How to Write Essay Online - Top Tips

How to Write Essay Online - Top TipsFor everyone who is learning to write essays online, there are so many tutorials, writing samples and lessons available online. You will find that there are tutorials offered in easy format which you can follow. The writing sample is provided by professionals for you to understand the importance of correct grammar. In addition, you have access to free writing samples that are being given by professionals to learn to write online and how to compose essays effectively.In the present day, there are also lots of guides to help you conduct the entire procedure easily and successfully. You can find many helpful tips for composing essays online and how to study material and so on.It has been found that many students are very good with writing essays. That is why they do not need to pay money to writers as they can find the articles for free.All of us were taught by our professors in college about how to write well. There are so many resources available, w hich you can read if you want to know how to write essay properly. There are a number of books and articles available that teach you the fundamentals. However, for those who want to learn how to write well, there are so many resource available and you can get your hands on them if you wish to make your writing more effective.If you want to learn how to write well, there are many writing techniques that you can use to accomplish it. There are ways to write creatively using fancy paragraphs and keywords in your essay.Many have employed those tricks while writing their books and articles but there are so many ways to succeed in writing an essay. Many individuals also find it difficult to write essays. However, there are several ways available for you to learn how to write an essay. You can start from the basics and become more comfortable with the art.There are so many free resources and essays available in the internet that can help you write an essay. There are online and offline tut orials. When you take time out from your daily chores, you can easily access these resources to learn how to write essays and how to compose great sentences.

Analysis Of The Book Tom Sawyer - 1094 Words

Mark Twain’s book titled Tom Sawyer has great popularity. Twain is a famous American author known for his stories. 1876 is the year of publication of the book. Nevertheless, over the years there have been many editions of it. I chose the book because it is quite an interesting read since it presents the adventurous life story of a boy as he grows up. It is thus an adventurous book. His life and the manner in which he interacts with people around him are impressively demonstrated in the book. This paper is a book report on this book as authored by Mark Twain. Themes Adventures are a major theme in the book. It is clearly exemplified through the life of Tom and the boys whereby there are able to exposed to experiences incomparable to children their age. It crucial to note that this theme is founded on the theme of manipulation since in the absence of manipulation there would be no adventurous moments. In a manipulative way, Tom succeeds in coercing his friends to be a part of his adventurous life whereby they are able to explore life to a level that is above their age. Another theme is superstitious where the boys are able to follow the community’s belief as it will be demonstrated in the plot by visiting the grave. Among other themes in the book, social exclusion stands out as well, which is illustrated by the character of Huck whereby he does not get the opportunity to interact with other kids. Huck fends for himself due to the fact that his Muff Porter is person addictedShow MoreRelatedAnalysis Of The Book Tom Sawyer 1629 Words   |  7 PagesTom sawyer is a very fun and entertaining book and is great for all families and children alike. Why do i say this, I say this because the book of Tom Sawyer is set in St. Petersburg, St. Petersburg may be small but it s got everything a boy could ever want. This really adds to the excitement and appeal of the book. Another thing that adds to the appeal of the book is the narrator point of view. Twain does a good job of using versatility and verbal skill in the narrator point of view. For exampleRead MoreCritical Analysis Of The Adventures Of Tom Sawyer904 Words   |  4 PagesThe Adventures of Tom Sawyer Critical Analysis â€Å"Sometimes problems don’t require a solution to solve them, instead they require maturity to outgrow them.† (1). Eventually in life we will have to grow up and face our problems maturely, and it’s a large price to pay. In The Adventures of Tom Sawyer, Tom faces a challenge of maturity. The question is, did Tom mature socially or morally more? My thesis is Tom matured morally over socially in the book, due to how much he doesn’t learn to obey thoseRead MoreLiterary Analysis Term Paper for Tom Sawyer : a Classic Novel771 Words   |  4 PagesLiterary Analysis Term Paper for Tom Sawyer: A Classic Novel Mark Twain’s book is a novel that follows the juvenile life of a small boy. You will see how much fun the main character, Tom, and his friends have by skipping school, fishing, swimming, and using with their imaginations to have a good time. The Adventures of Tom Sawyer is a classic novel for many reasons. The plot gives us an idea about how people lived in the era the book takes place in. Readers enjoy the book because they can relateRead MoreThe Adventures Of Tom Sawyer . __________________. A Book1061 Words   |  5 PagesTHE ADVENTURES OF TOM SAWYER __________________ A Book Review Presented to Mr. Parsons and Mrs. Amy Lack Woodville High School __________________ U.S. History I and English 10 __________________ by Arian Campbell April 19, 2017 The Adventures Of Tom Sawyer The Adventures Of Tom Sawyer by Mark Twain is a 271-page novel. Tom is a boy, and merely and exactly an ordinary boy on the moral side. What makes him delightful to the reader is that on the imaginative side he is very much more, andRead MoreMark Twain s Adventures Of Tom Sawyer1586 Words   |  7 Pagescharacters, and plot of The Adventures of Tom Sawyer are closely related to Mark Twain’s own life experiences. The fictional town of St. Petersburg very closely resembles Twain’s childhood home in a small town in Missouri, because of the Mississippi River (Stanley 1). He remembers both the ups and downs of his childhood and conveys these in the novel (Higgins). Many of his memories of living by the Mississippi river are displayed in this novel as Tom has several encounters with rivers (â€Å"Mark Twain†)Read MoreAnalysis Of The Adventures Of Huckleberry Finn 1679 Words   |  7 Pages1. Analysis of an Important Character Adventures of Huckleberry Finn is a story about growing up, facing the world, and fighting for what’s right. Huckleberry Finn matures greatly throughout the book, and Tom Sawyer plays an important role in showing this change. His character allows the reader to see Huck’s increase in maturity throughout the story. Tom is the constant, his immaturity not changing from the beginning to the end of Adventures of Huckleberry