What Business Is Zara Essay Example | Topics and Well Written Essays - 1250 words

What Business Is Zara - Essay Example The essay "What Business Is Zara" investigates Zara business model. GAP introduces new line clothing not regularly but approximate once in a year. This is during periods when its sales are high. Sales are high about thirteen weeks a year during the back to school/ work and holiday periods. GAP, Inc does not manufacture its clothes: it is a retailer company sourcing its clothes from various factories. GAP makes its money majorly through sales and partly through return on assets and debt. Its financial performance is given by financial ratios which include; return on sales, leverage ratio, solvency ratio and liquidity ratios. Zara business model is unique and distinct from others because it has taken control of its supply chain independently. It understands the market and its demands. Use of technology; technology has enabled Zara to communicate directly with its production centers and designers. It has also facilitated direct placement of ordr4s by store managers basing on the demands of that region. Understanding customers demand. Zara produces new collections every three weeks and this is done after analysis of the design in most demand by customers through the store managers. Use of personal digital assistance. Store managers use PDAs to place orders as requested by customers. This has facilitated time delivery as it has allowed a customer to even get the product within two days. Being customer based. Zara send group of commercials to different countries in which its stores are located to observe the style.

Coursework in Arts Essay Example for Free

Coursework in Arts Essay 1. In Elisabeth Vigee-Lebrun’s painting of the Queen of France, Marie-Antoinette, in the late 18th century, the queen is shown sitting with her three children in a formal gown at the edge of the Hall of Mirrors. Colors that were used can be described as basically feminine—shades of ruby, cherry, velvet, scarlet, and salmon; yet darker colors were used in the crib of the eldest son to portray his death. From the colors of the painting, the queen appears to be sitting on a shiny spot, but around her is a darker, gloomier color that may portray danger to her and her children. Textures, on the other hand, appear to be soft and feathery, which shows wealth and comfort. The lines in the background are parallel and horizontal, which points to her straight, firm position in her seat. The position of the queen and her two children beside her form a straight cross beside the crib that looks like a cave. The eldest son alive who points to the crib may appear like the angel beside the cave where Jesus was buried. The son was like saying, ‘You’re looking for my brother? He’s not here anymore but has gone up to the Father. ’ On the other hand, the eldest son alive stands firmly alone, which shows independence and strength†¦even at an early age. The stairs in the background may mean political fame, but it was portrayed to be darker and more shadowy above, so that it would be best for the queen to be where she is—with her children and her home (please see painting in the appendix). Formal elements show that this good queen is a devoted mother—full of quiet dignity—by the way the colors, the textures, the lines, the shapes, and the space interact with one another. The whole scene portrays quietness, peacefulness, as well as acceptance—things that picture her as a good and pleasant being. There is also the hint of wealth and extravagance, especially the portrayal of the Hall of Mirrors. In the overall, the painting is meant to give her a positive, submissive, and motherly aura. 2. John Singleton Copley’s painting of Paul Revere in 1768 is an example of a Rococo painting. The Rococo style, which emerged in France, characterizes opulence, grace, and lightness, as seen in the painting (Figure 2 in the appendix). Copley used contrasting colors like black (as the background) and white (as Revere’s shirt) to put more emphasis on the main object. The lines, colors, and objects are all simple. Lines, especially in the head and in the table, are all parallel, which may point to neutralism and evenhandedness. It was said that Revere was â€Å"uninterested in politics; he wanted only to be neutral, which was not possible† (Artchive, 2007). The eyes, on the other hand, portray innocence, knowledge, and fairness. The textures used are all smooth and shiny, which may also reflect opulence. It focuses on ‘carefree aristocratic life’, with direct reference on Revere’s being a silversmith—with a piece of silverware on his hand. He was portrayed with such extravagance, as shown in the linen cloth, which at that time was not yet available in America and could only be imported to the land†¦ as well as the golden buttons that lay on his vest. However, the portrayal of ‘flowing linen’ could point—not to the linens of England—but to the production of a hundred ells of linen in America during that time, which for Revere was something to be proud of. However, it is said that the painting is a sort of a ‘balancing act’ conducted by painter Copley (Artchive, 2007), especially that he is about to marry one of the Clarkes who were owners of â€Å"the notorious tea concession† (Artchive, 2007). The silver teapot appears to be a large issue then, since only their enemies—the Tories—drank tea (the Whigs drank the Boston tea, which was a punch). Revere is shown as a neutral person who wears rich linen clothing, but which comes from his own land. He is holding a silverware teapot, which is one of his expertise, but points to the character of the enemies and to the business of the Clarkes with which Copley is about to share his life with. Therefore, Revere is neutral, as he is open to all.

The Handmaids Tale by Margaret Atwood :: essays research papers fc

James Fils-Aime The Handmaid’s Tale Fact or Fiction The Handmaid's Tale is a dystopian novel in which Atwood creates a world which seems absurd and near impossible. Women being kept in slavery only to create babies, cult like religious control over the population, and the deportation of an entire race, these things all seem like fiction. However Atwood's novel is closer to fact than fiction; all the events which take place in the story have a base in the real world as well as a historical precedent. Atwood establishes the world of Gilead on historical events as well as the social and political trends which were taking place during her life time in the 1980's. Atwood shows her audience through political and historical reference that Gilead was and is closer than most people realize. Atwood closely scrutinizes Colonial America, back in the 1700's it was a society founded on religion and ran as a theocratic order. Puritans who had just fled Europe for religions freedom settled in the Americas where they could run their society in the way they saw fit. Especially in New England, religious freedom was not allowed, and people were punished by the courts for failing to uphold the common religions requirements. Those who were not of a specific type of Christianity were considered heathens. Men who controlled the society enforced rules on others based on their interpretations of the bible. They believed that "as God's elect, had the duty to direct national affairs according to God's will as revealed in the Bible." (3) Later on puritanical control faded but in the South there was the enslavement and resulting racism toward blacks. Again so called male leaders of society promote injustice and oppression in order to benefit themselves. Atwood also uses her novel to comment briefly on the issues of race, those not of a specific type of Christianity or skin color were sent away to the colonies, or killed. The "children of Ham", which in the bible represent the descendants of the black race, are relocated outside of Gilead. Even the location in which she places Gilead is reminiscent of early American for Boston, Massachusetts was a puritan center. The world of Gilead which Atwood is a society controlled by power hungry men who use religion as a means of control. Atwood also references the oppression of Jew's during the holocaust in her novel. Under Hitler's rule 6 million Jews were killed, and many more sent to concentration camps where they were mistreated by their captors.

