Police Brutality: Raw Unfinished

Police Brutality, is not only an American issue, it is a world-wide problem. Police brutality has been going on since the late 1800's and is getting worse every year. Police brutality is caused by so many things, race, boredom, power insecurity, life problems. The same reasons we get angry in life, but they chose to abuse people because they are the only gang who can get away with it. Police is the largest gang of all, most organized, and the most manipulative. In Reynoldsburg, Ohio, A group of police buddies formed their own mirror squad which was named â€Å"S.N.A.T. Squad† This stood for â€Å"Special Nigger Arrest Team† believe it or not it was kept for years. Here is a timeline of important milestones of civil rights be disregarded in the United States. In 1886, Haymarket Square Riot. About 1,300-1,400 people gather in Chicagoà ­s Haymarket Square to protest police brutality against striking workers that had been exercised the day before. 180 police arrive to disperse the throng. From somewhere a bomb is thrown into the midst of the police. In 1991, when Rodney King was brutalized, for one reason only, the color of his skin. Civilians in the neighborhood caught the whole thing on tape. Brought to court for evidence was the video, and witnesses. With the 99% white jury, it made no differance. The police officer who lead the attack was found not guilty. In 1995, Anibal Carasquillo was shot in the back by police officers in January 1995. His mother, who attended Amnesty's press conference, said, †this kind of killing is happening every month and they' re getting away with it†. In 1998, Six policemen from the North East Rand Dog Unit set their dogs on three suspected illegal immigrants, allowing the animals to attack the three men as the officers shouted racial insults. The incident was caught on video and televised nationally by the South African Broadcasting Corporation on Nov. 7, 2000, causing widespread outrage. All six policemen were ultimately sentenced to jail terms of between four and five years each. In 2008, 15-year-old Alexandros Grigoropoulos was shot dead by police officer Epaminondas Korkoneas shortly after 9 p.m. in the Exarcheia district of Athens, Greece for being suspected of resisting arrest. Demonstrations and riots erupted throughout Athens almost immediately after the shooting, sparking weeks of civil unrest and workplace and university occupations throughout Greece and beyond. In 2010, Yao Wei Wu was beaten by officers from Vancouver Police Department who knocked on the wrong door while investigating a report of a violent domestic dispute. After Yao Wei Wu opened the door officers grabbed Yao and drug him down the stairs while beating him untill they reached the car, then afterwards they asked him his name, then realizing they had the wrong person. Speaking through a translator, Yao Wei Wu told CBC News that as soon as he opened the door the officers pulled him out of the house and beat him. In 2011, A pedofile bust included police officers, teachers, club scout leaders. The ring included 30 countrys, and had over 70 thousand members around the globe.

Review of Literature Essay

2.1Introduction This chapter reviewed the available literatures written on this topic and in other related areas in this chapter. This was made possible by the identification, collection and review of these literatures from various sources such as text books, journals, reports and the internet. 2.2The Concept of ATM ATM is typically made up of the CPU for controlling the user interface and transaction devices, magnetic or Chip card reader for identifying the customer, display which is used by the customer for performing the transaction, function buttons usually close to the display or a Touch screen used to select the various aspects of the transaction and a record printer which provides the customer with a record of a transaction (Cronin and Mary, 1997). Most ATMs are connected to inter bank networks, enabling people to withdraw and deposit money from machines not belonging to the bank where they have their account or in the country where their accounts are held thus enabling cash withdrawals in local currency (Maxwell, 1990). They are often identified by signs above them indicating the name of the bank owning them. 2.2.1Evolution of ATM ATM is said to have evolved from early cash dispenser and is said to have first been introduced in the early 1970’s. The dispensers were operated by a token inform of a punch card. This enables a customer to withdraw as sachets of suitable values of bank notes. These sachets processes and then return the card to the customers. Another source has it that ATM concept was started around 1967, and that it was first installed in Endfield town, on the London Borough of Endfield by Barclays Bank. Thomas (1996). This is said to have been accredited to John Shepherded Baron, although George Simon registered patent in New York and Don Wetzel and two other Engineers from Docatel Company also registered patent in June/ April 1973. Brendan (1996). This in the second generation was improved to the extent that made it possible to count proved money. 2.2.2Operation of ATM ATMs typically connect directly to their ATM Controller via either a dial-up modem over a telephone line or directly via a leased line. Leased lines are preferable because they require less time to establish a connection. Musiime and Biyaki, (2010). It is observed that, most modern ATMs, the customer is identified by inserting a plastic ATM card with a magnetic stripe or a plastic smartcard with a chip that contains a unique card number. Security is provided by the customer entering a personal identification number (PIN). For one to access ATM service, he/ she (the card holder) has to insert the card (magnetic strip card) into the machine (ATM), which then reads the strip and makes contact with the central computer to confirm the genuity of the card which is either accepted rejected depending on whether it is valid or not. When accepted, the customer then punches his/ her PIN number which is then verified according to its compatibility with the information stored in the card. After w hich it then perform the service requested of like (issuing cash, accepting cash/ cheque deposit, balance enquiry, mini-statement) etc, and finally ejects the card. 2.3Effectiveness of ATM Without usage of technology the banking sector cannot provide customers with effective services (Patricio et al., 2003). Effective service delivery is a new or significantly improved service concept that is taken into practice (Drake, 2001). Customer expectations concerning service encounter experiences and service delivery mechanisms as well as the entire concept of what constitutes quality service are therefore key issues that need to be considered prior to the implementation of any structural change. Patricio et al. (2003). Effective service delivery is a service product or service process that is based on some technology or systematic method. It can be a new customer interaction channel, a distribution system or a technological concept or a combination of them. (Kelley et al. 1990). Kumbhar (2011). Observed that effectiveness of service provision have a significant relationship with overall customer satisfaction. Effective service delivery is positively related to customer satisf action in that, when a customer perceives that the delivery mode of the transactions that the bank is supposed to offer is quite good, the more the customers will be satisfied with the bank services. The Concept of Customer Satisfaction Cacioppo (2000) defines Customer satisfaction as the state of mind that customers have about a company when their expectations have been met or exceeded over the lifetime of the product or service as quoted by MALCOLM (2008). Increased customer expectations have created a competitive climate whereby the quality of the relationship between the customer and bank has taken on a greater significance in some cases than the product itself. (Musiime and Biyaki, 2010). Krishnan et al (1999). Point out that, the banking industry strives to succeed by putting the topic of rapid and changing customers needs to their agenda. This can be achieved through good customer care and offering attractive services or products that other competitors may not offer. Therefore, customer satisfaction is seen as a key performance indicator within business. The concept of customer satisfaction occupies a central position in marketing and practice (Cardozo, 1965). Customer satisfaction is a person’s feelings of pleasure or disappointment resulting from comparing a product’s perceived performance or outcome in relation to his or her expectations. (Musiime and Biyaki, 2010). In summary, Customer Satisfaction is the actual meeting of customer’s expectation after he or she has completed consuming a product or service. 2.4.1 Who is a Customer A customer is the most important visitor on our premises. He is not dependent on us. He is not an interruption to our work. He is the purpose for it. He is not an outsider on our business rather he is part of it, we are not doing him favor by serving him rather he is doing us favor by giving us an opportunity to do so. Wasswa, (2003). Pg 35. He further described a customer as one that enables the organization exists. They are the purpose of our business. In my own view, I believe that, customers are the heart, the life and the soul of our businesses, without whom we can’t hold even for a second to exist in business. Hence they should be accorded utmost respect and care when rendering service to them. 2.4.2Importance of Customer satisfaction Khirallah (2005) defines customer satisfaction as; a customer’s perception that his or her needs, wishes, expectations, or desires with regard to products and service have been fulfilled. Consumer satisfaction in short can therefore be defined as an evaluative process that contrasts pre-purchase expectations with the actual perceptions of performance during and after consumption experience. In summary, Customer Satisfaction is the meeting or even exceeding of a customer’s expectation after the use product. The outcomes of satisfying a customer are:- Customer loyalty- LOYAL customers are those who have the enthusiasm about the brands or products they use. The more enthusiastic a customer is, the higher the profit contributed to the brand. (MALCOLM 2008). Musiime and Biyaki,(2010). Loyalty is a combination of intentional repurchase behavior and psychological attachments of a customer to a particular service provider. The fundamental assumption of all the loyalty models is that keeping existing customers is less expensive than acquiring new ones. In summary, Loyalty is customer’s demonstration of faithful adherence to an institution despite the occasional errors. Thus satisfying a customer is very paramount to organizations existence. Customer retention- Customer Retention is the ability to hold on to customers over time. Joseph and Stone (2003). Customer retention is the activity that the selling organization undertakes to reduce customer account defections. It can also be described as a series of actions that the selling organization undertakes to reduce defections. Musiime and Biyaki, (2010). Ganesh et al., (2000)., observed that, long-term, customers become less costly to serve due to the bank’s greater knowledge of the existing customer and to decrease serving costs. They also tend to be less sensitive to comparative marketing activities (Czepiel, 1990). Loosing customers not only leads to opportunity costs because the reduced sales, but also to an increased need for attracting new customers which is five to six times more expensive than customer retention (Joseph and Stone, 2003). 2.4.3The relationship between ATM use and Customer satisfaction Earlier research by Brownlie (1989) has recommended that some consumers have positive attitudes towards ATMs based on dominant perceptions of convenience/accessibility/ease of use. As observed by Malcolm (2008). On the other hand, Reichheld and Sasser (1990) have recognized the benefits that customer satisfaction delivers to a bank. For instance, the longer a customer stays with a bank the more utility the customer generates. This is a result of a number of factors relating to the time the customer spends with a bank. Without usage of technology the banking sector cannot provide customers with a satisfactory service (Patricio et al., 2003). Effective service delivery is a new or significantly improved service concept that is taken into practice. Musiime and Biyaki,(2010). According to, Patricio et al. (2003) customers will use different service delivery systems dependent on their assessment of each channel and how it contributes to the overall service offering. Hence service satisfaction will not merely be based on isolated service encounters and experiences but rather on the overall feelings of satisfaction. With automated teller machines networks already in place in most of the urban areas, the drive is now focused towards the rural areas where the use of automated teller machines is still uncommon. Musiime and Biyaki,(2010). 2.5Conclusion From the review of literature, it can be observed that the operation and use of ATM services in the financial sector, has contributed a lot in changing the way in which financial services and products are being delivered to the banks clients. As the say goes that, for every step forward (development), a lot of challenges must have been faced, fought and overcome. Thus the development of ATM saw the emergency of some challenges for the industry as customers keep demanding for better service, while the financial institutions are very busy searching for the most efficient way by which they can improve on their service provision.