Finn, while Huck is the changing variableRead MoreHuck Finn Character Analysis Essay1057 Words   |  5 PagesThe Adventures Huckleberry Finn Character Analysis The Adventures of Huckleberry Finn was written by Mark Twain in 1884 and is considered to be a Great American Novel. Mark Twain’s adventurous novel depicts the image of a young American boy living along the Mississippi River in the mid-1800s and expresses interpretations on on rules, morality, and racism. This caused a lot of controversy and criticism, due to the moral compass of the times. Although main characters play a major role throughout theRead More Huck Finn Analysis Essay1322 Words   |  6 PagesHuck Finn Analysis The Adventures of Huckleberry Finn A Critical Analysis SECTION I- Chapters 1 through 11 The book introduces Huck as the first person narrator which is important because it establishes clearly that this book is written from the point of view of a young, less than civilized character. His character emerges as a very literal and logical thinker who only believes what he can see with his own eyes. In this section Huck’s life with the Widow Douglas and her attempts toRead MoreAnalysis Of The Book Adventures Of Huckleberry Finn 1332 Words   |  6 PagesHuckleberry Finn Cheat Sheet Title: Adventures of Huckleberry Finn Author: Mark Twain Publication: December 10, 1884 Setting and Time period: The setting throughout the story mainly takes place along areas by the Mississippi River, and as stated in the book, â€Å"Forty to Fifty Years ago†. Characters: Huckleberry Finn - The protagonist and narrator of the novel. Huck is the thirteen-year-old son of the local drunk of St. Petersburg, Missouri, a town on the Mississippi River. Frequently forced to surviveRead MoreHuck Finn, And The Symbolism Of Huckleberry Finn830 Words   |  4 Pagesinjustice as a way to suggest civilization will never advance unless Americans can overcome the greed they have gained from supremacy. Huck describes many men as great and heroic throughout the novel. The way Huck talks about Col. Grangerford and Tom Sawyer are some of the most evident examples of this. In fact, he dedicates the start of chapter 18 to describe Col. Grangerford as a â€Å"Gentlemen all over† and â€Å"well born.† (105.) But quickly we see Huck’s view is tainted by the Grangerford’s romanticized

Ireland s Capital Of Culture - 1089 Words

Cork, Ireland is one of the most beautiful and culturally rich places on Earth. In 2005 Cork was selected as the European Capital of Culture. With Cork’s landscape dotted with old English castles and great Catholic cathedrals it is not hard to understand why Cork was 2005’s capital of culture. There are many examples showing Ireland’s rich cultural ties but a very good example is beer. Ireland is quite renowned for its beer production and consumption. â€Å"You can trace it back no fewer than 5,000 years, back into the earliest days of Irish agriculture, when the magical trilogy of fertile soil, soft rain and gentle, cool breezes made for a climate that could produce superb barley† (â€Å"A History of Beer in Ireland†). Cork happens to be headquarters of Murphy’s Brewery. In 1906 Murphy’s Brewery was the second largest brewery in Ireland and has remained a very large brewery ever since (Wilson). Beer is a simple example of one of the m any incredible things to visit Cork for. â€Å"Cork was originally founded by Saint Fin Barre in the 6th century† (Riain). The city itself is situated on the River Lee. The river splits making an island which is where the city center is located; the river re-converges at the eastern side of the city creating the Cork Harbour, one of the world’s largest natural harbors. Viking settlers, in about the 10th century, founded a trading post in Cork. It is hypothesized that Cork was an important trading center in the Scandinavian trading network (Moody). DuringShow MoreRelatedThe Creative Media Sector For My Assignment943 Words   |  4 PagesNorthern Ireland Screen The business I am researching in the creative media sector for my assignment is called – Northern Ireland Screen. The full name for the business is Northern Ireland Film Television Commission. It is a film production studio company which is a government-backed lead agency in Northern Ireland for the film, television and digital content industry, driving global growth through boosting our economy, celebrating our culture and enhancing our children’s education. This companyRead MoreNorthern Irelands Civil Unrest : Depressive Disorders And Suicide1726 Words   |  7 Pages Northern Irelands Civil Unrest in Relation to Depressive Disorders and Suicide Elizabeth Mathews Loma Linda University Northern Irelands Civil Unrest in Relation to Depressive Disorders and Suicide In Northern Ireland there has been a political, religious, and civil conflict prevailing for many years called ‘the Troubles’ (Mahedy, Todaro-Luck, Bunting, Murphy, Kirby 2012). It has resulted in immense civil unrest and social disturbances, many being traumatic, violent, andRead MoreUnited Kingdom Essay828 Words   |  4 Pagesthe North West of Europe that has four parts, England, Scotland, Wales, and Northern Ireland. The capital city is London, which the River Thames flows through from Thames Head to 140 miles later at Teddington Lock where it ends. Compared to the United States, the United Kingdom is quite small in fact it is approximately the size of New England. Despite being diminutive in size, there is layer upon layer of cultures and history. Also, it has geographic diversity, from the moors of Devon to the swampsRead MoreTaking a Look at Ireland1207 Words   |  5 Pages Project Proposal The country I’m choosing for my Sophomore English Research Paper is Ireland. I’m choosing this country because I want to be able to research and learn more about their religion, culture, etc. A recent problem in Ireland is Ireland is asking unemployed citizens to move away. The Irish government is sending letters to almost 6,000 unemployed people, asking them to take jobs in other countries. Although the IrishRead MoreThe History Of The Jig1321 Words   |  6 Pages‘to jump’.The Jig was popularly performed as a unique form of dance entertainment throughout England; commonly the Jig has a history of being displayed in many English plays. Ireland and Scotland took the Jig under their wing in the seventeenth century, where now the Jig plays a major part in these countries performance culture. The Jig includes many different formalities of the dance, such as the Slip Jig, Treble Jig, Light Ji g, and Hip Jig. All configurations of the Jig are equivalent in entertainmentRead MoreStrategic Management And Strategic Competition1596 Words   |  7 Pagesapplied to produce above average returns. Finally, the company mission and vision statement properly reflects how Microsoft plans to continue to lead the industry and promote global connectivity. Each category of stakeholder also impacts the company s success. How Microsoft serves its internal and external stakeholders is with the delivery of cutting edge products and the production of above-average returns. Microsoft will continue to be a major