Florida- Blind, Deaf, and Dumb Essay

Coleman already knew one thing for sure about his future, and that was that he wanted to make educating children his life’s work. Coleman knowing about the lack of educational decrees in Florida decided to take the opportunity to advantage, by writing to Governor William D. Bloxham asking for a sum of $20,000 minimum appropriation to start a school for the deaf and blind. Coleman’s hopes came true when in 1883 Florida’s legislature establishes an institution for blind and deaf children for two years at $20,000. The location of the school was put to a biding between the towns in Florida. Captain Edward E. Vaill offered St. Augustine the biggest bid of $1,000 and 5 acres. The original three wood buildings were erected by contractor William A. MacDuff at $12,749. The school was completed in December 1884. The first class entered in 1892 with 62 students. The two first graduates were both deaf, their names were Artemas W. Pope of St. Augustine and Cora Carlton of Island Grove. The two later married and became parents of Florida Senator Verle A. Pope. The first blind student graduated in 1908. The first African American graduates were Louise Jones a blind student in 1914, and Cary White a deaf student in 1925. The school originally only had 5 trustees in 1905, until 1963 were there were 7. Taylor Hardwick began construction on new dormitories in late 1958 and opened in 1959. The school is now the largest of its type in the U. S. The school now has 47 buildings and 72 acres. The school’s annual budget is over $30 million dollars. The schools no longer an boarding school but, now a public school. It’s the only school in Florida that is pre-school through 12th grade. It also has a post-secondary program. The school is accredited by the Southern Association of Colleges, and Schools. The Conference of Education Administrators serving the deaf, and the National Accreditation Council for Agencies Serving the Blind and visually handicapped. The school has two departments: the Deaf department, and the Blind department. The school also has outreach programs for parents, teachers, and other staff in small and rural school districts in Florida. The also has a healthcare center on campus for students, as well as two well-appointed auditoriums. The school boasts the Copeland recreation and fitness center, which is specially designed and constructed for the blind. The center is the site of the annual USABA’s youth national goalball tournament. Not only that but blind high school students get state of the art sound system within the school. The school has 11 sports you can join at the school: Football, Soccer, Volleyball, Basketball, Little League Baseball, Track, Cross Country, Swimming, Goalball, Wrestling, and Cheerleading. They have preforming arts groups, the deaf department has a traveling dance troupe, and the blind department has a band known as the OuttaSight. The school also has several clubs: the blind skier, academic bowl team (competitive), and a traveling math club called MathCounts. -Notable Alumni- * Ray Charles- He learned to read braille here. When he went to the school it was known as the Institute for the Blind, Deaf and Dumb. * Ashley Fiolek- A very well-known rider in motocross racing. * Marcus Roberts- A famous Jazz pianist. -My Perspective- I really enjoyed researching and writing this essay. Originally the essay was supposed to be about all deaf culture related things in Florida but, as I started one of the things that kept popping up was the Florida school for the Deaf and Blind. Since it kept popping up I clicked on it and was amazed that it was in St. Augustine (which is where I was going to go for spring break), and that it was the oldest school for the deaf in Florida. All of a sudden I knew that I wasn’t doing my project on the deaf culture in Florida but instead a certain school for the deaf in Florida. Then I realized I had to make a decision; the schools name is the school for the Deaf and Blind. Meaning I would have to decide if I wanted to do my project on the school as a whole which means the Deaf and Blind, or just the Deaf department. As you already know (because hopefully you read the essay) I choose to both. The reason I choose to do both is because if I’m writing (or typing) this essay about the school than I’m going to write about the school in a whole. When I saw the school in person was when I finally realized just how big 47 buildings and 72 acres is. the school is huge and looked like it could swallow are school times two. I wasn’t able to go into the school. I was also surprised that I didn’t see that many people who were either deaf or blind from what I could tell at least. I do remember seeing this one girl who was deaf a couple times, I think she might have been a tourist though because I saw her at a tourist spot. The first time I say her we were sitting across from each other at a restaurant. My dad kept telling me to go say hi, and I swear I told him a million times that I couldn’t and that it would be considered rude. All in all I feel extremely pleased with what I came up with for this essay, and I hope you are too.

American vs Hatian Revolution

American vs. Haitian Revolution While the revolutions in colonial America and Haiti had much compatibility, they were also unique in their own ways. In both revolutions, the rebels revolted against a foreign superpower that was in a weakened economic state in order to gain economic and social freedom. However, the Haiti revolution stressed freedom for everybody, including slaves, unlike the American Revolution that basically focused on the needs of the middle class. The revolutions in both of these countries revolutions would have been unsuccessful if it were not for the crippling problems faced by both opposing superpowers. The success of the Haitian revolution was due in no small part to the political turmoil brought about by the French revolution. This weakened the ability of the colonial administrators in Haiti to maintain order and caused the authority of colonial officials to no longer be clear; even the very legitimacy of slavery was even being challenged in France. The turmoil in France and Haiti paved the way for a struggle between the elite plantation owners and the free black slave owners. This fighting in turn gave the slaves, under the leadership of Toussaint L'Ouverture, the unheard of opportunity to revolt against their owners and emancipates them from a brutal system of bondage (Corbet). The revolution in the Americans was against its mother country, Great Britain, and unlike Haiti, the British army was in full force when war broke. There were, however, economic weaknesses that led to the inevitable revolution against Britain. Britain was burdened by debts from the French and Indian War, and therefore taxed the colonies substantially to make up for this. The ideologies of the revolutions in both Haiti and America were very similar. In America, philosophers such as Thomas Paine and John Locke preached social and economic freedom. Thomas Paine writes, â€Å"And he hath†¦

Biography of Carol Watson Essay Example

Biography of Carol Watson Essay Example Biography of Carol Watson Essay Biography of Carol Watson Essay Carols earliest memories were of living in prefab houses in Gilmerton, 1956. She was around four years old at this time, and she recalls how every night she would sit and wait for her father my grandfather coming home from work on his pedal bike at tea time. If it was a Friday, she would get her pocket money. She would get thru pence and her brother Billy would get sixpence as he was four years older. Her cousin Annie lived next door and they played together a lot and were always exchanging clothes. She and Annie were always getting into scraps. Perhaps the one that sticks out in her mind is when her mother told them not to play with the Arthur children as one of them had head lice, they asked to play and Carol said: no, my mum wont let me because you have nits in your hair. Of course they went and told their mum what Carol had said to them, and the next thing she knew her mum and Mrs. Arthur were yelling at each other over rows of washing lines in the back gardens. Later in the ye ar on a summer morning they moved into a flat. It was 10 storeys high and they moved into the 6th floor. She remembers that it had a balcony, and whenever she was hungry she yelled up to her mum who would wrap up a sandwich and throw it off the balcony for her to catch. Also if she wanted to go inside she would shout up for her mum to send the lift down. The flat had two bedrooms and under floor heating. Her brother Billy and she shared a bunk bed, she said it was a novelty at first but Billy always moved around on the top bunk and kept her awake so we took turns instead. She started school at a place called Pennywell, and soon made friends with a girl called Isobel, and Billy with Isobels brother, Graham. They lived on the 9th floor of the same set of flats. Her teacher was a woman called Miss Clarkson. She was very strict and every day she made the children place their snacks in her desk for them to re collect at the bell. One afternoon Miss Clarkson asked Carol if any were hers, she knew they werent, however they looked too good and she gave into the temptation and took the chews! Th e boy who they belonged too was upset and Carol was smacked for being dishonest. She didnt think she deserved it at the time and spent most of the day crying which displeased Miss Clarkson. A couple of years passed and they had settled into their new life though her brother Bill got into fights with Graham from upstairs, though Billy never hit him back. she said. She told her dad who then told Bill to hit him back to stop the bullying. One day Billy did hit Graham back and bloodied his nose; next thing she recalled there was a knock on the door and there was Graham with his dad, who was shouting and saying: look what Billy has done to my son Carols dad shouted on Billy and asked if this was true, and he replied yes. Her dad gave Billy a shilling and said: well done for standing up for yourself. She recalls how Grahams dad was not a happy man. Carols dad explained what Graham had been doing to Billy and said maybe hed think twice about doing it again, and then slammed the door. Billy never got any more bother from Graham after that. Carol recalls how the school she was at was an old school; they had big old desks that sat 4 people at a desk. Carol remembers how if one of them wanted something from their desk all four of had to take their arms off the desk to open the big lids. A new school was built when Carol was about eight years old. She lived in a good community and had good friends, and she really enjoyed her childhood. A few years later (1964) she moved into Craig Royston High School, and experienced being a teenager in the 60s A few of my favourite bands were The Beatles and Led Zeppelin. Its where she met her life long friend Gina Graham. By this time her brother Billy was at another High School Ainslie Park. They moved into a 5 bedroom house as she now had two younger sisters, Denise my mother and Frances. The summers now seemed longer and hotter than when she was younger. She met her first boyfriend at High School, his name was John and they were together for almost two years. She dropped out of Hig h School at 14 years old as did her boyfriend John. They broke up because he wanted to travel the world and she didnt want to leave home. She was devastated for months until she met another man called David. They started seeing each other and their relationship progressed quickly: At 16 I was pregnant she declared. Her father was old fashioned and insisted that they married although neither wanted to be. David became possessive over her and hit her if he suspected her of being with another man. He became involved in drugs and drink after her first child Mark was born and was always off his face when he got in at night, he would throw things at her and beat her until she passed out not matter how much she screamed and pleaded The more I screamed the more he hit me, I learnt very quickly to shut up. I used to wish someone would hear me and rescue me but no one ever came Carol couldnt get out of this marriage and her family had no idea what was going on. She remembers that I wasnt able to eat because I was sick with fear, I didnt know what would happen to me or Mark if I did- her weight dropped to 5 and a half stone. One day her younger sister Denise went to visit her and David. My mum said she looked completely emaciated. She was covered in bruises and tried to turn her face away. Denise was horrified and asked what was happening and Carol burst into tears and told her everything. About a week later Carol told David she was going with her sister to the station and that shed b e back shortly. In reality she was planning to run away with her son and start a new life. Unfortunately when they were going to get on the train Mark started screaming and did not want to leave, he ran off the train and they both had to go back to David. Denise cried the whole bus journey home and didnt know what to do. Denise told Billy, what had happened, and Billy went round and beat David up, he told him: if you ever touch my little sister again Ill be back round. That night when Carol got home David gave her the beating of her life, and she couldnt walk for days. Billy was worried and told his father, who then helped Carol get out of her marriage and she took full custody of her child Mark. A new life: Carol got a new house in England, far away from David, and a new job working for the Orange phone company. She regained a healthy weight and her brother Billy also moved down to England with his new wife Ina. They live in the same street now. One afternoon when she was working at Orange, a window cleaner was outside. She recognized him immediately. It was John, her first boyfriend from High School. He also recognized her and lots of hugs and tears were shared. Later on in the year they married and had a child together, he was named Keith. Revisiting the past: One evening when Carol was in Sainsburys she saw Davids sister. She came over and said hello. Carol was shocked as she had tried to forget that period of her life and she started to panic and thought that David might be there. However, Davids sister told Carol he died three years previously from a heroin overdose in a flat on his own. She felt guilty but also relieved. For once she could be completely at ease and has never been happier. She has her own family with John, a good job and family nearby.