Project-Proposal-Template

Project Proposal Template Project Proposal Template Company Name Company Name Write Company Address Here City, State, Zip Code Phone, Fax Email: www. proposaltemplatestips. com Website: www. abc. com Write Company Address Here City, State, Zip Code Phone, Fax Email: www. proposaltemplatestips. com Website: www. abc. com Project Proposal Project Proposal 2011/12 2011/12 Project Name Project Name Business Area Program Name Business Area Program Name Project Sponsor:| | Author (Business):| | Author (MIS):| | Project Sponsor:| | Author (Business):| |Author (MIS):| | DD/MM/YYYY DD/MM/YYYY a). Sample text —————————————————————————————————————- 1 b). Sample text —————————â⠂¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€- 4 c). Sample text —————————————————————————————————————- 6 b). Sample text —————————————————————————————————————- 8 d).Sample text ———————————————†”—————————————————————- 10 e). Sample text —————————————————————————————————————- 14 f). Sample text —————————————————————————————————————- 15 g). Sample text —————————————————————â⠂¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€- 19 h).Sample text —————————————————————————————————————- 20 i). Sample text —————————————————————————————————————- 24 j). Sample text ———————————————————————————â €”—————————- 27 k). Sample text —————————————————————————————————————- 28 l).Sample text —————————————————————————————————————- 29 m). Sample text —————————————————————————– ——————— ————- 31 n). Sample text —————————————————————————————————————- 32 o). Sample text —————————————————————————————————————- 33 p).Sample text —————————————————————————————————————- 35 q). Sample text —————————————————————————————————————- 39 r). Sample text —————————————————————————————————————- 41 s). Sample text —————————————————————————————————————- 43 t).Sample text —————à ¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€- 45 u). Sample text —————————————————————————————————————- 45 v). Sample text —————————————————————————————————————- 48 w). Sample text —————————— Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€- 49 x).Sample text —————————————————————————————————————- 52 y). Sample text —————————————————————————————————————- 53 z). Sample text ————————————————â€⠀Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€- 59 a). Sample text —————————————————————————————————————- 1 b).Sample text —————————————————————————————————————- 4 c). Sample text —————————————————————— Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€- 6 b). Sample text —————————————————————————————————————- 8 d). Sample text —————————————————————————————————————- 10 e).Sample text ————————————————————————————— ————————- 14 f). Sample text —————————————————————————————————————- 15 g). Sample text —————————————————————————————————————- 19 h). Sample text ——————————————————————————————————â€⠀Ã¢â‚¬â€Ã¢â‚¬â€- 20 i).Sample text —————————————————————————————————————- 24 j). Sample text —————————————————————————————————————- 27 k). Sample text —————————————————————————————————————- 28 l). Sample text — ————————————————————————————————————- 29 m).Sample text ————————————————————————————————————— 31 n). Sample text —————————————————————————————————————- 32 o). Sample text ——————— ——————————————————————————————- 33 p). Sample text —————————————————————————————————————- 35 q).Sample text —————————————————————————————————————- 39 r). Sample text ———————————— Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€- 41 s). Sample text —————————————————————————————————————- 43 t). Sample text —————————————————————————————————————- 45 u). Sample text ——————————————————†”——————– ———————————- 45 v). Sample text —————————————————————————————————————- 48 w). Sample text —————————————————————————————————————- 49 x). Sample text ————————————————————————â €”————————————- 52 y). Sample text —————————————————————————————————————- 53 z).Sample text —————————————————————————————————————- 59 Make a list of all sections of proposal along with applicable page numbers. Cover this section on one page. Make a list of all sections of proposal along with applicable page numbers. Cover this section on one page. Table of Contents Table of Contents Proje ct Details Project Details Summary Summary Provide a brief executive summary of your project proposal here in this section including background, current situation, objectives, time scales and expected benefits.Provide a brief executive summary of your project proposal here in this section including background, current situation, objectives, time scales and expected benefits. Provide a brief executive summary of your project proposal here in this section including background, current situation, objectives, time scales and expected benefits. Provide a brief executive summary of your project proposal here in this section including background, current situation, objectives, time scales and expected benefits.Provide a brief executive summary of your project proposal here in this section including background, current situation, objectives, time scales and expected benefits. Provide a brief executive summary of your project proposal here in this section including background, current situat ion, objectives, time scales and expected benefits. Provide a brief executive summary of your project proposal here in this section including background, current situation, objectives, time scales and expected benefits.Provide a brief executive summary of your project proposal here in this section including background, current situation, objectives, time scales and expected benefits. Provide a brief executive summary of your project proposal here in this section including background, current situation, objectives, time scales and expected benefits. Provide a brief executive summary of your project proposal here in this section including background, current situation, objectives, time scales and expected benefits. Business Objectives Business ObjectivesPlease identify main objectives of your project in this section by giving a concrete statement describing your project and what you want to achieve with this project. You have to show here that your project is SMART that is Specific, M easureable, Attainable, Realistic and Time bound. Please identify main objectives of your project in this section by giving a concrete statement describing your project and what you want to achieve with this project. You have to show here that your project is SMART that is Specific, Measureable, Attainable, Realistic and Time bound. Objective No| Objective Description| | | | | | | | |Please identify main objectives of your project in this section by giving a concrete statement describing your project and what you want to achieve with this project. You have to show here that your project is SMART that is Specific, Measureable, Attainable, Realistic and Time bound. Please identify main objectives of your project in this section by giving a concrete statement describing your project and what you want to achieve with this project. You have to show here that your project is SMART that is Specific, Measureable, Attainable, Realistic and Time bound. Objective No| Objective Description| | | | | | | | |Deliverables and Limits Deliverables and Limits The deliverables are the changes that the project has to make in order to achieve the business objectives. Typically these will be system implementation or change to achieve the business process changes described in objectives. In many projects mis-understandings often arise because there are limits to the scope of the project that have not been clearly stated e. g. the system will only be available to a certain group of users, the deliverable is only intended to capture a proportion of the transactions, the system will only be delivered on University supported browsers.Typical deliverables for IT projects are listed below. * New IT Service * New MyEd channel * New Software system * Suite of Reports * Implementation service * Infrastructure Upgrade * Business Process Change The deliverables are the changes that the project has to make in order to achieve the business objectives. Typically these will be system implementation or change to achieve the business process changes described in objectives. In many projects mis-understandings often arise because there

MBA Entrepreneurship Essay Example | Topics and Well Written Essays - 3500 words

MBA Entrepreneurship - Essay Example The company seeks to provide storage facilities to the residents of the area along with additional packing, and moving services. Also, it seeks to ensure that the possessions of people are well protected and cared for. The market for the service is somewhat competitive in the sense that there are a few large scale competitors who can make it hard to launch and develop the storage facility. However, most of the competitors operate in certain particular areas and so none has a monopoly over the whole of Hong Kong. The market plan therefore, at least in the short run, is to start the storage facility business from a densely populated area (Kwun Tong) where there are a lesser number of competitors and a greater demand. In the long run, the company may concentrate on the spreading of the business to other areas. Over the past few years Hong Kong has progressed in terms of economic growth with an average GDP increase of 5% each year. (HKs Current Economic Situation) Although this has been beneficial for the domestic companies of Hong Kong (our company included) because of the increase in the domestic demand, however it is also true that the economic prosperity of Hong Kong has attracted many foreign investors. The presence of such investors poses a threat in the form of the competition that they generally provide. In order to overcome the consequent harsh operating conditions that have arisen, the company has concentrated on certain objectives. The company has formulated certain objectives keeping in mind certain observations from the past. This includes the clarification of the goals of the business that has to be started as Bergsman (2004) relates. The company is keen to invest in mini storage facilities often referred to as the self storage facilities. Self storage facilities consist of self storage spaces that are

Organizational Change Essay Example | Topics and Well Written Essays - 500 words - 7

Organizational Change - Essay Example Negative publicity refers to publicity with which leads to negative outcomes for an organization. Handling negative publicity may not be easy but eventually the organization will find a way of tackling the problem. According to the Interstate School Leaders Licensure Consortium, several standards have been set to ensure efficient handling of negative publicity. These standards include:Negative publicity refers to publicity with which leads to negative outcomes for an organization. Handling negative publicity may not be easy but eventually the organization will find a way of tackling the problem. According to the Interstate School Leaders Licensure Consortium, several standards have been set to ensure efficient handling of negative publicity. These standards include:†¢ Cultivating a caring and inclusive school community†¢ The involvement of parents and outside community  Ã¢â‚¬ ¢ Coordinate school resources for effective learning†¢ Manage and develop staff members' pro fessional skills†¢ Building a shared vision of the school communityAccording to the incident of the school bus driver who was caught on camera choking a child, which is a negative publicity, the school management should have managed the situation before it went out of hand causing the loss of job to the bus driver. Considering that the child required a monitor, and it was hard for the bus driver to manage both her task and that of calming the child. Unless the change is attempted, one may not know its importance. According to Richard and Judy, allowing, acceptance and involvement in change may result in a much-desired results needed for effective leadership and administration. This includes: ensuring a well-detailed reason for the change, impacting the importance of the change to the people so that they own the change and ensuring that the change has a clear vision and has received adequate support for its implementation.