competitor and industry leader through its strategicRead MoreGlobal Economic Trends Ireland3169 Words   |  13 PagesIndividual Work: â€Å"Ireland† Professor: Ricardo Vicente Student: Roksolana Sliusar Tallinn 2014 Content Introduction 1. General information about Ireland 2. Globalization in Ireland 2.1 General globalization information 2.2 Ireland Political Globalization 2.3 Ireland Social globalization 2.4 Ireland Economic Globalization Conclusion 2 Introduction When I was thinking about that I would like to write in individual work I checked a lot of information about different regions. But then Ireland attractedRead MoreMcdonald s Impacts Of Globalization And Technology1315 Words   |  6 PagesAbstract McDonald s is a privately owned company that is part of a food industry that is consistently evolving with strategic management and strategic competitiveness at the forefront. McDonald s goal is to be a pioneer in delivering exceptional customer service in meeting the needs of their customers with quality and affordability. This research will present McDonald s impacts of globalization and technology. The industrial organization model will be discussed to determine steps needed to maximizeRead MoreIreland As A Short Break Destination1375 Words   |  6 PagesIntroduction This report will be discussing Ireland as a short break destination. It will also discuss the opportunities Ireland offers such as in their niche tourism. Niche tourism can be divided into many sectors for example: Special Interest tourism, Wild Life tourism, Adventure tourism, Cultural tourism, Religious tourism, Photographic tourism and many other forms of tourism. For tourists, niche tourism offers a more meaningful set of experiences (Robinson and Novelli, 2005) this report willRead MoreA Research Study On Management Styles772 Words   |  4 Pagesis provided through government funding through the graduate school level. India is a collectivist culture emphasizing the person-organization fit as a predictor of the turnover rate in that country. Individual technical skills are prevalent in their pool of talent. Management styles are less authoritarian and include more group decision-making processes. United States is an individualistic culture focused, in contrast, on the person-job fit. HRM systems focus on how worker performs individually

Advance Issues in Accounting Ethical Practice

Question: Discuss about theAdvance Issues in Accounting for Ethical Practice. Answer: Introduction This study deals with unethical issue that is present in accounting. In this given case, a recent event had been selected in Queensland Brisbane where it is noted that red roosters are under paying their employees by the owners (Martinov-Bennie Mladenovic, 2015). In the books of accounts, the accountants are showing that the workers were paid in accordance to the standard wages rates. This give rise to an unethical issue that is present in the financial reports and biased so that the company can avoid the tax Ethical Practice that could have Adopted to Produce More Positive Outcome A seven News Investigation had revealed the fact that Red Rooster franchises have been underpaying their staff members especially who is migrant workers (Apesb.org.au. 2017). Red Rooster is a fast food chains where the young human resources have been ripped off. According to Fair Work Commission Officers, it is viewed that they had acted firmly to simultaneously raid seven of the take-away outlets on Brisbane Southside that reports that the workers were underpaid for their work (Kuan, 2014). Accounting Professional and Ethical Standard Board Limited issued APES 110 Code of Ethics for Professional Accountants (Accounting Professional and Ethical Standards Board (APESB). 2013). In this particular case, it is understood that several red roosters have been under paid by the owners but in the books, it was clearly mentioned by the accountants that they are paying the workers according to the standard wage rates (Jaber Fadda, 2016). In this case, there is unethical practices prevails in the company named as Roosters as they are involved in paying less wages to the employees and misrepresent the financial figures. The accountant involved is committing unethical practices of showing the actual standard wage rates of the employees in the financial report that is not true and leads to an ethical issues. The accountants do so to avoid tax and it leads to biasness of actions that needs to be avoided as soon as possible (Apesb.org.au. 2017). According to the fundamental principles as mentioned in the APES 110 Code of Ethics for professional accountants, it is needed for the members to comply with the given principles and these are explained under with proper justification: Integrity- An accountant should remain straightforward as well as honest in making the decisions and maintaining cordial professional and business relationships at the same time (Hossain et al., 2016). Objectivity- An accountant should not allow biasness in their action, disagreement of attention or any kind of undue power of others for overriding the specialized or industry judgments (Apesb.org.au. 2017). Professional competence and due care- An accountant need to have professional knowledge as well as ability at the level that is essential for ensuring that a client or employer receives knowledgeable qualified Services that is based upon the current expansion in performing, method and legislation where they have to act diligently by following the technical and the professional standards (Apesb.org.au. 2017). Confidentiality- An accountant should be maintaining confidentiality of information that is obtained as a result of maintaining specialized as well as trade relationships and should not make effort in disclosing the information to any of the third parties without any special authority. They cannot use the information for their individual benefit of the Member on in that case third parties (George, Jones Harvey, 2014). Professional behavior- An accountant need to fulfill with the applicable laws as well as regulations and try to avoid any achievement that discredits their occupation at any point of time. In this particular case, an accountant should be abiding by the above-mentioned fundamental principles at the time of preparing the financial report for the company named as Roosters (Apesb.org.au. 2017). Accountants should be mentioning the wage rate that is actually paid to the employees of Rooster as it is accordance with the ethical principles. As mentioned the professional competence and due care, it is essential for the accountant to mention the same figures in the financial reports. The accountant should be using their knowledge and skill where they can provide professional services to the client through use of professional standards (Freeman Evans, 2016). The ethical practices that should be adopted by the accountant of Roosters are that they should start correcting the misinterpreted figures that they had shown in the previous years as this is resulting in unethical practices (Apesb.org.au. 2017). The accountants here need to follow the principles where it