Historical Roots of Christian Diversity Essay Example | Topics and Well Written Essays - 750 words

Chronicled Roots of Christian Diversity - Essay Example Universal and Roman Catholic Christians concur with the lessons of the initial seven gatherings as authentic translations of the gospel, yet just Roman Catholics recognize orders planned after the nineteenth century. Custom is a specific translation of sacred text as depicted inside the Christian people group and asserted by the congregation. Given that custom initially allowed new understandings to meet inquiries not especially tended to in the sacred writing, it was intended to be liquid as opposed to fixed. At the point when a gathering demonstrates a propensity to consecrate custom creation it seem inflexible, pressure may result. This improvement of custom was not intended to prompt strict unbending nature, however was rather grown explicitly to perceive the dynamic collaboration between, the solid fixed authority of sacred text, and the liquid creating authority of ordinary practice. Since it is dynamic, convention adds a little new thing to Christianity as it develops sacred w riting. Individuals as a rule extend a substantial correspondence past tradition’s unique degree, as it is a factor of practicing human inventiveness in the improvement of custom (Weaver and Brakke 64). The intensity of Rome At when the Roman persona was at its pinnacle, Jesus was naturally introduced to the Mediterranean world administered by Rome. The world had never encountered a domain so immense that when individuals thought of Rome, they imagined a lot of related thoughts. Caesar, who directed Rome, was a focal decision authority who stood near heavenly nature and represented in his individual the wonder of Rome. The magnificence of Rome darkened and afterward appeared to be reestablished to some level by Constantine. It was entirely expected to ponder whether the old Rome may recover the world’s consideration. On the off chance that Rome can be considered more to be a thought than a spot, at that point maybe it very well may be comprehended why it was amazingly ground-breaking and appealing. Rome turned into an objective, and a plan to nature strategy. As a reality, it isn't astounding that that pulled in Constantine and Christians as a rule. As the roman sovereign, plainly Constantine had the best case on the venture. At the point when he moved his capital from the city of Rome to another site in the Eastern piece of the Roman Empire, a political vacuum was left in the West which thusly welcomed rival inquirers. A few gatherings were propelled to reestablish Roman wonder in the West, and they included; old senatorial families, new brute families, and the priests of Rome, who later are known as popes. The old types of Christianity developed into discrete chapels by and large as a result of widely contrasting political encounters. The Orthodox Church was sorted out into two different ways: at the nearby level and along the managerial lines of the Roman Empire. The patriarch of Constantinople comprehended that his position was attached to th e ruler. Both the patriarch and the pope considered themselves as Roman and as beneficiaries of the best political domain in the world’s history. This prompted an extraordinary faction between the two places of worship that went on until the current day (Weaver and Brakke 78). The two Christian models The primary Christian model is; Constantinople as the new Rome in the Greek Orthodox framework. At the point when the ruler rejoined the pieces of the Roman Empire, he did as such under the indication of the cross. Constantine’s bibliographer made a case that Constantine was legitimately called by God to grasp Christianity.

How to Cite an Ebook in IEEE Referencing

The most effective method to Cite an Ebook in IEEE Referencing The most effective method to Cite an Ebook in IEEE Referencing Having the option to download a whole library onto a solitary gadget is exceptionally helpful for understudies and scientists. What's more, this makes it imperative to realize how to refer to a digital book in IEEE referencing. In this post, at that point, we’ll take a gander at both in-content references and the reference list section for a digital book in IEEE. In-Text Citations In-content references in IEEE referencing are shown with numbers in sections. Each number focuses to a source in the reference list, which is the place you give full distribution data. For instance, we would refer to the main source referenced in an archive this way: It is hard to shock a shark with customary gear [1]. This would then highlight the primary source in the reference list. What's more, to refer to the equivalent digital book again later, we would basically utilize a similar number as in the principal reference. The principle minor departure from this fundamental reference framework happen when: You have just named the creator in the content, when you would give the reference following the name as opposed to toward the finish of the sentence. Citing a source legitimately, which expects you to incorporate page numbers. You can see more on the best way to organize in-content references in our review of the IEEE referencing framework. The most significant thing, however, is that the numbers in your in-content references coordinate the situation of the important sources in the reference list toward the finish of your report. Adding an Ebook to an IEEE Reference List In an IEEE reference list, treat a digital book likewise to a print book. The main distinction is the need to show where it very well may be gotten to on the web. The right configuration for a digital book in IEEE referencing is consequently: [#] INITIAL(S) Surname, Book Title, release (if not first version). City of Publication: Publisher, year. [Online] Available: URL By and by, at that point, the reference list section for a digital book would resemble this: [1] R. Schneider, A Bigger Boat: Innovations in Electrofishing. Oak Bluffs, MA: Vineyard Publications, 2005. [Online] Available: electrofishing.com/assets/schneider-greater boat.html Don’t neglect to incorporate a little balancing indent for each line after the first. What's more, if you’d like any assistance checking the referencing in your work, or just creation sure a report is sans mistake, we’re constantly here to help.

Improvements to APA Citations are Here!

Improvements to APA Citations are Here! (0) At , we are dedicated to providing students and educators with the most accurate citations possible. That’s why we have developed technology that improves the quality of APA citations, specifically targeting the correct capitalization of titles of sources. When you are citing in APA on the citation generator on , we double-check each source’s title for the correct application of sentence-case capitalization. While our citation checker has made dramatic advancements in overall APA citation quality, we are constantly improving its results, and will be tweaking it as needed. Have more questions about citing in APA? Check out our comprehensive APA format guide. Citing in MLA style instead? We have a tool and guides for that, too.

Factors of Economic Development - 1163 Words

Factors of economic development Economic development involves actions that are sustained and concerted by policy makers and the entire community. These actions lead to improved standards of living as well as the economic health within a specified area either in the local, regional or global environment. Economic development can also be termed as the qualitative and quantitative changes that occur within an economy. For economic development to take place there has to be contributions by various factors. Some these factors can lead to economic development if they are appropriately managed (Mohr, 2012). There is a lot of interest in macroeconomics when it comes to these factors of economic development. Macroeconomics deals with performance, behavior, structure and the entire decision making of an economy in general as opposed to looking at individual markets. This encompasses national, regional as well as the global economies. Through microeconomic there is the aggregation of indicators like GDP, price indexes and the rates of unemployment that enable the understanding of the functioning of the entire economy. This paper will look at various factors of economic development and how they contribute to economic development. Good government The system of government that is found within a country is a major determinant of the economic development that can take place within the country. This is because; most of the industries in a country are under the control of the governmentShow MoreRelatedsummarise main development, analyse key social, economic and environmental factors which may influence development712 Words   |  3 Pagesï » ¿Summarise the Main Development of a Child from the Age range 0-2, 3-5, 5-8 Years From birth a baby can only lie on its back, by the end of 3months they start to lift their heads and kick their feet. At 3-6 months they can hold objects and transfer them from one hand to another. They also start to attempt to put objects in their mouths. At 9-12 months babies usually become more mobile by rolling, shuffling, or crawling. They can generally sit unaided for a length of time. Between 1-2 yrsRead MoreAssess the Effect of Three Factors Which May Limit Economic Development in Developing Countries2008 Words   |  9 Pagesthree factors which might limit economic development in the developing countries. Economic development can be defined generally as involving an improvement in economic welfare, measured using a variety of indices, such as the Human Development Index (HDI). A developing country is described as a nation with a lower standard of living, underdeveloped industrial base, and a low HDI relative to other countries. There are several factors which may have the effect of limiting economic development in suchRead MoreAssess The Significance Of Three Factors Which Might Limit Economic Development In The Developing Countries2005 Words   |  9 Pagesthree factors which might limit economic development in the developing countries. Economic development can be defined generally as involving an improvement in economic welfare, measured using a variety of indices, such as the Human Development Index (HDI). A developing country is described as a nation with a lower standard of living, underdeveloped industrial base, and a low HDI relative to other countries. There are several factors which may have the effect of limiting economic development in suchRead MoreBest Route for Economic Development for Poor Countries1724 Words   |  7 Pagesilliberal democracy or authoritarian rule is the best route to economic development for low income countries Introduction Democracy and economic development are two concepts that were not related initially, however, with the rise of democracies and the subsequent economic development there is an established correlation between the two concepts. The question that this paper will seek to address is â€Å"which is the best regime for economic development†. In responding tothis question it is significant to firstRead MoreProblems Associated With Geography And Economic Development Across Countries1431 Words   |  6 PagesDo you agree that twentieth century divergence in economic development across countries was largely the result of geographic factors? The traditional view associated with geography and economic development across countries is that distance has played a huge role in creating disparities in terms of location . However, this interpretation is questioned by some who note that the failure of developing economies can be attributed to the persistent problem of institutional failure, which prevents individualsRead MoreWhat Does The Study of Regional Economy Teach Us?1436 Words   |  6 Pagesregional science help us understand? What are the three â€Å"building blocks† that underlie the complex patterns of location of economic activity? Should jobs move to people or should people move to jobs? Regional science is a sub field of social sciences that analyzes approaches to urban, rural, or regional problems. It involves the study of spatial patters to analyze the economic factors of a region. The study of regional science is necessary to improve the economy in todays competitive global market. ThisRead MoreSources Of Economic Growth And Social Justice Essay1402 Words   |  6 Pages3.1 Sources of Economic Growth and Social-Justice Egyptian per-capita income has been significantly improved in the second half of the first decade of 21st century, as it recorded, in average, $1984 (standard deviation $167), compared to $1312 (standard deviation $597), in average, during the first half of the decade. Figure (1) illustrates the development of per-capita income through the first decade of 21th century and it shows that per-capita income growth rates were, in most, negative duringRead MoreEcon3109 Course Notes Essay1064 Words   |  5 Pages1. Economic Growth, Technology and Structural Change Economic Development: Growth is associated with structural, social change and change in the important institutions of the economy. These institutions evolve within the development process. Institutions are the result of past historical and social developments. Since different countries have different pasts, institutions will vary. â€Å"Development is about improving the quality of people’s lives, expanding their ability to shape their ownRead MoreEcnomic Growth1252 Words   |  6 Pages------------------------------------------------- Economic Development ------------------------------------------------- Definition of Economic Development Economic development is a process of economic transition involving structural transformation of an economy through industrialization, raising gross national product and per capital income. According to Lewis, Economic development means increase in output per head. According to Micheal Todaro, Economic development must be conceived of as a multi-dimensionalRead MorePestle Analysis867 Words   |  4 Pagestool that acts as a prompt to the staff and governors involved in the analysis of the developments in the school’s environment that could affect its risk profile. It may help them carry out a more comprehensive analysis. The initials stand for: Political e.g. a new government initiative creates the risk that the school may fail to deliver the policy or be diverted away from local priorities etc. Economic e.g. central or local government funding decisions may affect school finances, closure