The Rocking Horse Winner, David Herbert Lawrences Essays

The Rocking Horse Winner, David Herbert Lawrences Essays The Rocking Horse Winner, David Herbert Lawrences Paper The Rocking Horse Winner, David Herbert Lawrences Paper Essay Topic: Literature In David Herbert Lawrences The Rocking-Horse Winner, Paul was a young child from a money-oriented family whose personality evolved from an introverted and inquisitive little boy seeking his mothers attention to an obsession with trying to please her. Pauls mother was merely attracted to material possessions and uninterested in her offspring. She was in debt and continued to live beyond their funds. Paul was starving for love and attention from his mother and struggled to please her. He became captivated with laying a bet on horse racing and making money to satisfy his mother. Pauls obsessions with trying to gain his mothers warmth eventually lead to his downfall. D. H. Lawrence shows of the traumatic ruin of an upper middle class family stressed to maintain appearances in the face of customary overspending. The most terrible offender is the status-conscious mother because unfortunately, no matter how much capital Paul earns, her over-elaborate tastes only grows rapidly. In literature, theoretical analysis behaves as a crucial function in the understanding and critical meaning of a text. Some writers supply hidden meaning that is suitable to these theories to produce a greater density in the plot of the story. The Rocking Horse Winner is a leading example of an author skillfully utilizing this theoretical approach to the development of a story. In this story the psychoanalytic theory is applied. In literature, there are two types of psychoanalytic theory. One is built on the work of Sigmund Freud and the other is the modification of Freuds work by Jacques Lacan, a French psychoanalyst. From these two perspectives of this specific theory, Jacques Lacans theory appears to be the inspiration that Lawrence wrote his story from. In Lacans vision, he points toward the development of children and society. He sees the evolution of the child from the early years to maturity as a progression of stages in life. This development stresses the affiliation of the child to language and the relationships it has with others. This accentuation directly influences the childs sense of self. In application to the Psychoanalytic Theory, the story extensively reflects Lacans mirror stage. The similarity may possibly cause an individual to trust that Lawrence was an intense advocate in this theory. Not only from Pauls obsession and ultimate downfall, but the relationship of child and mother expressed in the course of the story makes it apparent that Lacan did have a substantial inspiration on the tale. The psychological aspect of the story also manifests Freuds Oedipus complex. Freud sugge sted that all boys go through a stage where they want to take their fathers place. Pauls desire to earn money for the family can be said to be an unconscious desire to take his fathers place. Pauls desire to take care of the familys needs is Oedipal. In the story, it is the lack of the fathers luck that originally causes Paul to be fixated with the desire to be lucky, generously for his mother. Psychological Criticism is a technique that concentrates on the unconscious thoughts of the human intellect. Psychological criticism makes an effort to reveal those profound and unexplained concepts in the literary field. In numerous ways D. H. Lawrences story, The Rocking-Horse Winner deals with the contradictory feelings and perspective of the two main characters, mother and son. Through the story, it is obvious that the mother concentrates primarily on her misery in life, predominantly that she lacks all the wealth she desires. This is noticeable where she mentions to her son I used to think I was, before I married. Now I think I am very unlucky indeed. (Kennedy 595) When Paul makes an attempt to get her to see that despite her bitterness towards her life, his outlook on luck is distinct from hers. Despite her resentment, he states at one point to her Im a lucky person. The mothers great denial of any opportunity of happiness though transforms the Pauls plan. In addition, the action alone unmistakably manifests the sons desire to please his egocentric mother. The son seems determined to give his mother some good luck. It was not until she was married that she claimed her bad luck began. This is apparent when her son asks her if she received anything pleasant for her birthday, which to she responds coldly Quite moderately nice. Paul was never fully satisfied with his earnings for the reason that he felt it wasnt sufficient for his mother. Every time the house chanted, There must be more money! There must be more money! there was a consistent drain of Pauls strength and determination for life, leading him to a painful stage. His life is taken because of his obsession to be lucky. To be lucky, in the words of his mother, was to be wealthy. This misunderstanding drives Paul to go insane where it ultimately results in his young death. The depictions of trauma in the story are illustrated through Paul and his obsession. His mother conditions him in a way that he feels the only way to prove to her his adoration is to be as prosperous as he can be. Yet, being a young child, he forces all of his power into pleasing her desires and ends up taking his own life. At the end of the story, Paul lies dead due to a sickness apparently brought on by exhaustion. He has ridden his rocking-horse for the last time, and received a considerable amount of money for his mother, thus proving to her that he is, in fact, lucky. Paul was an inquisitive little boy. He was concerned as to why his mother was so miserable. His mother told him that they were the poor ones in the family because they were unlucky. Paul, in an attempt to please his mother told her that he was lucky. His mother belittled this idea causing Paul to feel rejected. Paul went in search of luck to gain his mothers approval. As with most children Paul had a longing to be loved and accepted by his mother and felt that he could accomplish this by providing her with the material things she longed for. This was shown by the development of his character from curious to pleasing to obsessed. His successful efforts in providing his mother with monetary wealth proved to be pointless in obtaining the love that he desired from her. Pauls mother in The Rocking Horse Winner is a cold, unloving parent who is extravagant and materialistic. The mother has a cold heart and an inability to love when it comes to her children. The cold and unloving quality of the mother is demonstrated clearly by Lawrence. She married for love, and the love turned to dust. She had bonny children, yet she felt they had been thrust upon her, and she could not love them (Kennedy 594). The quote creates an image of how cold the mother is towards her children. Hester stopped respecting and loving her husband, once he was unable to provide her with all her extravagant taste. Hester blames their financial failure to her unlucky husband. The situation made her grow bitter. Hesters priorities; obviously not the children but her greed, has made her unable to display any affection toward the children. This story critically judges those who associate love with money and luck with happiness. The mother with her insatiable desire for material possessions believes that money will make her happy despite the obvious fact that so far it has not. Paul, who learns from his mother to associate money with love, represents the desperate search for values in a cash culture. Mothers mold their sons into men who are the opposites of their undesirable husbands. Since mothers cannot change their husbands they create desirable sons. Making her feelings known the mother coldly characterizes her husband as very unlucky. By telling Paul this she sets in motion the boys useless mission to please her to be the man his father could not.