is clearly mentioned that there should no manipulation of accounting figures and no hiding of data to avoid taxes and generate profits for the business. It is thereby advisable to the accountants to present the correct figures of wages that are actually paid to the workers and Roosters should not be involved in unethical practices as it will hamper the goodwill of the business in real time (Clayton Staden, 2015). Importance and Role of Ethics in Business Especially in Accounting Practices It is necessary to maintain ethical standards in business entity that has an intention to survive in the market as well as improve over the organizational competencies as well as efficiencies. In this particular case, accountants working under Roosters should be developing total efficiencies of the employees to write the actual wage rates that are paid to the employees and should not misinterpret the figures in the financial reports. The accountant should follow the ethical standards that will help business in achieving future success rates. This can be done by training as well as guiding the human resources in a way so that they build their competence in all feature of trade (Chaplin, 2016). In this time business stress upon maintaining the ethical standards in an effective way On the contrary, it is necessary to understand as well as uphold the business ethics as it help in overall business activities so the professional accountants should be abiding by the ethical standards. Ethics is a term that relates directly with the morality, integrity and honesty. Addition to that, ethics means the fundamental concepts of right human conduct that takes into consideration differentiation between right and wrong activities where the accounting professional need to follow the principles (Carey, PMonroe Shailer, 2014). The accounting profession takes up various purpose of secretarial like recording of trade events that are of monetary nature and classifying the form of profit and loss statement where the activities are performed for maintaining proper accounting ethics of accountants (Carey, 2015). Professional accountants needs to be showing ethical behavior and they needs to be impartial as well as loyal to Roosters at the time of preparing the financial reports with sincerity. In this case, the professional accountants fail to do so and misinterpret the figures but they need to correct it by following the ethical fundamental principles such as professional competence and due care (Apesb.org.au. 2017). The accounting information is extracted from the financial statements that have great value as well as significant where it can be properly relied upon. It mainly depends upon the success or failure of a business where the accountants engages in manipulating the accounting figures so that they hide the real information. It is necessary for the professional accountants of Roosters to properly present the figures and do not engage in manipulating the data to avoid tax for the business (Apesb.org.au. 2017). In this case, the accountants ha actually changed the figures of employees payment and there is difference between what is written in the pay slip and what is paid to the workers for their work. Here, it is understood that the accountants adopts unethical practices as they changed the accounting figures to avoid taxes and make profits for Roosters. It is advisable to the accountants of Roosters to abolish the previous unethical practices and engage in correcting the figures in the financial statement to bring reliability of financial information. Accounting professionals are advisable to provide with accurate information to the business authorities without changing any figures that shows less wage rate that paid is workers (Ball, Tyler, Wells, 2015). Accounting ethics needs to be applied in every single activity of process as it will help in getting complete, accurate as well as consistent information that can be obtainable to the potential users of financial declaration in the company named as Roosters (Accounting Professional and Ethical Standards Board (APESB) 2013). Conclusion From the above case, it is understood that the owner of Roosters are involved in unethical practice as they were paying less wages to their employees that was not even mentioned by the accountants, rather they are showing as per the standard wage rates. This unethical practice should be avoided by the professional accountants by following the ethical standards as mentioned in APES 110 Code of Ethics. This standard clearly mentions that professional accountants should be engage in manipulating any accounting information in the company reports at any point of time. Therefore, the unethical case can be resolved when the professional accountant of Roosters follows the professional competence and due care in their auditing activities. Reference List Accounting Professional and Ethical Standards Board (APESB). (2013). APES 110 Code of Ethics for Professional Accountants. Apesb.org.au. (2017).Accounting Professional and Ethical Standards Board. [online] Available at: https://www.apesb.org.au [Accessed 29 Apr. 2017]. Ball, F., Tyler, J., Wells, P. (2015). Is audit quality impacted by auditor relationships?. Journal of Contemporary Accounting Economics, 11(2), 166-181. Carey, P. J. (2015). External accountants business advice and SME performance. Pacific Accounting Review, 27(2), 166-188. Carey, P. J., Monroe, G. S., Shailer, G. (2014). Review of post-CLERP 9 Australian auditor independence research. Australian Accounting Review, 24(4), 370-80. Chaplin, S. (2016). Accounting Education and the Prerequisite Skills of Accounting Graduates: Are Accounting Firms Moving the Boundaries?. Australian Accounting Review. Clayton, B. M., Staden, C. J. (2015). The Impact of Social Influence Pressure on the Ethical Decision Making of Professional Accountants: Australian and New Zealand Evidence.Australian Accounting Review,25(4), 372-388. Freeman, M., Evans, E. (2016). Professional Associations, Accreditation and Higher Education: Foundations for Future Relations. Relevance And Professional Associations IN 2026. George, G., Jones, A., Harvey, J. (2014). Analysis of the language used within codes of ethical conduct.Journal of Academic and Business Ethics,8, 1. Hossain, S., Monroe, G. S., Wilson, M., Jubb, C. (2016). The Effect of Networked Clients' Economic Importance on Audit Quality. Auditing: A Journal of Practice Theory, 35(4), 79-103. Jaber, R. J., Fadda, M. M. A. (2016). Awareness Level of Professional Independence Requirements, through Assimilation of Fundamental Principles of Professional Ethics, by Jordanian CPA Auditors, in Auditing Process: Field Study. International Journal of Economics and Finance, 8(9), 11. Kuan, K. T. C. (2014). Auditor independence: an analysis of the adequacy of selected provisions in CLERP 9 (Doctoral dissertation, Queensland University of Technology). Martinov-Bennie, N., Mladenovic, R. (2015). Investigation of the impact of an ethical framework and an integrated ethics education on accounting students ethical sensitivity and judgment.Journal of Business Ethics,127(1), 189-203.