Writing Style Research Paper Example | Topics and Well Written Essays - 500 words

Writing Style - Research Paper Example For me, the writing process involves several challenges. The first one is organizing ideas. I am lucky to have a teacher in my primary years who emphasized the importance of organization in writing. That teacher taught me that in every composition I make, I should take the initial step of organizing my ideas. I could still remember the exercises we had on outlining, with the main topics and subtopics organized under some roman numerals and letters. This training in writing has been very valuable to me because it makes writing easy. An organized essay is easier to read and understand. In addition, teachers appreciate an organized essay with the main ideas carefully laid out in separate paragraphs. As I move along in schooling, I learned about the challenge of composing a thesis statement. I believe that training students to make plausible thesis statements should be an important aim of Writing teachers. Teaching students to make thesis statements will enable them to achieve emphasis and organization. Identifying the thesis statement goes along with outlining. The thesis statement serves as the guide in expounding a topic and composing paragraphs to make up the essay. In my experience, establishing the thesis statement allows me to expound on the topic without going beyond it. Nevertheless, I still have to improve the way I construct a thesis statement and introduce it in the first part of my composition. The next challenge is expounding ideas. Some people find it easy to expound ideas on any topic. Maybe they are gifted with a lot of information to write about. In my case, I find expounding ideas easy when I am interested in the topic. Personal experience, home decorating, gardening, and entrepreneurship are some topics I find easier to write about, whereas sports, statistics, and environmental issues are some of my waterloos. Academic writing, unlike other forms of writing, also challenges me to use outside sources.

The Great Depression Essay Example | Topics and Well Written Essays - 1250 words

The Great Depression - Essay Example The great depression was an economic disaster that affected Europe, North America and other industrialized nations for a period of one decade; from 1929-1939. The depression was the worst depression the Western industrialized world has ever experienced in the modern times (McElvaine 46). America started feeling the depression earlier than other countries due to the collapse of the prices of stock market of the New York Stock Exchange in the year 1929. Within the next few years, the stock price continued falling; they lost their value with a decrease of 20%. This decrease in assets’ value ruined countless numbers of investors, and the performance of banks started declining. Many financial institutions could not withstand the strain from the ensuing depression. People lost trust in the economy and minimized their levels of demand and spending (Burgan 117). Consequently, production declined with a big margin; the overall consequences of these situations escalated the advancement of the great depression. Sudden fall in output led to a deadly situation of unemployment in America because more than fifteen million Americans lost their jobs. Although the utter depression began in the US, it swiftly became an international economic crisis because of the close relationships, which developed between the European economies and US after the First World War (Burgan 117). The US was the chief creditors of Europe during and after the war since the European economies were destabilized by the war debts and the war itself. Other nations like Germany had suffered heavy economic strains due to defeat in the battle because they were required to reimburse war damages. This c onnection was extremely tight and close. When the American economy crushed down, the Europeans countries were also affected since the flow of traders and investors to Europe ceased. Unemployment in Germany skyrocketed within a short period claiming the jobs of more than six million people (McElvaine 46). The great depression was a bit soft on Britain because the unemployment levels were not as high as in America and Germany. However, Britain’s export and industrial sectors were depressed for a longer period that other countries, and they only recovered in the mid 1940s. All countries came up with strategies that would guard the domestic industries and boost their production. Nations imposed tariffs and increased the existing tariffs to discourage international trade (Downing 94). Imports were crowded with quotas; this resulted to a decline in international trade with more than half. When the world trade collapsed, the international economy was disintegrated into trading blocs , which were influenced by currency of trade and political allegiance. This trade between blocs was open to many countries. Political implications of the great depression The political implications of the great depression were profound. Countries such as Japan and Germany reacted to the depression by forming militarist governments who came up with regressive foreign policies, which resulted to the Second World War. In Britain and the US, the government intervened in the issues that affected people by forming welfare system for the citizens (McElvaine 47). The government managed all the economies with little intervention from individuals. President Roosevelt came up with employment schemes, which aimed at reducing unemployment. People were given street cleaning jobs and painting the public buildings. Further, Roosevelt came up with policies that supported the industrial and agricultural sectors. Although these measures did not yield to rapid economic recovery, they enhanced the overa ll

Hypothesis Tests for Means and Proportions Research Paper

Hypothesis Tests for Means and Proportions - Research Paper Example Type I error is defined as the error of rejecting a null hypothesis when it is true. In this case type error would be the error of inferring that the bags are less than 12.0 ounces (less than claimed value) but in reality its weight is either 12.0 ounces or even greater. Level of significance refers to the probability of type I error, that means a fixed probability, in statistical hypothesis testing, of wrongly rejecting a null hypothesis Ho, when it is true. It is represented by . As evident from the given problem, the investigator had a doubt that the claimed weight of the potato bags is greater than the actual weight. To verify the authenticity of this claim, he collected some 30 bags and found the mean of those bags, which came out to be 11.9 ounces. Although the mean weight came out to be lesser than the claimed one. But the real question or logic behind hypothesis testing is that we want to ascertain that whether it would be appropriate to consider the difference of 0.1 ounces from observing 30 bags with the standard deviation of 0.4 a 'significant' one and infer this difference as on the entire population.

Literature review about a journal article Example | Topics and Well Written Essays - 750 words

About a journal article - Literature review Example 50 - 64). For a certain amount of time, now, the activity of marketing is long being attributed with understanding environmentally aware consumers as well as devising strategies to connect with such consumers. In the domains of marketing as well as strategic management, it is often highlighted that the process of decision making by the managers should also include the environmental issues which include ideas on sustainability of the environment as well as conservation of the resources. It is important to state that by the process of addressing the worries of both the consumers as well as the manager in regards to natural as well as physical environment, the organizations can expect to attain a better performance in business along with the enhancement of its reputation. In the current days, while the significance of sustainable environment in connection to competitive advantage and business performance is better perceived, the research initiatives for various strategies to implement s ustainable environment based corporate programs for the business to business segments are in their stages of infancy. This particular paper on industrial marketing management shed light on the domain of business to business marketing and intends to develop a framework which highlights the marketing role in sustainable supply chain strategies. Summary From the theoretical aspects, sustainable development is explained as the line of development which fulfils the needs of the current generation without destroying the capacity of the upcoming generation to fulfil their needs. However, some experts feel that the factor of business interest as well as the society’s interest overlap with each other to a great extent. This process of overlapping is referred to as the sustainability sweet spot. In linking environmental sustainability with marketing, it needs to be stated that the large business customers are often more credible in implementing environmentally friendly policies in othe r firms with which they are engaged in a transactional manner (Drumwright, 1994, p. 1- 19). The business customers often has the larger power in creating the pressure on multiple smaller and dependent firms to opt for environmental friendly measures and thereby develop and build eco-friendly products. Critique From the critique’s point of view, it is important to focus on the sustainable market framework that is discussed in this paper. The framework is being built by relying on two very important objectives of sustainable environment. The first objective is that when firms do manufacture optimum number of units with regards to the demand in hand, the factor of over production is being negated which helps in lower levels of product disposition. This creates a sustainable environment, which is commonly referred to as the reduced surplus supply strategy. The second objective is in connection to the reduction of number of products which requires recycling. This strategy which is termed as reducing reverse supply, highlights that firms should concentrate on developing repairable products along with more extensive recycling as well as remanufacturing strategies. The implementation of the reduced surplus supply strategy, which is based on the Build To Order (BTO) concept, brings into focus that the challenges associated with inculcating changes in the product design and manufacturing process. The set up costs are

Should Disabled Veterans Get Preferential Treatment over Better Essay Example for Free

