived, he built a house, which was later to become the first mosque. He then renamed the town Madinah. This is where the central community was established. After Muhammad died, no one knew if he had named a successor. Usually, it would pass to his eldest son. In the end the leader was chosen by the Muslim community as a person of great personal integrity. This is the belief of the Sunni branch of Islam, who did not want a government, but they wanted to rely on an authoritative ruler. The Shi’a branch believes that the early history was biased against Ali, Muhammad’s cousin. When Ali did become the leader, those who believed Ali to be the true successor formed the separate ‘Party of Ali’. The Shi’a branch wanted a leader from the family of Muhammad. Islam was greatly diversified by the achievements of the first four caliph successors to Muhammad. Here is who they are and what they achieved in their rule: * Abu Bakr (632-634 CE) He and his armies conquered Arab tribes, and they went as far as the Byzantine Empire’s borders. Abu Bakr had more than a personal belief of Islam and he had a belief of political ideology. * Umar (634-644 CE) He continued after Abu Bakr and captured Jerusalem and North Africa. * Uthman (644-656 CE) After Ali turned down the caliphate, Uthman was chosen and he expanded the empire through North Africa and Eastwards to India and China. * Ali (656-661 CE) He made Mu’awiya co-caliph, a disastrous move. Two parties were formed, one supporting Ali, the other supporting Mu’awiya. Islam today is the second largest religion in the world and it is growing fast. It is significant in the modern politics. It also contributes to art, music, architecture and philosophy. The religion has grown to have over 2 billion followers. However recently Islamophobia has stepped in. Islam has been treated very cruelly by the western media in the last few years. However Islam means to surrender, or submit, and it is linked closely to another Arabic word meaning peace. Indeed a Muslim is ‘one who surrenders’.

Research proposal Example | Topics and Well Written Essays - 1500 words

Research Proposal Example Increased sales is one of the potential benefits of customer relationship managent and results from identification and utilization of customers’ needs. Market expansion and higher profit margins are other benefits that organizations may reap from implementing customer relationship management. In addition, developing an understanding of customers’ needs ensures utility among the customers, a factor that also ensures customer retention and even marketing through customers’ testimonies. Customer relationship management also has an ultimate effect of decreasing an organization’s sales and other marketing expenses (Chaturvedi 2009, p. 5). Different approaches and techniques, however, exist that determine banks’ application of customer relationship management and may be a factor to the current trend in application of the management approach in the financing sector and establish a difference in application of customer relationship management by different t ypes of players in the sector (Rai and Singh 2012, n.p.). The study focuses on the current trend among banks and micro-finance institutions in the United Kingdom. Customer relationship management offers numerous advantages towards competitive advantage, should an organization implement it. This study seeks to investigate the use of the management towards these benefits with the aim of identifying possible inefficient application and creating awareness among the target organizations towars higher competitiveness and customer utility. Identifying trend in application of the managent and comparing this with trends in applicable technologies for customer relationship management will help inform the target population of necessary changes in the applications. In addition, understanding applications of customer relationship management, as applied by banks and other micro-finance organizations, will help in integrating techniques in the management branch, and

A SEPARATION Movie Review Example | Topics and Well Written Essays - 500 words

A SEPARATION - Movie Review Example In relation to analyzing the movie we will discuss the theme of the film, the camera’s angles and its effectiveness and casting of the actors, where they adequate in their job or not. Moving to the plot of the film, Simin (Leila Hatami) wants her husband Nader (Peyman Moaadi) and an eleven year old daughter Termeh (Sarina farhadi) to emigrate, citing the circumstances of Iran and its rigid rule for women. However, Nader is not willing to agree, since his father, who is an Alzheimer patient, is not well and he cannot leave his father in such condition, leaving the pair in an unreasonable situation. This consequently leads to Simin asking for a divorce, which Nader is not willing to give. From here, Razieh (Sareh Bayat) enters as a maid hired by Nader to look after his father, since Simin has left him for her parents’ house. Thus, one events lead to another and the movie ends with Termeh deciding the custody for her, while her parents are waiting, separated by a glass wall. Outlining social barriers and criticism of inequality among the gender in Iran culture make up the theme of the movies. Starting with the first theme, the introductory scene of the film in which images of passport being photocopied are shown, depicts that the value of the people has stooped to a strings of numbers, as if they have no value. Similarly, the shot of Simin not able to have access to forthcoming travel, but is refused in the introductory scenes and not mentioned again throughout the whole film is also another depiction of social barrier. Interestingly, the other theme is inequality among men and women, for instance in regions such as Iran, women does not have the right or power to explore their opportunities or turn into a willful, independent and strong women, but Farhadi illustration of Simin shows that she is an educated and enlighten women who knows that her daughter will not have those opportunities at her disposal, if they continue their stay, as she will

