Ethical Issues In The ICU Essay

Medical practitioners are faced with the challenge of making decisions on whether to withhold or withdraw a patient’s life sustaining therapy in the intensive care unit. Intensive care units are departments which provide high quality and advanced forms of therapies to very ill patients in the intensive care unit at an increased cost. These patients’ expectations are high with regard to modern medicine, and as a result, have led to the rise of complex ethical issues in the ICU. Clinicians managing patients in the intensive care unit face many ethical problems during the patient’s routine care. This is seen in cases of withholding life sustaining therapy, withdrawing life sustaining therapy, informed consent and making decisions that affect the patients. Introduction Ethical related issues in the intensive care unit are a dilemma facing medical practitioners and nurses. This has affected the quality of care given to the patients in the ICU. Nurses responsible for caring for critically ill patients are faced with many ethical problems in the ICU due to the lack of enough full time critical care personnel and lack of enough funds to facilitate and run the intensive care units. A guideline on ethical issues in the intensive care unit demands that nurses offering critical care to patients apply the care with humanity by showing respect for the emotions and choices of the patients and their families. Nurses in this field are required to provide all necessary information to the patients and the family, counsel them and assist in interpreting the results so they can make well informed decisions. Nurses must consult with all physicians involved in the patients’ management. ethical problems facing nurses in he intensive care unit range from aggressive forms of treatment, following the wishes of the patients families to using extreme forms of reducing pain and assisted suicide and euthanasia.. Care of patients in the intensive care units involves aggressive forms of treatments with high risks associated with them and high-tech modern medicine which has higher risks than improving the patients’ prognosis. Critically ill patients and terminally ill patients who should be left to die in the comfort of their homes like in the earlier days are now made to undergo last minute aggressive treatments which may end up being no significant. In such cases when the treatment fails and the patient dies, the patients’ family blames the nurses and doctors for being insensitive to their wishes. Nurses are faced with the burden of not knowing where to draw the line between extending the natural process of dying by applying aggressive forms of medical care and when to apply life support systems. Ethics require that medical practitioners and nurses put the interests of their patients and their families’ first rather than applying futile medical technology to save the life of the patient or prolong their dying process against the family’s wishes. Nurses in the care of critically ill patients are required to set proper goals and interventions for terminal are of patients. End of life decisions should be made after consensus with all involved physicians. Critically ill patients in the intensive care unit get the most complex forms of treatment even in cases where their prognosis is poor. These patients also die under the most undesirable situations such as comatose conditions or under ventilatory support. Research studies have shown that critically ill patients are put through very aggressive forms of treatment which the clinicians would not want to undergo. The same studies have shown that the majority of patients in the intensive care unit are on a life-limiting care. Only very few patients in the intensive care unit receive full life support treatment and CPR. Most nurses and medical care givers are faced with the burden of choosing whether to resuscitate a patient or not when their prognosis is poor. Categories of ethical problems Cost reduction Critical care of patients in the intensive care unit is the most expensive form of treatment. Critical patients who die are said to accumulate more expenses than those who survive. This is because aggressive modern medicine for sustaining life is very expensive. Due to this the standard of care give in intensive care units has deteriorated as it focuses more on cost reduction rather than provision of quality health care. Medical care providers are often faced with the burden of how to establish when to provide full life support to patients and when to withdraw life sustaining support. These decisions are usually based on the patient’s age, type of illness or their prognosis. In effect the medical care providers are influenced to make biased decisions. Defining the standards of care to be given in the intensive care units is based on reducing the incurred costs. (Lo B. (2005). Quality of care Most health care institutions have developed strategies of limiting life support on critically ill patients. Families of critical patients may wish to write do not Resuscitate orders if their patient’s rate of survival is low. In case this is done, this category of patients receives less attention from medical personnel and less care from nurses. Strategies of limiting life support have been based on the patients’ age, prognosis and the family wishes. Patients who are categorized as old and with a poor prognosis tend to get less attention from the medical care providers and the care given to them is of less quality. Rather that receiving actual medical care these patients are given sedatives and narcotic analgesia. Terminally ill patients receive fewer medical interventions before death and are usually given narcotic analgesics to mitigate pain and sedatives to reduce their suffering. Ethical guidelines urge that all patients be given quality care irrespective of their condition but medical care providers often base their interventions on biased decisions. The concept of futility Medical care providers use the concept of futile therapy to withhold or withdraw life sustaining treatment. In the clinical practice very few things are of absolute certainty and so physicians must avoid making decisions based on the futility of the treatment. The outcome of CPR application cannot be based on whether the patients’ family signed the Do not Resuscitate order. Every other patient in the intensive care unit should be given quality care based on facts rather than assumptions. Decisions on withholding or withdrawing life support should be discussed with the patients or with their family members. This expresses respect for their rights and wishes and helps in avoiding conflicts which may lead to legal litigations. The medical personnel are faced with a dilemma in cases where the patient’s prognosis is poor and extending the natural process of dying through aggressive treatment would be futile. In such cases some family members could insist on sustaining the patients’ life. The medical personnel thus have no option in deciding what is best for the patient. Putting such a patient through aggressive treatment enables the family to understand the realities of the concept on withholding or withdrawing the life support. Autonomy This principle demands that no form of treatment should be administered to patients without their own approval or that of their family members, except in cases of emergency where immediate intervention is required. Patients and their families have the right to disapprove any form of treatment and their wishes should be respected. These wishes should be indicated on a written consent in form of advance directive. However, when writing the directive the patient may not have anticipated his present condition or he may decide to change his mind. Medical personnel are thus faced with burden of making the best decision for the patient by putting the patient’s interests first. In the intensive care unit, medical personnel deciding whether to apply CPR on a patient with a good prognosis or to follow his family wishes to withdraw life support. The reliability of family members to represent the best interests of the patients is questionable because some family members may want to withdraw the patient’s life support for their own selfish interests. As a result, doctors and nurses are required to make the best decision for the patient irrespective of the family’s wishes. (Pozgar G. D (2005). Euthanasia and assisted suicide Euthanasia is whereby a medical care provider administers a lethal dose to the patient while in assisted suicide the killing drug is self administered by the patient with the help of a physician. This practice is no widespread, although physicians all over the world are engaging in the practice. They justify their actions as a form of relieving their patients from pain and suffering. In some cases patients do not give consent for euthanasia but still physicians practice it. Most family members choose terminal sedation whereby patients are put in a comatose condition and then food and water is withdrawn. (Morton P. G (2005) Organ donation Patients in the intensive care unit requiring critical care may require an organ transplant to assist in sustaining their life. Patients and family members might have advance directives which disapprove the idea of organ transplants. Medical care givers have a difficult time determining whether a patient should receive an organ donation or not. Performing an organ transplant without the patients or family’s consent could lead to a legal litigation. (Melia K. M (2004). The principle of beneficence In this situation the medical care provider is faced with a moral dilemma in making the best decision fro the patient with regard to his interests rather than those of the family. The role of a physician to apply his best judgement for the patient’s interest is hindered by the patients’ family which rejects the concept of futility. Such family members impose unreasonable demands on the physician to extend the natural process of dying. This only prolongs the patient’s pain and suffering. Medical personnel should therefore be able to make the best decisions for the patients. Ethical issues in the nursing field hinder the ability of physicians to administer quality medical care to critical patients in the intensive care unit.  Physicians are urged to shoe humanity and compassion when applying intensive care to critical patients. Nurses and doctors should set goals and objectives when giving end of life care to patients with both good and poor prognosis. In regard to ethical issues in the intensive care unit, medical care givers should know that their duties are both directed towards the patients and the families. Before carrying out any medical treatment and procedure, nurses and doctors should obtain written consents form patients or their immediate family members to avoid ethical dilemmas which may lead to legal litigations.

Partners Healthcare Case Question

Portfolio Theory Case (Professor David Moreno) PARTNERS HEALTHCARE CASE The goal of this case is to teach to students the relevance of non traditional assets (as real states or commodities) in a well-diversified portfolio. Moreover, students will be able to practice with the most important concepts from portfolio theory as efficient frontier, dominated portfolios, Sharpe ratio, among others. In addition, students are learning how portfolio theory can be useful not only for portfolio managers but for any company or firm with some funds to manage.To do this case students must work in groups and, at the end, each group must give a printed copy of the answers to all these questions. Moreover, they should prepare a presentation in Power Point or Word answering these questions for their presentation on the classroom. Short Questions (You should answer these questions very shortly) 1. How do the hospitals obtain their profits? Why do the hospitals use or need the Long-Term Funds? Compute th e annual returns obtained by the LTP between 1995 and 2004 and represent them on a graph.In addition, what has the average return been during that time period? 2. According to the text the physician organizations or hospitals can invest their financial resources in several centrally-managed pools. What are these pools? How are they? 1 Portfolio Theory Case (Professor David Moreno) 3. The problem presented in the case is a typical problem of portfolio theory. Is it a security selection problem or an asset allocation problem? Explain the differences among them. 4. During the last years the Parthners Investment Comitte have introduced a new asset class, REITs and Commodity Index.Explain these non traditional assets and if in your own opinion they should be interesting or not. Long Questions (in this case you will be considered a portfolio manager trying to explain or to answer to these question in a company or comitte, then use everything you need, computer, graphs, mathematics,†¦ ) 1. Suppose different hospitals within the Partners system choose different mixes of the â€Å"riskfree† STP and the baseline LTP, whose future expected returns and risks are shown in Exhibit 3.On Exhibit 3, plot the returns and risks of the various potential portfolios that can be formed by allocating funds between the STP and baseline LTP. What shape does a line drawn through these portfolios take? Why? 2. On Exhibit 5, plot the curve for the risks and expected returns of the optimal portfolio combinations in the 4 asset case detailed in Exhibit 6, namely: US Equities, Foreign Equities, Bonds, and REITs. Do the same for the 4 asset case shown in Exhibit 7: US, Foreign, Bonds, and Commodities.Do the same for the 5 asset case detailed in Exhibit 8: US, Foreign, Bonds, REITs, and Commodities. How much does each of the â€Å"real assets† improve the potential opportunities for the hospitals investing in the LTP? 3. About the results in the previous point: What are the i mportant factors that determine the degree of improvement when non traditional assets are introduced? 2 Portfolio Theory Case (Professor David Moreno) 4.Consider the hospital that wishes to invest in the STP and the LTP such that the total expected return on the portfolio is 6%. How does the introduction of real assets alter the risk and composition of their most attractive portfolio? 5. Consider the hospital that is fully invested in the LTP with its current standard deviation and wishes to maintain this level of risk. How much does the introduction of real assets help them, if at all? If it was needed consider the possibility of taking short positions. 3