Should Disabled Veterans Get Preferential Treatment over Better Essay Affirmative Action efforts were started in 1964 to end the long history of overlooking qualified people of color and women from higher education. Affirmative Action sets standards for a business or office of admissions, so that a white man does not have the upper hand over an equally or greater educated minority’s, female or disabled veteran. The initial way the government tried to justify Affirmative Action was to develop a human resource approach: first identifying the problem, which is racism, sexism and handicapped stereo typing then establishing the solution. The intent of the Disabled Veterans Affirmative Action Program (DVAAP) is to help cut down on discrimination in the work place, despite the fact that some believe that (DVAAP) is a form of reverse discrimination. In contrast, the first goal of (DVAAP) was to help disabled veterans across the nation receive the entitlements they deserve when they apply for employment in the Federal Government. I believe that Charles J.  Muhl was trying to say that the Affirmative Action techniques have the advantage of not only persuading employers not to discriminate when hiring or accepting, but to expand employment and educational opportunities for groups that might be just as deserving but less fortunate. Therefore the (DVAAP) is legitimate because it does reduce discrimination in the work place and related areas such as various jobs on Government Installations and Federal Offices. In the end, it should in no way be abolished. A California Superior Court had upheld the states use of 3 affirmative action programs but struck down 2 of them owned by minorities, woman and disabled veterans. The program that the Superior Court upheld was intended to remedy discrimination and according to proposition 209 there was no discrimination towards minorities or disabled veterans. Those two programs mentioned nothing about minorities or disadvantaged veterans only disadvantaged businesses. I feel that the Superior Court rejected the states laws because it seemed like they felt it was reverse discrimination and unconstitutional. Affirmative action is becoming highly controversial. Right now Proposition 209, in California, which bans all programs involving race and sex preferences run by the state, has passed but it will not be put into total action due to some questions of constitutionality. But one must ask themselves â€Å"Is the DVAAP a new form of Affirmative Action? † The DVAAP has employed about 93,000 disabled veterans during 2005. Without programs like this, there would have been about 93,000 unemployed veterans’ just collecting disability and unemployment, resulting in more tax money being spent on disabled veterans. With this system they are able to make a valued contribution to society and not become a financial burden on the rest of the economy. Mark Rosenbaum of the Southern California Branch of the American Civil Liberties Union declared an argument. Proposition 209 should be declared unconstitutional because it singles out women and minorities at a time when discrimination still exists, Now let just think for a minute, How many of these Disabled Veterans are women or minorities? Also take into consideration if you add some sort of combat wound to that Veteran, what would you have without the help of the (DVAAP)? I will tell you. People would look at those brave Veterans that put there lives on the line and call them a â€Å"BUM† These people are not bums, they are fallen heroes that need help. Discrimination does still exist in our not so perfect world, and so far various forms of Affirmative Action is our only solution; so why is California trying so hard to put an end to it? Abolishing Affirmative Action is not the answer. President Clinton spoke out in his speech for National Archives: Let me be clear: Affirmative Action has been good for the United States we should have a simple slogan: Mend it, but dont bend it. The problem with the Affirmative Action debate could be that those arguing for it do a poor job defending their position. Due to the fact that Affirmative Action has been in place for more than a generation, critics have lost sight of how the job market and higher education looks without Affirmative Actions stabilizing effects. They could possibly make a stronger stance if they pointed out that there are thousands of injured veterans (woman and minorities) in the current ongoing war trying to readjust back to civilian life. They are also highly qualified for many forms of employment. (Section 4214(a)(1) of the title 38, United States Code) Many critics that were not hired for jobs that they felt that they deserved seem to think that Affirmative Action is a cleverly disguised form of racism and ineffective, but taking a look at what happens when there is no Affirmative Action, such as in court case’s around the United States reverse discrimination suit. Some courts are ruling to ban the race card, gender card and disabled veterans card when applying for government jobs. I would like to point out The whole reason that there are handicapped preferences is that the handicapped do not meet the standards applied to others, if they were require that they meet the standards then they would not have gotten in. I have a handy capped person that works with me and when I asked him how did he get his job, he told me I clearly got in through an Affirmative Action program, and I dont apologize for it Im proud of it. † It got me in, but it didnt get me out, didnt take the bar exam for me, didnt pass the two hundred and eighty five or so pieces of legislation Ive authored. He is a perfect example of Affirmative Action, a handicapped minority getting the chance to prove himself. Affirmative Action did not get him where he is today it just simply got his foot in the door. Affirmative Action gave him a chance he would not have gotten if Affirmative Action did not exist. Although sad, but true we do not live in a perfect, color-blind country. I believe It is simply wrong to play politics with the issue of Affirmative Action and divide our country at a time when, if we really want to change things, we have to be united. I have had experience with Affirmative Action, nearly twenty years of it now, and I know it works. In conclusion, Affirmative Action, just as it started, is trying to create unity within the real world, which is not perfect and there is lots of handicapped stereo typing. So why are we still asking the question of why we are using various forms of Affirmative Action? Proven that it abolishing Affirmative Action would be a negative effect to the work place, why should we go back to the days of handicapped stereo typing, why not move forward still some until we can create unity. We should seek not just equality as a right and a theory, but equality as a result. Maybe the world hasnt exactly found equality as a result, but with the Disabled Veterans Affirmative Action Program, the world is a lot closer to equality than without it.

Depression: Medication versus Therapy in Adolescents

Depression: Medication versus Therapy in Adolescents A Literature Review Mental health is a growing issue in the United Kingdom. According to Reynolds (2016), one in four individuals are diagnosed with a mental health illness. This literature review will look at the various perspectives of the use of medication to treat depression against the perspectives of psychotherapy as there has been a great increase in the number of prescription antidepressants dispensed, with 3.9 million additional antidepressant drugs dispensed in 2015 than in 2014 in England alone (Health and Social Care Information Centre, 2016). On the other hand, in 2014, 947,640 were referred to psychological therapies (Health and Social Care Information Centre, 2014). However, in 2015, there were 1,267,193 referrals made to psychological therapies (Health and Social Care Information Centre, 2015). According to Compton et al (2004), At any one time, approximately 1 in 20 children and adolescents suffers from major depressive disorder, with rates of depression rising dramatically in adolescen ts, especially in girls.. Depression is a mood disorder which causes a constant feeling of sadness and a loss of interest (Mayo Clinic, 2016). Depression was originally known as melancholia and was first noticed in the second millennium B.C, however, it was considered to be due to demonic possession (Nemade et al, 2007). The first medications to be introduced to treat depression were Iproniazid and Imipramine in the 1950s (Là ³pez-Muà ±oz and Alamo, 2009), there are now over thirty types of antidepressants on the market which are separated via categories: Selective serotonin reuptake inhibitors (SSRIs), Serotonin and norepinephrine reuptake inhibitors (SNRIs), Monoamine oxidase inhibitors (MAOIs), Tricyclics and other types, with SSRIs being the most common type (Tracy, 2017). In relation to psychotherapy, there are many types of therapies an individual can have, however, this literature review will focus on cognitive-behavioural therapy (CBT). There has been a substantial amount of research done in regards to treating depression with either medication or therapy. First to be discussed is the findings for combination treatment i.e CBT plus SSRIs. A qualitative study by Melvin et al (2006) found that both CBT and SSRIs, specifically Sertraline, were recommended for the treatment of adolescent depression. This study consisted of 73 participants: 22 were assigned CBT alone, 26 were assigned Sertraline alone and 25 were assigned a combination of both treatments. Participants receiving the CBT treatment were required to attend twelve 50 minute individual weekly sessions while the participants receiving Sertraline were required to take 25mg/day for one week. All groups exhibited considerable improvements which were then maintained for the following six months. Furthermore, a previous study by Asarnow et al (2009) also found the combination of medication and CBT to be superior to medication alone. However, this was only the case with adolescents who were white, in their late adolescent years and who did not exhibit self-harming behaviour. Contradicting, a qualitative study by March et al (2004), revealed a combination of a SSRI and CBT was found not to be the most effective form of treatment. This study included a variety of groups including SSRI alone, Placebo alone, CBT alone and CBT plus SSRI. In regards to limitations, the groups who received SSRI alone and placebo alone were blinded, meaning they did not know what medication they would be receiving. This was done to eliminate bias, however, some say that this is unethical as it deceives the participant (Schattner, 2011). On the other hand, Goodyer et al (2007) conducted a qualitative study involving SSRIs and CBT treatment in the NHS Child and Adolescent Mental Health Service (CAMHS) yet found no evidence to suggest that the combination of CBT plus a SSRI was superior to SSRI alone. This study consisted of 208 adolescents between the ages of 11 and 17 with moderate and severe depression. 103 received a SSRI medication and routine care while 105 received SSRI, routine care and CBT.   Although the medication in this study was different to the Melvin et al (2006) study, they were both in the SSRI group. Contrasting Melvin et al, Goodyer et al included adolescents who were experiencing active suicidality and self harm, which Melvin et al did not. This could explain the differences in results between the two studies. Although combined treatment has been shown to be an effective way of treating adolescent depression, it can also have some its disadvantages. Vitiello (2009) voices that combined treat ment requires more resources and is more expensive. To be argued next are the findings for SSRIs superior to CBT. Returning to the study carried out by March et al (2004), unlike the other studies March et al found that the SSRI alone treatment was superior to CBT alone treatment. However, it is noted that this could be due to the low dose of SSRI used. Although SSRI in this study was superior in rapidly reducing depressive symptoms, it doesnt present to be more beneficial than psychotherapy in the long run. Also, it has been found that there are disadvantages to SSRI treatment. According to a systematic review, of eight studies, conducted by Barbui et al (2009), there is an increased risk of contemplated or attempted suicide among adolescents who are prescribed SSRIs. Barbui et al also mentioned that specific SSRIs such as Paroxetine and Venlafaxine would be better avoided when treating adolescent depression as the risks associated with these medications outweigh the benefits. Contradicting, a meta-analysis of randomised controlled t rial by Bridge et al (2007), found the benefits of antidepressants for adolescents to be far greater than the risk of suicidal thoughts and/or suicide attempts. Due to these risks, in 2004 the Food and Drug Administration (FDA) (as cited in McCain, 2009) required a black box warning, which is the most serious warning and consists of the warning surrounded by a black border. The FDAs boxed warning on the labelling of antidepressants mentioned an increased risk of suicidal thoughts and behaviours in paediatric patients when using the medication. Conflicting, Valuck et al (2004) conducted a study which involved 24,119 adolescents from across the United States of America and found SSRIs has no significant independent effect on the risk of suicide attempts among adolescents. Next to be discussed are the findings for CBT superior to SSRIs. Returning to the study conducted by Melvin et al (2006), Although this study found the combined treatment to be effective, Melvin et al (2006) also found that CBT received a stronger response at the posttreatment assessment compared to Sertraline alone. Although, Melvin et al recognised that this cannot demonstrate an advantage to CBT as the lower dose and slower titration schedule could explain the difference compared with previous studies. In addition, an evidence-based medicine review by Compton et al (2004) found CBT, at the time, to be the best treatment for depressive disorders in adolescents. CBT can be extremely helpful in cases where medication hasnt worked. According to the National Institute of Mental Health (NIMH, 2008), about 40 percent of adolescents with depression do not adequately respond to a first treatment course with an antidepressant medication. In cases like this, a combination of both CBT and SSR Is are used. Moreover, there has been research done on other types of treatment for adolescent depression, one being exercise. Although there has been little research done on this topic a randomised controlled trial orchestrated by Nabkasorn et al (2005), found exercise to improve depressive states. However, Nabkasorn et al did note that this study had some limitations such as its participants only being a very small group of adolescent females, 59 to be exact. Meaning that results from this study could not be transferred to other populations, ages, and severity of depression. In addition, a meta-analysis review (Cooney et al, 2013) of twenty five randomised controlled trials comparing exercise to various treatments such as placebo, pharmacological and psychological treatment. Cooney et al, found the exercise groups to have substantial improvement in depressive symptoms as opposed to the other groups. Divergent to Cooney et al, Blumenthal (1999, as cited in Carek et al, 2011) found that a variety of groups including exercise, pharmacological and combined, all had considerable improvement in their depressive symptoms with no a major difference between them. Another treatment method which has been studied is music therapy. According to Nauert (2014), a new study, the largest study of its kind, including 251 children and young people, found adolescents who received music therapy had significantly improved self-esteem and significantly reduced depression compared with those who received treatment without music therapy. Nauert states that these findings show the need for music therapy to be readily available as a treatment option. In addition,   Erkkila et al (2011), conducted a randomised controlled trial for music therapy alone or in combination with standard care including 79 participants. The results showed participants who received a combination of those treatments showed greater improvement in depression symptoms than those who received standard care only. According to Erkkila et al, the number of participants was sufficient enough to identify a difference between the two treatment options. Also, Castillo-Pà ©rez et al (2010), performs a randomised control trial for the effects of music therapy compared with psychotherapy for depression. This trial also consisted of 79 participants and found the participants receiving music therapy had fewer depression symptoms than those in the psychotherapy group. Dissimilar to Erkkila et al, Castillo-Pà ©rez et al noted that one of the major limitations for their trial was the somewhat small participant size yer the differences in depressive symptoms between the two trial groups were evident. There are many reasons as to why an individual would decide to take an alternative route for treating depression such as music therapy or exercise. According to Hanzell (2007, as cited in Maratos et al, 2008), this could be due to a lack of satisfaction with conventional treatments and/or a wish to avoid side-effects from medication or the stigma attached to seeking talking therapy. Also, Tartakovsky (2013) states other reasons could be the severity of the depression as many people arent sure if their state needs to be treated as there may be people with worse symptoms who need treatment more. Tartakovsky also states money can be an obstacle, in the UK the majority of the treatment individuals receive is free through the National Health Service, however, in other countries such as the USA, not everyone can afford to put their children into therapy and other treatments as their insurance plans may not cover the costs. In conclusion, it is apparent from research conducted that a combination of both SSRI treatment and CBT treatment is recommended to treat adolescent depression and appears to be the most effective way of treating adolescent depression. Although this is the most effective treatment it is not always the first in line, and SSRIs are more commonly the first point of call for adolescent depression. However, it has been noted that other forms of treatment such as exercise are equally as beneficial and should, in fact, be one of the first lines of treatment for adolescent depression. In addition, other treatments such as music therapy have shown to be beneficial and could be used as an additional treatment. Although there is research showing the benefits of treatments, there could be more research done in order to quickly find the right course of treatment for the individual.