Charles I Essay Example | Topics and Well Written Essays - 1500 words

Charles I - Essay Example full term at the helm of the throne, and the conflicts that characterized his term, emanating from his perceived loyalty to the Catholicism, leaving the Protestants to feel aggrieved. The conflict with the parliament soared so high to the point of having the structure of leadership change after his execution and the parliament ruled without the monarch, when fifty-nine among the commission of judges signed a death warrant and committed him to be executed (Hibbert, 273). While covering the life story of Charles I, the book has also sought to give the backgrounds that led the King to act in the manner he acted in different situations of his leadership, seeking to create a full understanding of the life and the circumstances that surrounded the life of the King. This book covers an important aspect of the history of England, most especially by delving deeply into the aspect of the conflict between the parallel systems of leadership; the monarchial system and the parliamentary system. Additionally, the book covers the core of the emergence of a constitutional monarchy while also highlighting the role that religion has played to influence the politics of England throughout its history. Thus, this subject needs to be covered, so that it can create deeper insights into the history of the conflicts between parliamentary system and the monarchial system and the reason as to why the two parallel system works in present day without much of a conflict. Through this subject, the history of religion and religion conflicts also will be understood, thus creating an understanding of religion and how it has shaped religion, thus enabling an appreciation how things work the way they work in present day. The thesis of this book points to the idea that; Charles I was not suited to the throne when assessed by his physical appearances, and neither was his father King James. Because of the negative things that he was perceived to have done to some people, which deprived them of their

Operations and Business Systems Management Research Paper

Operations and Business Systems Management - Research Paper Example Cadbury’s have been a renowned English manufacturer of chocolate products for more than 100 years. Today, as Cadbury – Schweppes, the firm is a major food products conglomerate, but one with very deep roots. Indeed, the current mission statement of the company echoes the philosophy of John Cadbury, the committed Quaker who founded the company in 1794. Cadbury’s mission stresses on many objectives. It also explicitly sets out a commitment to encourage the personal fulfillment of employees and a major thrust is given to customer satisfaction. How the company manages its different processes as such – manufacturing, distribution, etc and its various operations and sub-operations would be detailed here. There have been a large number of strategic decisions and a operational research and development involved in making the products a huge success throughout the world. The emphasis was laid not only on the major operations of manufacturing, marketing and distributing but also on a large number of sub-operations which are essential in very process. Cadbury is now market leader in UK chocolate confectionery, with worldwide exports and volume is continuing to increase by about ten percent per year. Volume in general refers to the number of times an operation has to deliver a service or product. The usual descriptors for the volume dimension are high volume, medium volume and low volume. The distinction between these three categories is usually drawn on a subjective basis. The firm deals with high volume operations.... The firm deals with high volume operations supplying repetitive or standardized products and services. This allows for repeatability, specialization and systemization usually resulting in relatively low unit costs. Higher volume operations can gain efficiency by breaking down the tasks into small units so staff specializes in only a small part of the total work. It is a known fact that volume is the inverse of variety. A low variety market is by definition high volume. Operations can be set up to produce a single product or service, or a range of very similar products, very efficiently. There is no need to allow for variation in material, specification or process. Indeed Cadbury's deal with similar products mostly chocolate based - cocoa, drinking chocolate, chocolate bars and so on, thus the operations could be set up to produce them more effectively and efficiently. The major challenge here would be global deployment of a set of volume products. This could also be overcome if correct measures are taken and right strategies are being followed. Similarly, the greater the variety of product or services produced, the more flexible the operation has to be. Flexibility can be seen as a response to two types of stimuli - variety and uncertainty. Variety indicates the necessity of the processes to adopt a range of operating conditions. For example, to cope with the existing range of service parts, components or products, to adapt products or services to varying customer requirements, to be able to adjust output levels to cope with seasonality, or to be able to expedite orders to different levels of priority. Initially, Cadbury Ltd sold only tea, coffee, cocoa and drinking