Assessing Leadership, Motivation, and Conflict Resolution through the Essay

Assessing Leadership, Motivation, and Conflict Resolution through the Myers-Briggs Personality Type Indicator - Essay Example The MBTI is determined based on seven (7) human mental underlying performances: verbal comprehension, word fluency, numerical, spatial, memory, perceptual speed, and inductive reasoning. These performances are generally grouped and classified into four (4) cognitive styles: (1) sensation/thinking; (2) intuition/thinking; (3) sensation/feeling; and (4) intuition/feeling. These cognitive styles helps assess the individual's leadership potential and skills, motivations as part of an organization and group, and abilities to resolve conflicts. The sensation/thinking or ST cognitive style individual utilizes perception and rational thinking in decision-making tasks. An intuition/thinking (NT) makes use of impersonal analysis based not on facts, but on "possibilities" or what the individual perceives as the proper basis for his/her assessment/judgment. A sensation/feeling (SF) individual combines both personal judgment and perception based on facts in assessing a particular task or developing decisions for the group. Lastly, the intuition/feeling (NF) person would most likely use personal judgment and personal perception when analyzing a problem or undertaking within a group or organization. Given these kinds of characteristics for each cognitive style, the MBTI helps assess leadership based on the manner at which the individual develops

Gun Control Research Paper Example | Topics and Well Written Essays - 500 words

Gun Control - Research Paper Example Strict laws should be conceded, necessitating gun holders to be certified in the similar way car motorists are certified. Earning a license should entail a background checks, fingerprinting, and firearm safety teaching (Gold 49). Guns acquisitions should be limited to one month. Rigid consequences should be passed for stealing a gun. Gun traders should also be accredited, and obligated to pay an annual fee to run the gun business. People believe having a gun in the home makes the home a safe place. In contrast, scholars argue guns at home are five times more probable to murder a resident of the family than a burglar to the home. People say they are scared everybody has a gun, so they purchase one for themselves, for defense (Goss 54). It is intended to engage civilians to assist in the usage and control of firearms, especially to safeguard the minds of children, who experience gun violence at tender ages, and have no support. In some areas, many of the children assume to die brutally, possibly by a gunshot. United States children do not have the liberty to trust that one day they will be adults. Even though United States is one of the world’s lushest, toughest, ablest nations, the degree of gun violence points it out as not being one of the safest nations to live in (Carter 67). In addition, this project intends to shed lights on physical and emotional consequences of gun violence, suffered by the affected individuals and their families. Coming up with enhancement programs is one of its goals, programs which will synthesize voluntary spending time with victims of gun violence, and their families, in order to gain an insight of the well rounded consequences suffered by the whole community at large (Goss 71). Gun violence control will require community support (Gold 53). Developing young people skills and minds, and providing them an opportunity to actively live and participate in violence free, caring, and supportive society, is one of the aims of this project.

Amazon.com as one of the largest online retail stores of the world Case Study

Amazon.com as one of the largest online retail stores of the world - Case Study Example By, 1996, Amazon became the World’s largest web retailer, earning about $15.6 revenues. After that, they established themselves as renowned online music retailers in the world. Answer 1 Though Amazon.com gets a huge success as world’s most preferred and trusted online book and music retailers, they are facing immense internal as well as external problems from different dimension like huge competition they are facing from the competitors (Dringoli 22). With the growing number of online book retailers and publishers, the competition has become immense among the competitors of online book stores like Amazon. The major competitors of Amazon.com are Barnes & Noble, Random House Inc publisher, etc. Barnes & Noble is considered as the largest competitor of Amazon.com as they have focused on differentiated products. Amazon.com has always believed on customer oriented approach not on the competitor oriented approach. Music stores opening were one of their expansion strategies. T he company always tried to satisfy the customer’s demand by offering them differentiated product. The decision of Amazon.com to go for a retail store depends on the feasibility and market situation analysis. Amazon.com is capable enough to introduce the physical retail store as they have huge scale of operation, strong human resource management (Angerer 27).

Critically evaluate a UK based company of your choice in relation to Essay

Critically evaluate a UK based company of your choice in relation to how successful they are at social marketing - Essay Example price, product, promotion and place. Various strategic models, tools and concepts are made to enhance the effectiveness of overall strategic formulation. This paper will attempt to discuss about social marketing followed by an UK based company and how its social marketing has contributed to the success of the company. The Marks & Spencer is UK based company that has been selected for this report. At first, this essay will present a brief introduction of the Marks & Spencer followed by the discussion on social marketing strategy of the company. The next section will discuss about the competitors’ move in respect of social marketing comparing the Marks & Spencer. Finally, proper recommendations will be provided in order to bring improvement in social marketing strategy for obtaining term sustainable competitive advantage. ‘Social marketing’ is a concept that concentrates on communicational and promotional aspect of marketing. As per the Social Marketing Institute, â€Å"social marketing is the planning and implementation of programs designed to bring about social change using concepts from commercial marketing† (Social Marketing Institute, â€Å"Social Marketing†). According to Kotler Roberto and Lee, â€Å"social marketing is the use of the marketing principles band techniques to influence the target audience to voluntarily accept, reject, modify, or abandon a behavior for the benefit of individual, groups or society as a whole† (Kotler Roberto and Lee, p.5). Social marketing is meant to bring social changes to its targeted groups. Social marketing can be used to achieve profit making or non-profit making organizational goals. The social marketing is basically customer, client or audience centered. Therefore, for successful social marketing, it is very necessary to identify the appropriate and potential group and to develop proper communication for increasing the effectiveness. For planning and

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

Juvenile Justice - Essay Example Eras of juvenile court Juvenile justice therefore was solely created to rehabilitate minors. Its evolution can be classified into three major Eras, namely: the pre-juvenile era, the juvenile court era and the juvenile rights. The pre-juvenile court Era (1600-1898) Before the establishment of a separate juvenile justice system, minor law breakers were dealt with by the family and communities. The family and the community were charged with the responsibility of ensuring that the children behaved in the most acceptable manner in the society. There were no established juvenile justice systems by then. The juvenile court Era (1899-1966) The first juvenile court was created in United States by juvenile court Act passed by Illinois’ Legislature. These court replaced family and the community at large, who were responsible for minors rehabilitation. The juvenile court therefore began to exercising guardianship rights, so that it could discover and correct conditions that contributed to the minors’ misconduct Juvenile rights Era (1967-1979) Because every establishment must have its critics, pros and cons based on the analysis on ground, the juvenile court system attracted many critics. ... I have a personal conviction that the juvenile rights Era were the most productive, as it ensured fair system of justice and juvenile right protection. In the other hand pre-juvenile court era as far as I am concerned, was damaging, because in many cases parents do sympathize with their children, leading to their forgiveness, hence no rehabilitation could take place if it was left in the hands of the parents so the rule of Stare Decisis should hold. Problems facing juvenile courts today Nevertheless, juvenile courts have been faced with many challenges, both administrative and legal issues. These problems have risen significantly and taken different paths. Many critics have come out to claim that the court system of justice have not properly embraced the zero tolerance policies on crimes. Moreover, researches have shown that juveniles in the court system don't always receive the best defense and ironically those teens that have lawyers often are treated worse than those who donâ€⠄¢t. All juvenile under trail should receive legal representatives and that the lawyers must make their defenses based on the constitution and law. Bearing in mind that the juvenile justice system has been accused of passing unfair judgments and harsh punishment to minors, formidable solution must be established to help correct this. First of all, children need to be educated on the effects of being arraigned in the juvenile court because it can psychologically affect them. Here prevention programs are very important as they will lead to decrease juvenile crimes. Future of juvenile justice If prevention programs are not considered, youths might continue facing psychological problems, with mental problem not in exception. Mental health programs

Macro Economic Policies Adopted by the Bank of England Essay

Macro Economic Policies Adopted by the Bank of England - Essay Example Government regulates many things in an economy including inflation, exports and imports, prices of many vital commodities, and many important economic aspects. Government of England has entrusted the job of determining the monetary policy, in the hands of Bank of England. Bank of England looks into many other big issues. One of the most important issues is that of ensuring monetary stability in the economy, which can be achieved through a combination of stable prices of goods and services across the economy coupled with a low inflation level and level of confidence of the investors in the currency of the country. The Bank comes out with the monetary policy in order to ensure a certain key objectives like, delivering price stability with a low inflation level coupled with an objective to support the Government's economic objectives of growth and employment. Price stability is taken care of, by the Government's usual inflation target of 2%. There is a need to contemplate the crucial and critical role played by price stability in achieving the aforesaid economic stability, and in providing just the right conditions for a sustainable and longe r living growth in output and employment. Chancellor of the Exchequer announces the Government's inflation target every year in the annual Budget statement. Though The 1998 Bank of England Act enables it to set interest rates independently, however, The Bank does hold accountability to the parliament and the wider public, which cannot be refrained from. The legislation provides the government the power to instruct the bank on the interest rates issues for a limited period of time during emergency, for the sake of national interests. (How Monetary Policy Works) The Bank of England has a monetary policy and it uses the same to regulate mechanism of the economy. Like when it decides to change the interest rate, the government is trying to check the overall expenditure of the economy. A change in interest rates is mostly used to contain inflation, which is the result of lavish expenditure by the country. The bank sets a fixed interest rate at which it lends money to financial institutions and depending on this interest rate, individual banks and other financial institutions set up their own interest rates, which apply to the whole economy. This step is of indispensable importance to the economy, as this is very widely used to contain inflation. The only purpose behind such a step is just to contain undue inflationary levels prevailing in an economy. The point to be noted here is that, this interest rate set by the Bank of England is so effective and powerful that it chips in greatly to regulate the whole economy. It affects the stock and bond prices and also influences the asset prices throughout the country. This interest rate also regulated the savings in an economy, which eventually results in capital formation and reinvestment. It is note that when interest rates are high, people prefer to invest money in government deposits that are less risky in nature than the stock markets and similarly high interest rates boost up the savings. Lower interest rates make asset and real estate prices go up, as

Social Networks and Reputation Management Essay

Social Networks and Reputation Management - Essay Example Besides, people are also concerned about the self image they project on the online portals. Particularly in case of celebrities like Paris Hilton, their social network accounts are accessible to a large number of people (Andrzejczyk 236). People are mostly interested in knowing about the personal life details of such celebrities. So such high profile people must be careful about what they post on the social networks. Studies have found that younger people are often more careful about maintaining their privacy on the internet (Andrzejczyk 236). One reason for this is that young people spend more time on social networks and have greater experience with them. The second reason is that young people do care about the impact their online information could have on their career. The recent research has also shown that an increasing number of employers are getting more interested in knowing about the prospective candidates from social networks (Andrzejczyk 236). More and more companies are en couraging their HR departments to engage in such activities. People are also aware of this fact. Many social networking users are opting for measures that would safeguard their personal information from the interested employers. Many users have adjusted their privacy settings to bar some people from accessing their sites. Some users have even gone to the extent of deleting some contacts. Researchers have come to the conclusion that the internet has made it much easier to locate the personal images of and information about the people one wants to. Google is one great aid in such a case. Early only the secret agents used to investigate about others. Today, anyone having access to Google can do so. Pew Internet Centre has found that young people are less cautious about what they publish on net (Andrzejczyk 237). This is because most of them already have safety measures in place. Still, the strange thing is that younger adults tend to have greater instances of coming across bad experien ces on the internet. The age of internet and information technology has given way to a new service that manages identities on the net. Greater number of people and especially the professionals prefer to see themselves as a brand. They believe that managing their identity on the internet helps business. That is why many people tend to have two social networking accounts, one for personal relations and the other for business. People need to be more cautious in the age of internet. A single mistake could sometimes make one loose much in terms of personal reputation. Argument It will be practical to say that the Paris Hilton incident should not be used to pass such a generalized judgment on social networking. It was simply the instance of a culprit getting caught red handed on the internet. In the earlier times people used to socially interact in the real space. Social networking has further modified social interactions by adding virtual space to the real social space. Social networking or no social networking, eventually it is the people who are finally responsible for safeguarding their reputations. Even when the social networking and the internet were not there, people do needed to be careful about the things that they could convey publically and the things that needed to be kept personal. Now the very same rules apply to the internet aided social networking. People need to understand that social networking like any social space is accessible to others.