Derechos migratorios de padres de ciudadano de EE.UU.

Derechos migratorios de padres de ciudadano de EE.UU. En la actualidad, ser padre o madre de un ciudadano americano menor de 21 aà ±os no da lugar a ningà ºn derecho desde el punto de vista de las leyes migratorias de Estados Unidos. La respuesta es muy clara y no admite lugar a interpretaciones. No hay derecho a quedarse en Estados Unidos por esta razà ³n ni tampoco a sacar  una visa por el mero hecho de ser el pap o la mam de un nià ±o o nià ±a que es estadounidense. Es otras palabras, no es suficiente tener un bebà © en Estados Unidos Unidos  para emigrar legalmente. Adems, dependiendo de los casos puede ser un problema para los padres que desean renovar sus visas de turista. En este artà ­culo se informa sobre los distintos supuestos que pueden darse cuando unas personas extranjeras tiene un hijo que tiene ciudadanà ­a estadounidense. Quà © pasa si estando en Estados Unidos se tiene un hijo Si una mujer extranjera da a luz en Estados Unidos, su hijo es ciudadano de Estados Unidos salvo en el caso de que sea hijo de padre o madre diplomtico que est en el paà ­s en esa funcià ³n. La ciudadanà ­a estadounidense por nacimiento en el paà ­s, que tambià ©n se conoce como ius solii, se produce con independencia del estatus legal de los padres, en otras palabras, no importa si son indocumentados. En estos casos el bebà © tambià ©n adquiere la ciudadanà ­a.  Ni siquiera sirve para proteger frente a una posible deportacià ³n.   Pero lo que no pasar es que los padres puedan cambiar su estatus migratorio por razà ³n del nacimiento. Si son indocumentados, seguirn siendo indocumentados. Adems, para evitar perder la custodia de los nià ±os en caso de detencià ³n por estar indocumentado, es altamente recomendable explorar la posibilidad de hacer un  poder de representacià ³n  (power of attorney)  en previsià ³n de que se pueda dar esa circunstancia. Por otro lado, los padres del bebà © nacido en EE.UU. estn en el paà ­s legalmente con una visa temporal como, por ejemplo, de trabajo o de turista, debern conservar el visado para no perder su estatus y salir dentro del plazo autorizado para permanecer en el paà ­s. Padres que regresan a su paà ­s de origen con hijo nacido en EE.UU. El padre o la madre no tienen derecho a conseguir ningà ºn tipo de visado o de tarjeta de residencia por razà ³n del nià ±o. Pueden solicitarla, pero sà ³lo le ser concedida si reà ºnen por ellos mismos los requisitos para su obtencià ³n. En otras palabras, si por ejemplo, solicita un visado de turista, deber ser considerado elegible y admisible. En caso contrario la peticià ³n ser rechazada. Y asà ­ sucede con todas las visas. Por otro lado, el nià ±o que nacià ³ en Estados Unidos conserva su ciudadanà ­a aunque nunca regrese a vivir a su paà ­s de nacimiento, ya que esa no es causa para perder la nacionalidad americana. Si se desea solicitar un pasaporte para el menor o algà ºn tipo de documentacià ³n pueden pedirle un acta o certificado de nacimiento, que puede conseguirse desde el extranjero. Lo que sà ­ suceder es que de acuerdo a las leyes actuales, si el nià ±o nacido en Estados Unidos vive toda su vida en el extranjero entonces con el paso del tiempo no podr transmitirle su nacionalidad americana a sus propios hijos nacidos tambià ©n fuera de USA. Y es que para que pueda funcionar ese tipo de transmisià ³n derivada de la nacionalidad se requieren ciertos aà ±os de residencia en EE.UU., que varà ­an segà ºn se trate del padre o la madre y de si estn solteros o estn casados. Quà © pasa si el hijo es estadounidense aunque ha  nacido en el extranjero Hay casos en los que un nià ±o/a nacidos en el extranjero son estadounidenses y asà ­ consta en el Reporte Consular de Nacimientos en el Exterior. Si la ciudadanà ­a se da porque sà ³lo uno de los padres es estadounidense, el otro no puede reclamar ni una tarjeta de residencia ni una visa para los Estados Unidos argumentando que tiene un hijo americano. Sà ³lo puede obtener documentacià ³n para viajar de dos formas. En primer lugar, para emigrar definitivamente por medio de una green card, sà ³lo puede hacerlo si reà ºne por sà ­ mismo los requisitos para sacarla o si est casado con un estadounidense que le pide.   En segundo lugar, si es para viajar temporalmente a Estados Unidos, sà ³lo podr sacar una visa  no inmigrante tipo turista, estudiante, intercambio, trabajo, etc. si califica por sà ­ mismo y cumple con todos los requisitos. Quà © pasa cuando el hijo estadounidense cumple los 21 aà ±os de edad El ciudadano americano que es mayor de 21 aà ±os puede solicitar la tarjeta de residencia para sus padres. Si bien deben darse los siguientes requisitos: Vivir en Estados Unidos, ya que se trata de una visa para reunificacià ³n familiar.Tener ingresos para patrocinar suficientes.Firmar un affidavit of support o juramento de apoyo econà ³mico de sus padres.Adems, es necesario que el padre o la madre que quieren gozar de este beneficio no incurran en ninguna de las circunstancias por las que se puede rechazar una peticià ³n de tarjeta de residencia permanente. ​ Si el padre o la madre se encuentran ya en EE.UU e ingresaron ilegalmente al paà ­s entonces hay un problema grande ya que no puede ajustar el estatus.  En estos casos, antes de presentar los papeles es recomendable consultar con un abogado ya que en la mayorà ­a de los casos, en la prctica, no va a ser posible arreglar los papeles.   Pero como cada caso es à ºnico, tener en consideracià ³n que en ocasiones es posible pedir un perdà ³n provisional  por dureza extrema,  tambià ©n conocido como waiver y asà ­ sacar la green card, aunque seguirà ­a  siendo necesario viajar fuera de EE.UU. para una entrevista en el consulado. Caso de hijos abandonados o abusados por sus padres Si el hijo o la hija obtienen los papeles por medio del programa de Estatus Especial de Inmigrantes Juveniles (SIJ), los padres nunca jams podrn obtener beneficios migratorios por peticià ³n del ese hijo. Caso de hijo nacido en EE.UU y padres estaban en el paà ­s con visa temporal No es infrecuente que una mujer embarazada ingrese a Estados Unidos y dà © a luz a un bebà © que, por derecho de suelo, adquiere la ciudadanà ­a estadounidense. En estos casos es importante pagar los gastos del parto porque si no se hace, lo har Medicare, un programa del gobierno federal de los Estados Unidos. Hacer esto es considerado como carga  pà ºblica y, por lo tanto, causa para negar una visa o su renovacià ³n. A veces pasan aà ±os antes de que el problema se detecta, pero si el consulado o los agentes en el paso migratorio determinan que se tiene un hijo estadounidense y se sospecha que no se ha pagado por el gasto hospitalario entonces se puede negar la visa, cancelarla y, en el caso de estar en la frontera, prohibir el ingreso a Estados Unidos. Curiosidad sobre los apellidos hispanos en USA   Aunque en las à ºltimas dos dà ©cadas la migracià ³n ha llegado a niveles histà ³ricos realmente altos lo cierto es que a dà ­a de hoy la mayorà ­a de los hispanos son estadounidenses ya nacidos en el paà ­s.   Debido a los altos nà ºmeros de los flujos migratorios y de nacimientos, los latinos somos en la actualidad la mayor minorà ­a, habiendo pasado en nà ºmero a los afroamericanos. Una prueba de esta importancia demogrfica se encuentra en el censo, donde casi una veintena de apellidos latinos se encuentran entre los 100 primeros e incluso 2 estn en el top 10. Este es un artà ­culo meramente informativo. No es asesorà ­a legal para ningà ºn caso concreto.