Research Paper on Eliminating Job Stress Thesis

Research Paper on Eliminating Job Stress - Thesis Example .................................................................................16 Results & Analysis........................................................................................20 Discussion of Findings†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦31 Conclusions†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦34 Recommendations†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.35 Limitations†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦...†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.35 References.................. ...................................................................................37 Introduction This paper will study job stress in organizations and how it impacts employee performance. It will take on a qualitative approach to research by conducting interviews/ focus group discussions with employees with varying positions in a selected company. The growing complexity of living in contemporary times is brought about by several factors related to progress. Working in various jobs may be much more challenging due to the evolution of job descriptions to include maximized work schedules filled with unceasing tasks. Oorganizations deemed to be successful may still run into internal problems, mostly related to their employees. These employees form a major part of the organizational setup. and majorly it is due to their performance that organizations become successful or bankrupt (Dewe, Driscroll O, & Cooper L, 2010). A major concern of organizations is the productivity of their employ ees as achievement of organizational goals depend on it. One major factor that may severely impact employees’ performance at work is â€Å"job stress†. (Dewe, Driscroll O, & Cooper L, 2010). Executive Summary The awareness that job stress can adversely affect the performance of workers in an organization can be alarming since stress may be inherent in most organization. This study explores how job stress affects the work performance of employees in an organization. Specifically, this study engages discussions with teachers and staff of a school. A focus group interview was conducted with 10 members of the educational institution concerned. They were asked their opinions regarding the relationship between job stress and employee performance; the main causes of job stress; what happens to them when they are stressed and the impact of job stress in both their personal and professional lives. Background of the study With the increase in volume of work, complexity in situat ions and heavy competitions job stress is on the rise. Generally, stress is what one feels when the demands on his life exceed his ability to meet those demands. According to data from health and safety, company executives recorded that in Britain around 420,000 were going through stress, anxiety and other pressure issues. In 2006, the figures mounted to 195,000 fresh cases (Dewe, Driscroll O, & Cooper L, 2010). Over the years the rate has continued to increase and by 2007 it was stated that out of every 6 individuals at work, one among them was experiencing job stress. When carrying out research, it is important to understand the scope of the problem and how it will benefit the industry in that regard. As it can be seen from the statistics mentioned above, job stress is a significant issue. Since each employee is an asset of the organization and is contributing to the running of the organization it is essential to study his/her interests and issues and keep them at

Consumer Behavior- B Essay Example | Topics and Well Written Essays - 500 words

Consumer Behavior- B - Essay Example 3-Graham is a college student who is impulsive and somewhat rebellious.   He seeks out variety and excitement, usually looking for something new, offbeat, and risky.   Even though he was 18 years old and  eligible to vote, he didnt vote in the last presidential election and is not very interested in world events.   To which VALS segment does Graham belong? ESSAY 1- Discuss how a small bio-technology firm could influence the reference group infrastructure and the lead users to accelerate adoption of its products in the market. A small bio-technology firm can significantly influence the reference group infrastructure and its lead users to accelerate adoption of its products in the market by way of exploring key characteristics of lead users and major reference groups like key consumers, suppliers, and industry experts. Only after gaining acquaintance with their key characteristics or their behavior can a firm hope to sell more products in the market. This is because such knowledge can inform a firm about what are the currently hot demands in the buying market. This can boost adoption of products in the market because the firm will be then able to act in accordance of those demands. Lead users form a major reference group and researching such users’ preferences and dislikes can give a firm a lot of valuable material regarding how they can influence other potential customers in foreseeable future. A seller organization hoping to accelerate adoption of its products in the market should essentially understand the buying motives and decisions of their lead users. They can later use this kind of information to convince other customers to make the same kind of decisions. ESSAY 2- Unheard of twenty years ago, discuss the rationale people use today to shop or NOT shop on the Internet.   Given  your response,  what are the benefits to purchasing an iPod direct from a channel member.  

The future of intrusion prevention Essay Example | Topics and Well Written Essays - 2500 words

