Tuesday, November 26, 2019

PCBs and the enviroment essays

PCB's and the enviroment essays Life is a precious element to a broad range of creatures. When a chemical toxin invades life's environment, we should all be concerned. Polychlorinated biphenyls (PCBs) are a group of chemical compounds that are invading and polluting the environment. They cause severe health problems in humans and affect many creatures in nature. Scientist found high PCB levels in two orca whales that washed up dead last February near the Strait of Juan de Fuca (Ko, 2002). The United States Environmental Protection Agency claims they are quick to act on all PCB discoveries, but it may be too late. There are some remedies to remove PCBs from the environment, but it doesn't take care of the entire problem. Polychlorinated biphenyls are a group of chemicals compounds that have no molecular breakdown. They were used by the industrial manufacturing industry between 1930-1970. They were primarily used as electrical insulators in transformers and other electrical equipment. They were also used in a variety of products such as: power saws, typewriters, cereal boxes, and bread wrappers (Heimlich, 2002). They were released into the environment during their use by smokestacks, leakage of old equipment, leaching from landfills, and other polluted sediments. In 1976 after growing concerns and findings of high levels of PCBs in the environment; Congress banned all uses including the processing and distribution of PCBs (U.S. Environmental Protection Agency [EPA], 2002). These chemicals have filtered into every aspect of the environment. It has seeped into the soil and been carried down streams into our oceans. The toxic effects of PCBs include the death of animals, low growth rate in plants, and severe health problems in humans (Heimlich, 2002). According to an EPA study that was completed in 1987; chronic exposure to PCBs can cause cancer (EPA, 2002). It can also affect the reproductive system, immune system, and the nervous system. Ther...

Friday, November 22, 2019

Free sample - Should local sales tax be increased or decreased. translation missing

Should local sales tax be increased or decreased. Should local sales tax be increased or decreasedContent of the problem Currently, taxes added on top of prices of goods or services that are purchased within a country are either being increased or decreased depending on the country. Sale tax is a consumption that is displayed as a percentage of the sale price. It is vital to assess sale taxes in every state, county or municipal level in order to determine the amount that is being taxed and can help in knowing whether to increase or to decrease. The biggest problem with sales tax evaluation is the state-local tax burden due to increasing population and changes in the tax policies is also another area that is supposed to be considered. In the past it was a bit different since most of the states’ population was not so high and thus it was easy to determine whether sales tax be increased or decreased. But as time has moved, this has been witnessed to have taken another different direction and the states’ population must be put into consideration since most of this has to determine the increase or decrease of sale tax in every state (Frederick, 315). Statement of the problem In the today’s world, employment has hit and most of the people graduate and do not get job and thus imposing sales tax on such people may deem to be the biggest problem. The tax imposed on property is also important on the other hand as it helps in ensuring that it is used in curing the budget. This is due to the fact that revenue gotten from corporate net is usually viewed as volatile, especially in cases whereby recession and therefore it will be unworthy to states to lean heavily on it. Even though the income tax increase helps in budget deficit, raising the income tax by even just 5% would lead to a drop on the tax Foundation’s Tax Climate Index. This may also lead to not having lower personal income tax in such regions.   This may also lead to the corporate income tax to drop even further. And also, in increasing the tax of corporate income may set a state an even bigger fall in the future and that is really a demerit. This paper will look at the barriers of sales tax increase and decrease since this is a tool that will in turn help in determining whether to increase or decrease sales tax in any state. This can be done through in co-operating some programs into the scheme of sale tax evaluation system. Research question Given that it is important to determine whether to increase or decrease the sales tax in any given state; there are a number of questions that must be put into consideration. Since sale tax is also important to the government, it is vital for the government to treat those contributing to tax revenue as important figures in the society. This in turn will make not to appear as a burden to those contributing to sale tax (Merriman, 21). Nonetheless, in order to gather the required information regarding sales tax increase or decrease it is vital to address the following questions during the research process: a)  Ã‚  Ã‚  Ã‚  Ã‚   How imperative is tax reduction or increase to both the government and the citizens? b)  Ã‚  Ã‚  Ã‚  Ã‚   Are there some economy tax credit programs that can be employed instead of just increasing or decreasing the sales tax and how is it helpful to the common man? c)  Ã‚  Ã‚  Ã‚  Ã‚   What is the purpose of considering change in tax policy and can this help in tax expenditure justification? d)  Ã‚  Ã‚  Ã‚   What are the cautions for both tax increase and tax decrease?  Ã‚  Ã‚      Significance of the study According to research carried by Arnold in 2004, (228) in both the United States and the whole world at large it is vital not to impose so much tax on the common man as this will have tremendous effect in future, either positive or negative. Even though most citizens suffer from high taxation, it is vital not to increase the sales tax to the common man and impose tax on goods and services rendered internationally. This proposal aims at looking into ways in which sales tax can be imposed without causing any havoc to the common man and thus improves the economy of the country. This must also focus on developing a positive attitude to those imposing tax on property without experiencing state-local tax burden. This is important since it is used to determine how Tax Foundation yearly calculation concerning how heavy the state-local tax burden is for the population in any given state (Rodgers, 229). Objectives of the study Just like any incentive program, it is vital to look at the objectives, basically in numeric terms. This specifically helps in determining the final result such as increasing sales, or purchase by your reseller. Some of the objectives include:    i)  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Obtaining a certain percentage of shares for a new product in its full year. ii)  Ã‚  Ã‚  Ã‚  Ã‚   Increasing the percentage of sales. iii)  Ã‚  Ã‚   Increase the number of showroom displays in both local and international market. iv)  Ã‚  Ã‚   Increase the number of people participating in product training programs.      Research Design and Methodology This research study will focus on both the quantitative and qualitative approach since it requires collection of data and carrying out of surveys in relation to the past sales tax estimations and calculations. Another approach will be the descriptive since it will require first hand information from previous research in order to avoid misunderstanding. Finally the research will carry our surveys by interviewing the concerned using semi-structured questioners.   Conclusion It is vital to look at the disadvantages and advantages associated with sales tax increase and decrease. This is likely to help determine which one is the most appropriate option. All in all it is also significant to understand the limitation of the research process since it can be applied as a cautionary measure before deciding on which way to go. It is vital to understand that fiscal problems should not be addressed by tax alone (Arnold, 229).    Work Cited Arnold, Raphaelson, "The Property Tax," in J. Richard Aronson and Eli Schwartz, eds., Management Policies in Local Government Finances, 3rd edition, (2004) p. 229 Frederick, Stocker. "Diversification of the Local Revenue System: Income and Sales Taxes, User Charges, Federal Grants," National Tax Journal, September (2006), p. 315 Merriman, David. The Control of Municipal Budgets: Toward the Effective Design of Tax and Expenditure Limitations. (New York: Quorum Books, (2001), pp. 20-23 Rodgers, James. "Sales Taxes, Income Taxes, and Other Nonproperty Revenues, " in J. Richard Aronson and Eli Schwartz, eds., Management Policies in Local Government Finance, Third Edition (Washington, DC: International City Management Association, (1997), p. 229. Sherwood-Call, "The Labor Tax as an Alternative Revenue Source," Proceedings of the Seventy-Ninth Annual Conference (Columbus, OH: National Tax Association, (2002), pp. 86-93