Can Lollardy be considered a vigorous movement in the later fifteenth Essay

Can Lollardy be considered a vigorous movement in the later fifteenth and early sixteenth centuries - Essay Example The Lollard movement started when the followers of John Wycliff, after the death of Wycliff in 1384, started circulating Lollard doctrine around different regions of the world such as Southern and central England. Continuing its connections to Oxford and considerable gentry support, Lollardy was recognised as a small but persistent sect during the fifteenth century. Different scholars have been presenting different views regarding Lollards movement. Some consider Lollards movement as a small-scale movement resulted as a response to Wycliff teachings however, some scholars consider it as a coherent reform movement that prefigured sixteenth-century changes (Amold and Lewis 2004).2 After the emergence of Lollards movement in the fourteenth century, there has been always a dilemma regarding the nature of Lollards movement. Therefore, the aim of this report is to evaluate whether Lollards movement be considered as a vigorous and coherent movement in the fifteenth and sixteenth century. Various studies have been conducted to cover the concepts of Lollards movement. Historians and scholars have been always keen to evaluate the impact on Lollardy. Before presenting arguments, analysing the work of historians and scholars is very essential. Lollard is a problematic label and there are many issues regarding the origins, coherence and affect of this movement.3 There are two extreme views regarding the Lollards movement. The first view argues that not all but most of the Lollard writings are written by Wycliffe. Therefore, Lollardy as an incoherent movement was encouraged by social and economic grievance. This movement was primarily started to spread the thought of Wycliffe and it can be termed as either Lollardy or Wycliffism. On the other hand, the other extreme view suggests that Lollardy is not a movement but it is a projection of the anxieties of monarchies or churches. The second view considers Lollardy as a coherence of diverse beliefs and practices

Computer and Innate Ability Essay Example for Free

Computer and Innate Ability Essay We sometimes think of being good at mathematics as an innate ability. You either have it or you dont. But to Schoenfeld, its not so much ability as attitude. You master mathematics if you are willing to try. Thats what Schoenfeld attempts to teach his students. Success is a function of persistence and doggedness and the willingness to work hard for twenty-two minutes to make sense of something that most people would give up on after thirty seconds In the book â€Å"Outliers†, Malcolm Gladwell discusses some specific factors of extraordinary achievement. Some of the main ideas he discusses is advantages to succeed in life. According to Gladwell, there are tremendous advantages people have over their competitors to meet opportunities. In examining what made outliers like Bill Gates and the Beatles such phenomenal successes, Gladwell hits upon the important role played by opportunity. In each case, these successful people are given opportunities that most others do not have. In the case of Bill Gates, he goes to a school that owns a computer terminal connected to a large central computer. This is unusual in the 1960s and 1970s, when computers are room-sized devices costing millions of dollars and are owned only by large universities and corporations. Gates is able to start u We sometimes think of being good at mathematics as an innate ability. You either have it or you dont. But to Schoenfeld, its not so much ability as attitude. You master mathematics if you are willing to try. Thats what Schoenfeld attempts to teach his students. Success is a function of persistence and doggedness and the willingness to work hard for twenty-two minutes to make sense of something that most people would give up on after thirty seconds One example of this is Billy joy’s lucky advantage that leads him to success. Bill joy attended University of Michigan the year the advanced computer system was introduced so he began to visit the computer room more often than most; he even got a job with the computer science professor. (Sounds like he got same job with professor. I don’t know I think something wrong with that sentence) Working in collaboration with a small group of programmers, Joy to on the task of rewriting Unix, which was a software system developed by ATT for mainframe computers. Billy joy took advantage of his early computer skills to allow him opportunity that was given to him. One example of this is given by Gladwell how their (who? ) birthday can affect their overall performance . The age cutoff entry for junior hockey leagues is January, 1. A 5 year old hockey player born on that day is a little older than other competitors, giving them an advantage in size, strength and coordination. The effect at the age of nine or ten, and of course they are more likely to view as talented the bigger and more coordinated players, who have had the benefit of critical extra months of maturity. So the advantage of being more developed can potentially land them on a professional team, all due to the cutoff dates in professional hockey. Another example of an advantage in succeeding is your IQ score. In the book Gladwell interviews Chris Langan who has the highest IQ score in America. Chris Langan discusses how he had an opportunity to go to college, but never did because his mother never turned in the financial aid paper work Chris should have gone to college to reach his full potential to meet better opportunities to succeed in life. I think you have to change those paragraphs†¦?