Stress And Time Management - Free Essay Example

Sample details Pages: 3 Words: 910 Downloads: 8 Date added: 2019/05/31 Category Management Essay Level High school Tags: Time Management Essay Did you like this example? Stress is a fact of every human life in day to day activities. Stress is a normal psychological reaction when the brain recognizes threats of life (Bernstein, 2016). Stress is both positive and negative stressors. It can help to cope with life challenges. Students suffer from stress on some level. It mainly based on empirical study. This research focuses on stress and time management in college students during their academic studies. Time is an essential resource everyone possesses equally but fails to utilize at the same level due to a variety of reasons. The only asset that cannot be changed or purchased or stored is time itself. The secret to achieving success in life is effectively managing this resource that everyone possesses equally and paying enough emphasis to plan (Scott, 2018). Good time management is essential for everybody, especially for university students whose schedule is often packed with activities and lessons. Don’t waste time! Our writers will create an original "Stress And Time Management" essay for you Create order Good time management to reduce stress include techniques such as setting goals, prioritize, determine if you are being proactive or reactive, monitor the use of time, and do not procrastinate can facilitate productivity and minimize stress, contributing to work effectiveness, maintaining balance and academic success (Five Time Management Techniques to Reduce Stress, 2015). From this broadened perspective, people can see that the real value of time management is that it enhances their lives in all dimensions. What people gain from time management is not more time, but a better, lower stress level, life. Time concept is a problem for university students academic life and their social life. In trying to read all the books and chapters assigned, meet paper deadlines, and participate in extracurricular activities, university students may become overwhelmed with feeling that there is not enough time to complete all their work adequately. Good time management behaviors can facilitate productivity and minimize stress (Tresca, n.d.). On the other hand, poor time management behaviors, such as not allocating time properly or last-minute cramming for exams are sources of stress and poor academic performance. The importance of time management and time practices has been increasing day by day and especially there is a lack of studies related to time management and academic achievement (Tresca, n.d.). Time management has been referred to as techniques for managing time a technique for effective time use, planning and allocating time; the degree to which individuals perceive their use of time to be structured and purposive; a technique to increase the time available to pursue activities; self-regulation strategies aimed at discussing plans, and their efficiency (Sloan, 2018). It is argued that time management refers to the process of stacking greater amounts of work and activity into a certain length of time. Additionally, research has reported evidence for the multi-dimensional nature of the time management construct. Time management was conceptualized in terms of short-range planning, time attitudes, and long-range planning (McCarthy, 2018). Not only the matter of time management bothers university students, but also the stress created during the academic years. Stress can be defined as a process in which environment demand strains an organismrs adaptive capacity, resulting in both psychological as well as biological changes that could place a person at risk for illness (Tresca, n.d.). University students might experience high stress due to academic commitments, financial pressures and lack of time management skills. When stress is perceived negatively or becomes excessive, it can affect both health and academic performance. It is important students deal with stress. For those students who do not deal with stress, it could result in feelings of nervousness, unnecessary worrying, and lack of sleep. Certain levels of stress can either enhance or decrease performance (Sloan, 2018). A reasonable amount of stress may be crucial in order to encourage an individual to get the job done (Ingram, LaForge, Avila, Schwepker, Williams, 2017). Also, a certain level of stress may increase performance. Those times when stress pushes you to study hard or cause you to spend more time on a class project can be helpful. However, too much stress may drastically slow down academic success for a college student by impairing memory, an important component of learning. Certain levels of stress are normal, but students need to learn how to manage their stress when it becomes overwhelming. A negative relationship was found between time management and perceived stress. For example, it is found that lower stress levels were most strongly correlated to the factor perceived control of time (Sloan, 2018). This suggests that regardless if one undertakes time management activities and behaviors, such as writing lists and setting goals if they do not perceive to be in control of their time, they will still feel stressed. A negative correlation was found between time management behaviors and perceived academic stress (Sloan, 2018). This would mean that stress levels are decreased among students who manage their time well. Based on the research, it perceives that both time management and stress are significant predictors of academic achievement. Also, the good predictor of academic achievement was found to be the combined effect of time management and perceived stress. This research emphasizes the importance of understanding the role of time management in academic achievement and everyday life to help reduce stress (Five Time Management Techniques to Reduce Stress, 2015). Certainly, students who are unable to manage time well may be at risk for underachievement. In order to remain successful and maintain a low-stress life, one needs to manage time in a fashion that will help them succeed and not fail academically and professionally.