Creativity and Innovation week 1 Essay Example | Topics and Well Written Essays - 500 words

Creativity and Innovation week 1 - Essay Example One of the organizations that have undergone an innovation is the California Institute for Regenerative Medicine (CIRM). California Institute for Regenerative Medicine is an organization that improved the development of therapies and potential cures based on the stem cell science (Michael & Panetta, 2005). In order to meet this mission that had been set, the organization had to focus on innovations both internal and external by carrying out research, product development and clinical trials. In order to be more successful, the CIRM developed a collaborative network that consisted of funding entities in 2 international states, 2 foundations, 12 countries and one domestic state. Additionally, the National Institute of Health also entered a collaborative relation with the CIRM. Through a good external collaborative network, California would be able to collaborate with several people from outside the state on several projects of innovation that would help in identifying solutions to diffe rent conditions such as HIV/AIDS, Parkinson’s disease, childhood neurological disorders, cancer and genetic diseases( Chesbrough, 2003). The Main inspired idea that led to the innovation was to successfully fulfill the various objectives that were laid by the organization. The objectives include; increasing the development of stem cell therapies, implementing the recommendations of the external review panel. With the objectives set, the project came out with a more valuable result that would help in fulfilling the mission and improving people’s health status with most chronic conditions. Self expression can be referred to as an expression of one’s personality or feelings such as in poetry, painting or any other creative work or activity (Slowinski, 2005). The development of creativity and self-expression involves the use of technological tools in order to produce a range of creative works. The activities

Mutiple intelligence Essay Example | Topics and Well Written Essays - 2250 words

Mutiple intelligence - Essay Example According to Howard Gardner there are seven types of intelligences: musical intelligence, bodily-kinesthetic intelligence, logical-mathematical intelligence, linguistic intelligence, spatial intelligence, interpersonal intelligence, and intrapersonal intelligence. The naturalist type of intelligence was added after Gardner developed the seven types of intelligence (Levitin, 507-520) (Daniel L. Levitin is a prominent American cognitive psychologist, neuroscientist, record producer, musician, and writer). The theory of multiple intelligences has brought a pragmatic approach that would allow cultivation of student’s strengths towards learning and how we define intelligence. Numerous educators, parents, researchers, and students deemed the idea of multiple intelligences as important however, multiple intelligences theory has also risen criticisms among scholars in the field of psychology. My goal in this paper is to investigate the issues surrounding multiple intelligences by examining the point of view of Howard Gardner and those critics of the multiple intelligences theory. To achieve this goal, this paper will discuss four main sections, two of which have sub-sections. The first section will discuss the history of multiple intelligences, together with the evolution of the definition of intelligence. The second section will discuss each type of multiple intelligences, and issues surrounding the multiple intelligence theory will be discussed in the third section. Lastly, the fourth section will discuss the impact of multiple intelligence theory on the education of America. The history of multiple intelligences started through the attempts to reform the common notion of the term â€Å"intelligence†. More often, people measured intelligence through the ability to solve problems, to find the answers to specific questions, and to learn new material quickly and

Special Education Essay Example | Topics and Well Written Essays - 1500 words

Special Education - Essay Example Again, the paper looks at the modern technologies that are used in the elementary adult education. And lastly, controversial issues surrounding adult education are discussed. ADULT EDUCATION The main purpose of any form of education is to enlighten the learners and to equip them with the necessary skills and knowledge to overcome many life challenges. And since it is not possible to have knowledge of everything, education therefore is a lifelong process; we spend all our life learning, whether formally or informally (Lindeman, 1926). Education is one, therefore, in terms of its goals and aims. However, education can be classified in terms of the category of learners (age of the learners) who undertake it, and in this classification we have, early childhood education, elementary education, middle School education, High school education, and adult education. This paper deals with adult education, focusing specifically on elementary adult education. It investigates the historical develo pment of adult elementary education and the current legislation that shapes it, the paper goes on to discuss many other pertinent issues on adult education in the contemporary world. ... Adult elementary education has a long history. In formal setting, adult elementary education in Western world was pioneered by Reverend B Morgans, Vicar of Trelach near Monmouth in 1754 (Hudson, J. W., 1851). After realizing that many adults in his congregation could hardly read the scriptures, Rev. Morgans decided to do something for them. He therefore started special classes for the illiterate adults in his congregation. In these classes, the adults were taught elementary reading and writing skills. And to his surprise, as time went on, many more illiterate adults volunteered to join his classes. All the participants benefited greatly from the classes and from then henceforth, the programme of adult education continued in his parish. In 1811, Reverend T. Charles, B.A, established a school in Great Britain at Bala, in Merionethshire. This school was dedicated exclusively for the education of the adults. And just like Morgans school in Wales, some time back, the main intention of sta rting this school was to help the old illiterate members of the congregation to read the bible. Rev. Charles’s enterprise turned out to be a big success for many adults enrolled in his schools from all over Wales. The school became famous in Wales, and many more such Schools were opened in Wales to help many illiterate adults who had desire to read. And by 1813, there were adult schools established as far as in Bristol. These schools were started by the lay people and not the clergy men/women. From 1813- 1818, adult elementary schools spread all over European countries, and by around 1819, adult elementary schools had been established in the USA. Later, during the colonization period, the Europeans established elementary adult

Young people 's attitude to health (young people who eat McDonald's Essay

Young people 's attitude to health (young people who eat McDonald's more than once a week do not care about their health) - Essay Example nald's more than once a week. The researcher has used two separate hypothesis regarding health awareness and hedonic value drivers of eating in fast food restaurants in order to develop research problems. As research methodology, the researcher has used triangulation approach in order to address the research problem in robust manner. Close ended questionnaire and open ended interview were used in order to collect the data. On the basis of data analysis, influence of hedonic value drivers on fast food consumption of young people has been identified but the study has failed to find any significance of the primary hypothesis: â€Å"Young people who eat McDonald's more than once a week do not care about their health†. It is not the fact that the research paper has only the academic value of fulfilling gap in the literature but the research findings will also have commercial value such as, findings of the research can be used by fast-food marketers to decide their marketing strateg y. Chapter 1: Research Background In the last couple of years, fast food industry has witnessed phenomenal growth in terms of both value and volume across different countries. Ali, Kapoor and Moorthy (2010) found that demand for fast food among customers have increased due to three reasons, 1- convenience for customers to consume fast food in quick succession in contrast to waiting in long queue to dine out in traditional restaurants, 2- fast foods are low cost food offerings which can satisfy the hunger of consumer without costing them huge chunk of money in contrast to dining in posh restaurants and 3- while consuming fast food, consumers often pass through health-indulgence antinomy which helps them to establish trade-off between immediate gratification and prophylactic reward. According to Ali, Kapoor and Moorthy (2010), children, adolescents, young people and working professional are the prime target market for fast-food marketers like McDonald, Kentucky Fried Chicken (KFC), Pi zza Huts, Domino’s, US Pizza etc. Anand (2011) and Ali, Kapoor and Moorthy (2010) identified reasons why fast-food marketers target young people and the identified reasons can be summarized as, 1- income of young people is low as compared to adults, therefore they show the preference for low cost fast-food items in contrast to high end food items, 2- young people prefer to eat out in fast food joints with friends due to convenience, 3- health consciousness among young people regarding the ill effects of fast foods is less as compared to young people and 4- young people prefer to indulge themselves in fast-food experience in order to satisfy hedonic value. Now the question is whether eating fast-food offered fast-food marketers like McDonald, Kentucky Fried Chicken (KFC), Pizza Huts, Domino’s, US Pizza has only benefits or there is presence of dark side of the story? The answer is yes and health related issues regarding fast-food consumption among people are central the me of the research paper. Consideration of the research works of Ritzer (2001) and Williams (2006) reveals the fact that periodic and frequent consumption fast food can lead to multiple health problems such as obesity, diabetes, cardiovascular disease and even cancers. Ali, Kapoor and Moorthy (2010) found a direct link between growing obesity among young people