Scope Of Relationship Marketing

Scope Of Relationship Marketing The process of identifying the products and services required by the customers and implementing the policies in order to achieve the needs of the customers and developing the product based on it is known as marketing. It is an incorporated process by which the industries concentrates mainly on the requirement and needs of the customers and hence creates customer relationships stronger. Marketing process is implemented in order to recognize the customer, to satisfy the customer and to retain the customer. It is stated that marketing management is one of the important part of business management as it is related with the activities which are focused on the customers. The development of the marketing was originated because of the mature markets and overcapacities over some past few 2-3 centuries. In order to attain profit the industries started to mainly concentrate on the customers rather than the production. Marketing concept means understanding the needs of the customers, knowing the requirement and demand of the market; and reaching the satisfactions. According to marketing concepts, industries must predict the needs and wants of the customers and should always try to satisfy it more than their competent. Scope of relationship marketing The purpose of the relationship management is at its centre if the viewpoint and it also portrays different methods for researching the relationships which the industries enhance along with the internal communities. The scope and the purpose of relationships management has been identified and stated by various authors including (Christopher, et al., 1991; Doyle, 1995; Kotler, 1992; Morgan and Hunt, 1994; Webster, 1992). The relationships management scope contains six markets: internal, supplier, customer, influencer, referral and employee recruitment markets (Christopher, 1991). A previous survey of the six models had placed the customer market at the centre of the relationships marketing. Figure : The Six Market Model Limitations The marketing six models produce very detailed information and there are two important fields in which these six models contain limitations. These limitations should be corrected by all the users implementing these models for decision making in an industry. The limitations contain: The concentration provided more on the short term sales rather than the long term sales. When used for media mix optimization, these models have a clear preconception in favor of time-specific media (such as TV commercials) versus less time-specific media (such as ads appearing in monthly magazines); biases can also occur when comparing broad-based media versus regionally or demographically targeted media. The brand products and varieties are effected due to the long term sales failure. The marketing mix models are not confined by the involvement of the marketing spend on its brand variety. One of the reasons for this is the long time period taken by marketing in order to put an impact on the brand variety will go beyond and continue at the best. The other reason could be the variations in the financial and social areas and this reason or variation will not effect the marketing and the brand variety a lot. In the short term sales the market shares may get worsen day to day but the brand variety will be higher. Hence, this higher brand variety will help the industries to retain the sales and market share. Market segmentation Marketing segmentation is related with the separation of the customers into a single individual carrying the similar requirement and needs. For instance, Kelloggs cereals- the frostiest are marketed to the kids and crunchy nut cornflakes to adults. Here, both the customers are different and both the products are marketed as per the needs and wants of the customer. Market segmentation is performed for two main reasons. The first reason is segmentation permits perfect distribution of the industrys limited resources. An organization contains only limited resources. Hence, it should always select the particular group of customers. Moreover the tastes of the current western customers can be served better. Market segmentation can be further called as STP that is segment, target and position. Account based marketing system Account based marketing (ABM) is also called as key account marketing which is a planned approach to a business marketing where in an industry contacts with every single customer accounts by considering it as single market. This approach is considered as one of the best approaches as some companies like BearingPoint, Progress Software, Xerox and Hp are leading by implementing this approach. Strategies The following are the tactics and steps to choose a correct strategy for any particular accounts: Campaigning: Lead generation campaigns can be formed for fixing the appointments in a huge target accounts. Intelligence: Marketing role in outlining the target account and contacts within to recognize appropriate schemes. Awareness: communications will play a major role in building a positive insight as the awareness of the supplier is very low in target accounts. Sales: marketing also plays a role in supporting the sales proposal in order to progress the exchange rates and to reduce the sales cycle. Advocacy: The cycle will be finished when the customers turn to advocates and also implements to compel further growth in business. Retaining and Developing Customer Relationships In order to make sure long-term banking customer relationships gimmicks and enticing trinkets are not the best approach just like in personal courtships and it has learned by Caribbean retail financial institutions. The customers who are not having any long-term inducement to be with their company will be effortlessly lured by competitors product of the week next week and the best performers know this thing very well. Hence, the business development remains cost efficient with existing customers than planning to obtain new customers. Implementing these inventive strategies which is stands on this knowledge stays very much easy for many industry participants. Task 2 New online marketing technology Structuring and reflecting of social relations and social networks in between the people who share interests and activities is concentrated by a social network service. Social network service generally includes a variety of extra services, representation of each other user (often a profile) and his/her social links. Users can interact by using internet like e-mail, instant chatting as many of the social network services are web based. Online community is treated as social networking sometimes and social networking means an individual focused service and online community deals with groups. In social networking sites users can share ideas, interests and creativity within their individual networks. The major type of social networking services are the one which includes group places, ways to connect with friends and a suggestion system linked to trust. The famous procedures unite many of theseas Twitter and Face book are used globally. The most common sites used in north America are Linkedin and MySpace; in Canada Nexopia is used; in Netherlands- Bebo, Hi5 and Hyves;in Germany-StudVZ ; iWiW is mostly used in Hungary; Tuenti in Spain; Tagged, XING, Decayenne, Badoo and Skyrock are used in some regions of Europe;Hi5 and Orkut in south America and Central America; in India Orkut and Face book; Friendster, Mixi, Multiply, Orkut, Wretch, renren and Cyworld in Asia and the Pacific Islands. There are some steps taken for optimizing the services in order to evade the need to some duplicate entries of the friends and interests, although this has created few security and privacy concerns. Some largest social networking sites have originated a concept of making the world digital, while others concentrate on different sectors from music and books to non profit business to motherhood in order to provide both services and community to the individuals along with the interests shared among them. Additional features Few social networking sites have many added features, which hold skills to make communities that will share the same interests or connections, downloading live videos, having a discussion through forums or blogs. Internet mapping is opted by geosocial networking in order to categorize user involvement in the geographic characteristics and their elements. Mobile social networking has become most popular and the latest trend. Users having a mobile phone social networking can now be able to create their own profile, involve in the chat rooms, make friends, create chat rooms, can distribute or share photos and videos and also can share some blogs. Users of mobile phone are provided every option that people who sit with the computer have. The wireless services provided by some companies allow the customers in building their own communities for mobiles and also permits them to brand it. But, among many, Face Book is the most popular social networking site through the wireless services. Certain innovative features are provided to the site by some companies which give the real world experience. Linkedin.com is one more professional aspect in social networking. With this users can exchange their ideas, information, and the knowledge. This helps the professional to be posted with the updated knowledge in the respective fields. Business model To get membership few of these social network sites charge the user. This is because the concept of social networking is a new service and the value of it is not yet established nicely. Online advertises are given by the companies like MySpace and the Face book. Therefore they take memberships largely and the charges are given in a counterproductive way. Some companies believe that the core information about the user provided in the site can easily be targeted with advertises when compared to any other sites. In these social networking sites the members serves for both the roles that is for the suppliers and as the content consumers. This is kind of autonomous operation in these sites. But, in the world of business, the consumers and the suppliers are quite distinct. Gaining revenue is easier in the business with the means of the advertisement. But this is possible while the level of the content and the memberships are quite high. Several application domains use online marketing. They are: Application for the business Application for the dates Application of the government Applications on the Medical terms Applications on the education Various ways of Marketing Mobility marketing In marketing the mobile marketing can fall in to any of the category. Primarily, the marketing can be described by the mobiles devices such as mobile phone. Secondarily, the marketing is described as a moving with the trends. The Mobile Marketing Association has updated a definition of the marketing for mobile in the year 2009 as: Mobile Marketing is a set of practices that enables organizations to communicate and engage with their audience in an interactive and relevant manner through any mobile device or network. Mobile marketing via MMS Mobile marketing through MMS will include the video, audio, text, and the images. Here the content of the mobile is delivered through the MMS. Now, almost all the mobile phones are capable to send and receive the MMS messages. But the brands can be able to send and receive the messages through the MMS A2P network to its subscribers. In some other networks, brands can also sponsor the messages which are sent person to person. For example: The campaign of the Motorola was initiated by the MMS mobile at the House of Blues Venue. Here the users can send the images and photos to mobile in real time. Mobile marketing via Infrared Infrared is one of the oldest mobile marketing. In late 90s, some of the companies based of Europe, have experimented the shopping window marketing through the free waves of Infrared. The range of infrared is limited and did not establish as a leader in the Mobile Marketing. Viral marketing Viral marketing is something which will encourage the individuals for passing the messages for marketing to others. This will create the potential to growth exponentially with the exposed messages. Like the virus, these strategies will take much advantage of multiplying rapidly for exploding a single message till thousands. In Internet this is called as Viral Marketing. Guerrilla marketing is invented as an unconventional system of the promotions which depends on time, imagination, and the energy instead of the big market. In the same way, the campaignings for the marketing is also unconventional and interactive. The consumers are targeted in the unexpected places. Its objective is creating the unique, and a sharp concept that provokes the thought. Jay Conrad Levinson has coined this term in the book Guerrilla Marketing. Since then this term has become most popular. The approaches such as the encounters in the public places, the products being sold in the streets, the stunts, any marketing that gives more results from minimal resources etc, are involved in the Guerrilla Marketing. The digital technology is being used by the mobile as one more approach to the guerrilla marketing. This will help them to create more customers and have a good brand. As the base of the guerrilla marketing Levinson identified few principles. they are as follows: This is mainly to serve the business and the entrepreneur that are small Instead of the experience, judgments, and the work done by guessing it should involve the humans. Investing time, imagination, and the energy are the primary issues rather than money The profit ratio is the primary issue to measure the business and not the sales Also concentrate on the number of new relations made per month Instead of diverting the focus concentrate on creating a standard. Concentrate on more referrals and transactions, instead of trying to get more number of customers Cooperate more on the business instead of the competition These marketers have to use the combination of the methods in the marketing for the campaign Build the business by making use of the technologies that are more updated Aim the messages to the smaller group of the audiences instead of the larger groups Focus more on an individual to gain their consent. This will let them send more messages Social media marketing In the organization of the communications plan, Social Media Marketing is the recent competent. For connecting with the markets target, integrating the markets communication is the principle. In order to produce the message on which the customer easily focuses, the market communication has to be integrated with the elements like The models of the traditional marketing like the frequency, content, timing, and the communication medium with the organization is collaborated with the external agent like agencies for advertising, firms for the market researches, and the firms with the public relation. The communication of the organization the impact of the social media has an impact on the kind of communication made by the organization with the customers. Platforms of social media marketing The social media marketing will benefit the organization and the individual by providing the additional channel for the support of the customer. This becomes a mean for gaining the insight of the customer and the competitiveness and also provides a method to manage the online reputation. The main factors ensuring the relevance for the customer, the value provided to them with the strength of the base where it is built. The foundation that is strong will serve as the platform to centralize the information and for directing the customers with the developments made recently with the help of social media channels, and publications released through press. The goal is for creating a foundation that is strong and will engage the powers of the customers by providing the opportunities to the communication in the organization. Platform is most important due to the reason that the organization will measure and monitor the effects on the customers. Tools offered are more applicable than anything else to achieve the goal set by the customer. Example: With the Direct2Dell forum the Dell computers has the strongest blog. This also helps to improve the organization fame and gives a chance to improve the learning chances for the bloggers. Ever since the site is begun, the percentage of the blogs is improved by 22% from 49%. Dell, with the support to their customers by addressing the concerns, comments, and the questions through the blog was achieved. Target Targets are achieved on the Face Book by getting real with the customers and by the exposed products that matches the needs of the customers. Target focused more on the benefits by connecting to the customers and in understanding the medium. They have allowed the customers to shape the group and made the curve of learning easier. Starbucks This Starbucks will be found on the Face Book, Flicker, Twitter etc, and on other blogging sites by the My Starbucks Idea. This has the best strategies for the social media. They have focused more on gaining the customers needs, likes, and the information. This helps them maintain customers in good number. Conclusion The process of identifying the products and services required by the customers and implementing the policies in order to achieve the needs of the customers and developing the product based on it is known as marketing. It is an incorporated process by which the industries concentrates mainly on the requirement and needs of the customers and hence creates customer relationships stronger.