Strategic Plan for the System †Essay Free Essays

string(198) " regards to allocation of space and facilities maintenance, the institution’s present locations are large enough to handle both the current student population, as well as allowing for growth\." The System’s Mission and Vision Every educational institution should have a mission, which is its specific purpose for existing. The mission of the institution must be stated in the school’s catalog and in other publications readily available to the public. The mission must be completely, clearly, and simply stated In terms readily understandable by a prospective student, parents, the public, and other educational Institutions. We will write a custom essay sample on Strategic Plan for the System – Essay or any similar topic only for you Order Now The mission should be devoted substantially to career-related education and should be reasonable for the program of instruction and facilities of the institution. Each institution should be capable of demonstrating its educational effectiveness through assessment and documentation of student outcomes. This assessment must include evidence that the institution’s annual retention and placement rates are in keeping with its mission. The Institution’s mission statement should be consistent with educational and employment outcomes of Its students (Argosy. 201 2; Guthrie Ackermann. 2009). The corporate staff of the System originally developed the mission for all of the institutions within the System. Over the years the mission has been changed and updated to reflect the operations and culture of the schools. All employees and students have opportunities to express ideas and suggestions for the mission, so it comes a reflection of the way the employees and students, think and feel about the operations of the school. The villas of the System Is quite simple In that It Is: we care about the students, we care about the employees, and we care about the employers who hire the Students. Through this the mission is stated as: The System will demonstrate the we care vision by preparing career-focused, community-minded graduates for the global workforce through applied education. Strategic Planning Through this strategic planning process, the System strives to show that it cares about: student success, employment success, investment success, customer revive, communication, compliance, and community engagement. Student success shows that the System is committed to attracting students and delivering relevant, quality educational experiences that engage students and lead them to graduation and career success. Employment success shows that the System is dedicated to creating and maintaining a dynamic environment where performance Is recognized From a business perspective, the System cares and is concerned with investment success and providing a quality education that leads to a strong return on investment while exceeding the expectations of students, employers, employees, ND the surrounding community. This can only be done through engaging in and the management of effective communication and a culture of compliance. Once those items are in place, educational communities can be developed, so that all stakeholders feel as if they have a say and vested interest in the System as a whole. Key Decision Makers There are several key decision makers in the system. The founder of the System is the sole member of the Board of Directors that governs each campus. The founder also oversees a management group that manages the day-to-day operations of each campus as well as corporate support operations. The management team consists of the following positions: Campus Directors, six Regional Directors, and corporate directors as follows: Director of Marketing; Director of Research and Development; Director of Human Resources; Director of Government and Community Relations; Director of Information Technology; Director of Operations; Real Estate Development Manager; Chief Financial Officer; Chief Operating Officer, Provost and Vice President of Network Operations. Without the approval of all of the key decision makers, the accreditation process may be hindered and cannot move forward. Available Resources As the System moves towards accreditation, it must keep in mind the basic available resources and how those play a role within the system. Those available resources include: faculty, financial resources, personnel, library information services, information technology, and space allocation and physical location maintenance. Before accreditation can be sought, these items must be examined to determine if they are adequate enough to support and sustain campus accreditation. The faculty within the System is the most important component of operation. It is through casualty in which the System meets the objectives of the mission statement. It is also through faculty, that students are successful. The quality of curricula and delivery is primarily the main focus of faculty. Aside from classroom responsibilities, they are involved in curricular planning and development, book selection, hardware and software selection, and student advising. It is also largely through the faculty that the expectations of students are met. The financial resources of The System are allocated adequately to maintain a high standard of maintenance and support revise, and to allow the school to competitively seek and acquire qualified faculty and staff. Through this, educational needs of students are met while providing excellent customer service. Customer service is one of the reasons students choose to attend college in the System. The System strives to hire high-caliber faculty and support them with experienced management and administrative personnel. The System also seeks to support faculty and staff by having adequate resources for them to do their Jobs, compensating them adequately for their service, and providing them with professional development opportunities in their fields. The goal of library information services is to provide students with the resources, support, and learning environment necessary to successfully complete the courses in knowledge and skills required for their careers. In addition to this, library support services maintains a website so that students are able to access library resources remotely in order allow information to enhance their educational experience. The corporate information technology group plays an integral role in ensuring all computer equipment, hardware and software, as well as on-line connectivity, meets today’s demanding technical needs. There is a corporate director of technology who ultimately oversees the purchase of technical equipment and assists the campus with its technical needs. There are also individuals who are hired to work at the information technology helpless which further aids in the support of student and faculty in regards to troubleshooting and general system maintenance. In regards to allocation of space and facilities maintenance, the institution’s present locations are large enough to handle both the current student population, as well as allowing for growth. You read "Strategic Plan for the System – Essay" in category "Essay examples" The System employs a contracted facilities person during the day to keep lacrosse and facilities clean and in good condition, as well as an evening facilities employee who prepares the building for daily use. All of the resources above contribute to a comfortable and positive environment where students actively participate in their educational process. All of the above helps the System to fulfill the mission and responsibility to students. Data Availability Data is currently collected from several sources including the campus accountability report, student surveys, graduate surveys, employer surveys, and program advisory committee meeting minutes, annual assessment done by program rear for program effectiveness, course evaluations, and national examinations specific to career areas as applicable. The data is collected and analyzed on a quarterly and/or annual basis, subject to the various assessment tools. The Campus Effectiveness Plan (CAPE) spreadsheet identifies at a glance the data collection schedule. Annually the management team (campus and corporate directors) meets and incorporates the data results and analysis in the overall strategic planning process. The System President reviews the information with the management team during regularly scheduled quarterly planning meetings and in an annual strategic landing session. Together, all involved use the data to recommend changes in the programs, their respective facilities, personnel, and the overall operations of the school to provide the best possible education for students and to ensure achievement of the main objective of placing students in their chosen career fields. The System plans to improve effectiveness by assessing and analyzing the identified data (student surveys, program advisory committee meetings, retention rates, placement rates, employer surveys, graduate surveys, extrinsic site evaluations, student suggestions, and administrative meetings within and among campuses) and determine strengths and continue to build upon them, as well identify areas that need improvement and refinement. This data is evaluated on several levels by the following departments: administration, education, and financial aid/student accounts, as well as each programmatic area, student services, and career services. Each department identifies developmental areas and outcomes, and responses to the outcomes will be integrated and/or administered either departmentally and/or campus wide. Communication is also very critical component of self-assessment and student and employer suggestions and respond accordingly. The campus director discusses the results of the outcomes quarterly with the campus management team, and business review information is discussed monthly. The campus responds to all outcomes that show positive or negative trends. Each program chair reviews the outcome measurements that correspond to specific program plans. The results of these assessments are discussed at program meetings quarterly and program advisory committee meetings, typically annually. The faculty teaching in the program and the advisory committee members contribute ideas for curricular or programmatic enhancements and changes that relate to aerogram improvement. The campus directors regularly evaluate the plan and share the plan with their campus management team, and with the corporate management team, which includes directors from other campuses and corporate positions. Below is a more specific timeline for the current year in regards to the accreditation process. Key Stakeholders As previously mentioned, the key stakeholders are the students, the faculty, the campus personnel, and the community at large. In respect to accreditation process, data collection takes these key stakeholders in mind, from the surveys administered o how the surveys are administered. Anyone who is considered a key stakeholder is encouraged to participate with respect to how their comments and participation influences decisions made within the System, and ultimately whether or not the accrediting body will grant accreditation or not. Due to this, it is important that the key decision makers provide a positive and inviting environment from the beginning so that key stakeholders are willing to participate and give feedback accordingly. Timeline The timeline for obtaining accreditation will be as follows: Spring 2012 Semester will immense the compilation of data from various data sources as previously mentioned to complete the self study process as defined by the accrediting body. During this time, all stakeholders will meet to review and discuss key components of the self-study in an effort to have it completed in a timely manner. Once this has been done, the self-study will be submitted to legal counsel, the Board of Directors, the President, and the Provost for further review. Summer 2012 Semester, the self- study will be submitted to the accrediting body for the application process. The crediting body will have the completed application and self-study for review approximately two months in which the System will continue to compile data and also make any necessary corrections as indicated. The time frame for providing information is indicated by the accrediting body and should be no longer than three months from when the required information and necessary corrections have been noted and requested in writing. This will then take the process into the Fall 2012 Semester where at that time; the final application will be reviewed by all stakeholders and submitted. From the time of the final application submission to the actual approval or denial of accreditation shall be no more than six months time which will then take the strategic plan time frame into the Winter 2013 Semester. To conclude, from initial data collection and self-study process, the process shall take no less than a year and makers will need to re-evaluate the effectiveness of the strategic plan and make adjustments as needed. At the conclusion of the accreditation application process, the key decision maker will have a final review meeting to go over a SOOT analysis so s to improve the process when the System seeks accreditation elsewhere. Conclusion In order for a strategic plan to be effective, the input of all the key players, data analysis and collection, evaluation, and implementation along with other variables including resources and timeline must be in place. These items must not only be in place, but also done with respect to the mission and the vision of the organization in which the strategic plan is going to be implemented (Argosy, 2012; Guthrie Ackermann, 2009). In effect, the strategic planning process is not self serving nor is t single purposed, but rather the strategic plan keeps in mind the key stakeholders and how what is planned and implemented will impact, people, policies, processes, and procedures. How to cite Strategic Plan for the System – Essay, Essays

Speed Limits Essays - Traffic Law, Road Safety,

Speed Limits Imagine driving on I-75 as cars race by you at a blink of an eye. You are driving 60 miles per hour, the speed limit; they must be doing 100 miles per hour or more. This is not an illusion; this is the reality of driving on a highway. Believe it, it happens everyday. Cars race down the road at uncontrollable speeds that cause tickets, accidents, and sadly death. Speed limits are a must for traffic control, for safety in neighborhoods and for avoidance of collisions. Traffic control establishes a set of rules and regulations that people rely on to help avoid collisions and other hazards. With almost 160 million motorists and 3.8 million miles of public roads in the United States, traffic control on the highways is an important aspect of daily life. Without the control of speed there would be more fatalities than we already have now. Speed limits should be obeyed. A motorist going too slow could cause an accident. When everyone is traveling at the speed limit, a car comes up going 40 mph; if you break everyone will, too, perhaps causing a collision. Motorists depend on traffic control to avoid collisions and travel safely to their destination. Our neighborhoods need control of speed, too. Accidents not only happen on the highway, but also on residential streets, with the speed limits being 25 mph. Motorists are exceeding these limits as I speak. They would be unable to stop quickly enough for pedestrians, possibly swerving out of control and hitting a house or another car. My street has been monitored, by the city, due to this excessive speeding. The city of St. Clair Shores is trying to make the motorists aware of their speeding by posting a digital sign, which posts their current speed. Without a legal speed limit in residential areas, people would drive in excess of 25 mph all the time. We need this wild speeding controlled soon before something bad happens. Death! It's scary to think about that especially if it happens to someone you know. The single greatest cause of accidents in the United States is the automobile. In 1991, the U. S., automobile accidents were responsible for about 49.4 percent of all accidental deaths. That is not all from speeding, but it would be higher without speed limits. Motorists who exceed speed limits swerve in and out of lanes, which cause them to lose control of their vehicle. When seeing these cars on the news, speeding and getting into car accidents, you see the picture of the car and it is smashed. It leaves a fatal memory. Speed limits are a must for traffic control, for safety in neighbor hoods and for avoidance of collisions. Accidents are unintedtional and unforeseen, but result in personal injury or property damage. Let's try to avoid this by obeying the limits. Legal Issues