Thursday, November 21, 2019

Eating Attitude Test Research Paper Example | Topics and Well Written Essays - 2000 words

Eating Attitude Test - Research Paper Example A changed nutritional condition in individuals with eating disorders arises from the irregular or unusual eating patterns and attitudes and cognitive changes associated with the weight and food that are the main attributes of such disorders. Since eating attitudes and related behaviors differ considerably across patients and disorders, nutritional condition and consequent problems show significant variation. Nevertheless, a model for carrying out and assessing the nutritional evaluation of these patients can be helpful. Such a feature of assessment is a major part of the diagnosis for it allows continuous observation of the outcomes or impact of the intervention. Furthermore, it could help in the timely diagnosis of an emerging eating disorder or an at-risk person and hence could contribute to prevention. Due to the dominant belief that medical interviews are needed for diagnosis, self-assessment questionnaires evaluating such areas could be most helpful when used as screening instruments, as quantitative measures of the extent of eating-connected symptoms, and as indices of treatment effects and advancement. Among the instruments utilized for assessing eating-connected symptoms are Eating Attitudes Test (EAT); the Binge Eating Scale; and the EDI Symptom Checklist. Each instrument has been used in both research and medical settings and has been proven valid and reliable. The EAT was initially constructed to evaluate behaviors and attitudes typical of anorexic people. It not merely differentiates anorexic subjects from control groups but also differentiates bulimic ones from controls.  

Tuesday, November 19, 2019

Conventional Wars, Rules of Engagement, Chain of Command Essay

Conventional Wars, Rules of Engagement, Chain of Command - Essay Example The implementation of the rule of engagement led him to victories as his attacks were effectively launched. The chain of command broke down responsibilities based on the allocation of specific responsibilities at each position. In addition, each official reported to the one above them (Bevin, 2014). It shows the flow of duties through ranks, from the commander in chief of the armed forces to the individual soldiers in the field. The rules of engagement define the conduct of opposing sides in a war situation Napoleon’s military had individual soldiers in the field who executed decisions made by senior persons in authority. They were the junior most officials of his military. They formed the basis of every attack. Their fundamental task was going out to the battlefield and fighting their opponents. They focused on defeating their enemies in the shortest span of time. The process involved employing tactical methodologies and strategies in launching their attacks to force the opponents do things against their own will. This has always been the fundamental goal of any war (Greene, 2007). The attacks would be organized in troops that had adopted a policy that involved ambushing supply columns. The military had battalion commanders who would execute command from division commanders. The battalion commanders were second lowest in command. They directed orders to the soldiers in the field, who are a fundamental group to any military unit. They would mentor and coach their subordinate staff officers and company commanders. They would be involved in giving morale, enthusiasm in their organizations and training. This would eventually boost their performance at war and consequently lead them to victories. The battalion was capable of independent missions and operations of a specific period of time and scope The military had division commanders who would receive orders from the general. They directed their orders to the battalion commanders. They

Sunday, November 17, 2019

Material Selction Essay Example for Free

Material Selction Essay Park bench A park bench isn’t just for parks. It is an essential component of any public outdoor (or indoor) area. The 3 material I chosen ( wood concrete steel) These park benches provide strength and durability with a strong steel skeleton and high quality UV and weather resistant thermoplastic coating. One of the most popular bench styles, the thermoplastic coated steel park bench comes in a range of styles and colors. The thermoplastic coating protects the steel for years to come, and is maintenance and corrosive free. Made for the widest range of applications, these benches can be portable as well and permanent installs. Commercial park benches made with wood are always a top seller. Made usually of cedar, or pine, wood park benches offer strength and durability, reinforced with a welded metal frame construction for a long life. Wood is the popular choice also for its classic styling. When people think park bench, they will more than likely visualize a wood slat park bench with back and arms in an unfinished cedar nestled in a shady spot under an oak tree. This is obviously a great solution for a park, or outside of a mall but I would not recommend it for any city transit area. Other materials, like powder coated steel are better performers for high traffic. Concrete Park Benches are an inexpensive solution to a high traffic area. Dense and strong, anything concrete will last a long time and is ideal for parks, schools, bus stops, corporate break areas and rest stops, and other various street scapes or public areas. It is also resistant to vandalism and thievery due to its inherent density and bulk. It would be strenuous to attempt to move or damage one of these, making a concrete park bench the perfect solution for a permanent install. Hip joint The human hip is a ball and socket joint. This means that the top of the leg bone, the femur, is rounded and fits into the socket of the hip. This joint may need to be replaced if it has worn away, broken, or become chronically painful in some way. The process involves replacing the hip joint with 3 artificial parts, cup, ball, stem: Cup The cup is the most vital part of the hip joint process as the other 2 parts is dependable on the cup being good thus the material must not only be tough and strong but resistant to corrosion, degradation, and wear-.I chose the material ultra-high density polyethylene for the cup component in because of its outstanding toughness cut and wear resistance and its excellent chemical resistance. Fermoral ball – I chose the ceremaric material Zirconia for the head (ball) component in because of its Strength and Longevity, Zirconia is virtually indestructible ans should last a life ti. itcan be polished to give a very smooth surface and have a much lower wear rate than metal on polyethylene. Also using ceramics over metals for hip replacement parts are to do with the inherent biocompatibility of ceramic materials. Being highly oxidised, they are very inert and so the risk of any reactions with the host is negligible. However As with everything in life, all these benefits come with a price. Zirconia is very tough, which is good until you consider the abrasive effect of the material against the other compnenets. Fermoral stem – I chose the alloy material titanium for the stem component because not only does it have the combined properties of being light and strong it also allow for movement of the artificial hip joint with a minimal amount of friction. In addition, titanium are long lasting, strong and resistant to corrosion, degradation, and wear. Therefore, they will retain their strength and shape for a long time. Resistance to wear is particularly significant in maintaining proper joint function and preventing the further destruction of bone caused by particulate debris generated as the implant parts move against each other. However titanium is quite expensive.