Five-Antiretroviral Drug Class Resistant HIV-1

Five-Antiretroviral Drug Class Resistant HIV-1 Five-Antiretroviral Drug Class Resistant HIV-1 In A Treatment Naà ¯ve Patient Suppressed With Optimized Antiretroviral Selection Joseph M Volpe, Douglas J Ward, Laura Napolitano, Pham Phung, Jonathan Toma, Owen Solberg, Christos J Petropoulos, Charles M Walworth Abstract Transmission of HIV-1 exhibiting reduced susceptibility to protease and reverse transcriptase inhibitors is well-documented, but is evolving for integrase inhibitors and is limited for the fusion inhibitor enfuvirtide. We describe here a case of transmitted 5-drug class resistance involving protease, reverse transcriptase (nucleoside and non-nucleoside), integrase, and fusion inhibitors in an antiretroviral naà ¯ve patient that subsequently was successfully treated based on the optimized selection of an active antiretroviral drug regimen. Keywords: Transmitted Drug Resistance; TDR; Integrase Inhibitor Resistance; Tropism; Introduction Drug susceptibility can be a key determinant in choosing an initial antiretroviral (ARV)regimen for patients who are naà ¯ve to ARV therapy.The selection of aregimen in which individual components have less than full susceptibility can result in virologic failure.Transmission of HIV-1 exhibiting resistance to protease (PR) and reverse transcriptase (RT) inhibitors is well-documented[1-3] andbecause of this,DHHS guidelines recommend baseline genotypic resistance testing to guide drug selection in patients who are ARVnaà ¯ve[4]. However, given the relative newness of the integrase (IN)inhibitor class and the limited use of enfuvirtide (ENF), transmitted resistance for these drug classes is less well-defined[5-7]. To date, two cases of raltegravir resistant HIV-1 transmission have been reported in the literature[5-6]. Although transmission of virus resistant to more than one ARV class occurs less frequently than a single class[2-3], when it occurs, the selection of a baseline regimen can bemore challenging. Such was the case in 2005 when a New York City man acquired a dual tropic, multidrug-resistant HIV-1 strain[8], during a time when fewer therapeutic options were available. Here, we describe the first documented multidrug-resistant HIV-1 strain containing variants that exhibit resistance to five ARV classes. This reportnot only demonstrates one of the earliest cases of transmitted resistance to the integrase strand-transfer inhibitor (INSTI) class, but also exemplifies the need to develop a detailed resistance profile prior to initiating therapy. Case History A man in his forties was hospitalized in 2010 with severe flu-like illness. HIV-1 antibody testing during hospitalization was negative. HIV-1 RNA testing by PCR was not performed. Six months later, follow-up HIV-1 antibody testing was positiveand infection was confirmed by Western blot. Initial CD4+ count and viral load were 376 cells/mm3 and 211,540 copies/mL, respectively. Baseline genotypic resistance testing demonstrated extensive resistance to nucleoside and non-nucleoside reverse transcriptase inhibitors (NRTI, NNRTI) as well as protease inhibitors (PI) [Figure 1]. Confirmatory testing was performedto verify the initial genotypic resistance profile. Additional genotypic testing for INSTI resistanceand phenotypic testing for PI, NRTI, NNRTI and INSTIsusceptibility was conducted. Phenotypic co-receptor tropism testing was also performed to evaluate additional ARV treatment options. Due to the complexity of the baseline resistance profile, ENF susceptibility was also assessed. Methods Resistance-associated mutations (RAMs) to inhibitors of HIV-1 PR, RT, and IN were identified by conventional DNA sequencing(GenoSure ® MG, GenoSure ®Integrase, Monogram Biosciences and LabCorp).Phenotypic susceptibility to PR, RT,and INinhibitors, ENF, and co-receptor tropism were also assessed using well-established pseudo-virus infectivity assays (PhenoSense ®, PhenoSense GT ®, PhenoSense ®Integrase , PhenoSense ® Entry, and Trofile ®, respectively; Monogram Biosciences). Molecular clones of full-length envelope sequences were generated and evaluated for ENF susceptibility and co-receptor tropism (PhenoSense ® Entry, Trofile ®). The gp41 sequences of envelope clones were generated by conventional DNA sequencing. Phylogenetic analysis was conducted on clonal gp41 sequences to rule out co-infection. PR and RT regions were also interrogated by massively parallel (â€Å"deep†) sequencing. A sequence library was generated using the IlluminaNextera XT library preparationkitand an IlluminaMiSeq2x250bp paired-end run resulted in 1,017,032 reads with an average read depth of >15,000X (after alignment). Reads were trimmed using cutadapt and fastx toolkits and aligned to the NL4-3 reference genome (accession number AX032749.1) using bowtie2[9]. Results Genotypic resistance analysis of the baseline virus identified mutations associated with resistance to PI (L10Y, K20I, E35D, M36I, K43T, I62I/V, V82K), NRTI (M41L, D67N, L74V, L118I), and NNRTI (K101E, Y181C, V189I, G190S) [Figure 1]. Repeat genotypic resistance analysis from a second draw confirmed the initial findings, as well as mutations associated with INSTIresistance (G140S, Q148H). Reductions in susceptibility to PI, NRTI, NNRTI, and INSTI were confirmed by phenotypic testing, which demonstrated large reductions in susceptibility to efavirenz, nevirapine, and raltegravir. Notably, the NRTI resistance mutation M184V was not identified bygenotypicassessment although a phenotypicassessment revealedmodest reductions in susceptibility to emtricitabine and lamivudine (IC50fold change (FC) 7.16 and 5.25 respectively)that exceeded the biological cutoff (FC 3.5).Further analysis of the sample using deep sequencing failed touncover minor variants harboring an M184V substitution. Neither deep sequencingnor the phylogenetic analysis of envelope clone sequences yielded evidence for dual infection. Initial phenotypic analysis for ENFsusceptibility (FC 6.31)fell within 0.2 log10of the biological cutoff(FC 6.48). This cutoff is based on a reference population of ENF-naà ¯ve baseline isolates from the TORO clinical trials [10]. Given the proximity of the measuredENF susceptibility of the patient sample to the biological cutoff and considering both the broad distribution of the susceptibility of the reference population and the inherent variability of the phenotypic assay ( ±3-fold), further analysis was warranted. Consequently, envelope gp41 sequencing was performed on 44 molecular clones generated from the virus population. Phenotypic analysis to determine ENF susceptibility was performed on 20 of the 44 clones that had unique gp41 sequences relative to the consensus sequence of the virus population. Two clones, (#10 and #25), exhibitedreducedENF susceptibility(FC 46 and >MAX, respectively), well above the biological cutoff. The gp41 sequence of these two clonesrevealed novel substitutions (Q40R, N43S) at amino acid positions previously associated with ENFresistance [11]. Co-receptor tropism testing indicated that 19 of the 20 selected clones exhibited R5 tropism, consistent with the R5 tropism determination for the overall virus population. Based on resistance and co-receptor tropism testing, the patient was placed on a regimen of ritonavir-boosted darunavir, tenofovir/emtricitabine, and maraviroc, which successfully suppressed viral replication to 3 at diagnosis to 614 cells/mm3 at one year of treatment. At three years post-initiation of treatment, the patient’s virus remains suppressed with a CD4 count of 865 cells/mm3 (Table 1). Discussion To our knowledge, this case representsthe first confirmed report of the transmission of HIV-1 containing variants exhibiting resistance to five antiretroviral drug classes,as well as the third confirmed report of transmitted INSTI resistant HIV-1.The selection of tenofovir/emtricitabinein the treatment regimen was based upon an assumption that anM184V variant might have been present below the limit of detection for population sequencing. Often, lamivudine or emtricitabineis incorporated intoARV treatment regimens toexploit the impaired replication of M184Vvariants, despitelimited evidence to support this approach. Detectable reductions in phenotypic susceptibility due to M184V variantsrequire a viral subpopulation approximating 40% of the total viral population[12]. Here, the absence of an M184V-containing subpopulation below the limit of detection of genotypic assays was confirmed by deep sequencing.Thus, the observed reduction in phenotypic susceptibility to emtricitabine and lamiv udine waslikely due to the combination of L74V and V118I substitutions along with the thymidine analog substitutions M41L and D67N. This case further demonstrates the clinical utility of co-receptor tropism testing to guide maraviroc prescription.ARV treatment experienced patients have a lower prevalence of R5 tropic virus compared with ARV treatment naà ¯ve patients. Laboratory studies demonstrate preferential transmission of R5 virus[13] and data from clinical cohorts demonstrate that over 70% of ARV naà ¯ve patients harbor R5 tropic virus[14]. In ARV treatment naà ¯ve patients, there is no genetic linkage data to suggest that ARV resistant profiles in pol influence envelope co-receptor tropism. Despite the extensive ARV resistance profile identified within the pol gene, the case patient was treatment naà ¯ve and thus more likely to harbor R5 tropic virus. Envelope substitutions associated with ENFresistance include Q40H and the N43D.Clonal analysis of this case virus led to the identification of two novel substitutions Q40Rand N43S that were demonstrated to confer high level phenotypic resistance to ENF. The value of baseline resistance testing to determine an optimal ARV treatment regimen is highlighted in this case report. Current DHHS guidelines recommend supplemental genotypic INSTI resistance testing when transmitted INSTI resistance may be a concern[4]. There is evidence that transmitted INSTI resistance is followingthe same temporal coursepreviously observed for NRTI, NNRTI and PI[15]. With the recent approval of a third INSTI, more widespread INSTI use, overlapping INSTI cross resistance profilesand documentation of this third case of transmitted INSTI resistance, baseline testing for INSTI resistance may become prudent. Figure 1: Results of both the genotypic and phenotypic drug resistance analyses are listed here. The net assessment column considers both the genotype and phenotype test results and provides a final resistance call based on the cumulative data. †  Single values represent biological cutoffs, and ranges indicate lower and upper clinical cutoffs. †¡ Fold change is defined as the ratio of the measured IC50 for the patient-derived virus to that of the NL4-3reference virus. Table 1: Patient Clinical Parameters Viral loads, CD4 and CD8 counts, and CD4/CD8 ratiosfor this patient are listed over the treatment period. The initial viral load measurements were obtained using the Roche COBAS ® TaqMan ® 2.0until 7/12. Subsequent values were obtained using the Siemens Versant ® HIV-1 Branched DNA assay.