Narcolepsy is a sleep disorder

Narcolepsy is a sleep disorder Are you having troubles falling asleep at nights? Have you tried warm milk, exercise, yoga, all kinds of sleeping pills and youre still tired? Or that you were told that you had talked during your sleep? Maybe youre having sleep disorders. Sleep disorders can be related to mental conditions, physical conditions or substance inducement. There are about seventy different sleep disorders which are divided into two categories. One category comprises disorders in which a person has hard time in getting sleep or staying asleep or falling asleep at improper time. For example, insomnia, narcolepsy, nocturnal leg syndrome. Sleep disorders which people experience physical events while they are sleeping, such as somnambulism, restless leg syndrome, are categorized in another group. The most common sleep disorder that is suffered by millions of people in the world is probably snoring, which is not medically significant; whereas some sleep disorders can actually be very dangerous as it might caus e a sudden heart attack. One of the most interesting sleep disorders is narcolepsy. Narcolepsy is a sleep disorder which is suffered by one in every 2,000 people in the United States. It can be very hard to live with. It is easy for people who know nothing about narcolepsy to think that those who are suffering from narcolepsy are simply because partied too much as people who fall asleep at inappropriate times must be having way too much fun until the early morning. But thats a long way from the truth. Narcolepsy is a chronic neurological disorder that is caused by the brains failure to adjust sleep-wake cycles normally. People with narcolepsy experience temporary craving to sleep. Patients usually fall asleep for a period of few seconds to several minutes. In some cases, patients may even remain asleep for an hour or longer if the craving becomes overwhelming. Narcoleptic can easily fall into the REM stage of sleep within 10 minutes; whereas most people do not get into REM stage sleep after 90 minutes. Narcoleptic could not control when and where they fall asleep. T hey might fall asleep when waiting for the traffic light, or they could start snoring in the middle of an important meeting. So, narcolepsy can be very dangerous as patients fall asleep at improper times, such as driving, walking, and so on. Therefore, people with narcolepsy should have someone beside to take care of and avoid driving. Do you think people with narcolepsy seem to have longer sleeping time than normal person? In fact, they spend a weaker proportion of their time asleep during a day. Most of them do also experience frequent awakening during night time sleep due to daytime drowsiness and uncontrolled sleep. How do you know youre actually having narcolepsy? There are several symptoms you might have if you suspect youre a narcoleptic. Cataplexy, sleep paralysis, hypnagogic hallucinations, and excessive daytime sleepiness are common traces of narcolepsy. Cataplexy is an immediate loss of muscle tone that leads to a feeling of weakness and a loss of voluntary muscle control, such as limpness at the neck or knees, sagging facial muscles, or failure to speak clearly. The most critical attack results in a complete loss of tone in all voluntary muscles that leads to total physical collapse in which patients are incapable to move, speak or even keep their eyes open. Nonetheless, patients remain conscious throughout cataplexy. The attack can occur at any time during waking period but mostly triggered by instant emotional reactions, such as surprise, anger, fear or laughter. Episode can last for a few seconds or even several minutes. According to the National Institutes of Health, about 10% of all cases, cataplexy is the first symptom to appear and can be misdiagnosed as a sign of a seizure. Patients should avoid having extreme emotional changes to prevent the attack. Sleep paralysis which is also one of the symptoms can cause fleeting inability to move or speak while in both waking period and sleeping period. Sleep paralysis may too last for seconds or even minutes. Generally, patients remain breathing during sleep paralysis, but, its possible that some patients have experience a disheartening sensation of unable to breath. Hypnagogic hallucinations are dream-like experiences that appear before sleep. The sleeping mind beginning to dream earlier than the body has gone fully asleep is the cause of hypnagogic hallucinations, which means that whatever the patients conscious mind is thinking of will become full sensory hallucinations, similar to what happens in dreams. However, the difference between dreams and hypnagogic hallucinations is these images and sounds are occurring while someone is still actually awake. In additional, hypnagogic hallucinations are usually frightening and vivid. Generally, the excessive daytime sleepiness is the first symptom of narcolepsy to occur. The other symptoms may occur after months or year after the onset of the excessive daytime sleepiness. The excessive daytime sleepiness is mostly last permanently, but sleep paralysis and hypnagogic hallucinations may not. How do we really confirm that if were infected by narcolepsy, as having some individual symptoms may not prove that were narcoleptics? For example, hypnagogic hallucinations can occur without narcolepsy. The symptoms of narcolepsy are like symptoms of other illness; therefore, it takes as long as 10 to 15 years to have narcolepsy diagnosed after the first symptoms occur. Narcolepsy is always misdiagnosed as learning problem, seizure disorders or even laziness. Nonetheless, there are some tests available, such as Multiple Sleep Latency Test(MSLT), Polysomnography, and the Hypocretin Test. In the MSLT test, patients are required to have a daytime nap for about 20 minutes every 2 hours. Normal people without narcolepsy usually fall asleep within 10-20 minutes; whereas patients with narcolepsy usually fall asleep within 5-8 minutes. This test also shows that how fast you get into REM stage of sleep which narcoleptics easily get into it. Polysomnography is an overnight sleep study which r esult brain activity, eye movements, heart rate, and blood pressure that can find out how quick one falls asleep, how fast one experiences a REM stage of sleep after sleeping and how often one wakes up during the night. The hypocretin test which has not yet become the main diagnosis tool for narcolepsy can measure the level of hypocretin in cerebrospinal fluid. Nacroleptics normally have lower level of hypocretin. Narcolepsy is so interesting yet dangerous, but what causes narcolepsy? Some say heredity, some say infections. What is confirmed is that narcolepsy is a neurological sleep disorder. It is not caused by mental illness or psychological problem. In fact, scientists have also discovered that narcoleptics are usually lacking in hypocretin, also called  orexin, which is a chemical in the brain that helps promote wakefulness. Nevertheless, the causes of low hypocretin level arent well understood. Researchers think that low hypocretin level isnt caused by individual factor, it might be caused by several factors together, such as infections, brain injuries, heredity, and autoimmune disorders. Despite the disorder has been studied for a long time, the causes of narcolepsy are not determined. However, World Health Organization has discovered some narcoleptics were actually born with a gene that increases the risk of having this rare disease. Scientists found that this gene might have joint effect with H1N1 swine flu vaccine to cause narcolepsy. This is because many cases of narcolepsy among children and adolescents that have been reported in 12 countries in 2009 have received the H1N1 swine flu vaccine earlier before as well. Patients are likely to develop narcolepsy symptoms between 2 and 10 weeks after receiving the vaccine. Researchers also claimed that the risk for those who got vaccinated to get narcolepsy is about 9 times higher than those who did not get vaccinated. There are also reports that show children who ages 5 to 15 are most likely to get narcolepsy. Nevertheless, cases which narcolepsy is linked to H1N1 swine flu vaccine have only been observed in Finland and Sweden, although the vaccine is used in all over the world. Hence, the link between H1N1 swine flu vaccine and the sleep disorder narcolepsy is still being investigated by the World Health Organization. Due to the fact that the causes of narcolepsy are still not known, there is no known way to prevent this dangerous sleep disorder, even treatment of narcolepsy is only to reduce the number of attacks. The goal of treatment is to improve daytime alertness and minimizing symptoms such as cataplexy, hallucinations and sleep paralysis. Narcolepsy can usually be controlled with treatment, though. The treatment of narcolepsy is mainly changing in lifestyle. Patients should eat light meals during the day and try to avoid caffeine, alcohol and nicotine as these are factors that may increase the odds of an attack after meals. Narcoleptics may also take naps during the day for 20 to 30 minutes to maintain well functionality and social obligation. Medications can be used to control the symptoms as well. Medication such as Ritalin helps to reduce excessive daytime sleepiness and improves alertness. It has side effects such as headache, irritability, nervousness, notwithstanding its usefulness. U nfortunately, there are no surgical procedures for the treatment of narcolepsy at this time. From the Chinese traditional medicine point of view, the cause of narcolepsy is explained by the Ying-Yang theory. Narcolepsy is developed because of the Ying of ones body is greater than the Yangs and in additional that ones spleen is not functioning well. These are the two main points that cause one to experience drowsiness and also excessive daytime sleeping. However, in Chinese traditional medicine method, it seems to have better treatment than the normal western medicine method. The Chinese have recently invented a medicine that has no side effects for narcoleptics. According to the research done by Mrs. Yang in China who is a Chinese medicine practitioner, 68 patients who taken this healing method for a period of 90 days, 72% of them have obvious improvement, as in the excessive daytime sleeping has been fully cured; 24% of them have improvement, as in the excessive daytime sleeping has almost cured; the other 4% of them have no improvement. This is a great step of treatment fo r narcolepsy as 96% of patients have improvement after taking this healing method. Therefore, this healing method is now spreading out very quickly in China and also received tons of good comments. In conclusion, narcolepsy is a devastating disorder that causes extreme fatigue and often results in the patient falling asleep immediately without warning. It often causes muscle weakness and comes with snoring. Narcoleptic experiences episodes of uncontrollable sleepiness several times a day and it usually happens after meals, but it may also happen at any inappropriate time during the day and last for about fifteen minutes. Patients will then awaken refreshed, only to become exhausted within the next hour or so. It is known that narcolepsy represents a neurological problem of sleep wake mechanisms in the brain yet the causes are still unknown. Although it is not fatal, it still has serious repercussion if the situation gets worse. Thus, it is a dangerous disorder without a cure as it actually affects the brain and muscles. In my opinion, narcolepsy is horrible as it may affect patients in several areas in their lives included daily activities, social functioning and working abilit ies, and it can result in total paralysis, leaving the patients to suffer for the rest of their lives.

The Marburg Virus :: Personal Narrative, Autobiographical Essay

The Marburg Virus Why did I decide to choose to study Kongolese Art? Why didn't I just decide to study something safe, like British watercolours? If I had, I would have never had to spend the past three days in isolation in a hospital in Germany to ensure that I wasn't harbouring the Marburg virus. My experience with Marburg started about three weeks ago in early April--April 1, 2005 to be exact. I had been in Angola for the past seven weeks conducting an intense study of Kongolese art in the rural villages of Uige Province. Angola is not exactly the safest place in which to conduct research so instead of identifying myself as an Art Historian I had been traveling with a group of volunteers who were building schools in remote villages. During the day I would help with the construction, and at night I would conduct my research. At the end of March, we arrived in the town of Uige to build a new two-room schoolhouse. When we arrived, as we did every time we entered a new village, we went to the local authorities to make sure they were OK with what we were going to do. Instead of the normal warm reception that I was used to, the Police Chief, Constable Sammy, warned us that many of the folks in the town were sick, with an unknown illness. Illness was nothing new to us, so we set about our business. Later that evening we met up with Dr. Smith, a British doctor volunteering in the local hospital. He showed us some of the infected patients--he said that most of them appeared to have malaria, as they were presenting all of the classic symptoms: fever, chills, horrible headaches, and an overall feeling of being unwell. (CDC Marburg Fact Sheet) But, we didn't worry as we were all taking malaria pills. Two days later, when we met up with Dr. Smith again, he was a different man. He was not the cheery man that we had met two days ago; instead he was in a frantic situation. He told us that his patients were not responding to the typical drugs used to fight malaria, and to make things worse they had developed "nausea, vomiting, chest pain[s], a sore throat, [and] abdominal pain." (CDC Marburg Fact Sheet) In addition some of the patients had developed a rash on their torso.

Children and Eating Disorders Essays -- Anorexia Bulimia Weight Essays

Children and Eating Disorders In the past few decades researchers have focused on eating disorders, the causes of these disorders and how they can be treated. However, it has mainly been in the last decade that researchers have started looking at eating disorders in children, the reasons why these disorders are developing at such a young age, and the best recovery program for these young people. To understand this growing problem it is necessary to ask a few important questions: Is there a relationship between family context and parental input and eating disorders? What effect do mothers who suffer or have suffered from an eating disorder have on their children and specifically their daughters’ eating patterns? What is the best way to treat children with eating disorders? TYPES OF CHILDHOOD EATING DISORDERS In an article focusing on an overall description of eating disorders in children, by Bryant-Waugh and Lask (1995), they claim that in childhood there appears to be some variants on the two most common eating disorders found in adults, anorexia nervosa and bulimia nervosa. These disorders include selective eating, food avoidance emotional disorder, and pervasive refusal syndrome. Because so many of the children do not fit all of the requirements for anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified, they created a general definition which includes all eating disorders, "a disorder of childhood in which there is an excessive preoccupation with weight or shape, and/or food intake, and accompanied by grossly inadequate, irregular or chaotic food intake" (Byant-Waugh and Lask, 1995). Furthermore they created a more practical diagnostic criteria for childhood onset anorexia nervosa as: (a)... ... and Allied Disciplines 36 (3), 191-202. Edmunds H., Hill AJ. (1999). Dieting and the family context of eating in young adolescent children. International Jounal of Eating Disorders 25(4), 435-40. Kreipe RE. (1995). Eating disorders among children and adolescents. Pediatrics in Review, 16(10), 370-9. Lunt P., Carosella N., Yager J. (1989) Daughters whose mothers have anorexia nervosa: a pilot study of three adolescents. Psychiatric Medicine, 7(3), 101-10. Marchi M., Cohen P. (1990). Early childhood eating behaviors and adolescent eating disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 29(1), 112-7. Smolak L., Levine MP., Schermer R. (1999). Parental input and weight concerns among elementary school children. International Journal of Eating Disorders, 25(3), 263- 71.

Essay --

Gilpin observed that the establishment of the World Trade Organization (WTO) on January 1, 1995 as the principal forum for trade liberalization marked the biggest reform of the international trading system since the end of the Second World War. In this paper, I will provide an analysis of the evolution of the international trading system from its inception as the General Agreement on Tariffs and Trade (GATT) to its incarnation as the World Trade Organization (WTO), taking into account the changing international economic environment and political realities. This paper comprises of three parts. The first part outlines the historical context in the creation of GATT; the second part gives a brief synopsis of its structure and functions, with the third covering the paradigm shift in events that brought into existence the WTO intended to regulate an ever increasingly market-oriented global economy. Established in 1944 and taking its name from the New Hampshire town where the agreements were drawn up, the Bretton Woods conference was a gathering of finance ministers from Allied countries following the end of the Second World War. Under American leadership, the group met to discuss the failings of World War I’s Treaty of Versailles and the creation of a new international monetary system which could fund post war reconstruction, economic stability and facilitate international trade. This conference led to the establishment of two of the most important post war economic institutions, the International Monetary Fund (IMF) and the International Bank for Reconstruction and Development, now known as the World Bank (An introduction to the WTO and GATT, pp. 42, 2003). Originally, the architects of the international trade system in the post war ... ...requests from other members and notify the WTO of changes to its trading policies. This clause is provided to help improve predictability and stability to the international trading system and discourage the use of quotas and other measures used to limit the quantity of imports. Today, the WTO membership numbers 146 which comprises of approximately 97 per cent of the worlds’ trade (www.WTO.org). The evolution of GATT to the WTO was a significant step towards liberalising markets and ushered in a new era of free trade. Although the WTO is still a relatively young international institution, its origins are rooted in the Bretton Woods conference following the end of World War II. The WTO has evolved to cover areas such as trade in goods and services as well as Intellectual Property Rights (IPR) and continues to provide the key disciplines affecting international trade.