Thursday, November 14, 2019

Proposal for the Installation of Emergency Telephones On Highways in Connecticut :: Proposal Paper

Proposal for the Installation of Emergency Telephones On Highways in Connecticut Introduction I propose to install emergency telephones along Connecticut highways. Connecticut highways do not provide immediate help for emergencies. Daily, there is a 50/50 change of an accident or emergency happening. There are 45 and up to 70 emergencies in the Greater Hartford area alone. Proposal This report proposes that emergency telephones be installed on Connecticut highways. They would offer efficient ways to get help immediately for emergency situations and also would decrease the chances of crime that may occur while people have to wait for help. Benefits The following is a list of advantages Connecticut drivers would have along our highways when there is an emergency: It would be possible to get efficient help if there is an emergency. You would not have to wait for someone to stop or a police cruiser to come along. You will not have to walk miles before you get to a gas station or pay phone for help. Senior citizens and handicapped people would not have to do either 2 or 3. The chances of a crime happening will be decreased greatly. CURRENT SITUATION Connecticut Highways Connecticut highways do not provide efficient or accessible ways to get help immediately. There are between 45 and 60 emergencies in the Greater Hartford area that require roadside assistance. Usually, those people are helped by the state police, which are usually efficient, but emergency telephones would help greatly. Increasing Crimes Crime in the Greater Hartford area has risen 70% since 1988 and is still rising. Many times it may be dangerous to get stuck on certain parts of our highways. Emergency Illness If there were an emergency illness of some sort, the victim would no doubt suffer a while before help would arrive. What would happen if someone was having a heart attack? Weather Conditions We also have to consider bad weather conditions. It is almost impossible for a senior citizen or handicapped person to walk to a gas station or pay phone for help in a snow storm. PROPOSAL FOR CHANGE Installing Emergency Telephones Installing emergency telephones will create safer driving along our highways. Whenever there is an immediate emergency, help will not be far away. Senior Citizens and Handicapped People Senior citizens and handicapped people would have a better chance of getting help whenever they need it. It will not be as difficult for them as it is now. Eliminate Chances for Crime Emergency telephones would also lessen the opportunities for criminals to prey upon the disabled.

Tuesday, November 12, 2019

Case Summary of Jamie Turner the Case Describes the Evolution

Case Summary of Jamie Turner The case describes the evolution of an interpersonal mismatch between a previously successful manager, Jamie Turner, and his new boss, Pat Cardullo. Turner, a 32 year old MBA graduate, has been recruited by Cardullo to be vice president of marketing and sales at Modern Lighting Industries, Inc. (MLI). MLI, a struggling regional distributor of industrial lighting systems and equipment based in Chicago, has recently been acquired by a division of the much larger San Diego-based Specialty Support Services (Triple S).Cardullo, the president of MLI, is the chief proponent of the Triple S acquisition, and he has told Turner to revive MLI, implying that if Turner succeeds he will soon advance to company president. It becomes apparent, however, that Cardullo and Turner have very different assumptions and expectations about turning MLI around. The case portrays Turner's developing problems and his unsuccessful attempts to resolve them, and also Cardullo's passage through several managerial challenges. Questions 1. Give a summary of the case. 2. What type of leadership style is shown in the case? 3. Pat Cardullo’s leadership style, is it right for Jamie turner? 4. Is the relationship between Pat Cardullo and Jamie turner is right? If not then give a description of the problem between their relationships. 5. What could be the solution of this problem? Give a long term solution for the future to avoid such type of problem. 6. If you are the C. E.O of the company then how you will solve the problem? * Some guidelines for report In the report you have to give a brief about the case as well as give your opinion about the problem. Mention the leadership theory shone in the case. There are also some questions to answer in the last page of the brief case. In the presentation slide you have to give a summary first. Then give the other points of the report. †¦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‚¬ ¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.