The future of intrusion prevention - Essay Example The reasons for conducting a risk assessment are (Neumann, 1995; Smith, 1993; Reid and Floyd, 2001; Katzke, 1988; Hancock, 1998; Brewer, 2000): new threats, new technology, new laws and new available safeguards. The issue taken for the risk analysis and threat assessment was the students' violent behaviour at school. The aim of the assessment was to identify the next rebel by developing the profile of a typical rebel. To achieve this, a four spiked model of assessment was designed. This model provides a framework for evaluating a student in order to determine if he or she has the motivation, means, and intent to carry out a proclaimed threat. The assessment is based on the sum of the circumstances known about the student in four major areas. Spike 1 (Personality of the student): Evidence to a student's personality can come from observing behavior when the student expresses characteristics like, managing with conflicts, disappointments, failures, insults, or other stresses encountered in everyday life, anger, frustration, disappointment, humiliation, sadness, or similar feelings. Spike 1 (Personality of student): There may be involuntary signs shown by the student about his inclination to violence in his behavior, thoughts or attitudes. The student might often show out frustration and tries to alienate. There is a collection of acts of "injustice" done against him registered in his mind. The student often shows signs of depression such as lethargy, physical fatigue or lack of interest towards any activity performed. He exhibits selfishness and has self-centred thoughts with great inclination towards entertainment filled with violence. He behaves inhumane and has low tolerance levels. Spike 2 (Family Background): The student might have a damaged relationship with parents. He might have easy access to weapons at home, unlimited non-monitored access to the media and internet. Spike 3 (Academic History): The student might have a low tolerance for punishments and bullying at school. He might be with a school having fixed culture with unsupervised computer access. There might little trust with the teachers. Spike 4 (Social History): The student might have companions who have great inclination to violent activities. He might have unlimited access to internet, computer and media. The knowledge of a student and his attitude towards the use of drugs and alcohol too play a vital role. The Intervention Process An effective intervention process by the school would be to manage the threat effectively by taking the following measures: 1. Inform the students and parents of the school policies 2. Appoint a Co-Ordinator for threat assessment 3. Enforcement of law in three levels - low, medium and high - while the intervention at low level would involve interview with the student and parents; the intervention

ICT Usage by the Eldery Essay Example for Free

ICT Usage by the Eldery Essay In this unit of my coursework I shall be writing about an elderly lady with special needs who is helped with the usage of ICT. The person that Im going to be writing about is Mrs Ann Reynolds, an 87 year old lady suffering from arthritis, she lives alone in her own house that she has being living in for over 40 years, it is located in central Harrow. Due to her suffering of arthritis mobility has being very difficult for her, moreover she increasingly has become deaf in the recent years, however this old bird is still mentally tip top and alert and enjoys listening to the radio, in particular the womens programs. Mrs Reynolds has two siblings and two twin granddaughterss aged 12, who currently live in Southampton Some of her Personal needs include the need to move around the house with ease, something that has become increasingly hard due to her condition of arthritis, also she has the need to control appliances and regulate the heating in her house, with old age comes the reduced ability of regulating the bodies temperature, meaning she has the need for constant heating, moreover she also has the need to feel safe in her house, due to recent brake in she has being scared with memories of the incident and has increasingly grown scared of the outside world trying to get in, furthermore she also has the need to do the shopping, cmon old she may be but she still has to eat, in addition she also has the need to receive her medical care. Socially she has the need to be able to keep in touch with friends and family. CCTV Camera and a TV Mrs Reynolds has a special CCTV camera fitted into her porch, which is connected to the her TV inside which is located inside her living room, this empowers Mrs Reynolds to see who is at her door furthermore she also has the ability to speak to them. The CCTV Camera helps meet Mrs Reynolds needs due to it allowing her to see what or who is outside her front door/porch, it also allows her to speak to them if necessary, this helps meet Mrs Reynolds needs because now she can see who is outside her porch without actually opening the door, this therefore gives Mrs Reynolds the convenience of knowing that she can remain safe and unharmed inside her house. This goes back to the time that she was attacked by a bogus caller, which left quite a scar on poor old Mrs Reynolds, via the usage of CCTV Mrs Reynolds now feels safe inside her house and she feels much more independent. Telecare Mrs Reynolds uses a simple technology called Telecare its enables and empowers her so that she lives more independently in the community. Telecare is the new name given to advanced community alarm services. Community alarms plug into telephones lines and come with a call button (pendant) which can be worn by an individual such as Mrs Reynolds. Furthermore using the call button she in now enabled to call for help from anywhere in the home or garden. How does Telecare work? The Telecare unit is fitted to Mrs Reynolds telephone point and main power supply along with some sensors. Telecare sensors can also monitor where she is in her home and can detect if; * She has stopped moving. * Or if she has fallen. * Whether she has gone outside. * Also when she is in bed or sitting in a chair inside her house. Moreover other sensors fitted in her house -smoke detector and extreme temperature detector in her kitchen. When the call button is pressed or one of the sensors is triggered, its base unit will raise an alert through the service users telephone line to a monitoring and Response centre. In case of an emergency, or when the operator cant contact her at home, the operator will contact a family member, a friends or a neighbour to have them quickly pop round and see if everything is alright and that Mrs Reynolds is safe and healthy. If the operator is unable to contact any of the following above, the operator will alert the emergency services. All together Telecare helps meet Mrs Reynoldss personal needs, due to it ensuring that she remains independent and safe in her house, without fear of any incidents happening, even if god-forbid something does happen, most likely someone will be round to help her in no time. All-in-one remote control Mrs Reynolds uses a universal remote control that enables her to access her TV, DVD, satellite receivers and CCTV that is located in her porch, the remote control is fairly large and very easy to function, it is also easily functioned and the buttons are big and bright so its is easy for Mrs Reynolds to use them, furthermore they are highly sensitive to touch and are colour coordinated for easier use. Moreover the all-in-one remote control helps Mrs Reynolds switch between her different functions, for example if she is watching her favourite soap on BBC1 and gets a door knock, she can switch from AV1 to AV2 using the universal remote control, which means she can switch from TV on AV1 to her CCTV camera on AV2, which in response permits her to see and possible speak to whom it may be at the door. Furthermore the large universal all-in-one remote control helps meet Mrs Reynolds personal needs, because of its large shape it is easy for Mrs Reynolds to hold it in her hand and she is unlikely to misplace and loose it, moreover the large touch sensitive buttons, make life easier for Mrs Reynolds allowing.