Spinal Immobilization free essay sample

These resources have been analysed and a conclusion drawn from them in regards to spinal immobilisation in the pre-hospital setting. Method: This assignment uses an evidence based approach; the author explores spinal injuries and the current management of them in the pre-hospital setting across a number of countries. The author relates current practice with recent literature and draws a final conclusion from the findings. Conclusion: Prehospital care for patients with acute traumatic spinal injuries requires great care to avoid secondary injury; recognition of otential injury is of great importance. Although injuries to the spinal cord occur in 2% of the patients that paramedics immobilize, pre-hospital management and treatment can play a significant role in the patient’s outcome. There is growing evidence that full body immobilization can be of more harm than good if not done correctly. Introduction Traumatic spinal cord injuries are severe, life threatening and life altering . Managing the risk of spinal cord injury in trauma patients is an understandable concern for medical professionals. We will write a custom essay sample on Spinal Immobilization or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Spinal immobilization is initiated on a regular basis in pre-hospital setting for patients at risk of a spinal cord injury. In the past immobilization has been thought to be a relatively harmless procedure. There is now, however, growing evidence that this approach can be harmful, pre-hospital spinal immobilization in trauma patients should be questioned and explored. There is a large amount of literature on pre-hospital immobilization; the purpose of this paper is to review the current literature and make a recommendation for New Zealand practice. This paper explores current pre-hospital management of spinal cord injuries, the literature around cervical spine immobilization and full body immobilization. Spinal cord injury Spinal cord injury is injury to the spine with any localised damage to the spinal cord or to the roots that lead to some functional loss, either loss of motor function (paralysis) or sensory loss (paresthesias). Spinal cord injuries are caused by the spine being forced beyond its normal range, injury can be caused by hyperflexion, hyperextension, rotation, compression, or penetrating injury of the spinal cord. The leading causes of injury to the spinal cord includes car accidents (40%), falls (21%), acts of violence (15%), sporting injury (13%) (Sanders, 2012) Spinal injuries may be classified into sprains, strains, fractures, dislocations and/or actual cord injuries. Spinal cord injuries are further classified as complete or incomplete and may be the result of pressure, contusion or laceration of the spinal cord (Marieb amp; Hoehn, 2010). It is very important for paramedics and emergency personal to know that pain from a spinal cord injury is not necessarily localized to the area of the injury. In 18% of cervical, 63% of thoracic and 9% of lumbar injuries, the pain is located elsewhere (Bernhard, Gries, Kremer, amp; Bottiger, 2005). Current Management Pre-hospital management of acute spinal cord injury is of critical importance, it has been estimated that 25% of spinal cord damage may occur or be aggravated after the initial event (Bernhard, Gries, Kremer, amp; Bottiger, 2005). Pre-hospital treatment of patients with a spinal cord injury involves recognition of patients at risk and appropriate immobilisation (Tintinalli, 2011). Spinal immobilization and spinal precautions are common practices in the pre-hospital setting of patients with trauma. Despite this practice, spinal cord injuries are rare, approximately 2%, and are often obvious at the scene. Several rules exist that are designed to help pre-hospital providers clinically clear the cervical spine this helps reduce the need for radiography and reduce adverse effects from spinal immobilization (Alejandro amp; Schiebel, 2006). The goal of pre-hospital management of spinal cord injuries is to reduce neurological deficit and to prevent any additional loss of neurological function. Therefore, prehospital management at the scene should include a rapid primary evaluation of the patient, resuscitation of vital functions (airway, breathing, and circulation), a more detailed secondary assessment, and finally transportation to definitive care. In addition, after arriving at the scene, it is important to evaluate the scene and to understand the mechanism of injury in order to identify the potential for spinal cord injuries (Bernhard, Gries, Kremer, amp; Bottiger, 2005). Currently in New Zealand according to St John (2011) clinical guidelines and Wellington free Ambulance (2011). If the patient has any of the following signs or symptoms they should have their cervical spine immobilised: 1. Tenderness at the posterior midline of the cervical spine or 2. Focal neurological deficit or 3. Decreased level of alertness or 4. Evidence of intoxication or 5. Clinically noticeable pain that may distract the patient from pain of a cervical spine injury. Australia’s Queensland Ambulance service has similar cervical immobilisation criteria to New Zealand, they use a clear flow chart to that is similar to the Canadian C-spine Rule but includes distracting injury and intoxication. Their other treatments focus on limiting neurological deficit and prevent secondary injury. This is achieved through appropriate spinal immobilisation, maintaining a high index of suspicion of spinal cord injury (Clinical pratice guidelines Trauma, 2011). Saskatchewan, Canada also use the Canadian C-Spine rule, this rule is only used if the patient is co-oprative and has a Glasco comoa scale (GCS) of 15. If the patient meets ther criteria for cervical spine immobilization they are also fully immobilised on a long spine board or scoop stretcher. Full immobilization includes the head, neck and spine; this is done to prevent any further injuries during transport. Canada also administers an anti-emetic (anti-nausea medication) to prevent any unwanted and preventable movement (Saskatchewan Emergency Treatment Protocol Manual, 2012). In the United States of America to determine whether it is appropriate to apply full spinal immobilization which can include rigid collar, backboard, three point restraining device and head immobilization device, in the prehospital setting the following is assesses. If any of the below findings are positive, full spinal immobilization is to be implemented (Emergency medical services pre-hospital treatment protocols, 2012). 