Saturday, November 9, 2019

Blood pressure Essay

Blood pressure (BP), sometimes referred to as arterial blood pressure, is the pressureexerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, â€Å"blood pressure† usually refers to thearterial pressure of the systemic circulation. During each heartbeat, blood pressure varies between a maximum (systolic) and a minimum (diastolic) pressure.[1] The blood pressure in the circulation is principally due to the pumping action of the heart.[2] Differences in mean blood pressure are responsible for blood flow from one location to another in the circulation. The rate of mean blood flow depends on the resistance to flow presented by the blood vessels. Mean blood pressure decreases as the circulating blood moves away from the heart through arteries and capillaries due to viscous losses of energy. Mean blood pressure drops over the whole circulation, although most of the fall occurs along the small arteries and arterioles.[3] Gravity affects blood pressure via hydrostatic forces (e.g., during standing) and valves in veins, breathing, and pumping from contraction of skeletal muscles also influence blood pressure in veins.[2] The measurement blood pressure without further specification usually refers to the systemic arterial pressure measured at a person’s upper arm and is a measure of the pressure in the brachial artery, major artery in the upper arm. A person’s blood pressure is usually expressed in terms of the systolic pressure over diastolic pressure and is measured in millimetres of mercury (mmHg), for example 120/80. The table on the right shows the classification of blood pressure adopted by the American Heart Association for adults who are 18 years and older.[4] It assumes the values are a result of averaging blood pressure readings measured at two or more visits to the doctor.[6][7] In the UK, blood pressures are usually categorised into three groups: low (90/60 or lower), high (140/90 or higher), and normal (values above 90/60 and below 130/80).[8][9] Normal range of blood pressure While average values for arterial pressure could be computed for any given population, there is often a large variation from person to person; arterial pressure also varies in individuals from moment to moment. Additionally, the average of any given population may have a questionable correlation with its general health; thus the relevance of such average values is equally questionable. However, in a study of 100 human subjects with no known history of hypertension, an average blood pressure of 112/64 mmHg was found,[10] which are currently classified as desirable or â€Å"normal† values. Normal values fluctuate through the 24-hour cycle, with highest readings in the afternoons and lowest readings at night.[11][12] Various factors, such as age and sex influence average values, influence a person’s average blood pressure and variations. In children, the normal ranges are lower than for adults and depend on height.[13] As adults age, systolic pressure tends to rise and diastolic tends to fall.[14] In the elderly, blood pressure tends to be above the normal adult range,[15] largely because of reduced flexibility of the arteries. Also, an individual’s blood pressure varies with exercise, emotional reactions, sleep, digestion and time of day. Differences between left and right arm blood pressure measurements tend to be random and average to nearly zero if enough measurements are taken. However, in a small percentage of cases there is a consistent difference greater than 10 mmHg which may need further investigation, e.g. for obstructive arterial disease.[16][17] The risk of cardiovascular disease increases progressively above 115/75 mmHg.[18] In the past, hypertension was only diagnosed if secondary signs of high arterial pressure were present, along with a prolonged high systolic pressure reading over several visits. Regarding hypotension, in practice blood pressure is considered too low only if noticeable symptoms are present.[5] Clinical trials demonstrate that people who maintain arterial pressures at the low end of these pressure ranges have much better long term cardiovascular health. The principal medical debate concerns the aggressiveness and relative value of methods used to lower pressures into this range for those who do not maintain such pressure on their own. Elevations, more commonly seen in older people, though often considered normal, are associated with increased morbidity and mortality. Physiology There are many physical factors that influence arterial pressure. Each of these may in turn be influenced by physiological factors, such as diet, exercise, disease, drugs or alcohol, stress, obesity, and so-forth.[20] Some physical factors are: †¢ Volume of fluid or blood volume, the amount of blood that is present in the body. The more blood present in the body, the higher the rate of blood return to the heart and the resulting cardiac output. There is some relationship between dietary salt intake and increased blood volume, potentially resulting in higher arterial pressure, though this varies with the individual and is highly dependent on autonomic nervous system response and the renin-angiotensin system.[21][22][23] †¢ Resistance. In the circulatory system, this is the resistance of the blood vessels. The higher the resistance, the higher the arterial pressure upstream from the resistance to blood flow. Resistance is related to vessel radius (the larger the radius, the lower the resistance), vessel length (the longer the vessel, the higher the resistance), blood viscosity, as well as the smoothness of the blood vessel walls. Smoothness is reduced by the build up of fatty deposits on the arterial walls. Substances called vasoconstrictors can reduce the size of blood vessels, thereby increasing blood pressure. Vasodilators (such as nitroglycerin) increase the size of blood vessels, thereby decreasing arterial pressure. Resistance, and its relation to volumetric flow rate (Q) and pressure difference between the two ends of a vessel are described by Poiseuille’s Law. †¢ Viscosity, or thickness of the fluid. If the blood gets thicker, the result is an increase in arterial pressure. Certain medical conditionscan change the viscosity of the blood. For instance, anemia (low red blood cell concentration), reduces viscosity, whereas increased red blood cell concentration increases viscosity. It had been thought that aspirin and related â€Å"blood thinner† drugs decreased the viscosity of blood, but instead studies found[24] that they act by reducing the tendency of the blood to clot. In practice, each individual’s autonomic nervous system responds to and regulates all these interacting factors so that, although the above issues are important, the actual arterial pressure response of a given individual varies widely because of both split-second and slow-moving responses of the nervous system and end organs. These responses are very effective in changing the variables and resulting blood pressure from moment to moment. Moreover, blood pressure is the result of cardiac output increased by peripheral resistance: blood pressure = cardiac output Xperipheral resistance. As a result, an abnormal change in blood pressure is often an indication of a problem affecting the heart’s output, the blood vessels’ resistance, or both. Thus, knowing the patient’s blood pressure is critical to assess any pathology related to output and resistance. Mean arterial pressure The mean arterial pressure (MAP) is the average over a cardiac cycle and is determined by the cardiac output (CO), systemic vascular resistance (SVR), and central venous pressure (CVP),[25] Curve of the arterial pressure during one cardiac cycle The up and down fluctuation of the arterial pressure results from the pulsatile nature of thecardiac output, i.e. the heartbeat. The pulse pressure is determined by the interaction of thestroke volume of the heart, compliance (ability to expand) of the aorta, and the resistance to flow in the arterial tree. By expanding under pressure, the aorta absorbs some of the force of the blood surge from the heart during a heartbeat. In this way, the pulse pressure is reduced from what it would be if the aorta wasn’t compliant.[26] The loss of arterial compliance that occurs with aging explains the elevated pulse pressures found in elderly patients. The pulse pressure can be simply calculated from the difference of the measured systolic and diastolic pressures,[26] Arm–leg gradient The arm–leg (blood pressure) gradient is the difference between the blood pressure measured in the arms and that measured in the legs. It is normally less than 10 mmHg,[27] but may be increased in e.g. coarctation of the aorta.[27] Vascular resistance The larger arteries, including all large enough to see without magnification, are conduits with low vascular resistance (assuming no advanced atherosclerotic changes) with high flow rates that generate only small drops in pressure. The smaller arteries and arterioles have higher resistance, and confer the main drop in blood pressure along the circulatory system. Vascular pressure wave Modern physiology developed the concept of the vascular pressure wave (VPW). This wave is created by the heart during the systoleand originates in the ascending aorta. Much faster than the stream of blood itself, it is then transported through the vessel walls to the peripheral arteries. There the pressure wave can be palpated as the peripheral pulse. As the wave is reflected at the peripheral veins, it runs back in a centripetal fashion. When the reflected wave meets the next outbound pressure wave, the pressure inside the vessel rises higher than the pressure in the aorta. This concept explains why the arterial pressure inside the peripheral arteries of the legs and arms is higher than the arterial pressure in the aorta,[28][29][30] and in turn for the higher pressures seen at the ankle compared to the arm with normal ankle brachial pressure index values. Regulation The endogenous regulation of arterial pressure is not completely understood, but the following mechanisms of regulating arterial pressure have been well-characterized: †¢ Baroreceptor reflex: Baroreceptors in the high pressure receptor zones detect changes in arterial pressure. These baroreceptors send signals ultimately to the medulla of the brain stem, specifically to the Rostral ventrolateral medulla (RVLM). The medulla, by way of the autonomic nervous system, adjusts the mean arterial pressure by altering both the force and speed of the heart’s contractions, as well as the total peripheral resistance. The most important arterial baroreceptors are located in the left and rightcarotid sinuses and in the aortic arch.