Oedipus Tragic Hero Essays

Oedipus Tragic Hero Essays Oedipus Tragic Hero Paper Oedipus Tragic Hero Paper Aristotle uses six different points to define a tragic hero. The tragic hero must be of noble stature and have greatness. Though the tragic hero is pre-eminently great, he/she is not perfect. The hero’s downfall is partially his/her own fault, the result of free choice, not of accidental means. The hero’s misfortune is not wholly deserved and the punishment exceeds the crime. The fall is not pure loss. And though it arouses solemn emotion, tragedy does not leave the audience in a state of depression. VCC Lit Online) Using Aristotle’s definition of a tragic hero, we will show that Oedipus in Oedipus the King is in fact a tragic hero and how his decisions led to his downfall. As Aristotle said, the tragic [continues] Read full essay Cite This Essay APA (2012, 10). Oedipus, a Tragic Hero?. StudyMode. com. Retrieved 10, 2012, from studymode. com/essays/Oedipus-A-Tragic-Hero-1160926. html MLA CHICAGO Welcome StudyMode. com is the webs leading learning tool. We inspir e millions of students every day with over 650,000 model essays and papers, AP notes and book notes. Learn More Related essays Oedipus: a Tragic Hero Oedipus: A Tragic HeroOedipus Rex, or Oedipus the King 3 pagesApr 2001 Oedipus: a Tragic Hero Oedipus: A Tragic Hero Aristotles tragic hero is one of 3 pagesMar 2010 Oedipus a Tragic Hero Oedipus A Tragic Hero English 102 Literature and Composition Summer 7 pagesSep 2011 Oedipus The Tragic Hero imperfections, and he is imperfect, despite his honorability. The audience can easily see 6 pagesMay 2012 Oedipus The Tragic Hero say your own. ) The next characteristic that shows Oedipus playing the tragic 4 pagesOct 2008

Shakespeare Sonnet 4 - Analysis

Shakespeare Sonnet 4 - Analysis Shakespeare’s Sonnet 4: Sonnet 4: Unthrifty Loveliness, Why Dost Thou Spend is interesting because it is as concerned with the fair youth passing on his attributes to his children as the preceding three sonnets. However, to achieve this, the poet uses money lending and inheritance as a metaphor. The fair youth is accused of being frivolous; spending on himself, rather than thinking of the legacy he could be leaving his children. The fair youth’s beauty is used as currency in this poem and the speaker suggests that beauty should be passed onto his offspring as a kind of inheritance. The poet again depicts the fair youth as quite a selfish character in this poem, suggesting that nature has lent him this beauty which he should pass on – not hoard! He is warned in no uncertain terms that his beauty will die with him which has been a recurrent theme in the sonnets. The poet uses business language to clarify his purpose and his metaphorical position. For example, â€Å"Unthrifty†, â€Å"niggard†, â€Å"usurer†, â€Å"sum of sums†, â€Å"audit† and â€Å"executor†. Discover the sonnet first hand here: Sonnet 4. Sonnet 4: The Facts Sequence: Fourth in the Fair Youth Sonnets  sequenceKey Themes: Procreation, death prohibiting the continuation of beauty, money-lending and inheritance, not leaving a legacy to offspring, the fair youth’s selfish attitude in relation to his own attributes.Style:  Written in iambic pentameter  in sonnet form Sonnet 4: A Translation Wasteful, beautiful young man, why do you not pass on your beauty to the world? Nature has lent you good looks but she only lends to those who are generous, but you are a miser and abuse the amazing gift you have been given. A money lender cannot make money if he does not pass it on. If you only do business with yourself you will never reap the benefits of your riches. You are deceiving yourself. When nature takes your life what will you leave behind? Your beauty will go with you to your grave, not having been passed on to another. Sonnet 4: Analysis This obsession with the fair youth procreating is prevalent in the sonnets. The poet is also concerned with the fair youth’s legacy and is committed to convincing him that his beauty must be passed on. The metaphor of beauty as currency is also employed; perhaps the poet believes that the fair youth would relate to this analogy more easily as we are given the impression that he is quite selfish and greedy and is perhaps motivated by material gains? In many ways, this sonnet pulls together the argument set out in the previous three sonnets, and arrives at a conclusion: The Fair Youth may die childless and have no way of continuing on his line. This is at the heart of the tragedy for the poet. With his beauty, the Fair Youth could have anyone he wanted, and procreate. Through his children, he would live on, and so too would his beauty. But the poet suspects that he will not use his beauty properly and die childless. This thought leads the poet to write  Thy unused beauty must be tombed with thee. In the final line, the poet considers that perhaps it is natures intention for him to have a child. If the Fair Youth can procreate, then this leads the poet to consider his beauty enhanced because it fits into the overarching plan of nature.

Object and Data Modelling Assignment Example | Topics and Well Written Essays - 1750 words

Object and Data Modelling - Assignment Example The participants accessing the system, who can be either the diver or the customer, are both required to register on the system or sign up with their personal information. Personal information comprises of the names, sex, the users year of birth, mobile number, and email addresses of the system end users. The system is divided into a driver and client subsystem that categorically showcase the attributes and features required by the system. The registration details for sign up process are mandatory in order to allow automatic validation of the end user. The end users are expected to input additional information to support the subsequent data required for completing the sub-functions of the system. The sub-functions of the system simply include and extend other higher functions or authority within the system (SHOVAL 2007). For example getting registered on the system extends to being validated by the system. Including other use cases helps to reduce duplication of system functionalities for each user, therefore, describing other detailed parts of the system in the use case makes it easy to understand the hierarchy of actors (system end users) in the car sharing system as well. An activity diagram relatively represents the flow of information within the system showing and illustrating the sequence of activities. The conditions for the information for each activity can also be described within an activity diagram. In the case of the Car sharing system, the activity diagrams that are presented include that of the Registration and Payment process. The activity diagram shows the start and stop process for each particular activity. Designing an activity diagram requires the coordination of execution of sub-functions using a control and data flow model. The activity diagram developed and created in this particular case invokes other activities via a level of hierarchy that executes and resolves particular functions (GEORGE 2007). For

Supernaturalist View Found in Civilizations Essay

Supernaturalist View Found in Civilizations - Essay Example Believers of supernaturalism argue that any event that goes beyond scientific understanding does actually exist just as the same way as natural occurrences do. This view can be supported by the fact that natural phenomena such as rainbows, lightning and floods were interpreted in ancient times as having some kind of unearthly causes behind them. Another school of thought believes that each so-called supernatural phenomenon is explicable through the knowledge of science. Now the root of controversy surrounding these two conflicting beliefs lies in the fact that there is no universally accepted definition of 'natural'. We may say that any event that takes place in accordance with natural and scientific laws is natural. In other words, any natural event can be seen or perceived, and can be affirmed by a set of proved principles. Having said that, we cannot really set a parameter by which we can verify, for instance, the existence of God. Hence, the controversy remains when it comes to d raw a borderline between the supernatural and the natural. The Code of Hamurabi, laid down in the eighteenth century B. C., is a source of much historical as well as divine interpretation especially the way it is addressed to the Babylonian Gods. Elements of supernaturalism can also be traced in the Judeo-Christian tradition where the Ten Commandments enlist moral and religious duties to be followed to show obedience to the Almighty. This revered set of imperatives has been in use in many civilizations including the Roman and in the Middle-East. Egypt, the country of myths and mysteries, has innumerable supernatural elements to be explored. The Pyramid of Khufu, also known as the Great Pyramid, is a source of wonder for historians, scientists and archeologists alike. Many folklores and legends are associated with this gigantic and awe-inspiring construction. The preternaturalism is vividly depicted in the treatise of Herodotus: "[he] brought the country into all sorts of misery. He closed all the temple, then, not content with excluding his subjects from the practice of their religion, compelled them without exception to labor as slaves for his own advantage". (Tour Egypt, 1996) Evidences of supernaturalism are widespread in prehistoric cave paintings that have been found in many parts of Europe. Based on the timeline, these paintings are classified to three main epochs - Palaeolithic, Neolithic and Mesolithic. The literary significance of such art forms is of immense worth, considering how they have been preserving the essence of proto-European culture. The marvels of prehistoric sculpture are to be explored in the North European megaliths. Carved with symbolisms that substantiate physical and ideological beliefs surrounding the areas dwelt by the first Northern farmers, researches on the construction of megaliths have thrown light on the contemporary cultural and ritualistic landscape of the northern parts of Europe. The 'Emergence Myth' and the 'Creation Myth' carried by the Anasazi Symbolism are two of the most prominent religious structures from the New Mexico region. The 'Emergence Myth' tells about the sacred Spirits or the Kachinas, whereas the 'Creation Myth' is about the origin of the earth. (Granite School District Teacher Quality Center, 2004) The power of magic, divination and demonology was literally