Differences in Competencies between ADN vs. BSN Essay Example for Free

Differences in Competencies between ADN vs. BSN Essay According to the society of Human Resources Management, competency means the knowledge and skills required to perform a job, which all contributes a positive outcome. Even though the competency among ADN and BSN are almost similar, there are slight variations based on the departments where the nurse work, such as management level of care and neonatal department. Good start of an introduction. Consider a topic sentence here that states: this paper will describe†¦Ã¢â‚¬ ¦.. An Associate Degree Nurse is one who completed the 2 year program or 3 year diploma this is not true, these 2 are different course by a school of nursing, community, or junior college. They demonstrate competencies in various aspect of patient care. ADNs are competent to perform assessment by collection of patient’s health history, including past medical and surgical history. They perform the physical assessment by gathering information, such as height and weight, vital signs, and head to foot assessment, including all body system. They are also competent to perform cognitive, psychosocial, spiritual, and functional level assessment. After assessing the patient, they find out the nursing diagnosis using their knowledge, skills, and experience. The ADN analyzes the patient’s condition using their age, cultural diversity, and risk factor. He/she then formulates and plans the care by prioritizing the patient’s need based on Maslow’s hierarchy needs, in which patient’s safety is the first importance. They formulate the plan of care by critical thinking, reflection, and problem solving skills. Before they implement the treatment regimen, they let the patient make health care choices by providing accurate and reliable information. The ADN are competent to delegate the patient care to other authorized health care personnel by giving relevant instructions and supervisions. They implement the treatment within his/her accepted professional nursing practice in a different clinical setting. They also make sure to give teaching about the treatment, which includes the effects and side effects of drugs and expected outcome. These all help the patient to alleviate their anxiety about the health status. Finally, they evaluate the outcome and effectiveness by reassessing and continuous monitoring. Moreover, ADNs provide physical competencies like gross and motor skills, strength, and mobility by moving and positioning the patient by using proper body mechanism. Their sensory perception provides a safe environment. They are competent in life saving practices, such as cardiac monitoring and airway management. They provide patient care by giving I.V, oral medications, blood transfusions and wound care. They demonstrate care and respectful behavior towards the patient, family, and other co-workers. Need to reference data within the text Bachelor of Science Degree in Nursing is a 4 year bachelor program accredited by a college or university. A BSN has the same medicalbedside nursing skills of an ADN. He/she provides the same patient care by assessment, diagnosis, planning, implementation, and evaluation. They also have physical competencies and sensory perception. Apart from that, they do their clinical judgment by using their critical and analytic thinking, which they earned through researches and evidence based practices. They have sufficient emotional stability to be responsible and accountable during a highly stressful event. They know how to deal with unexpected and changing environment. They show interpersonal skills and communication skills by interacting positively with patient, family, and large communities both in verbal and written form. Their logical and analytic thinking in patient management will help them to acquire higher education. Moreover, they creatively respond to continuously changing health system. Good review of BSN competencies. Again, need to reference within the text. An ADN acquired knowledge and skills from years of experience in clinical practice. They work with patients in a relatively short time. However, a BSN has knowledge and skills based on their researches, evidence based practice, leadership, and management. Their skills help them to provide a better patient care in a short time period. For an ADN, the nursing is a job and have little commitment to the work. Without considering the long term results, they move from one job to another. However, BSN is a career, which is a life time dedication that requires development and on-going learning. They can function at high intellectual levels and carry a strong professional identity and follow code of ethics. They are more accountable, independent, and responsible. Nursing care and approaches to decision-making are different based upon the educational preparations. For example, we had a 50 year old patient in our floor that came with left hip fracture. The patient underwent an open reduction and internal fixation of left hip. After 4 hours of post anesthesia care, the patient came to the floor. The ADN, who is the primary care nurse, assesses the patient and carried out all post-op orders. The patient was drowsy and was on morphine PCA. After 2 hours, the patient suddenly woke-up with pain in the left hip. The ADN gave more pain medicine and monitored the respiratory status. All of a sudden patient complained of shortness of breath. The nurse found the patient’s oxygen saturation dropped to 82 percent. She stopped the PCA pump and put the patient on 2 liters of oxygen yet the patient was complaining about severe pain in her hip. Apparently, the patient continued to complained of chest pain and her oxygen level continued the same. The RN called the charge nurse, who is a BSN. She assessed the patient and went through the patient history. Suddenly, she called the rapid response team; meanwhile, she ordered a stat chest x-ray by thinking that patient had a pulmonary embolism and transferred the patient to ICU. Later, we came to know the patient had pulmonary embolism. In this situation, the RN gave the basic treatments according to the knowledge from her experience. On the other hand, the BSN treated the patient from her critical thinking and high level of knowledge, which saved the patient’s life. Good patient care scenario The ADN can handle the critical patient situation very minimally by using her basic knowledge, skills, and experience with the help of other person. However, the BSN can handle the same situation independently with his/her critical thinking. Different level nurses have different roles in a hospital, even though they have same preliminary education about providing forthe patient care. The job expectations, patient interactions and contact are different in perspective of the RN’s and BSN’s duty. Good conclusion . . References Catalano, J.T. (2003).Nursing now: Today’s issues, tomorrow’s trends. Philadelphia: F.A. Davis. Need to put title into italics Competencies and Performance Standards Essential for Nursing Practice.( 2011) St Louis University. Retrieved from http://www.slu.edu/x19905.xml Hollis, Forster, RN (2011) ADN vs. BSN Retrieved from need to include date of retrieval http://nursinglink.monster.com/education/articles/3842-adn-vs-bsn