[31] †¢ Renin-angiotensin system (RAS): This system is generally known for its long-term adjustment of arterial pressure. This system allows the kidney to compensate for loss in blood volume or drops in arterial pressure by activating an endogenous vasoconstrictorknown as angiotensin II. †¢ Aldosterone release: This steroid hormone is released from the adrenal cortex in response to angiotensin II or high serum potassiumlevels. Aldosterone stimulates sodium retention and potassium excretion by the kidneys. Since sodium is the main ion that determines the amount of fluid in the blood vessels by osmosis, aldosterone will increase fluid retention, and indirectly, arterial pressure. †¢ Baroreceptors in low pressure receptor zones (mainly in the venae cavae and the pulmonary veins, and in the atria) result in feedback by regulating the secretion of antidiuretic hormone (ADH/Vasopressin), renin and aldosterone. The resultant increase inblood volume results an increased cardiac output by the Frank–Starling law of the heart, in turn increasing arterial blood pressure. These different mechanisms are not necessarily independent of each other, as indicated by the link between the RAS and aldosterone release. Currently, the RAS is targeted pharmacologically by ACE inhibitors and angiotensin II receptor antagonists. The aldosterone system is directly targeted by spironolactone, an aldosterone antagonist. The fluid retention may be targeted by diuretics; the antihypertensive effect of diuretics is due to its effect on blood volume. Generally, the baroreceptor reflex is not targeted in hypertensionbecause if blocked, individuals may suffer from orthostatic hypotension and fainting. Measurement A medical student checking blood pressure using a sphygmomanometer and stethoscope. Arterial pressure is most commonly measured via a sphygmomanometer, which historically used the height of a column of mercury to reflect the circulating pressure.[32] Blood pressure values are generally reported in millimetres of mercury (mmHg), though aneroid and electronic devices do not use mercury. For each heartbeat, blood pressure varies between systolic and diastolic pressures. Systolic pressure is peak pressure in the arteries, which occurs near the end of the cardiac cyclewhen the ventricles are contracting. Diastolic pressure is minimum pressure in the arteries, which occurs near the beginning of the cardiac cycle when the ventricles are filled with blood. An example of normal measured values for a resting, healthy adult human is 120 mmHgsystolic and 80 mmHg diastolic (written as 120/80 mmHg, and spoken [in the US and UK] as â€Å"one-twenty over eighty†). Systolic and diastolic arterial blood pressures are not static but undergo natural variations from one heartbeat to another and throughout the day (in a circadian rhythm). They also change in response to stress, nutritional factors, drugs, disease, exercise, and momentarily from standing up. Sometimes the variations are large. Hypertension refers to arterial pressure being abnormally high, as opposed to hypotension, when it is abnormally low. Along with body temperature, respiratory rate, and pulse rate, blood pressure is one of the four main vital signs routinely monitored by medical professionals and healthcare providers.[33] Measuring pressure invasively, by penetrating the arterial wall to take the measurement, is much less common and usually restricted to a hospital setting. Noninvasive The noninvasive auscultatory and oscillometric measurements are simpler and quicker than invasive measurements, require less expertise, have virtually no complications, are less unpleasant and less painful for the patient. However, noninvasive methods may yield somewhat lower accuracy and small systematic differences in numerical results. Noninvasive measurement methods are more commonly used for routine examinations and monitoring. [edit]Palpation A minimum systolic value can be roughly estimated by palpation, most often used in emergency situations, but should be used with caution.[34] It has been estimated that, using 50% percentiles, carotid, femoral and radial pulses are present in patients with a systolic blood pressure > 70 mmHg, carotid and femoral pulses alone in patients with systolic blood pressure of > 50 mmHg, and only a carotid pulse in patients with a systolic blood pressure of > 40 mmHg.[34] A more accurate value of systolic blood pressure can be obtained with a sphygmomanometer and palpating the radial pulse.[35] The diastolic blood pressure cannot be estimated by this method.[36] The American Heart Association recommends that palpation be used to get an estimate before using the auscultatory method. Auscultatory Auscultatory method aneroid sphygmomanometer with stethoscope Mercury manometer The auscultatory method (from the Latin word for â€Å"listening†) uses a stethoscope and asphygmomanometer. This comprises an inflatable (Riva-Rocci) cuff placed around the upperarm at roughly the same vertical height as the heart, attached to a mercury or aneroidmanometer. The mercury manometer, considered the gold standard, measures the height of a column of mercury, giving an absolute result without need for calibration and, consequently, not subject to the errors and drift of calibration which affect other methods. The use of mercury manometers is often required in clinical trials and for the clinical measurement of hypertension in high-risk patients, such as pregnant women. A cuff of appropriate size is fitted smoothly and snugly, then inflated manually by repeatedly squeezing a rubber bulb until the artery is completely occluded. Listening with the stethoscope to the brachial artery at the elbow, the examiner slowly releases the pressure in the cuff. When blood just starts to flow in the artery, the turbulent flow creates a â€Å"whooshing† or pounding (first Korotkoff sound). The pressure at which this sound is first heard is the systolic blood pressure. The cuff pressure is further released until no sound can be heard (fifth Korotkoff sound), at the diastolic arterial pressure. The auscultatory method is the predominant method of clinical measurement.[37] Oscillometric The oscillometric method was first demonstrated in 1876 and involves the observation of oscillations in the sphygmomanometer cuff pressure[38] which are caused by the oscillations of blood flow, i.e., the pulse.[39] The electronic version of this method is sometimes used in long-term measurements and general practice. It uses a sphygmomanometer cuff, like the auscultatory method, but with an electronic pressure sensor (transducer) to observe cuff pressure oscillations, electronics to automatically interpret them, and automatic inflation and deflation of the cuff. The pressure sensor should be calibrated periodically to maintain accuracy. Oscillometric measurement requires less skill than the auscultatory technique and may be suitable for use by untrained staff and for automated patient home monitoring. The cuff is inflated to a pressure initially in excess of the systolic arterial pressure and then reduced to below diastolic pressure over a period of about 30 seconds. When blood flow is nil (cuff pressure exceeding systolic pressure) or unimpeded (cuff pressure below diastolic pressure), cuff pressure will be essentially constant. It is essential that the cuff size is correct: undersized cuffs may yield too high a pressure; oversized cuffs yield too low a pressure. When blood flow is present, but restricted, the cuff pressure, which is monitored by the pressure sensor, will vary periodically in synchrony with the cyclic expansion and contraction of the brachial artery, i.e., it will oscillate. The values of systolic and diastolic pressure are computed, not actually measured from the raw data, using an algorithm; the computed results are displayed. Oscillometric monitors may produce inaccurate readings in patients with heart and circulation problems, which include arterial sclerosis, arrhythmia, preeclampsia, pulsus alternans, and pulsus paradoxus. In practice the different methods do not give identical results; an algorithm and experimentally obtained coefficients are used to adjust the oscillometric results to give readings which match the auscultatory results as well as possible. Some equipment uses computer-aided analysis of the instantaneous arterial pressure waveform to determine the systolic, mean, and diastolic points. Since many oscillometric devices have not been validated, caution must be given as most are not suitable in clinical and acute care settings. The term NIBP, for non-invasive blood pressure, is often used to describe oscillometric monitoring equipment. Continuous noninvasive techniques (CNAP) Continuous Noninvasive Arterial Pressure (CNAP) is the method of measuring arterial blood pressure in real-time without any interruptions and without cannulating the human body. CNAP combines the advantages of the following two clinical â€Å"gold standards†: it measures blood pressure continuously in real-time like the invasive arterial catheter system and it is noninvasive like the standard upper arm sphygmomanometer. Latest developments in this field show promising results in terms of accuracy, ease of use and clinical acceptance. Non-occlusive techniques: the Pulse Wave Velocity (PWV) principle Since the 90s a novel family of techniques based on the so-called Pulse wave velocity (PWV) principle have been developed. These techniques rely on the fact that the velocity at which an arterial pressure pulse travels along the arterial tree depends, among others, on the underlying blood pressure.[40] Accordingly, after a calibration maneuver, these techniques provide indirect estimates of blood pressure by translating PWV values into blood pressure values.[41] The main advantage of these techniques is that it is possible to measure PWV values of a subject continuously (beat-by-beat), without medical supervision, and without the need of inflating brachial cuffs. PWV-based techniques are still in the research domain and are not adapted to clinical settings. White-coat hypertension For some patients, blood pressure measurements taken in a doctor’s office may not correctly characterize their typical blood pressure.[42] In up to 25% of patients, the office measurement is higher than their typical blood pressure. This type of error is calledwhite-coat hypertension (WCH) and can result from anxiety related to an examination by a health care professional.[43] The misdiagnosis of hypertension for these patients can result in needless and possibly harmful medication. WCH can be reduced (but not eliminated) with automated blood pressure measurements over 15 to 20 minutes in a quiet part of the office or clinic.[44] Debate continues regarding the significance of this effect.[citation needed] Some reactive patients will react to many other stimuli throughout their daily lives and require treatment. In some cases a lower blood pressure reading occurs at the doctor’s office.[45] Home monitoring Ambulatory blood pressure devices that take readings every half hour throughout the day and night have been used for identifying and mitigating measurement problems like white-coat hypertension. Except for sleep, home monitoring could be used for these purposes instead of ambulatory blood pressure monitoring.[46] Home monitoring may be used to improve hypertension management and to monitor the effects of lifestyle changes and medication related to blood pressure.[6] Compared to ambulatory blood pressure measurements, home monitoring has been found to be an effective and lower cost alternative,[46][47][48] but ambulatory monitoring is more accurate than both clinic and home monitoring in diagnosing hypertension. Ambulatory monitoring is recommended for most patients before the start of antihypertensive drugs.