Air Traffic Control and the operations of Airports all around the Essay

Air Traffic Control and the operations of Airports all around the world - Essay Example Nowadays these systems have been modernizing by means of latest electronic and information technologies available. Thus, the air traffic control and airport operations can provide ever better service to humanities of the world. The modernized air traffic controlling system is equipped with sophisticated instruments like radar, radio and wireless communication and computer facilities to locate the flying aircraft. Many trained personnel have been working together at the ground offices to provide better service to flying aircrafts and airports. They monitor all airborne signals and give proper instructions and guidelines as required. They can trace out the locations and speed of the aircraft on voyage. Sometimes they need to inform concerned superiors to provide expert instructions for overcoming complicated situations. Their main task is developing an environment that is very much safe for the free flying of the aircrafts. Thus, the number of aircraft carrying out the flights can be increased considerably. They are also authorized to warn aircrafts if they come closer each other. The pilots and crew of the aircrafts work closely with air traffic controllers for the proper management of the air traffic syste m. They are also capable to predict the weather conditions prevailing around airports. So according to predictions they can arrange for the safer take off and landing of airplanes. This weather information is beneficial not only to flight passengers but also to industries which mainly depends on air cargo carriers to transport their products, materials and officials. Thus, these trained personnel have become the integral part of air traffic and airport operations. The air traffic control consists of three main phases. The first phase is the rules and regulations to be followed by the pilots during flight. Second is the navigation system and instruments which work on the basis of electronics. This system and instruments

What does the book of Exodus contribute to our understanding of Essay

What does the book of Exodus contribute to our understanding of salvation - Essay Example His divine-human nature has allowed people to atone for their sins and be saved and have a blissful afterlife. Nevertheless, the origins of the issue can be found in the Old Testament, particularly in Exodus.2 Exodus raises important issues relating to the issue of salvation such as faith in God and commitment to spiritual and moral purification. In Exodus, salvation appears not only as receiving by the Jewish people their Promised Land. Salvation is presented as a spiritual and moral purification, in which the main role belongs to the sincere and genuine faith in God and His grace. â€Å"The importance of the Exodus event in the Old Testament cannot be underestimated.† 3 As noted above, salvation is seen by many people as the exemption from danger or suffering. To save someone means to free or secure him or her. This word carries the idea of ​​victory, peace, and protection. Sometimes the Bible uses the word "salvation" in relation to the interim and physical release, such as the release of Paul from prison.4 However, more often the word "salvation" refers to the eternal and spiritual liberation. When Paul told the Philippian jailer, that he should be saved, he was referring to the jailers eternal destiny.5 Jesus likened salvation with entering the kingdom of heaven.6 According to the Christian doctrine of salvation, people are saved from God’s "anger", that is, the divine judgment of sin.7 Sin had separated people from God, and the result of sin is death.8 Biblical salvation means liberation of people from the consequences of sin, and thus involves the removal of the sin. Exodus tells the story of the calling of Moses, the deliverance from the bondage of the people of God and the covenant between the Jewish people and God. The composition of the book is rather complicated. The book contains the epic story of the Children of Israel enslaved in Egypt and the calling of Moses (Exodus 1-5), the struggle

Air Traffic Control and the operations of Airports all around the Essay

Air Traffic Control and the operations of Airports all around the world - Essay Example Nowadays these systems have been modernizing by means of latest electronic and information technologies available. Thus, the air traffic control and airport operations can provide ever better service to humanities of the world. The modernized air traffic controlling system is equipped with sophisticated instruments like radar, radio and wireless communication and computer facilities to locate the flying aircraft. Many trained personnel have been working together at the ground offices to provide better service to flying aircrafts and airports. They monitor all airborne signals and give proper instructions and guidelines as required. They can trace out the locations and speed of the aircraft on voyage. Sometimes they need to inform concerned superiors to provide expert instructions for overcoming complicated situations. Their main task is developing an environment that is very much safe for the free flying of the aircrafts. Thus, the number of aircraft carrying out the flights can be increased considerably. They are also authorized to warn aircrafts if they come closer each other. The pilots and crew of the aircrafts work closely with air traffic controllers for the proper management of the air traffic syste m. They are also capable to predict the weather conditions prevailing around airports. So according to predictions they can arrange for the safer take off and landing of airplanes. This weather information is beneficial not only to flight passengers but also to industries which mainly depends on air cargo carriers to transport their products, materials and officials. Thus, these trained personnel have become the integral part of air traffic and airport operations. The air traffic control consists of three main phases. The first phase is the rules and regulations to be followed by the pilots during flight. Second is the navigation system and instruments which work on the basis of electronics. This system and instruments

Characteristics of Business Leadership Research Paper

Characteristics of Business Leadership - Research Paper Example It is after this that Steve struggle with the board for directors and left for NEXT Company which is, a computer plat-form development firm that specializes in higher education and business markets. Apple Computer Company was invented and established by Steven Jobs and Wozniak who formed it in his won garage since there was a challenge in raising more funds for its expansion compelling the company to look for more funds and resources for its expansion. Another challenge was insufficient competent personnel, and in this case, the Apple Two companies began looking for an experienced and a competent executive who could help them manage its expansion (Linzmayer, 2004). Therefore, the success and the growth of Apple Company at that time were met severely by insufficiency of both human and financial capital. As a consequent, Steven Jobs encountered a personality challenge of indiscipline and temperament which adversely affected the relationship between him, his workers and the general soci al environment within the company which incapacitated him on the daily running of the business. This led to a decline in the output of the company resulting to a slump in 1980s. Leadership Styles Used By Steve Jobs Steven Jobs throughout his life depicted an autocratic leadership style which realized especially because of him not making any assumptions and down to earth leader. Moreover, based on his leadership and managerial style, he was not boisterous and thus, he understood clearly the need for strong personal relations (Arnold, 2012). Steve Jobs were also identified as a transformational leader due to the fact that he is passionate and enthusiastic about his work. He is also known for creating visions and injects energy and motivation into his stream to ensure effective management. Apple Company developed a competitive culture especially at the work place, and this was as a result of jobs competency. Jobs control extended as far as the structure and design of the company bus an d necessities such as food served at the cafeteria. Within the company, Steven Jobs practiced and encouraged the concept of strictness that resulted into greater accountability into the entire organization. This was carried out through the frequent meetings especially on Mondays with various executives to set the main objectives for the week (Beahm, 2011). Similarly, to put this in place, the executives formed some agenda and at the same time the meetings also reviewed each and every product that was under development. This therefore, led to high out put in terms of quality and competence among the employees in the organization. Employees were recruited into the firm as specialists and were assigned duties based on their specific abilities and strengths, and this also helped in making feel motivated as they enjoyed whatever they were doing in the organization (Young & Simon, 2005). As a result of honesty accountability and transparency, the organization started to enjoy the global m arket. Steve jobs was also strict and encouraged competent work among his employees hence this created an environment for competent work, producing quality products that sell easily in the global market encouraging Jobs to exert all his control over every aspect of the business. As a Consequent, Steve jobs encouraged a working culture whereby there was a devoted employer-employee relationship and rapport in areas such as communication between the management and the employees, problem