The Use of Mixl1 in Ex Vivo and Chimeric Organ Regeneration

The Use of Mixl1 in Ex Vivo and Chimeric Organ Regeneration Anokhi Kashiparekh   TA: Goheun Kim Regenerative medicine is a field in biology that uses the underlying cell properties of differentiated growth to create entire tissues and organs from that cell. Regeneration in its true form, applies human pluripotent stem cell (hPSCs) differentiation, to make new organs like the natural regeneration of the human liver or that of the zebrafish heart (Mostoway et al, 2013). A very useful area for such a technique is the organ donation and replacement discipline. One of the greatest challenges for organ replacement is the shortage of organs donated for the cause. This is where the field of regenerative medicine can come in use. If the cells of the person in need of the organs can differentiate in a way that fills up the niche left by the diseased or missing organ, there could be a remarkable decrease in the need for organ transplantation and organ rejection. However, the development of the human organs is a gradual process and may take longer than the time the patient has to survive. A tactic to increase the speediness and the efficiency of organ regeneration is to manipulate certain genes to promote either ex vivo differentiation or differentiation in a chimeric host with a faster developmental time than humans. Specific genes can be engineered to perform specific functions, like prompting apoptosis using the Bcl-2 gene or assessing mesodermal markers using Wnt3 (Wu et al, 2016). Inducing Mixl1, the endoderm and mesoderm formation transcription factor, can play an important role in generating organs from induced pluripotent stem cells (iPSCs). Mixl1 plays an important role in chimeric and ex vivo regeneration models; although further research is required on the viability of these models. The Mixl1 transcription factor binds to the Mix gene and is a part of the hox gene family that codes for homeodomain proteins. The most important function of the Mixl1 is the regulation of cell fate and differentiation during the developmental stages of an organisms life. It regulates the formation of the endodermal and mesodermal layers and consequently can be used to manipulate hPSCs towards a particular lineage of growth. This principal property of the Mixl1 gene, as well its interactions with other genes, has been the focus of genetic regenerative medicine, in order to understand the role and consequent use of said genes. Various experiments have tried to incorporate the Mixl1 system in stem cell growth but two of the most widely known models are the ex vivo regeneration model and the chimeric model. Both of these models rely on the property of Mixl1 to guide iPSCs towards either endodermal or mesodermal fate. The basic difference between these models is the environment in which these cells are allowed to differentiate. The ex vivo model allows cell differentiation and growth outside an organism, generally in a laboratory. It is a widely preferred model due to the fact that cells from an organism can be extracted, cultured in a lab and placed back in the same organism. Each step in the experiment can be tracked and monitored and all the cells are cultured in a sterile environment. Thus, the cells placed back inside the animal are safe from potential bacteria or viruses. However, this also means that the organs generated from this may not be compatible with the surrounding tissue when introduced in an organisms body, due to the lack of interaction with other cells. Ex vivo culture of cells and ultimate organ regeneration is a step towards solving the problem of limited availability of desired cells. This ex vivo model of organ regeneration makes use of different substrates to recreate a natural differentiating environment for the cultured cells. However most times it is hard to push the hPSCs towards a particular lineage of growth, i.e. mesodermal or endodermal. The Mixl1 gene with its property to establish cell fate, is useful in resolving this. The forced expression of Mixl1 in hPSCs, in the right environment, with particular substrates and specific protein mediums, can promote ex vivo cell differentiation. Ex vivo culture, with connection to the Mixl1 gene is efficient due to the control over time of forced expression of the Mixl1 gene as well as external monitoring of the growth. Liu et al (2011)3 established this by using Là °Ã‚ Ã‚ Ã‚ °5ÃŽÂ ²1 and Là °Ã‚ Ã‚ Ã‚ °6ÃŽÂ ²1 protein ligands to promote Mixl1 induced hPSCs, in a BMP4 medium. The procedure included purifying polypeptides, culturing