Treating Long Head of Biceps (LHB) Pathology

Treating Long Head of Biceps (LHB) Pathology Abstract Background Clinical examination of the shoulder joint has gained attention in recent years as clinicians aim to practice with an evidence-based and accurate clinical examination of the biceps tendon. There is an increased desire for proper diagnosis while simultaneously minimizing costly imaging procedures and unnecessary procedures. Thus, the purpose of this study is to create a decision tree analysis that enables the development of a clinical algorithm for diagnosing and subsequently treating long head of biceps (LHB) pathology. Methods A literature review of level one and two diagnostic studies was conducted to extract characteristics of clinical tests for LHB pathology through a systematic review of Pubmed, Medline, Ovid and Cochrane Review databases. Tests were combined in series and parallel to determine final sensitivities and specificities, and positive and negative likelihood ratios were determined for each combination using a subjective pre-test probability. The gold-standard for diagnosis in all studies included was arthroscopy or arthrotomy. Results Seven studies regarding LHB clinical diagnostic testing met inclusion criteria. The optimal testing modality was use of the uppercut test combined with the tenderness to palpation of the biceps tendon test. This combination achieved a sensitivity of 88.4% when performed in parallel and a specificity of 93.8% when performed in series. These tests used in combination optimize post-test probability accuracy greater than any single individual test; adding a third test decreases accuracy. Conclusion Performing the uppercut test and biceps groove tenderness to palpation test together has the highest sensitivity and specificity of known physical examinations maneuvers to aid in the diagnosis of long head of the biceps pathology as compared to diagnostic arthroscopy (The PEC exam). A decision tree analysis aides in the PEC exam diagnostic accuracy post testing based on the ordinal scale pre-test probability. A quick reference guide is provided to use in the clinical setting. Level of Evidence: II Systematic Review and Meta-Analysis Key Words: biceps tendon; long head; physical examination; pathology; diagnosis; shoulder examination Introduction The physical examination is a requisite and inexpensive component to medical diagnosis. The shoulder examination, in particular, encompasses a myriad of special provocative maneuvers, displaying a wide range of sensitivities and specificities pertaining to diagnostic accuracy. Accurate understanding from the correct sequence of maneuvers or tests increases diagnostic yield. In the modern era, clinical diagnosis heavily relies on imaging modalities including ultrasound (US), magnetic resonance imaging (MRI), computed tomography (CT), arthrography, and arthroscopy to diagnose shoulder pathology21,33. Current gold standard diagnostic testing options have limitations. MRI has poor statistical characteristics for diagnostic accuracy as it very reader and technician dependent, adds both direct and indirect costs, and may be less accurate than the physical exam37. Diagnostic arthroscopy is successful in diagnosing intra-articular pathology, but is limited in visualization for extra-articular pathology, is costly, and increases patient risk37. Increased use of diagnostic imaging contributes to rising health care costs14,30,32,38. According to the Centers for Medicare and Medicaid Services (CMS), diagnostic imaging costs are significant, accounting for up to 40% of overall healthcare expenditure increases over the past 10 years25. Advanced imaging techniques res ult in not only higher direct costs, but may increase indirect costs and jeopardize outcomes36,39. As the healthcare landscape transitions to cost minimization and value-based healthcare delivery, the development of an efficient, cost-effective, shoulder examination is desired. Shoulder examinations have poor sensitivity and/or specificity that makes diagnosing certain pathologies difficult4,28,30,33. Thus, evaluating the long head of the biceps brachii tendon (LHB) pathology with high-yield examination maneuvers can aid physicians through increasing the accuracy of shoulder diagnoses and aid in surgical decision making. Previously published studies focused on the following questions: whether physical examination special tests correlate with surgical findings; whether imaging correlates with surgical findings; and whether physical exam tests are accurate enough to diagnose pathology effectively5,9,10,26,28,29,33. Currently, there is a need to develop new algorithms to provide shoulder practitioners with a practical but comprehensive evidence-based approach to diagnose LHB pathology during an office visit and to further reduce the need for diagnostic imaging20,22,34. The purpose of this study was to perform a systematic review and a secondary sensitivity analysis based on pre-formed likelihood scenarios based on the history of present illness (HPI) past medical history (PMH), and epidemiology to provide clinicians a practical, evidence-based clinical (P.E.C) physical examination algorithm to accurately diagnose patients with LHB pathology. Specific objectives were to: compile the peak performing physical exam tests extracted from level I and II studies within the English literature; synthesizing the most accurate test combination; develop a clinical algorithm to provide quantify LHB diagnostic accuracy; and create a diagnostic accuracy reference guide. Materials and Methods A systematic literature review with the terms proximal, biceps, clinical and examination in the Medline database through the Pubmed, Medline, Ovid and Cochrane Review databases was completed in May 2015. The searches included the use of Boolean operators such as AND and OR. The databases were scrutinized independently by three authors. Inclusion criteria included studies that were focused on physical examination tests and compared to the diagnostic gold standard from Level I and II studies published in scientific journals. Exclusion criteria were: non-English, non-full text, level III of evidence or lower, related to superior labrum anterior to posterior (SLAP) lesions, investigated rheumatoid arthritis patients, or did not compare tests to a validated gold standard. The validated gold standard utilized for all studies and systematic reviews included were diagnostic arthroscopy or arthrotomy to confirm anatomical findings. Relevant studies were independently assessed, and conflicting studies were included only if there were consensus amongst the authors. References of included studies were additionally evaluated to identify additional articles for inclusion. Applicable data was extracted by reverse calculation where the information desired was not directly stated. Using PRISMA guidelines for systematic reviews (Fig. 1), our original search retrieved 2,086 studies from Pubmed, Medline, Ovid and Cochrane Review databases. Twenty-eight additional records were included through a review of references from each article included in the systematic review. After duplicates were removed, the initial search yielded 2,112 studies. Subsequently, 1,689 studies were removed for irrelevant titles or abstracts, and an additional 362 were excluded because they were not in English. Lastly, the remaining 63 articles were assessed for eligibility; 14 were excluded for non-full text, 22 were excluded for not being level I or II study, and 18 were excluded for non-relevant data. The data extracted was summarized and analyzed according to the statistical methods described by Eusebi et al. focusing on test specificity, sensitivity, positive predictive value and negative predictive value12. Next, clinical tests were combined to assess improved diagnostic accuracy. The clinical tests were applied both in parallel and in series. The first approach in parallel analysis, consists of two special tests performed in theory at approximately the same time. The parallel analysis can interpret the findings in an and or or technique. When a parallel analysis is performed in an or technique, the overall sensitivity of the two tests is greater than the sensitivity of either special test alone. This parallel analysis allows for two opportunities to observe the potential pathology. If both tests are negative then it is considered a negative finding in the algorithm and rule out the pathology, but if just one of the two special tests is positive then it is not considered a negative result in parallel analysis. The second approach in series analysis, consists of two special tests performed; however, the overall negative or positive finding depends on the outcomes of both special tests. By utilizing two special tests in an and technique in series, the specificity for both tests is higher than for either test alone. If both special tests are positive, then it is considered a positive result. If either special test is negative, then the in series analysis cannot be considered a positive result. In order to calculate the post-test diagnostic probability of LHB diagnosis, we performed calculations for each test with four pre-test probability options. Pre-test probability is defined as the probability of a patient having the target disorder before a diagnostic test result is known. Therefore, pre-test probability is based on patient history, subjective complaints, epidemiologic probability and the medical opinion of the provider ordering the test. The ordinal scale created has four different probabilities: very unlikely 0.2 (20%); unlikely 0.4 (40%); likely 0.6 (60%); and very likely 0.8 (80%). The physical exam test combination with the optimal test performance was identified (named the PEC exam). A decision tree analysis was developed to determine the PEC exam diagnostic accuracy post testing based on the ordinal scale pre-test probability. A table was created as a simple reference guide to use in the clinical setting. Results The initial electronic database search retrieved 2,112 unique articles, with 28 obtained from a manual search of reference lists. Of these, 2051 studies were found unrelated to the topic of interest based titles and abstract