Non Conventional energy resources in India Essay

Non-Conventional Energy Resources in India Contents 1. Introduction†¦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‚¬ ¦ 02 2. Wind Energy†¦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‚¬ ¦. 03 3. Biomass Energy†¦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‚¬ ¦.. 05 4. Solar Energy†¦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‚¬ ¦. 06 5. References†¦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‚¬ ¦. 11 Page | 1 Introduction Major of India’s energy needs are met out by thermal and other conventional forms. But these are non-renewable in nature. What will happen after say 50 years when the coal gets exhausted? So we need to find an alternative way of extracting energy. In India around 80% of the electricity is got from steam turbines run by coal. With serious concern globally and in India on the use of fossil fuels, it is important for India to start using renewable energy sources. India is the 7th largest country in the world spanning 328 million hectares and amply bestowed with renewable sources of energy. In this paper let us see ï‚ · The various kinds of renewable energy methods present in India. ï‚ · Limitations with the current system. ï‚ · Possible expansion. Our main focus in this paper will be solar energy. We would also see other major players in this field, but we will see the detailed analysis of solar energy extraction and expansion. Page | 2 Wind Energy The development of wind power in India began in the 1990s, and has significantly increased in the last few years. Wind power can be utilized for drawing water, which is an essential requirement in watering agricultural lands in the rural areas. In addition, it can be utilized for electricity generation. Although a relative newcomer to the wind industry compared with Denmark or the US, domestic policy support for wind power has led India to become the country with the fifth largest installed wind power capacity in the world. As of December 2010 the installed capacity of wind power in India was 13,065.37 MW, mainly spread across: 1. Tamil Nadu (4132.72 MW) 2. Maharashtra (1837.85 MW) 3. Karnataka (1184.45 MW) 4. Rajasthan (670.97 MW) 5. Gujarat (1432.71 MW) 6. Andhra Pradesh (122.45 MW) 7. Madhya Pradesh (187.69 MW) 8. Kerala (23.00 MW) 9. West Bengal (1.10 MW) 10. Other states (3.20 MW) It is estimated that 6,000 MW of additional wind power capacity will be installed in India by 2012. Wind power accounts for 6% of India’s total installed power capacity, and it generates 1.6% of the country’s power. Page | 3 The major drawbacks of this power system are as follows: ï‚ · Electricity production depends on- wind speed, location, season and air temperature. Hence various monitoring systems are needed and may cost expensive. ï‚ · High percentage of the hardware cost (for large WT) is mostly spent on the tower designed to support the turbine ï‚ · The total cost can be cheaper than solar system but more expensive than hydro. The state and central governments are providing various subsidies and have come up with new policies to enhance the wind power generation in India. Wind turbines are becoming larger, efficiencies and availabilities are improving and wind farm concept is becoming popular. It could be combined with solar, especially for a total self-sustainability project. The economics of wind energy is already strong, despite the relative immaturity of the industry. The downward trend in wind energy costs is predicted to continue. As the world market in wind turbines continues to boom, wind turbine prices will continue to fall. Page | 4 Biomass Energy Among the renewable energy sources, biomass plays a vital role especially in rural areas, as it constitutes the major energy source to majority of households in India. Biomass energy is the utilization of organic matter present and can be utilized for various applications. ï‚ · Biomass can be used to produce heat and electricity, or used in combined heat and power (CHP) plants. ï‚ · Biomass can also be used in combination with fossil fuels (co-firing) to improve efficiency and reduce the buildup of combustion residues. ï‚ · Biomass can also replace petroleum as a source for transportation fuels. Recent developments in India: ï‚ · India produces about 450-500 million tons of biomass per year, which is 32% of all the primary energy use in the country at present. ï‚ · The current share of biofuels in total fuel consumption is extremely low and is confined mainly to 5% blending of ethanol in gasoline, which the government has made mandatory in 10 states. Biomass energy can play a major role in reducing India’s reliance on fossil  fuels by making use of thermo-chemical conversion technologies. In addition, the increased utilization of biomass-based fuels will be instrumental in safeguarding the environment, creating new job opportunities, sustainable development and health improvements in rural areas. The integration of biomass-fuelled gasifies and coal-fired energy generation would be advantageous in terms of improved flexibility in response to fluctuations in biomass availability with lower investment costs. Page | 5 Solar Energy Solar energy is genesis for all forms of energy. This energy can be made use of in two ways the Thermal route i.e. using heat for drying, heating, cooking or generation of electricity or through the Photovoltaic route which converts solar energy in to electricity that can be used for a myriad purposes such as lighting, pumping and generation of electricity. With its pollution free nature, virtually inexhaustible supply and global distribution- solar energy is very attractive energy resource. There are two different perspectives in utilizing solar energy: 1. Solar for grid connected electricity: Grid interactive solar energy is derived from solar photovoltaic cells and CSP Plants on a large scale. The grid connection is chosen due to following reasons: ï‚ · Solar Energy is available throughout the day which is the peak load demand time ï‚ · Solar energy conversion equipment have longer life and need lesser maintenance and hence provide higher energy infrastructure security ï‚ · Low running costs & grid tie-up capital returns (Net Metering) ï‚ · Unlike conventional thermal power generation from coal, they do not cause pollution and generate clean power. ï‚ · Abundance of free solar energy throughout all parts of world (although gradually decreasing from equatorial, tropical, sub-tropical and polar regions). Can be utilized almost everywhere. 2. Solar for off-grid solutions: While, the areas with easier grid access are utilizing grid connectivity, the places where utility power is scant or too expensive to bring, have no choice but to opt for Page | 6 their own generation. They generate power from a diverse range of small local generators using both fossil fuels (diesel, gas) and locally available renewable energy technologies (solar PV, wind, small hydro, biomass, etc.) with or without its own storage (batteries). This is known as off-grid electricity. Remote power systems are installed for the following reasons: ï‚ · Desire to use renewable – environmentally safe, pollution free. ï‚ · Combining various generating options available- hybrid power generation. ï‚ · Desire for independence from the unreliable, fault prone and interrupted grid connection. ï‚ · Available storage and back-up options. ï‚ · No overhead wires- no transmission loss. ï‚ · Varied applications and products: Lighting, Communication Systems, Cooking, Heating, Pumping, Small scale industry utilization etc. The technologies present in harvesting solar power are: 1. Solar photovoltaic: Solar photovoltaic (SPV) cells convert solar radiation  (sunlight) into electricity. A solar cell is a semi-conducting device made of silicon and/or other materials, which, when exposed to sunlight, generates electricity. Solar cells are connected in series and parallel combinations to form modules that provide the required power. These are the different solar cells used: ï‚ · Crystalline Silicon solar cells (C-Si): Monocrystalline and Polycrystalline. ï‚ · Thin-film solar cells: Amorphous Silicon Solar cells (A-Si), CIGS, CdTe. PV modules are manufactured by assembling the solar cells after stringing, tabbing and providing other interconnections. Page | 7 2. Solar thermal: Solar Thermal Power systems, also known as Concentrating Solar Power systems, use concentrated solar radiation as a high temperature energy source to produce electricity using thermal route. High temperature solar energy collectors are basically of three types: ï‚ · Parabolic trough system: at the receiver can reach 400 ° C and produce steam for generating electricity. ï‚ · Power tower system: The reflected rays of the sun are always aimed at the receiver, where temperatures well above 1000 ° C can be reached. ï‚ · Parabolic dish systems: Parabolic dish systems can reach 1000 ° C at the receiver, and achieve the highest efficiencies for converting solar energy to electricity. This is the next big leap in the energy sector, but this too has its own limitations such as: ï‚ · Initial cost involved in setting up the plant is high. Also a huge amount of space is required. ï‚ · Proper sunlight is required for these systems to work effectively and efficiently. ï‚ · On a cloudy day or during nights and rainfall, this system fails to produce power, thus requiring a backup power plan, so this cannot be completely relied upon. ï‚ · Many solar grids are setup in desert areas where no grids are present, making it costly to transmit. ï‚ · Maintenance cost is quite high and a specialized technician is required for it. Page | 8 There may be some difficulties and limitations in this field, many of which can be rectified by proper government involvement during large scale implementations. India needs a brisk involvement in this field considering the facts that: ï‚ · We get plenty of sunlight due to its proximity to the equator and we receive an annual average of 4-7KWh per day for every square meter, meaning we receive a lot more sunlight than what we can use in a year, making it an abundant source of power. ï‚ · We are a poor source for conventional fuel sources. We are dependent on the Gulf countries for its oil supplies. With the oil prices skyrocketing and the reluctance of the Indian government to hike the prices of LPG and kerosene, Indian oil companies are suffering major losses. Even electric  supply in the country is unable to meet the burgeoning demands of the growing population and businesses. ï‚ · India does not have resources to pay the huge bills of the oil producers. Now there are many researches going on in this field to increase the output as well as store the produced energy in SPV cells. Also many conventional coal thermal power plants are looking forward to installing the solar thermal plant to pre heat the water to reduce the use of coal, which is an effective way to cut down the use of coal. New grids and easier and cheaper ways of power transmission are being considered owing to the fact that a huge loss in power as well as money is involved in long range transmission of this produced power. The state governments are coming up with new policies to increase their capacity and mend out their acute power crisis. For e.g., the Government of Tamil Nadu has recently unveiled its new Solar Energy Policy which aims at increasing the installed solar capacity from the current approximate of 20 MW to over 3000 MW Page | 9 by 2015. The policy aims at fixing a 6% solar energy requirement on industries and residential buildings for which incentives in the form of tax rebates and current tariff rebates of up to Rs.1 / unit will be applicable to those who comply with the Solar Energy Policy. The policy also gives an option to those industries/buildings who do not want to install rooftop solar photo-voltaic systems to invest in the government’s policy and be given the same incentives as explained above. Even many private players are slowly but steadily coming up in this sector, knowing its future value. Government is providing subsidies and aid to these private companies to increase their involvement in this sector. Solar Power India, Tata and Reliance Industries are some of the big money players who have major plans for this industry. This will give a big boost to this field as these companies can invest a lot of money in research to make the technology cheaper. This, in turn, will make solar energy accessible to the common man. As more and more people take to solar power, the costs are expected to reduce. Page | 10 References 1. â€Å"Future Perspectives for Renewable Energy in India†, November 21st 2008, Ravi Soparkar, 2. India Wind Energy, (EAI), < http://www.eai.in/ref/ae/win/win.html> 3. India Biomass Energy, (EAI),< http://www.eai.in/ref/ae/bio/bio.html> 4. India Solar energy, (EAI),< http://www.eai.in/ref/ae/sol/sol.html> 5. â€Å"Solar energy: Watts Up†, January 06th 2013, K.R.Balasubramanyam, < http://businesstoday.intoday.in/story/the-future-of-solar-power-inindia/1/190741.html> Page | 11