1. Midline bony spinal tenderness to palpation 2. Physical findings with a neurologic deficit 3. Altered mental status to including substance abuse and loss of consciousness 4. The presence of additional painful or distracting injuries 5. The complaint of numbness 6. Language barrier i. e. patient not understanding the questions asked, dementia, speaks a different language, or mentally delayed 7. Pain in cervical region on movement 8. Children under the age of 12 9. Significant mechanism of injury or care provider judgment It appears that the United States of America fully immobilize the majority of suspected/ potential spinal cord injuries. Litigation associated with error in spinal management can be very costly, with the average payouts being $3 million per incident in the United States (Abram amp; Bulstrode, 2010). The Literature Cervical spine immobilization It is believed that movement of the non-immobilised patient with an unstable vertebral column injury places the spinal cord at risk of primary or worsening damage. There is a lot of evidence that cervical immobilisation can restrict movement, but evidence proving that cervical collard protect against secondary injury is lacking (Ramasamy, Midwinter, Mahoney, amp; Clasper, 2009). In prehospital care, paramedics are trained to immobilize all patients with possible spinal cord injury; in order to prevent additional neurologic injury. Many patients will be found to have no injury to the spine at all. Some will have an unstable fracture with an intact spinal cord; the goal is to prevent movement of the spine therefore preventing damage to the spinal cord. Others will unfortunately already have neurological disability on initial examination. In these patients, the goal is to prevent further cord injury (Peery, Bruice, amp; White, 2007). A number of risks may be associated with application of the cervical collar. If the jaw support of the collar clamps the teeth together, the airway may be compromised if the patient vomits. Cervical collars have also been found to place pressure on the neck this can cause an increase in intracranial pressure. Acute respiratory failure, hypoxia and hypoventilation have also been reporter (Bernhard, Gries, Kremer, amp; Bottiger, 2005; Hann, 2004; Abram amp; Bulstrode, 2010; Engsberg, et al. , 2013). A rise in intracrainal pressure (ICP) has been associated with a worse neurological outcome in patients suffering from a head injury. Cervical spine immobilisation has been foud to increase the ICP by approximatly 4. 5 mmHg. This is relevent because head injuries occur in an average of 34% of trauma patients (Abram amp; Bulstrode, 2010). Galim, et al. 2012) applied cervical spine imobilisation to nine fresh cadervers in order to assitaine weather or not collars exacerbate cervical spine injuries. X-ray’s were taken befor and after application of the collar. Galim found after the application of the collar there was a grossly abnormal seperation of the verterbra in all nine cadervers. The average seperation mesurement was 7. 33 mm (see figure 1). The collars did not cause the injury, but th is appears to promote seperation between vertebrea. This seperation sugests collars push the head away from the body, this causes stretching of the soft tissue including the spinal cord. Galin, et al recognises that the use of cadervers could repersent worst case scernario because of the difference in muscle tone in compard to an unconscious patine. The result of a randomized controlled trial on healthy volunteers has provided some useful insight into cervical spine immobilization and its effectiveness in trauma patients (Alejandro amp; Schiebel, 2006). Figure 1 Hann (2004) found that in general only 55% of patients will fit perfectly into cervical immobilization collars. The majority of patients will have an ill-fitting Collar. True cervical immobilization is likely to be unobtainable. Even a halo frame (which has mental pins that are screwed into the skull), allows a small amount of motion. However, the rigid cervical immobilization collar remains the best and most effective for the needs of the prehospital setting (Hostler, Colburn, amp; Seitz, 2009). Ideally, only patients with unstable spines would have a cervical collar applied. But these patients cannot be identified in the pre-hospital setting; determining spinal injury out of hospital is not easy nor is it accurate (Horodyski, DiPaola, Conrad, amp; Rechtine, 2011). In both Canada and Australia the Canadian C-Spine Rule is used to determine which patients could benefit from immobilisation (see figure 2). In one study on 8,283 patients who were assessed by emergency services and the Canadian C-Spine rule was applied. The paramedic’s received a short online tutorial on how the C-Spine rule worked. This study found that paramedics were able to apply this rule reliably, and did not miss any cervical spine injuries. The rule was found to be accurate; only 12 patients had clinically significant spinal cord injuries (Vaillancourt, et al. 2009). Figure 2 Full spinal immobilization There is growing questioning of the need to fully immobilise a patient, with many suggestions that immobilisation does not prevent additional spinal cord injuries, however it may in fact cause such injuries (Krell, et al. ,2006; Alejandro amp; Schiebel, 2006; Bernhard, Gries, Kremer, amp; Bottiger, 2005; Peery, Bruice, amp; White, 2007). The use of a spinal board is com mon in attempt to provide rigid spinal immobilization in the pre-hospital setting for trauma patients with potential spinal injuries. Nevertheless, the benefit of long backboards is largely unproven (Alejandro amp; Schiebel, 2006). A number of studies in the literature do present complications when poor standards of immobilisation are performed. Issues include occipital, lumbar and sacral pain development when padding is inadequate or absent, increased respiratory compromise with incorrect chest strapping, pressure sore development due to inadequate padding and spinal miss-alignment again are as a result of inappropriate/ inadequate padding. Perry, Brice amp; White (2007) found that if a patient is lying on a spinal board which is poorly trapped, it is likely the patient would move more during transport than if they were places on the stretcher. Inadequate pre-hospital spinal immobilization was found to occur on a regular basis; the main problem being straps had greater than four centimetres slack. Straps that have a four centimetres or greater slack cannot sufficiently