review, resulting in 63 full-text articles evaluated according to selection criteria. Fifty-four articles were excluded for the following: full-text unavailable (N=14), not a Level I/II study (N=22), and irrelevant data after full-text review (N=18). Seven relevant (N = 7) articles were identified through the systematic review and scrutinized (Supplementary Table S1). From the reviewed articles, special tests and modalities evaluated included Speeds, Yergasons, bicipital groove tenderness, uppercut, bear hug, belly press, OBriens, and anesthetic injection. Statistical characteristics for each test are documented in (Supplementary Table S2). The bear hug and uppercut special tests demonstrated the highest sensitivity for the physical examination special maneuvers (79%, 73% respectively), whereas the belly press and Yergasons tests demonstrated the lower spectrum of sensitivity (31%, 41% respectively). The belly press and OBriens special tests demonstrated the highest special test specificities (85%, 84% respectively), whereas the bear hug and bicipital groove tenderness tests showed the lowest specificities (60%, 72% respectively). Diagnostic ultrasound, used as a reference and also included to study as a potential application for in-office point of service testing, demonstrated the highest sensitivity and specificity of all statistical characteris tics revealed through the review (Sensitivity 88%, Specificity 98%). In series and in parallel assessments determined two physical exam tests improved test performance over any single test. Performing more than two physical examination tests decreased diagnostic accuracy. The uppercut test combined with the tenderness to palpation of the LHB test provided the highest physical examination accuracy for diagnosing pathology at the proximal biceps. This combination has a parallel testing sensitivity of 88.3% and a series specificity of 93.3%. We characterize this as the PEC exam. Additional combinations, including diagnostic ultrasound, are reported in (Supplementary Table S3). The uppercut test and diagnostic ultrasound in parallel revealed the highest sensitivity (97%). Each of the Speeds, Yergasons and upper cut tests paired with diagnostic ultrasound all achieved the highest specificity (100%). A decision tree analysis aides in the PEC exam diagnostic accuracy post testing based on the ordinal scale pre-test probability (Fig. 2). A quick reference guide is provided to use in the clinical setting (Fig. 3). Discussion LHB pathology is an increasingly recognized generator of shoulder pain and functional impairment in symptomatic patients. Physicians are faced with diagnostic challenges due to non-specific clinical presentations and lack of direction based on physical exam findings. As such, the purpose of this study was to perform a decision-tree analysis to create a clinical algorithm to diagnose biceps pathology with increased accuracy compared to previously reported diagnostic examinations 8,11,15-17,19,22,24. This was achieved by conducting a systematic literature review including only level I and II studies. Special test sensitivities and specificities were combined in series and parallel. Analysis showed that the uppercut test combined with tenderness to palpation of the LHB within the bicipital groove provided the highest accuracy physical exam tests for diagnosing pathology at the proximal biceps. Application of this PEC exam, coupled with pre-test probability assignments can now provide cl inicians diagnostic confidence in the office. In equivocal cases, point of care ultrasound examination can further improve diagnostic accuracy2,31. Applying the PEC algorithm provides a simple, efficient and reproducible physical examination protocol for shoulder clinicians yielding an accurate diagnosis in the clinic. Now, with the calculated accuracy reference guide available, a clinician may rely on the office-based diagnosis with improved certainty and may consider forgoing advanced imaging, thereby avoiding additional cost, treatment delays and possible patient risk. In order to cover an array of clinical scenarios, we used a pretest probability range of 20-80% at 20% increments according to the likelihood of pathology. After addressing the disease prevalence, HPI and PMH, the pre-test probability likelihood of long head bicep pathology was appointed. If the pre-test probability was above 90% or below 10%, we then assume there is no need to perform additional testing with acceptance of a 10% error rate. Combination of physical examination techniques demonstrated that the uppercut test combined with tenderness to palpation of the LHB provided the highest accuracy for diagnosing pathology at the proximal biceps. This combination has a parallel testing sensitivity of 88.3% and a series specificity of 93.3% (Supplementary Table S3). The values of the test used in series and in parallel were definitive and overpowered the value of the pre-test probability assessment in many clinical scenarios. This adds credibility to a reproducible, simplified two-step P.E.C. examination without the need for additional maneuvers to be performed. Furthermore, we feel that the application of the PEC test is generalizable to non-shoulder specialists, facilitating both increased utilization and diagnostic accuracy of LHB disease. Many studies have explored the accuracy of physical examination and special test maneuvers in diagnosing LHB pathology with limited conclusions regarding its efficiency18,22,23,37. However, our study is unique in that it additionally produces a diagnostic tool, both enabling accurate point of care diagnosis of LHB injury and minimizing the need for advanced imaging. The value of the P.E.C. examination corroborates with current clinical recommendations. In 2009, Churgay et al. stated that bicipital groove point tenderness is the most common isolated finding during physical examination of patients with biceps tendinitis, and that ultrasonography is the best modality for evaluating isolated biceps tendinopathy extra-articularly3,6. With regards to diagnostic accuracy and fluidity of exam, our study revealed that the best maneuver combination for diagnosing biceps pathology are the uppercut test and tenderness to palpation. Incidentally, our study has also concluded that use of ultrasound after equivocal physical examination findings improves the sensitivity and specificity of all evaluated test combinations. Unlike past studies, we incorporated a diagnostic algorithm to aid efficient shoulder examination and to increase physician confidence in biceps tendon diagnosis. In addition to enhancing diagnostic accuracy, development of a value-based clinical decision pathway may play a small, but essential role in the improvement of the current state of the healthcare system. High-yield, algorithm-derived examination like our proposed sequence further alleviate the number of follow-up visits needed until diagnosis, which often delay expedient care delivery35,39. Moreover, simplified diagnostic algorithms may also result in cost reduction and decreased iatrogenic injury associated with unnecessary advanced imaging studies. A shoulder examination that provides accurate diagnosis provides multiple advantages that benefits both physicians and the healthcare system with the ultimate goal of improving patient outcomes. However, it is important to note that clinical decisions should be tailored to patient clinical presentation, and that MRI may be a more appropriate diagnostic modality for surgical candidates or patients with inconclusive preliminary workup. These findings provide evidence towards the current trend in orthopedic surgery education as more national conferences and residency programs are increasing musculoskeletal ultrasound (US) courses incorporated into their curriculums. Accordingly, the American Medical Association for Sports Medicine has endorsed increased integration of sports US into sports medicine fellowship curriculums13. Studies have proposed that proficient level diagnostic skills may be quickly obtained by the inexperienced orthopedist with an established examination protocol1. Murphy et al. conducted a study investigating diagnostic improvement in four orthopedic surgeons who attended a formal training course to identify and size tears on the rotator cuff through US. In the later training period, results showed positive predictive value improving by 16%27. An additional study by Roy and colleagues also demonstrated improved diagnostic accuracy of US irrespective of whether a trained radiologist, sonographer or orthopedic surgeon operated the device32. US requires further studies to evaluate its cost effectiveness compared to advanced imaging techniques like MRI or arthroscopy, but an algorithm(Fig. 3) may provide a simple evidence-based decision analysis for physicians to rely on when considering LHB as the major source of pain. This study, however, also has its limitations. Foremost, a majority of the studies included in our data collection did not solely focus on LHB pathology. True positives may have included superior labrum, anterior to posterior (SLAP) lesions within the diagnosis of biceps pathology. Studies may have also incorporated biceps pathology into other diagnostic categories (e.g. impingement). Therefore, it was difficult to find studies which solely focused on diagnostic accuracy of LHB pathology. Additionally, only level I or II studies were considered for diagnosis, which routinely compare diagnostic testing algorithm (DTA) to the gold standard of diagnosis. Unfortunately, there is no clearly defined arthroscopic findings for diagnosis of LHB pathology. To aid in any study misinterpretations due to inaccurate language translations, only articles originally written in English were evaluated, and only published articles were included. This may have introduced both publication and/or selection bias. A method to eliminate some of these potential biases would be to perform a truly systematic review and meta-analysis combining results from multiple studies; however, even this can be hindered by bias with the lack of currently published methods for meta-analyses evaluating diagnostic testing. Another future direction for this study may be to further evaluate the accuracy of new special tests described to evaluate long head of the biceps pathology, specifically the uppercut test. Currently the uppercut test has only been described and analyzed in a single level I or II study that we utilized for our algorithm24. Further validation testing for this specific test may be warranted. Conclusion Performing the uppercut test and biceps groove tenderness to palpation test together has the highest sensitivity and specificity of known physical examinations maneuvers to aid in the diagnosis of long head of the biceps pathology as compared to diagnostic arthroscopy (The PEC exam). A decision tree analysis aides in the PEC exam diagnostic accuracy post testing based on the ordinal scale pre-test probability. A quick reference guide is provided to use in the clinical setting. References 1. Amoo-Achampong K, Nwachukwu BU, McCormick F. An orthopedists guide to shoulder ultrasound: a systematic review of examination protocols. Phys Sportsmed. 