the hPSCs and allowing them to differentiate. The results showed that the differentiation of cells peaked on the third (to) fourth day of culture when both the LÃŽÂ ±5ÃŽÂ ²1 and Là °Ã‚ Ã‚ Ã‚ °6ÃŽÂ ²1 protein ligands were used. This gradual growth was tracked using immunofluorescence and analyzed by flow cytometry. The results of this experiment encompass both the usefulness as well as the disadvantages of an ex vivo regeneration of organs using Mixl1. The biggest challenge encountered in an ex vivo organ regeneration model is the limited number of substrates that the hPSCs can use and differentiate into a mesodermal lineage. In various cases, Mixl1 is induced unsuccessfully. This is due to the high substance substrate specificity of the iPSCs that do not survive long enough for Mixl1 to express and differentiate. Another case seen in Liu et al was the very minute expression of Mixl1 when cultured with various other individual ligands, showing that this procedure also requires the correct combination of substrates. Various agencies have also raised ethical concerns over culturing animal cells in labs. The obtaining of cells, external media and substrates from animal bodies is cited as animal abuse (cruelty). To minimize the use of animal products, a more specific area of the ex vivo model has been developed, called the xeno-free culture. Typically, all components required for a xeno-free culture come from the same organism while taking care that it is completely free of animal or human elements, like bovine blood for culturing media, etc. As a replacement to these essential components, researchers are trying to synthesize new protein ligands that can function in a similar pattern4. To reiterate, genetic manipulation of the ex vivo model has the potential to save lives but requires a deeper study in the areas of limited substrate compatibility and availability. In contrast to the ex vivo model, the chimeric model revolves around cell differentiation inside a living body. Chimeras are organisms made up of a combination of two or more zygotes and thus this model introduces extraction from and cell differentiation in two different individuals. Generation of embryonic chimeras is of both practical and conceptual importance as it provides a method to assess the developmental competence of cells. The cells of the different individuals on the same embryo can be tracked and genes can be manipulated to create a chimeric organism that can act as a vessel for organ generation. Blastocyst complementation and target organ complementation are two important techniques in chimeric organ regeneration. While blastocyst complementation uses iPSCs transferred to an embryo of another species, generally a porcine embryo, target organ complementation is focused on the regeneration of specific organs of the body. Due to the unconventionality, the adherence to soci al and ethical limitations is of great importance and requires more research to be conducted. Experiments combining this regenerative model and the forced expression of the Mixl1 gene have been successful in producing organs in different hosts. By trying to reconcile the idea of targeted generation of organs derived by using the patients own PSCs as seen in the case of the mice, Kobayashi et al (2016) makes use of blastocyst complementation to create pancreatogenesisor nephrogenesis-disabled mice. Blastocyst complementation is a technique that makes use of induced human pluripotent stem cells (iPSCs) transferred to an embryo of another species; thus, following cell growth in another body. This study used Pdx1-LacZ heterozygous mice as the chimeric hosts and injected humanized pancreatic cells in the blastocyst. This complementation was followed by the forced induction and expression of the Mixl1 gene using the pRosa26-tTA-Mixl1 vector. The data was analyzed by Western blotting and flow cytometry. The immediate result showed chimeric cells throughout the bodies of the mice. The mice were then introduced to a cell medium without Doxycycline (Dox). Immunofluorescence confirmed the distribution of cells being confined to just the guts, showing that specific target organ regeneration is possible with suitable environmental conditions and resources for the culturing cells. The forced expression of the MIxl1 gene represses mesodermal fate determination and promotes endodermal fate determination, thus helping to induce the formation of target specific organs, including the pancreas or the liver, in the disabled mice. In order to test for the amount of time Mixl1 takes to express, these mice