Employee Handbook

Martino Landscape Contractors, Inc. Employee Handbook for Field Personnel TABLE OF CONTENTS INTRODUCTORY STATEMENT 3 MISSION STATEMENT 3 LETTER FROM THE OWNERS 4 PURPOSE OF THIS HANDBOOK NOTICE 5 SUPPLEMENTS/CHANGES 6 DEFINITIONS 6 EXCEPTIONS 6 Section I: EMPLOYMENT Organization Chart 7 Employment-at-Will 7 Equal Employment Opportunity 8 Affirmative Action Plan 8 Immigration Reform & Control Act of 1986 9 Americans With Disabilities Act (ADA) 9 Section II: PERSONNEL STATUS Employment Classifications 10 Tardiness and Absence 11 Personnel Records 12Work Rules and Performance Standards 13 Section V: GENERAL INFORMATION Open Door Policy 26 Injuries/Accidents 26 Sexual Harassment 27 Alcohol, Drugs, and Controlled Substances 29 Prohibited Items 29 Drug Testing 30 Moonlighting (Outside Activities) or Conflict of Interest 32 Personal Credit References 32 Driving Records 33 Personal Loans and Pay Advances 33 Media Relations 34 Use of Company Vehicles, Property, Equipment, Etc. 34 ATTACHMENTS Employee Statement of Acknowledgment Substance Abuse Testing Consent and Release Overtime 24 Disciplinary Form 24Performance Evaluations 25 Job Descriptions 25 INTRODUCTORY STATEMENT Welcome to Martino Landscape Contractors, Inc. This Employee Handbook – Field applies to all employees of Martino Landscape Contractors, Inc. It is intended to provide guidelines and summary information about the company’s personnel policies, procedures, benefits, and rules of conduct. It is important that you read, understand, and become familiar with this Employee Handbook and comply with the standards that have been established. Please talk with your immediate supervisor if you have any questions or need dditional information. The rules set out in this Employee Handbook are as complete as we can reasonably make them. However, they are not necessarily all inclusive because circumstances that we had not anticipated may arise. Some currently unanticipated circumstances may warrant the appl ication of discipline, including termination. In addition, Martino Landscape Contractors, Inc. reserves the right to modify, supplement, rescind, or revise any policy, benefit, or provision from time to time, with or without notice, as it deems necessary or appropriate. MISSION STATEMENTThe following is our mission statement at Martino Landscape Contractors, Inc. Martino Landscape Contractors, Inc. is committed to achieving the highest possible level of total customer satisfaction. Our goal is to make the environment safer and more attractive. All of our associates are dedicated, hard working people that have been equipped and trained to perform work in a correct and safe manner. We are committed to growth, stability, and providing meaningful employment. At Martino Landscape Contractors, Inc, we do the job ‘RIGHT. † LETTER FROM THE OWNERSWelcome to the Martino Landscape Contractors family! This Employee Manual answers some of the important and fundamental questions you m ay have about your employment with Martino Landscape Contractors, Inc. In it, you will find descriptions of Company policies and guidelines related to your employment. Should you have questions about your work here, please do not hesitate to discuss them with your immediate supervisor. We look forward to a long and mutually beneficial relationship. ______________________________ _____________________________ Roberto MartinoPURPOSE OF THIS HANDBOOK This Employee Handbook is intended to be a communications tool to inform employees about the policies, guidelines, benefits, and work practices that affect their employment with Martino Landscape Contractors, Inc. It will help you to understand your responsibilities to Martino Landscape Contractors, Inc. and the Company’s responsibilities to you. This Employee Handbook is not intended to, and should not be interpreted as, creating a contract of employment. While Martino Landscape Contractors, Inc. elieves that one of the best ways t o develop an employee’s trust and confidence in the Company is to perform in a consistent manner, it is important to realize that changes to our daily practices may occasionally be necessary. Therefore, Martino Landscape Contractors, Inc. reserves the right to change, modify, delete, or add to any of the policies and practices listed herein, in accordance with management’s best judgment. We require that you read all of this Employee Handbook carefully. You are also encouraged to take it home to your family so that they can also become familiar with it.You should refer to this manual first when you have any questions. If you still are not certain, please contact your immediate supervisor. NOTICE The policies in this Employee Handbook are to be considered as guidelines. Martino Landscape Contractors, Inc, at its sole option, may change, delete, suspend, and discontinue any part of its policies in this Handbook with or without any prior notice. Any such action shall apply to existing, as well as future, employees, with continued employment being the consideration between the employer and the employee.No one other than the President of Martino Landscape Contractors, Inc. may alter or modify any of the policies in this Employee Handbook. No statement or promise by a supervisor, manager, or department head may be interpreted as a change in policy, nor will it constitute an agreement with an employee. Should any provision in this Employee Handbook be found to be unenforceable and/or invalid, such finding does not invalidate the entire Employee Handbook, but only the subject provision. DEFINITIONS This Employee Handbook deals only with Field personnel.Field personnel include those employees whose work is performed principally in the Field. This includes the following: †¢ County Supervisors †¢ Tractor Operators or Crew Members †¢ Lawn Care Crew Members †¢ Weed Whacker Crew Members This Employee Handbook also covers Field personnel who are brought to the Main Office or the Shop on an as needed or temporary basis . EXCEPTIONS In some cases exceptions can be made to policies listed in this Employee Manual. In most cases exceptions will not be allowed. Only the President can make exceptions to stated Company policies.Exceptions are NOT automatically granted, and very few will be granted. If you request an exception, it is your responsibility to provide justification for the President to grant an exception. SECTION I: EMPLOYMENT ORGANIZATION CHART Martino Landscape Contractors has a formal, functional organization chart. This organization chart demonstrates the â€Å"chain of command† at Martino Landscape Contractors. It is your obligation to know and follow this â€Å"chain of command. † According to this chart, you have only one boss. Your boss is the individual who provides you with all work-related instructions.You should ask this individual, and this individual only, about all work related questions . If, after the conclusion of this discussion, you are not satisfied, let your immediate supervisor know that you would like to discuss this matter with their immediate supervisor. That individual will set the time for such a meeting after discussion with their immediate supervisor (See the Section on â€Å"Open Door Policy. †). You may discuss personal matters with the President, or any member of management, at your mutual convenience without first discussing these types of issues with your immediate supervisor.EMPLOYMENT-AT-WILL Employment is with the mutual consent of you and Martino Landscape Contractors. Consequently, Martino Landscape Contractors have the right to terminate the employment relationship at any time, with or without cause or advance notice. This employment-at-will relationship will remain in effect throughout your employment with Martino Landscape Contractors, unless it is specifically modified by an express written agreement signed by the President of Mar tino Landscape Contractors. All Field employees will have an Introductory Period of a minimum of 60 days.After the successful completion of this period, they may become considered as permanent employees. This employment-at-will relationship may not be modified by any oral or implied agreement. This Employee Handbook does not constitute an employee contract. TARDINESS AND ABSENCE You are part of a team. In most circumstances, the progress and productivity of the job depends on each of its team members acting together. Therefore, it is important that employees work their assigned schedules as consistently as possible.However, Martino Landscape Contractors understands that because of illness or emergency situations you may be unable to come to work. If you are unable to report to work for any reason, you must call in to your immediate supervisor before your scheduled time of arrival with the following information: †¢ If you will be late, you must state why and when you expect to b e in. †¢ If you will be absent, you must state why and how long you expect to be out. If your immediate supervisor has a cell phone, you must call that individual directly.It is your responsibility to keep the Company informed on a daily basis during a short-term absence. Except in the case of an emergency, employees must have their supervisor's permission to leave work before they are regularly scheduled to do so. Being late (tardy) or absent is considered â€Å"excused† only when you call promptly and the tardy or absence is for a compelling reason. The Company reserves the right, at its sole discretion, to determine what constitutes a compelling reason. A tardy or absence for a non-compelling reason, and failing to call in according to company policy, will be considered â€Å"unexcused. Furthermore, the Company recognizes that certain emergency situations would prevent you from giving advance notice. The Company will apply â€Å"the rule of reason† to all such situations Martino Landscape Contractors considers â€Å"unexcused† tardiness and absence to be a serious problem. Consequently, employees who are tardy or absent excessively or show a consistent pattern of absence, whether â€Å"excused† or â€Å"unexcused,† may be subject to disciplinary action, up to and including, possible termination.If you are late for work, or you are absent without an acceptable excuse, more than three (3) times within a year’s period (based on the date of the first occurrence), you will be subject to disciplinary action, up to and including, possible termination. If you do not call in and do not report to work for three (3) consecutive workdays, the Company will consider this to be a voluntarily resignation. WORK RULES AND PERFORMANCE STANDARDS It is not possible to provide a complete listing of every work rule or performance standard.As a result, the following are presented only as examples. You are responsible for understandin g and following these standards and work rules. Employees who do not comply may be subject to disciplinary action, up to and including, possible termination. Job Performance – employees may be disciplined, up to and including, possible termination, for poor job performance, as determined by Martino Landscape Contractors. Some examples of poor job performance are as follows: †¢ Below average or what the Company defines as acceptable level of work quality or quantity; Failure to follow safety requirements and regulations, including the utilization of required safety equipment, clothing, gear, etc. ; †¢ Failure to attain established goals; †¢ Poor attitude, including rudeness, or lack of cooperation – this includes dealings with representatives of customers, vendors, co-workers, representatives of local, State or federal governments, etc. ; †¢ Excessive absenteeism, tardiness, or abuse of meal or break time privileges; †¢ Failure to properly use a nd care for all Company owned or rented equipment and vehicles; Failure to follow instructions or Company policies and procedures; †¢ Failure to perform all job duties, tasks ands responsibilities. Misconduct – employees may also be disciplined, up to and including, possible termination, for misconduct. Some examples of misconduct are as follows: †¢ Insubordination; †¢ â€Å"Badmouthing,† the spreading of rumors, half truths, untruths, etc. of customers, co-workers, vendors, outside professionals, governmental representatives, Martino Landscape Contractors personnel, etc. ; Abuse, misuse, theft, or the unauthorized possession or removal of Company property or the personal property of others; †¢ Falsifying or making a material omission on Company records, reports, or other documents, including payroll, personnel, expense reports, and employment records; †¢ Being rude, disrespectful, using abusive and/or foul language with any client/customer â⠂¬â€œ actual or potential – vendor, co-worker, outside professionals, governmental representatives, competitor of the Company, etc. ; †¢ Divulging confidential Company information to unauthorized persons; Disorderly conduct on Company property – including fighting or attempted bodily injury, or the use of profane, abusive, or threatening language toward others, or possession of a weapon; †¢ Misconduct in company furnished motel rooms; †¢ Violation of any law adversely affecting Martino Landscape Contractors, or conviction in court of any crime which may cause the employee to be regarded as unsuitable for continued employment; †¢ Violation of Martino Landscape Contractors alcohol, drugs, and controlled substances policies; †¢ Violation of Martino Landscape Contractors harassment policies; Violation of safety rules, as may be established by Martino Landscape Contractors †¢ Continuous misuse and/or unauthorized use of any company equipment or property. Attitude – Martino Landscape Contractors strives to be a positive company and to create a positive working environment for its employees and clients. We expect that you will at all times and with all employees, customers, co-workers, vendors, representatives of governmental agencies, outside professionals, etc. only make positive remarks about Martino Landscape Contractors.If you have any complaints they should be handled discreetly with your immediate supervisor. USE of COMPANY VEHICLES, PROPERTY, EQUIPMENT, ETC. Some Martino Landscape Contractors Field personnel are assigned Company vehicles. These are intended for conducting official business ONLY. You should NEVER allow anyone other than a current Company employee, with a valid Driver’s License, to operate a Company vehicle. Also, you should not