2016 Aug 22;1-10. doi: 10.1080/00913847.2016.1222224 2. Ardic F, Kahraman Y, Kacar M, Kahraman MC, Findikoglu G, Yorgancioglu ZR. Shoulder impingement syndrome: relationships between clinical, functional, and radiologic findings. Am J Phys Med Rehabil. 2006 Jan 1;85(1):53-60. doi:10.1097/01.phm.0000297449.72296.3d 3. Armstrong A, Teefey SA, Wu T, Clark AM, Middleton WD, Yamaguchi K, et al. The efficacy of ultrasound in the diagnosis of long head of the biceps tendon pathology. J Shoulder Elbow Surg. 2006 Jan-Feb;15(1):7-11. doi:10.1016/j.jse.2005.04.008 4. Arrigoni P, Ragone V, DAmbrosi RI, Denard P,Randelli F, Banfi G, et al. Improving the accuracy of the preoperative diagnosis of long head of the biceps pathology: the biceps resisted flexion test. Joints. 2014 Jul 8;2(2):54-8. doi:10.11138/jts/2014.2.2.054 5. Bennett WF. Specificity of the Speeds test: arthroscopic technique for evaluating the biceps tendon at the level of the bicipital groove. Arthroscopy. 1998 Nov-Dec;14(8):789-96. No doi 6. Churgay CA. Diagnosis and treatment of biceps tendinitis and tendinosis. Am Fam Physician. 2009 Sep 1;80(5):470-6. 7. Chu K. An introduction to sensitivity, specificity, predictive values and likelihood ratios. Emergency Medicine Australasia. 1999 Sep 8;11(3):175-81. doi:10.1046/j.1442-2026.1999.00041.x 8. Chen HS, Lin SH, Hsu YH, Chen SC, Kang JH. A comparison of physical examinations with musculoskeletal ultrasound in the diagnosis of biceps long head tendinitis. Ultrasound Med Biol. 2011 Sep 30;37(9):1392-8. doi:10.1016/j.ultrasmedbio.2011.05.842 9. Cohen SB, Valko C, Zoga A, Dodson CC, Ciccotti MG. Posteromedial elbow impingement: magnetic resonance imaging findings in overhead throwing athletes and results of arthroscopic treatment. Arthroscopy. 2011 Oct 31;27(10):1364-70. doi:10.1016/j.arthro.2011.06.012 10. Dinnes J, Loveman E, McIntyre L, Waugh N. The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review. Health Technol Assess. 2003;7(29):iii, 1-166. doi:10.3310/hta7290 11. Dubrow SA, Streit JJ, Shishani Y, Robbin MR, Gobezie R. Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI. Open Access J Sports Med. 2014 Apr 28;5:81-7. doi:10.2147/OAJSM.S58225 12. Eusebi P. Diagnostic accuracy measures. Cerebrovasc Dis. 2013 Oct 16;36(4):267-72. doi:10.1159/000353863 13. Finnoff JT, Berkoff D, Brennan F, DiFiori J, Hall MM, Harmon K, et al.. American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships. Br J Sports Med. 2015 Feb;49(3):145-50. doi:10.1136/bjsports-2014-094220 14. Freeman R, Khanna S, Ricketts D. Inappropriate requests for magnetic resonance scans of the shoulder. Int Orthop. 2013 Nov;37(11):2181-4. doi:10.1007/s00264-013-1968-4 15. Gazzillo GP, Finnoff JT, Hall MM, Sayeed YA, Smith J. Accuracy of palpating the long head of the biceps tendon: an ultrasonographic study. PM R. 2011 Nov;3(11):1035-40. doi:10.1016/j.pmrj.2011.02.022 16. Gill HS, El Rassi G, Bahk MS, Castillo RC, McFarland EG. Physical examination for partial tears of the biceps tendon. Am J Sports Med. 2007 Aug;35(8):1334-40. doi:10.1177/0363546507300058 17. Gilmer BB, DeMers AM, Guerrero D, Reid JB, Lubowitz JH, Guttmann D. Arthroscopic versus open comparison of long head of biceps tendon visualization and pathology in patients requiring tenodesis. Arthroscopy. 2015 Jan;31(1):29-34. doi:10.1016/j.arthro.2014.07.025 18. Hanchard NC, Lenza M, Handoll HH, Takwoingi Y. Physical tests for shoulder impingements and local lesions of bursa, tendon or labrum that may accompany impingement. Cochrane Database Syst Rev. 2013 Apr 30;(4):CD007427. doi: 10.1002/14651858.CD007427.pub2 19. Hashiuchi T, Sakurai G, Morimoto M, Komei T, Takakura Y, Tanaka Y. Accuracy of the biceps tendon sheath injection: ultrasound-guided or unguided injection? A randomized controlled trial. J Shoulder Elbow Surg. 2011 Oct;20(7):1069-73. doi:10.1016/j.jse.2011.04.004 20. Hegedus EJ. Physical Examination of the Shoulder and Elbow with a Focus on Orthopedic Special Tests. In: Park JY, editor. Sports Injuries to the Shoulder and Elbow. Heidelberg: Springer. 2015. p. 35-44. (ISBN No. 978-3-642-41794-8. doi:10.1007/978-3-642-41795-5 21. Hegedus EJ, Cook C, Lewis J, Wright A, Park JY. Combining orthopedic special tests to improve diagnosis of shoulder pathology. Phys Ther Sport. 2015 May;16(2):87-92. doi:10.1016/j.ptsp.2017.08.001 22. Hegedus EJ, Goode AP, Cook CE, Michener L, Myer CA, Myer DM, et al.. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med. 2012 Nov;46(14):964-78. doi:10.1136/bjsports-2012-091066 23. Jordan RW, Saithna A. Physical examination tests and imaging studies based on arthroscopic assessment of the long head of biceps tendon are invalid. Knee Surg Sports Traumatol Arthrosc. 2015 Nov 26 [Epub ahead of print]. doi:10.1007/s00167-015-3862-7 24. Kibler BW, Sciascia AD, Hester P, Dome D, Jacobs C. Clinical utility of traditional and new tests in the diagnosis of biceps tendon injuries and superior labrum anterior and posterior lesions in the shoulder. Am J Sports Med. 2009 Sep;37(9):1840-7. doi:10.1177/0363546509332505 25. Health Care Spending and the Medicare Program. Medicare Payment Advisory Commission. Washington DC: 2011. p.1-207. 26. Momenzadeh OR, Gerami MH, Sefidbakht S, Dehghani S. Assessment of correlation between MRI and arthroscopic pathologic findings in the shoulder joint. Arch Bone Jt Surg. 2015 Oct;3(4):286-90. 27. Murphy RJ, Daines MT, Carr AJ, Rees JL. An independent learning method for orthopaedic surgeons performing shoulder ultrasound to identify full-thickness tears of the rotator cuff. J Bone Joint Surg Am. 2013 Feb 6;95(3):266-72. doi:10.2106/JBJS.K.00706 28. Naredo E, Aguado P, De Miguel E, Uson J, Mayordomo L, Gijon-Banos J, et al. Painful shoulder: comparison of physical examination and ultrasonographic findings. Ann Rheum Dis. 2002 Feb;61(2):132-6. doi:10.1136/ard.61.2.132 29. ÃÆ'-stà ¶r AJ, Richards CA, Tytherleigh-Strong G, Bearcroft PW, Prevost AT, Speed CA, et al. Validation of clinical examination versus magnetic resonance imaging and arthroscopy for the detection of rotator cuff lesions. Clin Rheumatol. 2013 Sep;32(9):1283-91. doi:10.1007/s10067-013-2260-0 30. Razmjou H, Fournier-Gosselin S, Christakis M, Pennings A, ElMaraghy A, Holtby R. Accuracy of magnetic resonance imaging in detecting biceps pathology in patients with rotator cuff disorders: comparison with arthroscopy. J Shoulder Elbow Surg. 2016 Jan;25(1):38-44. doi:10.1016/j.jse.2015.06.020 31. Read JW, Perko M. Shoulder ultrasound: diagnostic accuracy for impingement syndrome, rotator cuff tear, and biceps tendon pathology. J Shoulder Elbow Surg. 1998 May-Jun;7(3):264-71. doi:10.1016/S1058-2746(98)90055-6 32. Roy JS, Braà «n C, Leblond J, Desmeules F, Dionne CE, MacDermid JC, et al. Diagnostic accuracy of ultrasonography, MRI and MR arthrography in the characterisation of rotator cuff disorders: a systematic review and meta-analysis. Br J Sports Med. 2015 Oct;49(20):1316-28. doi:10.1136/bjsports-2014-094148 33. Sandrey MA. Special physical examination tests for superior labrum anterior-posterior shoulder tears: an examination of clinical usefulness. J Athl Train. 2013 Nov-Dec;48(6):856-8. doi:10.4085/1062-6050-48.3.14 34. Sciascia AD, Spigelman T, Kibler WB, Uhl TL. Frequency of use of clinical shoulder examination tests by experienced shoulder surgeons. J Athl Train. 2012 Jul-Aug;47(4):457-66. doi:10.4085/1062-6050-47.4.09 35. Seagger R, Bunker T, Hamer P. Surgeon-operated ultrasonography in a one-stop shoulder clinic. Ann R Coll Surg Engl. 2011 Oct;93(7):528-31. doi:10.1308/147870811X13137608454939 36. Skendzel JG, Jacobson JA, Carpenter JE, Miller BS. Long head of biceps brachii tendon evaluation: accuracy of preoperative ultrasound. AJR Am J Roentgenol. 2011 Oct;197(4):942-8. doi:10.2214/AJR.10.5012 37. Taylor SA, Khair MM, Gulotta LV, Pearle AD, Baret NJ, Newman AM, et al. Diagnostic glenohumeral arthroscopy fails to fully evaluate the biceps-labral complex. Arthroscopy. 2015 Feb;31(2):215-24. doi:10.1016/j.arthro.2014.10.017 38. Voigt JD, Mosier M, Huber B. In-office diagnostic arthroscopy for knee and shoulder intra-articular injuries its potential impact on cost savings in the United States. BMC Health Serv Res. 2014 May 5;14:203. doi:10.1186/1472-6963-14-203 39. Zhang AL, Kreulen C, Ngo SS, Hame SL, Wang JC, Gamradt SC. Demographic trends in arthroscopic SLAP repair in the United States. Am J Sports Med. 2012 May;40(5):1144-7. doi:10.1177/0363546512436944 Figure and Table Legends Figure 1: PRISMA Systemic Review Flow Diagram: This figure displays the process and rationale behind why studies were omitted from the systemic review. Figure 2: (A) Diagnostic Combination to Rule in Pathology: These findings demonstrate that the combination of tests that best help rule out pathology are the TTP + Uppercut test when performed in series. If both tests are negative in a scenario with a low pre-test probability (i.e. prevalence), then there is a very small chance of pathology being present. TTP = Tenderness to palpation (of the long head of the biceps within the bicipital groove); Diamond = TTP + Uppercut in series, square = TTP + Speeds in Series, triangle = TTP + Yergasons in Series (B) Diagnostic Combination to Rule Out Pathology: These findings demonstrate that the combination of TTP + upper