The Beatles :: Essay on The Beatles

When people hear the name "The Beatles" most people think of lead singer, John Lennon. However, the role of Paul McCartney is often overlooked. It was McCartney, not Lennon who was the driving force behind the Beatles. John Lennon and Paul McCartney were in many bands together before the forming of the Beatles. In 1962, along with Ringo Starr1 and George Harrison, they formed the rock group known as "The Beatles". The group featured a modern rock that was new and popular during the period with John and Paul composing and doing the leads on most of the songs. They were backed by George on rhythm and bass guitar and Ringo on drums. George and Ringo also assisted on backing vocals. When they first began playing, the main influence inside the band was John Lennon, who had an uncanny ability to compose songs at a moments notice with an inspiration that others missed. He pushed the members of the band during their touring years and was able to achieve the best possible results from the group. The band began playing in a Music Hall style that is very effective for the audiences but was lacking on their albums. Together with Paul, John began to evolve the band. As the years began to pass, the band was obviously beginning to grow musically. They had moved from simple lyrics like "Love me Do" to harshly aware reflections of life in their home country in "Eleanor Rigby"2. There were attempts, some more successful than others, to incorporate the other Beatles into the idea stage. George Harrison made this leap successfully with such tracks as "I want to tell you", "TAXMAN", and the psychedelic "Love you to". Ringo was featured in the humorous "Yellow Submarine" As the group matured, their creativity began to rely more on the effects and manipulations that they were able to produce in the studio. The Beatles agreed to end their touring career after an American tour of large halls that they failed to fill. It was around this time, that John Lennon began to search for himself. He began using any means that he thought might help him connect. This era was marked by the Beatles visits to the Maharashi Mahesh Yogi, and the beginning of heavy drug use 3. As Lennon began to use LSD in greater and greater quanti-ties4, the other Beatles began to have more and more influence in the production of the albums. Lennon began to become almost reclusive, and often delayed recording sessions.By the time that they were recording Sgt. Pepper's Lonely Hearts Club Band in 1967, Lennon would simply propose songs and themes, and McCartney was left to execute the

Antony and Cleopatra :: essays research papers

The representations and interplay of types of power: In Shakespeare’s famous play Antony and Cleopatra, the powerful are portrayed including their personalities, their reactions to other powerful figures and the interplay of these powers as the characters interact. Antony’s Power: Shakespeare uses Rome and Egypt as binary opposites not just to reflect qualities inherent in the two places, but the changes that come upon Antony depending on which place he is in. The changes in Antony’s behaviour and power-usage patterns can be seen through Shakespeare’s constant juxtaposition of the Egyptian and Roman worlds. Antony’s behaviour tends to change as in the exotic place that is Egypt Antony is allowed to escape from his Roman self : "I will to Egypt†¦I'th' east my pleasure lies.â€Å"2.3.38-40. The word â€Å"pleasure† indicates that Egypt has a sexual appeal to him in the form of Cleopatra. He adores his role as king in Egypt, being the self-indulgent lover of Cleopatra. However in Rome, Antony must attend to his political ambitions, duty to administration, his citizens and soldiers. These are duties he does not wish to be burdened with: "Let Rome in Tiber melt and the wide arch / Of the ranged empire fall!† Antony describes his feelings while in Egypt as a hyperbole, which reflects how his behaviour becomes irrational. Moving on to Cleopatra’s Power, it can be seen that she uses her coercive sexual power to entice and manipulate Antony’s behaviour and decisions, inevitably ending in the weakening of their relationship. Cleopatra knows her powers of manipulation: "I drunk him to bed;/ Then put my tires and mantles on him, whilst I wore his sword Philippan.â€Å"2.5.21-23. She makes a mockery of him as he is the Philippan victor that is metaphorically stripped of his sword and therefore his political and sexual power, by a woman. She is described by him in a metaphor, as an â€Å"enchanting queen† which connotes a sense of uncontrolled mesmerisation with a powerful figure. To those removed from the situation, such as Caesar, she is described as a â€Å"whore† and Antony's life with her is full of â€Å"lascivious wassails† demonstrating the wanton behaviour that Cleopatra has almost imposed on Antony.

Effect of Rizal’s Writings to the Filipinos

Jose Rizal is known for his writings which increased the awareness of the Filipino people of the wrong doings of the Spaniards and it united some Filipinos to form a group against the government. His writings sparked the rebellion against the Spaniards and they believed that Rizal was one of the masterminds of the war which was the reason why he was tested and sentenced to death.Rizal is considered as the national hero in the Philippines because he fought for our freedom and he showed the full potential of the Filipinos knowing that it would cost him his life. One interesting thing about Rizal is that he used a different method to attain peace compared to others. He used his knowledge in writing to make poems and novels instead of using force and violence which most people did to gain freedom.He embedded ideas to the Filipinos that raising arms is not the solution because people die but our ideals and beliefs will not. He was able to reclaim the hearts of the Filipinos and reminded t hem how important it is to love one’s country. Rizal was an excellent writer and poet. He was able to portray his beliefs and opinions clearly to the people which easily got their attention and realize what they are capable of doing. He showed the people that one can change even without violence. Nowadays, Filipinos rarely know who Rizal is.The only thing they know is that he is our national hero because it is what was taught to them in their basic education. Some don’t even know who he is or what he did for our country which is really depressing because we are forgetting our own culture. I believe that Rizal’s life and writings have minimal effect on today’s youth because it is considered by many as another waste of time since they won’t use it anyway when they graduate or in the courses they will take in college. In order to