were injected with Dox at various time intervals and the results were examined using EpCAM, an endodermal genetic marker. The cell growth apex was noted on the 4t h day of Dox administration. This leads to the belief that time is an important factor in understanding cell growth in chimeric organisms. To understand the regulation of Mixl1 based on biological functions, it was allowed to express under the influence of Oct3/4, a genetic marker seen to express in early development. The absence and presence of Dox in the host chimera was compared to establish that its absence would achieve specific target organ regeneration as compared to cell growth throughout the body. The data implied that Mixl1 presence was necessary until the epiblast stage. This gives way to the inference that the time taken for Mixl1 to express can be reduced, thus giving way to a quicker technique of organ regeneration. This model, although promising, is questionable due to the ethical controversies like the formation of human neural cells or germ cells in the host animal. This is a cause for concern due to the fact that the idea of a human brain trapped inside a mute animal is disturbing. Proper manipulation of cell differentiating genes like Mixl1 is essential to keep hPSCs from turning into cells that could humanize the host animal. While understanding and experimenting on techniques that help in human advancement, there has to be a larger focus on the social and ethical concerns of utilizing them. In conclusion, although it is limited by growing ethical concerns, genetic manipulation in chimera may help save lives with the advancement in understanding cell repair and regeneration. Thus, the idea of organ regeneration using chimerism should be looked into by science but in a way that can appeal to social principles. Another problem associated with this model of regeneration is the low success rate of differentiation in non- rodent animals2. Majority chimera experiments include rodent species as the main focus, due to both the size and relatively easy manipulation of the rodents. Although recent experiments have shown (that) porcine hosts act as good carriers for human pancreatic growth6, there is a lot of research to establish pigs as conventional hPSC hosts in order to continue chimeric research to generate bigger organs like the human heart or the human lungs. While comparing the advantages and the disadvantages of both these techniques of organ regeneration, the role and function of Mixl1 itself cannot be overlooked. Mixl1 has been shown to express within 4 days of being induced. More research may lead to a quicker expression time. Mixl1 has also helped to achieve a target specific organ regeneration by promoting mesodermal differentiation as required. The use of Mixl1 is enormous in the field of regenerative biology and can be used in other projects as well as models of regeneration. In conclusion, both ex vivo regeneration and chimeric regeneration have flaws but it is possible to refine them for better and more specific results. While the usefulness of Mixl1 cannot be denied, better models of regeneration must be established to achieve maximum efficiency for its expression. References: Mostowy, S., Boucontet, L., Moya, M. J. M., Sirianni, A., Boudinot, P., Hollinshead, M., Colucci-Guyon, E. (2013). The zebrafish as a new model for the in vivo study of Shigella flexneri interaction with phagocytes and bacterial autophagy. PLoS Pathogens, 9(9) Wu, J., Greely, H. T., Jaenisch, R., Nakauchi, H., Rossant, J., Juan Carlos Izpisua Belmonte. (2016). Stem cells and interspecies chimaeras. Nature, 540(7631), 51-59. Yang, L., Wang, X., Kaufman, D., Shen W. (2011) A synthetic substrate to support early mesodermal differentiation of human embryonic stem cells. Biomaterials. 2011 Nov;32(32):8058-66. Karnieli O., Friedner O., Allickson J., Zhang N., Jung S., Fiorentini D., Abraham E., Eaker S., Yong T., Chan A., Griffiths S., When A., Oh S.A consensus introduction to serum replacements and serum-free media for cellular therapies. Cytotherapy , Volume 19 , Issue 2 , 155 169. Kobayashi, T., Kato-Itoh, M., Nakauchi, H. (2015). Targeted organ generation using Mixl1-inducible mouse pluripotent stem cells in blastocyst complementation. Stem Cells and Development, 24(2), 182. Matsunari, H., Nagashima, H., Watanabe, M., Umeyama, K., Nakano, K., Nagaya, M., . . . Nakauchi, H. (2013). Blastocyst complementation generates exogenic pancreas in vivo in apancreatic cloned pigs. Proceedings of the National Academy of Sciences of the United States of America, 110(12), 4557-4562.