Single Member Plurality Electoral System Essay Example for Free

Single Member Plurality Electoral System Essay The Fallacy of the Single Member Plurality Electoral System Government efficiency is dependent on the capacity of the government to make decisions that mirror the views of the majority. This would require municipal representatives to be elected by at least half of the voters. This has not been the case in Canada. Electoral reform has been a highly debated issue throughout Canadian politics. Currently, Canada’s electoral system is being questioned for its inability to reflect the political views of its citizens. The single member plurality system (SMP), which Canada employs to fabricate a democratic election, can cause representatives to be elected without the majority of the popular vote. In contrast, the system of proportional representation eliminates an inequity in parliament composition by ensuring representation from every party that received votes. Although this system would inevitably result in minority governments, it would appropriately cater to the views of the constituents. To produce a more effective government, Canada’s single member plurality electoral system should be replaced by a system of proportional representation (PR). Another attempt to negate the effectiveness of the PR system is by charging that it would lead to the decline of responsible government. The reasoning behind this lies with the theory that PR disenfranchises a parties capability to â€Å"formulate policies, administer programs, make laws, submit budgets†(Barker, 287). Opponents contend that under PR, the government would be unable to garner enough confidence from the legislative branch. However, by looking at the opposite side of the spectrum, one would agree that this disadvantage is minimal compared to the policy making created through single member plurality. SMP encourages parties to form lowest common denominator policies in order to achieve a plurality of votes. Consequently, parties will create platforms that advocate policies that are indistinguishable to those of other party platforms. By providing ambiguous party principles, a constituent’s local MP can avoid being held accountable. In essence, â€Å"the plurality system encourages MPs and political parties to reflect some limited concerns of their geographic districts while ignoring the deeply held principles of the voters†(Heimstra and Jansen, 300). The only thing differentiating Canadian parties is their promise of â€Å"social benefits beyond what the economy could tolerate†(Irvine, 45). Since parties under PR do not have to compete for the median voter, â€Å"governing parties have less incentive to manipulate policy for short run ends†(Irvine, 50). As mentioned earlier, minority governments are likely to be assembled over a majority government under a PR system. This will entice legislature to form a coalition, thereby facilitating the demands of all the different regions comprising Canada. Eventually, long term policy making will be executed with less hesitation, as governments will soon realize that regardless the outcome of the following election, support for their proposed policy will still exist. The inability of the House of Commons to finalize long-term policy-making has stunted economic growth in Canada because of ineffective governments elected through SMP. The greatest disadvantage of single member plurality is its inhibiting effect on voter turnout. Voter turnout has been decreasing steadily as more people have come to the realization that their votes will not necessarily be accounted for. In Jeffrey Simpson’s book, The Friendly Dictatorship, the author reveals that â€Å"only 61 per cent of eligible Canadians bothered to vote in 2000, the lowest turnout by far since the Second World War†(Simpson, 144). It is important to note that Canada counts voter turnout by the number of people who vote in relation to the number of people on the electoral list. Since not everyone eligible to vote gets on the electoral list, the numbers are actually far lower than they appear. With a large number of eligible voters staying home, elected MPs do not have a real mandate to represent their constituents. This discrepancy has the potential to produce an ineffective government and a discontent amid the members of society. It has become increasingly important to determine the cause of this decreased interest in voting. electoral system is often described as a â€Å"first past the post† system. The way in which this system functions is that each voter is allowed one vote and the candidate with the most votes (or a plurality) becomes elected. Proportional representation, on the other hand, can be accomplished through a multitude of electoral methods. But for the sake of convenience, we will focus primarily on the two most notable systems: party list system, and mixed member proportional. The party list system used to achieve PR relies on the voter to choose the party they wish to support as opposed to the actual candidate.

Medieval Renaissance Middle Ages

Medieval Renaissance Middle Ages There are many differences in the beliefs and values between the Renaissance and the Middle Ages. The Middle Ages was a time of great suffering, including famine and widespread disease. The Renaissance, however, was a revival of art, learning, and literature. Their views of the purpose of life in the present world and mans place in the world were, perhaps, the greatest contrast. However, their views on politics, religion, and education were very different as well. The purpose of life and mans place in the world was viewed differently during the Middle Ages and the Renaissance. During the Middle Ages, also known as The Age of Faith, mans purpose was to serve God. Looking upon life as a journey is prevalent during this era. The focus of life was on the afterlife, primarily because there were no guarantees in the present life. The life of highest value was the contemplative life, one devoted to God. The passive virtues such as compassion, suffering, and humility were highly regarded. God was the center of mans world during the Middle Ages. On the Great Chain of Being, man was below God and the angels and above the animals, plants, and inanimate objects. It is amazing how aspects of society can and will change so significantly over the course of a few hundred years. Between the times of the Medieval era and the Renaissance, one can note numerous significant changes, mainly those pertaining to religion and art, and specifically, drama. In Medieval times, people seemed to rely mainly on the church and God for their entertainment purposes; whereas during the Renaissance, the focus was more secular: humans and life on earth. In general, ideals and subjects evolved from unquestionable Church dogma (and therefore very safe subject matter) to ideas that focused on the questions of humanity (and therefore creating an unstable and unsettling universe.) The evolution from the Medieval dogma to the humanistic focus of the Renaissance is apparent through the dramatic texts of the time. Although these two eras differ in many other ways, the most illustrated differences deal with the realm of drama, starting with the Medieval Cycle dramas and culm inating in Shakespeares King Lear. Drama noticeably shifted from religious awe to classical reason between the Medieval era and the Renaissance. During the Middle Ages, drama aimed mainly at making advancements in the church. Thus, the Cycle Dramas or English Passion Plays performed with the permission and help of the church. The belief is that the church clergy probably wrote the short stories or playlets and then gave them to the Guilds for their performance in theaters. Although the appearance of the Cycle Dramas seems unimaginative and commonplace at a first glance, there are some striking innovations in terms of furthering a dramatic structure. This is the first time we see the use of a double plot in which the honored and revered story is compared to a similar situation but of a base (and most times, immoral) story. A perfect example of this is in The Second Shepards Play where Mak and Maks wife, Gill, imitate the glorious scene of Christs birth in the manger by putting the stolen lamb in a basket and pretending it is a baby. Almost every Cycle Drama has a similar structure, and the dramas that came after the Cycle Dramas continue to use this structure. We can see the double plot/sub plot structure becoming more and more significant and taking on more importance in plays such as Gorboduc, The Spanish Tragedy, most of Shakespeares works, and ultimately in King Lear. As the Medieval era ends and the Renaissance emerges we also see a shift in the attitude towards evil. Through the texts of the English Passion Plays we can see that the attitude is playful and comic when the subject matter is the Devil or something equally as wicked. The possibility of questioning religion, faith, and humanity has not yet entered the picture. As soon as the possibility emerges, the safe and secure world of absolutes is violently thrashed. We see the possibilities emerge in Everyman when Death comes before Everyman has a chance to redeem himself. We see it again with more force in Gorboduc when the King cannot restore his kingdom from his sons. Another great example is in Marlowes The Tragedy of Doctor Faustus where Faustus has the opportunity to redeem himself, but does not, and evil conquers all. We see the culmination of the destroyed safety of the Medieval world in Shakespeares plays including Hamlet, Macbeth, Richard III, and King Lear. Shakespeare especially do minates this subject matter because of historic events in his lifetime. Because of political strife between the Catholics and Protestants, and to avoid conflict, Queen Elizabeth forbid the subject matter of religion to enter into any play, and thus Shakespeare very craftily described worlds in his plays that related to religion, but had none as specific as Christianity. With these circumstances he was able to open the door to a type of thought not used since the Greek age. In his play, King Lear, Shakespeare describes a world in which the gods are just, and of our pleasant vice make instruments to plague us. In other words, the gods are just but cruel. And thus, dramatic focus had changed from the security of religious dogma in the Medieval era to a more humanistic, questioning and circumstantial view of the world in the Renaissance. The steadfast, secure world of the Medieval age was at an end. Then it all crashes down and you break your crown.. In King Lear, we see the evolution of thought from the Medieval to the Renaissance played out for us onstage. The safe, secure world of Britain we glimpse at the beginning (not unlike the Medieval world) is a hoax and King Lear is the largest proponent of it. Lear must go through the process of learning to see the truth of the world around him, a world that is full of questions and not so many answers-in other words, a Renaissance world. When King Lear gives up his kingdom to his daughters, he is quick to dismiss any truth not to his liking. He is convinced that the world is an absolute, that he has absolute power and that he will never lose it. He has no need to listen to anything but flattery. And it all goes downhill for King Lear because he gives his kingdom to his dishonest daughters Regan and Goneril who are willing to flatter through forked tongues. Lear, in a fit of rage, disowns his honest daughter Cordelia for telling him a plain truth. He loses everything, including his power, money, family, and life. King Lears reign ends because of his foolishness and his corrupt daughters deceit. His once mighty grip upon his kingdom is now nullified and hes just left with just a memory of his rule. People still regarded him the king, however he has no money and no power. In Act IV, Scene 6, we see Lear dressed in wild berries and donning a crown made from weeds Lear has begun to see clearly and still believes himself to be a King, but, more realistically, a King of nothing. Lears life ends tragically without any kind of redemption of the Medieval sense. We can see that Shakespeare has completely opened up the curtain to reveal a shaky and unstable world where there is no God and possibly no gods either to remedy the situation. A Medieval audience would not have been able to handle this collapse of religious structure, but the Renaissance was ready for it. Perhaps the greatest and most evident way in which the Medieval and Renaissance time periods differ is found in the opposing premises of philosophy, which we see through, its dramas. Again, the theme of progression from religious-oriented thoughts in the Middle Ages to the secular ideals of the Renaissance is evident in texts from Everymans spiritual journey to Christian redemption, through Lears possibly godless universe. The general view of people in the Middle Ages was that of putting faith in the church, with beliefs that there would be a reward in heaven for them at the end of their tired lives (Everyman). During the latter Renaissance, however, thoughts were more associated with living life on earth rather than the afterlife in heaven. The consequences of King Lears actions appear before death and there is no resolution to say whether or not Lear is relieved of his burden through death. New confidence in human abilities and thought was developed in drama, and there were many mo re inquiries pertaining to science and reason (Faustus), rather than religion as it was in the Middle Ages. Faustus is an interesting mix of a Renaissance man in a Medieval world and the collision that these two subjects make is astronomical. Also, philosophic developments during the Renaissance were made to be more practical and had more realistic applications to everyday life. The philosopher, Machiavelli, is an example of this, as he made attempts to find a balance between freedom and authority, something that was very useful in life and put no confidence in the church or God. He developed the idea that a corrupt society needs to find a strong leader(who is not necessarily moral) to govern so that the people can learn to be capable of self-government. This was a practical idea and applicable to everyday life although not necessarily a popular idea. He also developed the classic archetype of the Machiavel, which we see in almost every dramatic text from The Spanish Tragedy on. The ultimate changing theme as is evident in the dramatic literature during the progression from the Medieval to Renaissance eras was that of religious-based ideals to ideals that were humanistic and questioning in nature. People turned from putting all their faith in religion and the afterlife, and began focusing more specifically on problems concerning everyday life. As seen in the English Passion Plays and Everyman the focus of Medieval drama is specifically on biblical topics, especially redemption and the journey of a religious nature, whereas the texts of the Renaissance describe situations of governmental disputes, issues of pride, truthfulness, and many other humanistic attributes of life. The focus has clearly shifted from the religious to the secular.