Gambling †the economy, household and society Essay

The subject of gambling has been a hot subject of debate amongst politicians for many years. The concept of people waging something of value for something not guaranteed is something that baffles many non-gamblers. Long before Christopher Columbus discovered North America gambling was practiced quite often amongst Native Americans (Sheppard, 2012). In fact one can trace the origins of gambling even farther back into biblical times. This is evident by the biblical verses in the Bible about the dangers of gambling and why individuals should not gamble (King James Bible Online, 2013). According to the Alberta Gambling Research Institute, â€Å"The history of gambling in Canada is inextricably linked to the Canadian Criminal Code, which in 1892 declared a complete ban on most gambling activities with the exception of horse racing†(Stevens, 2005). Over the next 77 years the Criminal Code will make many exceptions for smaller-scaled gambling, such as betting on horse races or gambling at ‘summer fair midways’ (Stevens, 2005). Eventually an amendment was made so that federal-run lotteries can be used to help fund meaningful activities, such as the 1976 Montreal Olympics. In more modern times the restrictions for gambling is much more relaxed. â€Å"Ticket lotteries, horse racing, and charitable gaming (including bingo) are currently legal in all ten provinces, Yukon Territory, Northwest Territories, and Nunavut Territory† (Stevens, 2005). Casino-style gambling is also allowed in most provinces and in all territories, as well as slot machines (Stevens, 2005). The focus of this argumentative essay will be why gambling is bad to Canadian society, and should continue being outlawed. Although one can argue that there are benefits to gambling, but this essay will look to dismiss such arguments and focus on the negative aspects of gambling. In order to go about this efficiently, this essay will look at gambling from an economical, moral and societal viewpoint. From an economic standpoint it is quite easy for one to say that gambling would improve the economy greatly. After all there are many who love nothing more than to poor their entire wallets into a machine, hoping to strike gold, not to mention that casino gambling, the highest grossing form of gambling, is the form of gambling that appeals to individuals the most (McLean, 2013). As I had mentioned previously, federal-run lotteries also helped to fun the 1976 Montreal Olympics. With all this said, gambling actually does not improve a country financially, and casinos will specifically be targeted to prove this point. Detroit is a city with 3 casinos, built with the intent of bringing in revenue to a city needing financial stability and quick income. Now, after over a decade of dumping hundreds of millions of dollars from taxes on the casinos, the city has more or less nothing to show for it. In fact, Detroit has become so financially strapped that the casinos no longer pays for anything ‘extra’, such a museum or an Olympic competition; Detroit museums instead pays for the garbage services and the electricity bill to keep the lights on the streets working (Henderson, 2012). Now one can argue that not all cities with casinos end up in financial trouble, with Las Vegas being a common example of this. The only difference with this argument is that Las Vegas has attractions that would flourish even without casinos (Henderson, 2012). In fact, the city of Toronto just recently came to its senses and decided against building a casino in the downtown area, saving the city millions of dollars that could better-used in other places (Baggage, 2013). There are many financial repercussions that come with having a casino, and although it is a wonderful argument it is not the entire focus of this essay. To touch upon how morally damaging a fact from an earlier paragraph will have to be drawn upon. In the Bible there are many passages that speak of how terrible gambling is. Now, there are many people who do not associate with the bible, and many of the historical details are debatable. With this being said, it is a fact that for many years Canada was primarily Catholic (Wallace, 1948), meaning it is religion played a major role in shaping Canadian society. With that said, one of the religious books Catholics use for moral guidelines is the Bible (Catholic Evidence Guild, 1921). Therefore, it is also indisputable that the Bible contains morals that are also right, as evident from Canadian society being sustainable and without war. Now the bible does not go into great detail as to why gambling is wrong, but one can look at today’s society and make a great case. In Canadian society there is a steady increase of problem gamblers (Problem Gambling Institute of Ontario, 2013). This problem has become a serious issue, and is, reflected in the industry growing to keep up with the demands (Koprowski, 2007). These problem gamblers are somebodies mother, father, son or daughter, which can and will affect a household in many different ways. Besides the obvious loss of money, belongings and property, there are many emotional effects as well. Many friendships are destroyed due to unpaid debts, partners do not want close contact with the person who has hurt them (Problem Gambling Institute of Ontario, 2013), and in the end the addict is left without affection in isolation. From a psychological perspective, the individual is left in isolation due to either being shunned or being too ashamed to be around others. Naturally there are extreme cases of those committing suicide after being driven to seclusion and gamblers are no exception; â€Å"1 in 5 compulsive gamblers attempts suicide and two-thirds have thought about committing suicide† (Gaultiere, 2011). From a sociological and anthropological perspective, this is proof of the family system deteriorating. In conclusion gambling is bad for Canada not only financially but socially speaking as well. Although it is unrealistic to want all forms of gambling to be illegal, there should be some form of restrictions on those who spend too much time at the casino, or something along those lines. Works Cited Baggage, M. Toronto rejects controversial downtown casino. http://www. ottawacitizen. com/news/Toronto+rejects+controversial+downtown+casino/8416596/story. html, 2013. Catholic Evidence Guild. Catholics and the Bible.http://catholiceducation. org/articles/religion/re0032. html, 1921. Gaultiere, B. Don’t Bet On It: Help For Compulsive Gamblers. http://www. newhopenow. org/notes/archive/dont_bet_on_it. html, 2011. Koprowski, G. Gambling Growing in Canada. http://www. onlinecasinocrawler. com/blog_gambling-growing-in-canada. php, 2007. McLean, J. Gambling In Canada. http://gocanada. about. com/od/thebestofcanada/tp/Gambling-In-Canada. htm, 2013. Problem Gambling Institute of Ontario. The Effects of Gambling on Families. http://www. problemgambling. ca/EN/GettingHelp/Pages/TheEffectsOfGambling. aspx, 2013. Sheppard, R. Gambling.http://www. thecanadianencyclopedia. com/articles/gambling http://www. kingjamesbibleonline. org/Jonah-1-7/, 2012. Stephen, H. Detroit has little to show for its casino revenue. http://www. freep. com/article/20120513/COL33/205130480/. Stephen-Henderson-Detroit-has-little-to-show-for-its-casino-revenue, 2012. Stevens, R. Legalized Gambling In Canada. http://www. abgamblinginstitute. ualberta. ca/en/LibraryResources/Bibliographies/LegalizedGamblinginCanada. aspx, 2005. Wallace, W. Religious History of Canada. http://faculty. marianopolis. edu/c. belanger/quebechistory/encyclopedia/CanadaReligiousHistory_000. htm, 1948.

Ivan Pavlov s Classical Conditioning - 1149 Words

Learning is defined as a relatively permanent change in behavior due to experience. A stimulus is anything that comes in through your senses. A response is anything that goes out through your muscles (anything you do). Habituation is a decrease in response to a repeated stimulus. Classical conditioning: Ivan Pavlov, J. B. Watson; works on reflexes and emotional behaviors through the repeated pairing of two stimuli. Operant conditioning: E. L. Thorndike, B. F. Skinner; works on all other behaviors by following a response with reinforcement or punishment. Cognitive Learning: Albert Bandura; works on any observable behavior when people learn by observing the behavior of others. Ivan Pavlov s classical conditioning In classical†¦show more content†¦This is called classical extinction. During extinction, the response will sometimes come back after a rest period. This is called spontaneous recovery. After conditioning an animal to respond to a particular stimulus, the animal will also react to other, similar stimuli. This is called generalization. Sometimes, an animal will respond to one stimulus but not to another. We call this discrimination. We can also present one stimulus with the unconditioned stimulus and another stimulus without the unconditioned stimulus. Over time, the animal will learn to respond to the first one and not respond to the second one. This is called discrimination training. When a person learns an emotional response through classical conditioning (such as learning to fear the sound of the dentist s drill), we call it a conditioned emotional response. The technique of systematic desensitization is based on classical extinction and can be used to help overcome fears. Mary Cover Jones used this technique to help a boy called Peter overcome his fear of rabbits. Psychologist Martin Seligman suggests that we are easily conditioned to fear things that were a threat to our ancestors, such as snakes and spiders. This is called biological preparedness. Robert Rescorla s work suggests that conditioning sometimes works better if the stimulus is logically connected to the response. Leon

Vaccinations Should Be Mandated For Everyone - 1053 Words

For many years, there has been a controversy about whether or not vaccinations should be mandated for everyone. In the United States, many diseases such as polio, diphtheria, measles, and whooping cough used to be extremely common, until vaccinations came around and started preventing these diseases. The main point for vaccines is to prepare a person’s immune system for any possible attack of a disease that comes in the future; a person’s body will be prepared to fight off the disease with the vaccine (â€Å"Basics†). Vaccines have the ability to prevent many cases of these diseases in advanced, but there are people who think vaccines are unnatural and should not be required for their children. It is said that immunity in child vaccines are about 90%-100%, which is an increase over the past few years (â€Å"Childhood†). Although many Americans believe that vaccines are unsafe and cause autism in children, vaccinations for children should be mandatory becau se they can save a child’s life, create herd immunity in a community, and they have been proven safe/cost-effective. To begin, vaccinations should be mandatory for children because they can save children from many diseases like measles and small pox. By mandating vaccines, parents are ensured that their child is protected from many diseases and has a lower risk of contracting a disease from an unvaccinated child. Frances Childs, a comprehensive teacher in England, believes that when parents choose to keep their childrenShow MoreRelatedVaccinations Should Be Mandatory Vaccinations1495 Words   |  6 PagesThe government should mandate vaccinations, and although it would sacrifice the liberty and choice for public health it would keep the well-being and health of everyone much more safe and away from the risk of disease. 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