[49] Aside from the white-coat effect, blood pressure readings outside of a clinical setting are usually slightly lower in the majority of people. The studies that looked into the risks from hypertension and the benefits of lowering blood pressure in affected patients were based on readings in a clinical environment. When measuring blood pressure, an accurate reading requires that one not drink coffee, smoke cigarettes, or engage in strenuous exercise for 30 minutes before taking the reading. A full bladder may have a small effect on blood pressure readings; if the urge to urinate arises, one should do so before the reading. For 5 minutes before the reading, one should sit upright in a chair with one’s feet flat on the floor and with limbs uncrossed. The blood pressure cuff should always be against bare skin, as readings taken over a shirt sleeve are less accurate. During the reading, the arm that is used should be relaxed and kept at heart level, for example by resting it on a table.[50] Since blood pressure varies throughout the day, measurements intended to monitor changes over longer time frames should be taken at the same time of day to ensure that the readings are comparable. Suitable times are: †¢ immediately after awakening (before washing/dressing and taking breakfast/drink), while the body is still resting, †¢ immediately after finishing work. Automatic self-contained blood pressure monitors are available at reasonable prices, some of which are capable of Korotkoff’s measurement in addition to oscillometric methods, enabling irregular heartbeat patients to accurately measure their blood pressure at home. Invasive Arterial blood pressure (BP) is most accurately measured invasively through an arterial line. Invasive arterial pressure measurement with intravascular cannulae involves direct measurement of arterial pressure by placing a cannula needle in an artery (usually radial, femoral,dorsalis pedis or brachial). The cannula must be connected to a sterile, fluid-filled system, which is connected to an electronic pressure transducer. The advantage of this system is that pressure is constantly monitored beat-by-beat, and a waveform (a graph of pressure against time) can be displayed. This invasive technique is regularly employed in human and veterinary intensive care medicine, anesthesiology, and for research purposes. Cannulation for invasive vascular pressure monitoring is infrequently associated with complications such as thrombosis, infection, andbleeding. Patients with invasive arterial monitoring require very close supervision, as there is a danger of severe bleeding if the line becomes disconnected. It is generally reserved for patients where rapid variations in arterial pressure are anticipated. Invasive vascular pressure monitors are pressure monitoring systems designed to acquire pressure information for display and processing. There are a variety of invasive vascular pressure monitors for trauma, critical care, and operating room applications. These include single pressure, dual pressure, and multi-parameter (i.e. pressure / temperature). The monitors can be used for measurement and follow-up of arterial, central venous, pulmonary arterial, left atrial, right atrial, femoral arterial, umbilical venous, umbilical arterial, and intracranial pressures. Fetal blood pressure Further information: Fetal circulation#Blood pressure In pregnancy, it is the fetal heart and not the mother’s heart that builds up the fetal blood pressure to drive its blood through the fetal circulation. The blood pressure in the fetal aorta is approximately 30 mmHg at 20 weeks of gestation, and increases to approximately 45 mmHg at 40 weeks of gestation.[51] The average blood pressure for full-term infants: Systolic 65–95 mm Hg Diastolic 30–60 mm Hg[52] Blood pressure is the measurement of force that is applied to the walls of the blood vessels as the heart pumps blood throughout the body.[53] The human circulatory system is 400,000 miles long, and the magnitude of blood pressure is not uniform in all the blood vessels in the human body. The blood pressure is determined by the diameter, flexibility and the amount of blood being pumped through the blood vessel.[53] Blood pressure is also affected by other factors including exercise, stress level, diet and sleep. The average normal blood pressure in the brachial artery, which is the next direct artery from the aorta after the subclavian artery, is 120mmHg/80mmHg. Blood pressure readings are measured in millimeters of mercury (mmHg) using sphygmomanometer. Two pressures are measured and recorded namely as systolic and diastolic pressures. Systolic pressure reading is the first reading, which represents the maximum exerted pressure on the vessels when the heart contracts, while the diastolic pressure, the second reading, represents the minimum pressure in the vessels when the heart relaxes.[54] Other major arteries have similar levels of blood pressure recordings indicating very low disparities among major arteries. The innominate artery, the average reading is 110/70mmHg, the right subclavian artery averages 120/80 and the abdominal aorta is 110/70mmHg.[55] The relatively uniform pressure in the arteries indicate that these blood vessels act as a pressure reservoir for fluids that are transported within them. Pressure drops gradually as blood flows from the major arteries, through the arterioles, the capillaries until blood is pushed up back into the heart via the venules, the veins through the vena cava with the help of the muscles. At any given pressure drop, the flow rate is determined by the resistance to the blood flow. In the arteries, with the absence of diseases, there is very little or no resistance to blood. The vessel diameter is the most principal determinant to control resistance. Compared to other smaller vessels in the body, the artery has a much bigger diameter (4mm), therefore the resistance is low.[55] In addition, flow rate (Q) is also the product of the cross-sectional area of the vessel and the average velocity (Q = AV). Flow rate is directly proportional to the pressure drop in a tube or in this case a vessel. ∆P ÃŽ ± Q. The relationship is further described by Poisseulle’s equation ∆P = 8 µlQ/Ï€r4.[56] As evident in the Poisseulle’s equation, although flow rate is proportional to the pressure drop, there are other factors of blood vessels that contribute towards the difference in pressure drop in bifurcations of blood vessels. These include viscosity, length of the vessel, and radius of the vessel. Factors that determine the flow’s resistance as described by Poiseuille’s relationship: †¢ ∆P: pressure drop/gradient †¢  µ: viscosity †¢ l: length of tube. In the case of vessels with infinitely long lengths, l is replaced with diameter of the vessel. †¢ Q: flow rate of the blood in the vessel †¢ r: radius of the vessel Assuming steady, laminar flow in the vessel, the blood vessels behavior is similar to that of a pipe. For instance if p1 and p2 are pressures are at the ends of the tube, the pressure drop/gradient is:[57] In the arterioles blood pressure is lower than in the major arteries. This is due to bifurcations, which cause a drop in pressure. The more bifurcations, the higher the total cross-sectional area, therefore the pressure across the surface drops. This is why the arterioles have the highest pressure-drop. The pressure drop of the arterioles is the product of flow rate and resistance: ∆P=Q xresistance. The high resistance observed in the arterioles, which factor largely in the ∆P is a result of a smaller radius of about 30  µm.[58] The smaller the radius of a tube, the larger the resistance to fluid flow. Immediately following the arterioles are the capillaries. Following the logic obvserved in the arterioles, we expect the blood pressure to be lower in the capillaries compared to the arterioles. Since pressure is a function of force per unit area, (P = F/A), the larger the surface area, the lesser the pressure when an external force acts on it. Though the radii of the capillaries are very small, the network of capillaries have the largest surface area in the vascular network. They are known to have the largest surface area (485mm) in the human vascular network. The larger the total cross-sectional area, the lower the mean velocity as well as the pressure.[55] Reynold’s number also affects the blood flow in capillaries. Due to its smaller radius and lowest velocity compared to other vessels, the Reynold’s number at the capillaries is very low, resulting in laminar instead of turbulent flow.[59] The Reynold’s number (denoted NR or Re) is a relationship that helps determine the behavior of a fluid in a tube, in this case blood in the vessel. The equation for this dimensionless relationship is written as:[56] †¢ Ï : density of the blood †¢ v: mean velocity of the blood †¢ L: characteristic dimension of the vessel, in this case diameter †¢ ÃŽ ¼: viscosity of blood The Reynold’s number is directly proportional to the velocity and diameter of the tube. Note that NR is directly proportional to the mean velocity as well as the diameter. A Reynold’s number of less than 2300 is laminar fluid flow, which is characterized by constant flow motion, whereas a value of over 4000, is represented as turbulent flow. Turbulent flow is characterized as chaotic and irregular flow.[56] Disorders Disregulation disorders of blood pressure control include high blood pressure, blood pressure that is too low, and blood pressure that shows excessive or maladaptive fluctuation. High Main article: Hypertension Overview of main complications of persistent high blood pressure. Arterial hypertension can be an indicator of other problems and may have long-term adverse effects. Sometimes it can be an acute problem, for examplehypertensive emergency. All levels of arterial pressure put mechanical stress on the arterial walls. Higher pressures increase heart workload and progression of unhealthy tissue growth (atheroma) that develops within the walls of arteries. The higher the pressure, the more stress that is present and the more atheroma tend to progress and the heart muscle tends to thicken, enlarge and become weaker over time. Persistent hypertension is one of the risk factors for strokes, heart attacks,heart failure and arterial aneurysms, and is the leading cause of chronic renal failure. Even moderate elevation of arterial pressure leads to shortened life expectancy. At severely high pressures, mean arterial pressures 50% or more above average, a person can expect to live no more than a few years unless appropriately treated.[60] In the past, most attention was paid to diastolic pressure; but nowadays it is recognised that both high systolic pressure and high pulse pressure (the numerical difference between systolic and diastolic pressures) are also risk factors. In some cases, it appears that a decrease in excessive diastolic pressure can actually increase risk, due probably to the increased difference between systolic and diastolic pressures (see the article on pulse pressure). If systolic blood pressure is elevated (>140) with a normal diastolic blood pressure (