Of Mice And Men Slim Questions Essay

Question A- How does the extract improve the reader’s understanding of Slim? The passage immediately introduces Slim as an authoritative and almost regal member of the ranch: â€Å"He moved with a majesty only achieved by royalty and master craftsmen.† Most of the men working on the ranch are transient and poor and, although Slim is no exception, he does not share their careless and selfish attitudes. Slim also accepts his authority and responsibilities, despite the fact that he would have little respect outside of the ranch, which, ironically, places him in high standing on the ranch. This is emphasized by the admiration and respect given to him by the others: â€Å"†¦the prince of the ranch†. He is awarded a title by the others due to the fact that they do not see him as equal to them; they view him as an almost mythical person of extreme benevolence and compassion. They therefore give him more attention and hold him higher esteem than they do with anyone else on the ranch, meaning that Slim has, in the men’s opinions; become the unofficial leader of the ranch. Furthermore, the passage describes Slim as something similar to a divine being: â€Å"His hatchet face was ageless†. This suggests that, to the others, Slim is god-like and unique in his ability to never fail physically and consequently never to suffer the pain, humiliation and uselessness anyone else would be forced into, as demonstrated by Candy. Despite all of the adoration and respect surrounding Slim, it is clear to the reader that his future is that of the other men, as shown in the statement: ‘Like the others he wore blue jeans and a short denim jacket.’ Slim is like every other worker on the ranch; he is exactly as lonely and incomplete as they are, symbolised by his clothing, and he has to cope with the same problems. The reader is shown the reality before the idolised view, but it makes the build-up of his prowess and pre-eminence all the more staggering. It becomes apparent that despite all of the idolisation and respect that surrounds Slim, he will eventually succumb to his fate and become like Candy, useless and alone. Slim is displayed with an aura around him of intelligence and importance that is felt by everyone at the ranch: â€Å"There was a gravity in his manner and a quiet so profound that all talk stopped when he spoke.† Slim is constantly presented as a stark difference to the other characters, someone to idealise and appears as something abnormal yet desired by them all. He becomes the other character’s paragon of perfection, everything they had wished to be. Similarly, he is shown to be considered omniscient by the others on the ranch: â€Å"His ear heard more and was said to him, and his slow speech had overtones not of thought, but of understanding beyond thought.† Slim is revered by the others as someone far beyond their comprehension as well as something they could only wish to be. They are all lonely and so connect to Slim as someone who they believe could protect them and could advise them without judging or pitying them; in his understanding of them, he becomes their guide and protector. Contrastingly, Steinbeck gives his character a very real and human nature to him as well: â€Å"‘It’s brigther’n a bitch outside,’ he said gently.† It is easy for the reader to become swept up in the exaggerated, romanticised and dramatised version of Slim but the reader is shocked by the simplicity of Slim’s mannerisms and behaviour, but this shock is not unpleasant. The contradiction throws the reader, but also shares with them the characters’ ability to befriend Slim despite his apparent superiority and further shows that despite his air of mystery and omniscience, he is similar to the other men. How does Steinbeck use the character of Slim to convey ideas and themes in the novel? Loneliness and isolation is despairingly apparent throughout the novel and Slim is used to highlight it: â€Å"Slim came directly to George and sat down beside him, sat very close.† Steinbeck uses Slim as a protector of George and a life line to redeem him, to accent the fact the in the aftermath of Lennie’s execution; George is then as completely alone as everyone else on the ranch and like the other transient workers during that time period. Slim is used throughout the novel to show the need for hope during the Great Depression, as shown when he comforts George. Slim is also used to show the inevitable loss of hope and the realisation that many cannot achieve their ‘American dream’: â€Å"You hadda, George. I swear you hadda.† The speech here is used as comfort to George after he shoots Lennie, but it also an equivocation and implies that George never really had an opportunity to achieve his and Lennie’s ‘American dream’, that none of the characters in the novel did and that they would always end up alone, no matter how hard they fight to change this. Furthermore, Slim’s character is used to display the harsh reality of the world and displays the efficient and unsentimental view of a ranch: â€Å"Candy looked a very long time at Slim to try to find some reversal. And Slim gave him none.† The cruel reality of a world where worth is decided by a single party and skills have no sway over events appears as a strange concept to the reader and Slim is used to demonstrate that it is necessary for him to pass judgement over the other men on the ranch and the events of the novel. Slim is displayed as the embodiment of strength and skill in the novel: â€Å"†¦capable of driving ten, sixteen, even twenty mules with a single line to the leaders.† This shows that he has value to the ranch and that he is still capable of working for them successfully and while used to boast his abilities, this description of Slim is also used to show that characters in the novel and the transient workers of the time needed to be useful in order to stay on for work and to keep in high opinions of their employers and co-workers. In this, Slim is shown to be useful, and therefore have value because he is still young and fit enough to work. Contrastingly, he is also shown to be limited and allows a shift in the good and evil balance: â€Å"You stay here with her then, Candy. The rest of us better get goin’.† Even though Slim’s abilities and influence are exaggerated by the imaginations of the men on the ranch, they are still real and if he had wished to stop Curley’s attempts to kill Lennie he probably would have succeeded. Steinbeck uses him here in the crucial moment that decides Lennie’s fate, to show that all evil needs to succeed is for good people not to stop it.

The effectiveness and roles of CAMHS Emergency/Paediatric Liaison Teams in general hospital/Paediatric settings: A Systematic Literature Review