immobilise a patient with a potential spinal injury. Abram amp; Bulstrode (2010) has noted that correct immobilisation of the cervical spine, with placing a patient on a backboard with the straps tightened correctly, that the patients respiratory function can be restricted by up to 15%. If the patients head is strapped in place but the body is poorly immobilized, this creates a situation where the body can pendulum at the neck. This situation is potentially more dangerous than not immobilising at all because it allows transport forces to move the weight of the body against an unstable spine (Peery, Bruice, amp; White, 2007). The general theory of spinal immobilisation is that movements would be reduced if neck protection is used along with a backboard to aid smooth extrication form a motor vehicle. Engsberg, et al (2013) found a significant decrease in movement (as opposed to full assistance i. e. spine board) when the patient exited the vehicle unassisted with a cervical collar in place to protect the neck. The results indicated that an unassisted cervical protected technique had significantly less range of motion than the unassisted unprotected and the fully assisted technique. In fact, with the addition of the cervical spine collar the level of protection was increased and range of motion was decreased in many instances (Engsberg, et al. , 2013). The use of backboards have been found to induce three to five as much movement than a scoop stretcher if the patient is on the ground (Krell, et al. , 2006). Abram amp; Bulstrode (2010) sugests that the risk of futher neurological injury due to inadiquate immobilisation may be overestermated. They back this statement up with a 5 year retrospective study. The neurological outcomes for patients where no routine pre-hospital immobilization was used were compared to trauma patients who received spinal immobilization. Two physicians acted independently, the patients were categorised into disabling r non-disabling. The trial found deterioration occurred less frequently and there was less over all neurological disability in the patients with no routine immobilization. It was suggested that, a large amount of force is required to damage the spine and injure the spinal cord; Abram amp; Bulstrode concluded that movement created during transport was unlikely to generate sufficient energy to res ult in additional injury. There were however weaknesses in this study. Patients who died at the scene or during transport were excluded. It was concluded that neurological deterioration in patients with spinal cord injury occurs in around 5% of patients even with good immobilization of the spine. Conclusion Immense care needs to be taken when providing medical care to an acutely injured patient with suspected spinal injury in the pre-hospital setting. Approximately 2% of all trauma patients will have sustained a spinal injury. Patients with acute traumatic spinal injury are at risk of neurologic deterioration which is thought to be due to secondary injury to the spinal cord. A potential cause of secondary injury is through unintentional manipulation of the spinal cord predominately in the setting of an unstable injury. Minimizing the chances of secondary injury can be challenging in the pre-hospital setting due to the location and accessibility of the patient, transport. Treatment that is initiated in the pre-hospital setting can lead to significant morbidity in other body areas, such as pressure areas, decreased respiratory effort. There is large variation in how care is administered in the pre-hospital setting from one country to another. There is a possibility that fill body immobilization may be contributing to mortality and morbidity in some patients, this warrants further investigation. The Canadian C-spine study showed that only 0. 14% of patients immobilized had clinically significant spinal cord injuries. New Zealand could improve their current practice by improving pre-hospital criteria to establish which patients really are at significant risk for needing spinal immobilization, this could reduce the number of patients exposed to the unnecessarily risks of spinal immobilization. Bibliography Abram, S. amp; Bulstrode, C. (2010). Routine spinal immobilization in trauma patients: What are the advantages and disadvantages. The Surgeon, 218-222. Ahn, H. , Singh, J. , Nathens, A. , MacDonald, R. D. , Travers, A. , Tallon, J. , . . . Yee, A. (2011, August). Pre-Hospital Care Management of a Potential Spinal Cord Injured Patient: A Systematic Review of the Literature and Evidence-Based Guidelines. Journal of Neurotrau ma, 8(28), 1341–1361. doi:10. 1089/neu. 2009. 1168 Ahn, H. , Singh, J. , Nathens, A. , MacDonald, R. D. , Travers, A. , Tallon, J. , . . . Yee, A. (2011, August). Pre-Hospital care management of a potential spinal cord injured patient: A systemic review of the literature and evidance-based guidelines. Journal of Neurolotrauma, 28, 1341-1361. doi:10. 1089/neu. 2009. 1168 Alejandro, A. , amp; Schiebel, N. (2006). Is routine spinal immobiilization an effective intervention for trauma patients? Emergency Medicine, 110-112. Bernhard, M. , Gries, A. , Kremer, P. , amp; Bottiger, B. (2005). Spinal cord injury Prehospital management. Resuscitation, 127-139. Clinical pratice guidelines Trauma. (2011, September). Retrieved from Queensland Ambulance Service: http://www. mbulance. qld. gov. au/medical/pdf/09_cpg_trauma. pdf Dunn, T. M. , Dalton, A. , Dorfman, T. , amp; Dunn, W. W. (2004). Are emergency medical technition-basics able to use a selective immobilization of the cervical spine protocol? Prehospital emergency care, 207-211. Emergency medical services pre-hospital treatment protocols. (2012, January 3). Retrieved from Commonwealth of Massachuse tts : http://www. mass. gov/eohhs/docs/dph/emergency-services/treatment-protocols-1001. pdf Engsberg, J. R. , Standeven, J. W. , Shurtleff, T. L. , Eggars, J. L. , Shafer, J. S. , amp; Naunheim, R. S. (2013). Cervical spine motion during extraction. The Journal of Emergency Medicine, Vol 44, 122-127. Galim, P. B. , Dreiangel, N. , Mattox, K. L. , Reitman, C. A. , Kalantar, S. B. , amp; Hipp, J. A. (2012). Extrication collars can result in abnormal seperation between vetebrae in the presence of a dissociative injury. The Journal of Trauma, 12-16. doi:10. 1097/TA. ob013e3181be785a Hann, A. (2004, August 20). A photographic guide to prehospital spinal care: Edition 5. Retrieved April 2, 2013, from Emergency technologies: http://www. neann. com/pdf/psc. pdf Horodyski, M. , DiPaola, C. P. , Conrad, B.