Thursday, November 7, 2019

A Perspective on Why Abortion Isnt Murder

A Perspective on Why Abortion Isn't Murder The question of whether or not abortion is murder is one of the most contentious social and political issues of the day. Although the United States Supreme Court decision Roe v. Wade legalized abortion in 1973, the morality of terminating a pregnancy has been debated in the U.S. since at least the mid-1800s. A Brief History of Abortion Although abortions were performed in colonial America, they were not considered illegal or immoral. Premarital sex, however, was outlawed, which may have contributed to abortion being considered taboo by some. As in Great Britain, a fetus was not considered to be a living being until quickening, usually 18 to 20 weeks, when the mother could feel her unborn child move. Attempts to criminalize abortion began in Britain in 1803, when the procedure was outlawed if the quickening had already occurred. Further restrictions were passed in 1837.  In the U.S., attitudes toward abortion began to shift after the Civil War. Led by physicians who saw the practice as a threat to their profession and people opposed to the emerging womens rights movement, anti-abortion laws were passed in a majority of states by the 1880s. The outlawing of abortion in the U.S. did not make the practice disappear, however. Far from it. By the middle of the 20th century, it is estimated that as many as 1.2 million abortions were performed annually in the U.S. Because the procedure remained illegal, however, many women were forced to seek out abortionists who worked in unsanitary conditions or had no medical training, leading to the unnecessary deaths of countless patients due to infection or hemorrhaging. As the feminist movement gained steam in the 1960s, the push to legalize abortion gained momentum. By 1972, four states had repealed their abortion restrictions and another 13 had loosened them. The following year, the U.S. Supreme Court ruled 7 to 2 that women had a right to an abortion, although states could impose restrictions on the practice. Is Abortion Murder? Despite or perhaps because of the Supreme Court ruling, abortion continues to be a hotly debated issue today. Many states have imposed severe restrictions on the practice, and religious and conservative politicians often frame the issue as one of morality and preserving the sanctity of life. Murder, as it is typically defined, involves the intentional death of another human person. Even if one were to assume that every embryo or fetus is as sentient as a grown human being, the lack of intent would still be enough to classify abortion as something other than murder. A Hypothetical Argument Lets imagine a scenario in which two men go deer hunting. One man mistakes his friend for a deer, shoots him, and accidentally kills him. Its hard to imagine that any reasonable person would describe this as murder, even though we would all know for certain that a real, sentient human person was killed. Why? Because the shooter thought he was killing a deer, something other than a real, sentient human person. Now consider the example of abortion. If a woman and her physician think theyre killing a non-sentient organism, then they would not be committing murder. At most, they would be guilty of involuntary manslaughter. But even involuntary manslaughter involves criminal negligence, and it would be very hard to judge someone criminally negligent for not personally believing that a pre-viable embryo or fetus is a sentient human person when we dont actually know this to be the case. From the point of view of someone who believes that every fertilized egg is a sentient human person, abortion would be horrific, tragic, and lethal. But it would be no more murderous than any other kind of accidental death. Sources Ravitz, Jessica. The Surprising History of Abortion in the United States. CNN.com. 27 June 2016.  BBC staff. Historial Attitudes to Abortion. BBC.co.uk. 2014.Carmon, Irin. A Brief History of Abortion Law in America. BillMoyers.com. 14 November 2017.Gold, Rachel Benson. Lessons from before Roe: Will Past be Prologue? Guttmacher.org. 1 March 2003.