our site – CUSTOM ESSAY WRITING – DISSERTATION EXAMPLES Abstract CAMHS Emergency/Paediatric Liaison plays a vital role in the mental and physical health of children and adults, and has numerous benefits, both for the practitioners and for the patients. This report presents a systematic review of literature on the effectiveness and roles of CAMHS emergency/paediatric liaison teams in general hospital/paediatric settings. The main source of literature that were used in this study comprised of journal articles obtained from different scientific databases such as PubMed and Emerald. Whilst the role of CAMHS emergency/Paediatric liaison teams in healthcare are acknowledged in this research, it has been established that their effectiveness is hampered by their current limited capacity. Introduction In healthcare, interdisciplinary or multidisciplinary teams play a key role in provision of overall services to different groups of interest. Such teams comprise of healthcare professionals and workers specialised in different disciplines, each providing different services that contribute to the overall well-being of the patient(s) (Ke et al., 2013). An example of such teams is the collaboration between professionals in child and adolescent mental health services (CAMHS) and paediatrics, who work in liaison to provide mental and physical health interventions for children in different healthcare settings (Lamb & Murphy, 2013). The link between mental and physical health problems among children have been recognized for a long time, and one way in which this can be addressed is through the integration of child psychiatric and paediatric services (Herrenkohl et al., 2013). Child psychiatrists who work in paediatric liaison settings argue that there are several cases of children whose parents/guardians incur high service costs in treating physical symptoms that turn out to have underlying psychiatric issues (Costello et al., 2014). Such conditions include Somatoform disorders, which are exhibited through physical symptoms(Perez et al., 2015). These high costs can be effectively through hospital paediatric liaison mental health services because it facilitates evidence-informed diagnoses and treatment from both physical and psychiatric practitioners. Other benefits include proper interventions for physical and psychiatric health issues among children(Costello et al., 2014). However, evidence from researches such as Foster (2009) indicated that in the United Kingdom, such liaisons are few and as well, have a high vulnerability to service cuts. As this literature review explores of the effectiveness and roles of CAMHS emergency/paediatric liaison teams in general hospital/paediatric settings, it critically evaluates its possible positive and negative implications in child care. It is based on this reviews that recommendations for practice can be provided to ensure that such multidisciplinary teams solve the problems that may be currently being faced as a result of the shortage of paediatric liaison mental health services (PL CAMHS). The objectives that are to be addressed in this review of literature are as listed below: To examine how CAMHS Emergency/Paediatric Liaison Teams in general hospital/Paediatric settings work. To establish the effectiveness of CAMHS Emergency/Paediatric Liaison Teams in general hospital/Paediatric settings. Methodology During this research, a secondary study approach, through a systematic literature review, was used. This research approach involved the utilization of data from sources that have already been published on the subject being studied. The selection of this research approach was because a lot of information can be obtained from a wide variety of sources within a short time (Lilford, et al., 2017). This is as compared to primary research where respondents would have to be selected, and data collection approached administered to them, which is both time consuming and costly. With regards to the inclusion and exclusion criterion, priority was given to article that have been published in reputable journal databases such as Pubmed, Wiley Online Library, Biomed and Emerald. This was instrumental in ensuring the authenticity of both the sources and the information contained in them because journal articles published on these databases undergo a rigorous process of review. When searching for data sources on the internet, keywords were used in order to return the articles, books or reports that had the most relevance for the research. Some of the key words that were used included ‘paediatrics, ‘child mental health’, ‘CAMHS Emergency/Paediatric Liaison’ and ‘multidisciplinary teams in healthcare’. Another criterion used for selection was the time of publication. The sources used were only to be those published within the past 10 years. Selection of recent data sources is ideal because it provides information that is still relevant and valid. Given that the UK health sector undergoes constant changes in order to make it more effective and efficient, reliance on older sources might provide an inaccurate description of the current situation with regards to CAMHS Emergency/Paediatric Liaison. On application of these search, inclusion and exclusion criteria in searching for secondary sources, there was an assurance that the information presented in the systematic review was highly relevant. Tables were used in the presentation of results.FindingsIn most cases, caregivers of the patients may be concerned, and wish to access some advice so as to determine the possible impact of an illness to a child and also explore some of the possible ways of getting to communicate about the illnes ses (Herbert et al., 2016). Referrals in most cases get to typically involve those situations where there are some additional psychological issues. The liaison service has a great advantage as it is multidisciplinary and it provides so many interventions that could include; psychiatric nursing, family work, and some psychological therapies. Teaching, consultation, supervision and training is provided for the therapists and also the staff that is working hard towards the provision of the required services. Young people and child mental health is sub-specialty of both paediatrics and also mental health. The disparity that exists between the fields leads to some delay in the development of young people and child mental health services (Wilson, Metcalfe & McLeod, 2015). Berelowitz, and Hugo (2015) claim that liaison between the mental health and general services can be quite challenging and it is often unmanaged and unplanned. The need for a robust liaison model is recognized, however collaborative working especially between the professionals is rarely evident. A framework that is multidisciplinary is the most effective working model for liaison. There needs to be a lot of commitment in the psychiatric, paediatric and also psychological disciplines as they are very essential to its overall success. More children and also adolescents are presenting the A & E departments with harm that they cause on themselves, they are admitted with other conditions that include, psychosis, psychosomatic problems and also some eating disorders (Griffith &Glasby, 2015). It has generally led to an increase in the number that is accommodated on the adolescent units and the pediatric wards. Provision of the inpatient CAMHS is yet to catch up with an increase in the recognition of the increased need. The mental health needs of the children and adolescents have received a high priority especially in those health policies that have been formulated recently. The nurses have a role to ensure that they provides collaborative and also evidence based mental healthcare for the children and adolescents as well irrespective of their clinical environment (Wilson, Metcalfe & McLeod, 2015). CAMHS nursing role is very specific and adds a lot of dimension in most cases to the care that the children and also adolescents that have the mental health issues need. It is inclusive of those other disciplines that lack time, resources and also skills so as to deliver effectively. Liaison nursing has its major focus on the relationship that exists between the patients and also the nurses rather than the treatment and also diagnosis of various diseases (Cleaver, 2014). Nurses that are available in CAMHS liaison have the duty of providing, consultation, clinical care, education, supervision, nursing and also ensure that they undertake research(Ke et al., 2013). They ensure that they provide both support and also nursing advice to the colleagues that are in the paediatric setting and they all the time as they have a responsibility of ensuring that the wellbeing and also safety of the clients is provided fully. Recognition of the fact that nurses are providing care in an environment t hat is less than perfect is very important to the building of partnerships that are effective. It also leads to the acknowledgement of the challenges of caring for those adolescents that are troubled in the emergency departments or even the paediatric ward (Herbert et al., 2016). Glazebrook, Townsend and Sayal (2015) found out that the response given to the children and adolescent mental health needs requires some serious consideration of the variety of services that are provided at different levels. They are the early intervention programs, the ones of mental health promotion, the primary and also community mental health care services, and specialist services on mental health for those conditions that are more serious. A lot of evidence has been documented to clearly demonstrate that the behavioural difficulties and also early implementation of the programs that are meant to support the families can lead to better outcomes in the health of the children and also adolescents that are at risk of developing chronic mental health problems (Griffith & Glasby, 2015). CAMHS programs have been very crucial in addressing the risks that are faced and also providing some protective factors early in life need (Glazebrook, Townsend & Sayal, 2015).Wilson, Metcalfe, and McLeod (2015) add that for those children and also adolescents that are at more risk, this includes those ones that come from families that have a lower income, low levels of education, and also all those ones that live in those areas that are disadvantaged. The schools also have a role of ensuring that they focus on promoting positive mental health. An approach that is based on the school encompasses the whole learning environment of the learner and this includes the physical environment, curriculum, and also the links that exist between the community and the parents as well (Cleaver, 2014). There are some capacity building and also personal elements of mental development that lead to the general improvement of the children and also provide more opportunities that promote their wellbeing. Prevention of bullying is a key element that leads to the promotion of health, so there is need to develop some policies that deter such vices from existing in the learning environments(Costello et al., 2014). Adolescent is a very crucial stage in the psychological development of a child. The children require a lot of understanding of the life challenges that they face so that they can develop skills so as to cope with those emotions that are considered to be difficult (Cleaver, 2014). The adolescence stage is a time that a higher risk of poor mental health that may result in depression, anxiety, depression, psychosis, substance misuse and even some eating disorders. There is also an increasing risk of suicidal behaviour and even deliberate self-harm. CAMHS is very crucial in providing the children and also adolescents the services that they need (Glazebrook, Townsend & Sayal, 2015). Discussion The increasing number of both children and also young people who have mental problems and receive care in the paediatric settings presents a huge challenge to the nurses. Some of them do not have any mental nursing experiences or even qualifications (Herbert et al., 2016). Cleaver (2014) claims that on call nursing support is something that most of the nurses feel is the most beneficial, aspect of the services of liaison teaching and also individual support with the young person is very important. There is need to ensure that a project is initiated that will lead to improvement of liaison in the general paediatric wards and the child and also adolescent mental health services. There is a gap that exists in addressing the need of the many children and young adults that have physical illnesses and also some mental health needs. CAMHS paediatric liaison service tends to focus on the mind and also body interface. The service offers consultation to so many referrers. They provide a lot of help to the children and also adolescents that have mental health problems. Interventions that they offer are of help not only to the affected group, but also to their families as well (Cleaver, 2014). Herbert et al. (2016) assert that they also target the psychological barriers that exist to physical care, the psychological management of the physical symptoms among many other issues. It has over the years provided consultation and also advice to adult services especially in the hospital for those patients that need some care due to their mental state. Even though the objectives of the research were met, there are several limitations that were encountered in this research that may have limited the effectiveness with which the research objectives could have been met. One of these was the challenge in the selection of article to include in the report, out of hundreds that were found online. In addition to this, the fact that many databases had to be accessed, some of this requiring paid access, also contributed to the limitations of the study. Whilst the secondary research approach has its strengths, there are some associated limitations. The strengths include the fact that the need for ethical clearance before carrying out the research is less emphasised (Mallett et al., 2012). This is as compared to primary research where research ethics have to be adhered to in order to avoid exposing research subjects to any form of harm. A limitation, on the other hand, is in the fact that the information collected is not first hand and thus, makes it difficult to ascertain that indeed, that is the exact issue or challenge being faced in CAMHS Emergency/Paediatric Liaison situations in the United Kingdom. In conclusion, the findings from the different sources that were included in this systematic review highlight the importance of CAMHS-PL liaisons in general hospitals. Children and adolescents who may have psychiatric issues that are manifested through physical symptoms have an assurance of getting the necessary intervention and relief by seeking these services. Another advantage is that the overall costs incurred in treatment are less than when physical and mental healthcare are disconnected(Costello et al., 2014). Some of the issues that can be effectively addressed by CAMHS/Paediatric liaisons include tobacco use among adolescents that may lead to mental issues, insecure attachments that contribute towards self-harm, acute mental distress and ICD-10 psychiatric disorders, among others. This justifies the need for more multidisciplinary teams in child and adolescent physical and psychiatric care. References Berelowitz, M., & Hugo, P. (2015). Management of the Really Sick Child or Adolescent with Anorexia Nervosa in Hospital: The Role of Child and Adolescent Mental Health Services. In Critical Care for Anorexia Nervosa (pp. 11-40). Springer International Publishing. Cleaver, K. (2014). Attitudes of emergency care staff towards young people who self-harm: a scoping review. International emergency nursing, 22(1), 52-61. Costello, E. J., He, J. P., Sampson, N. A., Kessler, R. C., & Merikangas, K. R. (2014). Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey–Adolescent. Psychiatric Services, 65 (3), 359-366. Foster, C. (2009). Adolescents in Acute Mental Distress on Inpatient Pediatric Settings: Reflections From a Pediatric Liaison Practitioner. Journal of Child and Adolescent Psychiatric Nursing, 22 (1), 16–22. Garralda, M., & Slaveska-Hollis, K. (2016). What is special about a Paediatric Liaison Child and Adolescent Mental Health serviceChild and Adolescent Mental Health, 21 (2), 96–101 . Glazebrook, K., Townsend, E., & Sayal, K. (2015). The Role of Attachment Style in Predicting Repetition of Adolescent Self?Harm: A Longitudinal Study. Suicide and life-threatening behavior, 45(6), 664-678. Griffith, L., &Glasby, J. (2015). â€Å"When we say ‘urgent’it means now†¦Ã¢â‚¬  Health and social care leaders’ perceptions of each other’s roles and ways of working. Journal of Integrated Care, 23(3), 143-152. Herbert, A., Christian, C. I. S., & RA, C. (2016). CAMHS/AMHS Transition Policy, Islington. Policy. Herrenkohl, T. I., Hong, S., Klika, J. B., Herrenkohl, R. C., & Russo, M. J. (2013). Developmental impacts of child abuse and neglect related to adult mental health, substance use, and physical health. Journal of family violence, 28 (2), 191-199. Ke, K. M., Blazeby, J. M., Strong, S., Carroll, F. E., Ness, A. R., & Hollingworth, W. (2013). Are multidisciplinary teams in secondary care cost-effectiveA systematic review of the literature. Cost Effectiveness and Resource Allocation, 11 (1), 7. Kulkarni, M., Huddlestone, L., Taylor, A., Sayal, K., & Ratschen, E. (2014). A cross-sectional survey of mental health clinicians’ knowledge, attitudes, and practice relating to tobacco dependence among young people with mental disorders. BMC Health Services Research, 14 (1), 618. Lamb, C., & Murphy, M. (2013). The divide between child and adult mental health services: points for debate. The British Journal of Psychiatry, 202 (54), s41-s44. Perez, D. L., Barsky, A. J., Vago, D. R., Baslet, G., & Silbersweig, D. A. (2015). A neural circuit framework for somatosensory amplification in somatoform disorders. The Journal of neuropsychiatry and clinical neurosciences, 27 (1), e40-e50. Wilson, S., Metcalfe, J., & McLeod, S. (2015). Comparing Choice and Partnership Approach assumptions to Child and Adolescent Mental Health Services in NHS Greater Glasgow and Clyde. International journal of health care quality assurance, 28(8), 812-825. Wilson, S., Metcalfe, J., & McLeod, S. (2015). Comparing Choice and Partnership Approach assumptions to Child and Adolescent Mental Health Services in NHS Greater Glasgow and Clyde. International Journal of Health Care Quality Assurance, 28 (8), 812 – 825.