allow anyone to ride in the vehicle that is not a current Company employee. Violation of this policy may result in disciplinary action, up to and ncluding, termi nation. SECTION II: PERSONNEL STATUS EMPLOYMENT CLASSIFICATIONS Introductory Period: All personnel hired by Martino Landscape Contractors will start off in a minimum 60-day Introductory Period. While classified in this status you are not eligible for any company benefits, unless required by law. The Introductory Period is a time for the Company to get to know its employees and their capabilities. It is also a time for you to get to know the Company and your job tasks and /or duties. Throughout this period we will be evaluating each other.At any point in time during this Introductory Period, the Company or you may decide to terminate the relationship. At the end of the period, your immediate supervisor will conduct a performance evaluation interview with you and will determine your status with Martino Landscape Contractors. This period may be extended beyond the initial 60-day period discussed above. However, throughout this period you are encouraged to discuss your performance and a sk questions of your immediate supervisor regarding all tasks and duties assigned to you. Part-Time Employees:Employees scheduled to work less than 40 hours per week. If the position or job function is to be part-time, you will be notified at the time of your hiring. Seasonal Employees: Employees in non-supervisory, field positions. The length of time that any individual will be needed is dependent on the work volume and specific projects that are performed. Temporary Employees: Employees hired on a temporary basis. This may include the hiring of some individuals during the summer months. It may also include using temporary employment agencies to obtain this additional, short term, help that the Company requires.Hourly: These positions have an hourly wage rate. The individuals in these positions are paid for the actual hours they worked during the pay period. However, under federal law these individuals are paid time-and-a-half for all hours worked above 40 hours in a given pay peri od. Employment of Minors: The Company will not knowingly hire any individual who is considered to be under age for employment in any job classification as defined by State and federal laws. Generally speaking, this is 18 years of age to operate equipment and/or vehicles and 16 years of age for other positions. MEAL PERIODSAll hourly employees who work more than six (6) hours in a given workday will receive an unpaid meal period of 30 minutes. In the field, it is up to you to determine the exact time of this break. You should consider your current location and the time it would take to get to a convenient spot for taking your meal break. Consequently, there is no exact time for taking your meal break on a daily basis. 30 minutes per day will be subtracted from your time sheet. Employees who do not work more than six (6) hours in a workday may not take a meal break without the expressed approval of their immediate supervisor.You are expected to be back at work within 30 minutes after you left for the start of your meal period. Leaving early and/or returning late is considered a serious offense and will lead to disciplinary action, up to and including, possible termination. SECTION IV: COMPENSATION WAGE and SALARY REVIEWS Wage and Salary increases are based upon performance only. Your length of service with the company has nothing to do with being granted a wage or salary increase. Martino Landscape Contractors considers your pay rate, salary, and/or your total compensation package to be highly confidential information.Under no circumstances should any part of your compensation package be discussed with anyone but your immediate supervisor, the Payroll Clerk, the Office Manager, the Controller, and the President. Violation of this policy is considered to be a very serious matter and may subject you to disciplinary action, up to and including, possible termination. WAGE ASSIGNMENTS or GARNISHMENTS On occasion, employees may have Wage Assignments or Garnishments fi led against them. These are legal documents and require that Martino Landscape Contractors deduct a certain amount from your weekly paychecks.The Company will inform you regarding any such Garnishments against your wages as soon as possible after they have been received and processed in the Accounting Department. You will be provided with copies of any documentation that is given to the Company. If you disagree with the Garnishment, then it is your responsibility to handle this matter with the appropriate court and/or institution. The Company has no say whatsoever on these issues. They are strictly legal requirements with which the Company must comply by law. For each assignment or garnishment, the employee will be assessed an Administrative Fee of $3. 0 per transaction. PERFORMANCE EVALUATIONS All Field employees will receive a written performance evaluation annually, based on their anniversary dates. They may be provided more frequently. New employees will receive a written perfor mance evaluation at the conclusion of their 60-day Introductory Period. The purpose of the performance evaluation is to let you know how well you are doing. Written performance evaluations may include commendation for good work, as well as specific recommendations for improvement. You will have the opportunity to discuss your performance evaluation with your immediate supervisor.This is a good time to ask questions and to clarify important points. Performance evaluations help Martino Landscape Contractors make important decisions about job placement, training and development, and pay increases. A satisfactory performance evaluation does not guarantee a salary increase nor does it alter, modify, or amend the at-will employment relationship between you and Martino Landscape Contractors JOB DESCRIPTIONS SECTION III: GENERAL INFORMATION INJURIES/ACCIDENTS All injuries while on company time must be reported as soon as possible to your immediate supervisor.PLEASE, ensure that medical atte ntion is sought first in an emergency. Your supervisor will have a listing of emergency telephone numbers. If you witness or are present when an injury occurs, and the situation so calls, please call for help IMMEDIATELY. Your and your co-workers’ health and well-being are of prime importance. In addition, you are expected to immediately report any and all unsafe situations to your immediate supervisor. SEXUAL HARASSMENT Martino Landscape Contractors are committed to providing a work environment that is free of discrimination and harassment.In keeping with this commitment, Martino Landscape Contractors maintains a strict policy prohibiting harassment, including sexual harassment. Sexual harassment of employees by supervisors, co-workers, customers, representatives of governmental agencies, outside professionals, vendors, etc. is prohibited. Individuals who have been determined to have violated this policy will be disciplined, up to and including, possible termination. Martino Landscape Contractors makes the following commitments to all employees: Examples of sexual harassment include, but are not limited to, the following: Un-welcome sexual flirtations, advances, or propositions; †¢Verbal abuse of a sexual nature; †¢Using explicit or derogatory sexual terms in reference to any employee; †¢Subtle pressure or requests for sexual activities; †¢Unnecessary touching of an individual; †¢Graphic comments about an individual's body; †¢A display in the workplace of sexually suggestive objects or pictures, including, but not limited to, magazines, posters, calendars, photographs, and drawings; †¢Sexually explicit or offensive jokes; †¢Physical assault; Retaliating in ANY way against an employee who has complained of, or reported, sexual harassment or who has participated in the investigation of such conduct. If you believe that you are being, or have been, harassed in any way, you MUST report the facts of the incident or in cidents to your supervisor immediately, without fear of reprisal. If for ANY reason you are uncomfortable talking with this person, or this person is the one whom you believe is guilty of sexual harassment, you should immediately talk with the President. Do not wait to see if the behavior stops.To properly protect all of our employees, customers, vendors, business associates, Martino Landscape Contractors must be notified at the first opportunity. Any accusation brought to the attention of supervision and/or management MUST be brought up the chain of command of the organization or directly to President for investigation. It is a condition of employment at Martino Landscape Contractors that if it is deemed necessary to use an outside arbitrator to resolve any sexual harassment disputes, you hereby accept this condition and agree to abide by the judgment and determinations of this arbitrator.ALCOHOL, DRUGS, AND CONTROLLED SUBSTANCES Martino Landscape Contractors has adopted a policy o n drugs, alcohol, and other prohibited items in order to help insure a safe, healthy, and productive drug-free environment for our employees and others on Company property, to protect Company property and assets, to maintain a favorable public image, and to assure efficient operations.It is the policy of Martino Landscape Contractors to maintain its property and to provide a drug-free working environment that is both safe for our employees, including others having business with the Company, or on Company property, or at work sites where Martino Landscape Contractors is performing work, and conducive to efficient and productive work standards.This policy restricts certain items and substances from being brought to work, being used while working or being present on Company property and/or Company work sites, and prohibits Company employees and all others from, reporting to work, working or being present on Company property and/or Company job sites, whether or not on duty, from having detectable levels or identifiable trace quantities of certain drugs and other substances, and prohibits the unauthorized possession, by employees or others, of property, equipment, materials, supplies, or proprietary information belonging to Martino Landscape Contractors or others. OUTSIDE ACTIVITIES) or CONFLICT of INTEREST Because of the possibility of a conflict of interest, employees are prohibited from holding a position with any competitor, governmental agency, and customer, outside professional entity, or vendor or any business entity working with Martino Landscape Contractors. Therefore, you are required to inform your immediate supervisor if you have any outside employment – with any company or any self-employment venture.Martino Landscape Contractors will be the sole judge as to whether that company or business venture falls into any of these categories. While you are free to have outside employment (a second job), it must not interfere with your ability to perform your duties and responsibilities for Martino Landscape Contractors. in a productive and safe manner. In addition, it must not limit your ability – on a regular basis – to be available for required overtime and/or weekendIn addition, all employees are prohibited from engaging in outside employment, private business, or other activity, which might have an adverse effect on, or create a conflict of interest with, Martino Landscape Contractors and the type of work that the Company performs. DRIVING RECORDS Employees, whose job/position requires the ability to operate a motor vehicle, must present and maintain a valid driver's license and a driving record acceptable to our insurer. You will be asked to submit a copy of your driving record to Martino Landscape Contractors from time to time.Any changes in your driving record must be reported immediately. Failure to do so may result in disciplinary action, up to and including, possible termination. If you are authorized to ope rate a Company vehicle in the course of your assigned work, or if you operate your own vehicle in performing your job, you will be considered completely responsible for any accidents, fines, or traffic violations incurred – other than those imposed on a Company vehicle for being overweight, unsafe, etc.Your immediate supervisor will advise you on what to say and do (and what not to say and do) in the event of a vehicular accident All drivers will be subject to investigation annually by the insurance carrier to verify the status of their driving record and to determine their insurability. Martino Landscape Contractors is not liable for any employee that is turned down for coverage. However, if our insurance carrier will not insure you, then you cannot hold a position that has a requirement for driving a vehicle.ONLY Martino Landscape Contractors employees may operate any vehicle or piece of equipment owned or rented by the Company. PERSONAL LOANS and PAY ADVANCES It is the pol icy of Martino Landscape Contractors, Inc. NOT to enter into any type of loans for any employee. Generally, it is the policy of Martino Landscape Contractors, Inc. NOT to provide a pay advance to any employee. However, under emergency conditions, an exception can be made to this policy. If such an exception is granted, the following conditions apply: 1.For salaried personnel, no pay advance can be made for a sum greater than 50% of salaried employee’s regular or base weekly salary. 2. For hourly employees, no advance can be made for sum greater than 20 hours pay (20 hours times the employee’s hourly wage rate. ). 3. There is a $3. 00 processing fee, per transaction, per week to cover the administrative time and effort involved in this process. 4. All advances granted must be paid back to the Company by the end of the last business paycheck of the year. 5. Employees are eligible for a pay advance only once within each calendar ear. 6. ONLY the Vice President, the Contro ller, or the President may grant exceptions. EMPLOYEE STATEMENT OF ACKNOWLEDGEMENT This is to acknowledge that I have been given information on accessing the website to read and review the Dixie Lawn Service, Inc. â€Å"Employee Handbook† and the â€Å"Safety Manual†. It is the employee's responsibility to read and be aware of Dixie Lawn Service, Inc. policy and procedures that are kept up to date on this website. Printed copies may be available upon request. Employee Signature Date