Tuesday, November 5, 2019

How to write a winning business plan - Emphasis

How to write a winning business plan How to write a winning business plan Whether youre setting up a new business venture or trying to get the go-ahead for a project, theres one essential document you need. Rob Ashton, Chief Executive of Emphasis, gives a step-by-step guide to writing a good business plan. Why you need one Theres a memorable conversation in Lewis Carrolls novel Alice in Wonderland, where Alice asks the Cheshire cat for directions. She says it doesnt matter where she gets to, as long as she gets somewhere. This leads the cat to reply: Then it doesnt matter which way you go. If you dont have a crystal-clear vision of where you want your business to go, youll be as confused as Alice when you hit a crossroads. Your business plan is your route to growth and success. But in order to write it, you need to know what you really want to achieve. This means youll have to spend time examining the strengths and weaknesses of your business, a process that has numerous pay-offs in itself. Researching your own company helps you to take a critical look at what you have to offer and who your competitors are. This enables you to better navigate the industry minefields and gives you a benchmark against which to measure success. Many people think of business plans as a necessary evil, written only to gain external funding. Instead, look at yours as an essential planning tool, whatever your financial situation. Remember, if you dont plan where to go, youre inadvertently planning on going nowhere. Crafting your business plan Heres a seven-step guide to writing your business plan. Work through each section and youll have an ordered, content-rich document that gets you where you want to go. Step one Description of the business After the executive summary (see step seven), the first thing youll need to do is describe your business. Get started by asking the following questions: What do I sell or offer? Why? To whom do I sell? What is the history of the business? What is my vision for the future? What is different about the services I offer? What is the legal structure of the company? Think about your audience carefully before you write the description. Ask yourself what words and phrases they will understand and be careful not to include too much jargon. Step two Market research Think about your industry and what you think the future trends will be. Then analyse your competition. Determine what size of the market they hold and then clearly define where you fit into the mix. Step three Marketing and sales strategy Ask yourself why companies buy what you offer, and how you sell it. Think about how you are going to reach the organisations that need your services and what pricing plans youll offer. Whether youre an in-house department, specialist contractor or a large multi-service company, therell be a variety of ways to reach prospective clients. Step four Management and personnel team Many facilities management companies claim that people are their best asset. Think carefully about your management team and outline the background, experience and qualifications of each individual. The people on your team will often make or break your success. Fully evaluate their credentials and look out for any skill gaps that could be improved with training. Step five Operations Analyse the location of your business, in terms of advantages and disadvantages. Your own premises, production facilities and IT systems must be excellent. Make sure you address any weaknesses in your plan with recommendations for improvement. Step six Financial forecast This section requires you to translate the contents of your plan into numbers. Include cash flow statements, profit and loss forecasts and a sales forecast. Dont forget that if youre looking for funding, you need to spell out how much you need and how youll repay the loan. Step seven The executive summary Leave this until last, even though it goes right at the beginning. Once youve followed all the other steps, youre in a position to write this stand-alone document, which outlines the key points in your entire plan. Keep it to a maximum of two pages. Remember, some people will only read this section so make it shine. Tip: rather than trying to distil the full document down, follow your original document plan. Just write less in each section this time (a couple of sentences or a paragraph, rather than several pages). Finally, the ink may be dry but your business is constantly changing. Your business plan is a dynamic document, so youll need to update it regularly.

Sunday, November 3, 2019

To what extent employee satisfaction is an antecedent for customer Dissertation

To what extent employee satisfaction is an antecedent for customer satisfaction and loyalty among Small and medium Enterprises - Dissertation Example logy 30 3.1 Research Philosophy 32 3.1.1 Phenomenological Style or Interpretivism 33 3.1.2 Positivist Style 33 3.2 Justification for Positivism Philosophy 34 3.3 Research Approach 35 3.3.1 Deductive Research 35 3.3.2 Inductive Research 36 3.3 Characteristics of this Research 37 3.4 Research Strategy 39 3.4.1 Qualitative Methodology 41 3.4.2 Quantitative Method 42 44 3.4.3 Semi-Structured Interviews 44 3.5 Time Horizon 45 3.5.2 Cross Sectional Perspective 46 3. 6 Data Collection Method 47 3.6.1 Secondary Data Collection 47 3.6.2 Observation 48 3.6.3 Interview 48 3.6.4 Sampling 49 3.6.5 Questionnaire Survey 50 3.7 Validity Testing 50 3.7.1 Construct Validity 50 3.7.2 Internal Validity 51 3.7.3 External Validity 51 3.7.4 Reliability 52 3.8 Analysis Tools 52 3.8.1Chi Square Test 52 3.8.2Â  Weighted Average Method 53 3.8.3 Karl Pearson’s Coefficient of Correlation 53 3.8.4 Percentage Analysis 54 3.8.5 Graphs 54 3.9 Ethical Considerations 54 4.2.1 Analysis 1 63 4.2.2 Analysis 2 66 4.2.3 Analysis 3 68 4.2.4 Analysis 4 70 70 4.2.5 Analysis 5 71 4.2.6 Analysis 6 74 4.2.8 Analysis 8 81 4.2.9 Analysis 9 & 10 84 4.2.10 Summary 86 Chapter 5 Conclusion 87 5.1 SME Retail Sector-Ireland 89 5.1.1 Competitive Advantage for Retail Stores 90 5.1.2 Human Resource Challenges 90 5.1.3 Marketing Challenge 91 5.1.4 Competitive Advantage through People 92 Chapter 6 Recommendation 93 Chapter 7 Self Reflection 94 7.1 Genesis of the Research Problem 94 7.2 My Concern 95 7.3 Collecting and Analyzing Data 95 7.6 Cost Management 98 7.7 Significance of the Research 99 7.8 Understanding Knowledge of Journal and Books 100 101 Reference 102 Journals 102 Books 107 Appendices 110 Appendix 1- Interview Transcript 110 Appendix 2- Questionnaire 113 List of Figures Fig 1: Competitive Advantage 13 Fig 2: Competitive Advantage through People 16 Fig 3- Employee Satisfaction 20 Fig 4: Customer Satisfaction & Employee Satisfaction 28 Fig 5: Customer Satisfaction 29 Fig 6: Research Method 32 Fig 7: D eductive Research 36 Fig 8: Inductive Research 37 Fig 9: Research Strategy 39 Fig 10: Qualitative versus Quantitative Analysis 44Fig 11: Service Profit Matrix 63 Fig 12: Distribution for Satisfied Population in Retail Stores 64 Fig 13: Distribution of Motivated Population 69 Fig 14: Key Motivators for Satisfaction 70 Fig 15: Correlation between Employee Satisfaction and Employee Motivation 74 Fig 16: Distribution of Engaged Employees 75 Fig 17: Variation in Employee Engagement and Employee Satisfaction 78 Fig 18: Correlation between Employee Commitment and Employee Engagement 81 List of Tables Table 1: Distribution for Satisfied Population in Retail Stores 63 Table 2: Satisfaction booster most favoured by employees 66 Table 3: Weighted Average of Satisfaction Booster most favoured by Employees 67 Table 4: Distribution of Job Satisfaction Booster 68 Table 5: Key Motivators 70 Table 6: Relational Matrix for Employee Commitment and Satisfaction 73 Table 7: Distribution of Employee Enga gement 75 Table 8: Dispersion between Employee Satisfaction and Engagement 77 Table 9: Relational Matrix between Employee Engagement and Commitment 80 Table 10: Observed Value 82 Table 11: Expected Value 83 Table 12: Chi Square Analysis 84 Table 13: Impact of Customer Care Service on Customer Satisfaction (X) 85 Table 14: Impact of Employee Satisfac