Review on Abraham Lincoln And The Second American Revolution essays

Review on Abraham Lincoln And The Second American Revolution essays McPhersons book on Abraham Lincoln is about his struggle as president to keep the union together. The book explained the different strategies, decisions, and speeches Lincoln used in order to keep the confederacy from seceding from the union. His timing on military strategy and national strategy helped the outcome of the revolution. McPherson also talks about the lives of African Americans after the Emancipation Proclamation was put into effect. The most believed reason for the Civil War was Lincolns decision to abolish slavery and the emancipation. McPherson discusses how this outraged the south, where slavery was necessary for the everyday functions of their plantations. Lincoln immediately had to defend his decision and himself. Thus the war was a struggle between two conflicting capitalist systems- one reactionary, based on slave labor, and fearful of change; the other progressive, competitive, innovative, and democratic (P. 9). Mcpherson goes into depth about the generals Lincoln appointed, and the war tactics he had them oversee. Some of the generals had been quite inexperienced which led to many battle losses. Lincoln had spent a good amount of time studying war strategies for the use of putting down the confederates. Some of these In-depth facts McPherson includes in his book are quite interesting. Others were a little too much. He had many examples which provided the reader with a wide variety of mental pictures that could help the reader understand Lincolns reasoning. For example, the uses of Lincolns Metaphors helped a great deal. McPherson includes many of these in his book to show how wise Lincoln was, and to show how he could relate things to one another in order to get his point across to his listeners. An example of this is his story about the shepherd, the sheep and the wolf. The shepherd drives the wolf from the sheeps throat, for which the sheep tha...

Business Environment Essay Example | Topics and Well Written Essays - 2000 words - 1

Business Environment - Essay Example Therefore, it is sound to assert that the variations in demand and supply for any economic resources, and the country’s practices contribute to its growth and competence at a global platform. The following discussion seeks to highlight economic perspectives in different versions with reference to their effects to the economic environment. P4: Explanation of how economic systems attempt to allocate resources effectively Despite the two country’s economic practices, UK practices the mixed enterprise approach whereby some resources belong to the national government thus limiting any probable exploitation of the citizens (Dransfield, 2004, p. 98). For instance, the country owns majority of the shares in those firms operating in products, which seem critical for human welfare. Such a resolution enables the UK to expressly influence companies’ decision-making processes in for the benefit of the citizens’ benefit. Further, the UK is able to use the mandate expres sed by its constitution’s to influence the privatization of companies in order to create wealth to the citizens. Individuals own the remaining resources, but there are regulations enforced by the government to ensure that that the practices are ethical and beneficial to the citizens. On the contrary, the military command economy restrains the local population from the exclusive indulgence into businesses that may lead to the exploitation of resources for economic prosperity. Arguably, the country owns 95% of the industries leaving a 5% margin for its citizens. The socialist approach thus tends to practice a monopoly approach in the allocation of resources, a factor that deters increment in the GDP and leads to increased poverty levels. Economists explain that U.S.A sets an analytical approach to the economic issues and establishes fiscal policies to stimulate growth, control amount of money in supply, dictate inflation rates of the dollar, and subsequently reduce the unemploy ment levels. The United States is observant on whether the factors will affect the country positively or negatively in the end (Arnold, 2007, p. 55). Analysts describe that the US free market enterprise economy allows for the room of innovation thus; the country’s entrepreneurs have the ability to improve products that in turn lead to economic growth since they are able to earn returns on their investments, create employment, and remit taxes to the federal government (Rodrik, 2007, p. 67). P5: The impact of high taxes and high interest rates The influence of high taxes on employees is a factor born from the Keynesian theory. Theoretical arguments are that enforcement of high taxes to a country’s employee population is a significant approach to reducing the rate of inflation since the approach diminishes the rate of individual expenditures. The factual further increases productivity in the economy since the government’s accrued revenues are spent on utilities suc h as infrastructure, and the provision of other resources to the entire population (Arnold, 2007, p, 58). The approach is significant in shaping up an economy in accordance to changes in demand and supply with a perception that whenever the supply shifts to an increase or decrease, the prices will remain constant since the population will bear the existing ability to purchase a given quantity of a product. On the other hand, the impact of executing high interest to business organizations remains an ill