Diabetes Mellitus Essay -- Health Diseases Diabetes Essays medical

Diabetes Mellitus Diabetes is the seventh leading cause of death listed in the United States. Diabetes is the leading cause of blindness. â€Å"In 1996 diabetes contributed to more than 162,000 deaths†(Lewis 1367).   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"Diabetes mellitus is not a single disease but a group of disorders with glucose intolerance in common† (McCance 674). Diabetes mellitus is a metabolic disorder characterized by hyperglycemia (increased blood sugar) and results from defective insulin production, secretion, and utilization. There are many forms of diabetes. â€Å"Diabetes increases the risk of heart and blood vessel disease, amputation, infections, kidney damage, eye problems (including blindness), and nerve malfunction† (Husain). I will briefly define the different forms of diabetes and then I will discuss diabetes mellitus in general. 1.  Ã‚  Ã‚  Ã‚  Ã‚  Insulin dependent diabetes mellitus (IDDM) or type 1 is when the pancreas will produce little or no insulin, therefore requiring injections of insulin to control diabetes and prevent ketoacidosis. All patients with this type of diabetes need insulin to survive (Deakins 34). Five to ten percent of all diabetic patients have IDDM. Usual presentation is rapid with classical symptoms of polydipsia (increased thirst), polyphagia (increased hunger), polyuria (increased urination), and weight loss. IDDM is most commonly seen in patients under thirty, but can be seen in older adults. 2.  Ã‚  Ã‚  Ã‚  Ã‚  Non-insulin dependent diabetes mellitus (NIDDM) or type 2 is caused by a defect in insulin manufacture and release from the beta cell or insulin resistance in the peripheral tissues. Approximately ninety percent of diabetic patients have NIDDM. Genetics play a big role in the etiology of NIDDM and is often associated with obesity. Usually presentation is slow and often insidious with symptoms of fatigue, weight gain, poor wound healing, and recurrent infection. Primarily occurs in adults over thirty. 3.  Ã‚  Ã‚  Ã‚  Ã‚  Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance, which occurs during pregnancy. Occurs in approximately three percent of pregnancies, and usually disappears after pregnancy. Women with GDM are at higher risk for having diabetes in the future. GDM is associated with increased risk of morbidity. Women should be screened for GDM between the 24th and the 28th weeks of gestation. 4.  Ã‚  Ã‚  Ã‚  Ã‚  Diabetic ketoacidosis is a serious... ...ur to six hours to reach the bloodstream, but stays in the bloodstream for about thirty-six hours. It peaks about fourteen to twenty-four hours after injection. Diabetes affects the entire body. It slowly deteriorates every one of the body’s organs. You can live a long and prosperous life as a well-controlled diabetic, but a short and miserable life if noncompliant. Works Cited Deakins, Dee A. Oral Hypoglycemics. Nursing 92; The World’s Largest Nursing Journal Nov. 1992: 34-39. Doenges, Marilynn E. Nursing Care Plans; Guidelines for Planning Patient Care. Philadelphia: F.A. Davis Company, 1989. Drass, Janice. Insulin Injections. Nursing 92; The World’s Largest Nursing Journal Nov. 1992:40-43. Harkreader, Helen. Fundamentals of Nursing; Caring and Clinical Judgment. Philadelphia: W.B. Saunders Company, 2000. Husain, Rahat. The Diabetes Information Page. Undated. http://www.geocities.com/Athens/Forum/5769/diabete.html. Lewis, Sharon Mantik. Medical Surgical Nursing: Assessment and Management of Clinical Problems. St. Louis: Mosby, 2000. McCance, Kathryn L. Pathophysiology; The Biologic Basis for Disease in Adults and Children. St. Louis: Mosby, 1994.

Housewife vs. Working Women Essay

I watched a debate on the television on this topic. There were two groups who discussed this. Surprisingly, each group had a husband/wife whose spouse was in the other group. This opportunity was too good to be missed, I guess! The debate was lively, did not reduce to a wrangling match because of the mediator. He was able to conduct the whole debate very smoothly. Those who do not want their wives to work have no problems if their daughters or sisters work. Why these double standards? Their explanation is till the kids are young they need their mothers. So their wives could take up jobs after a few years. But they refused to admit what these few years are. One lady wanted to know how long she was supposed to wait. She was a double post graduate, and professionally qualified. She said her skills would become redundant if she waited any longer. She has been waiting for over ten years. Her husband had no answer to her question. One gentleman said his was a transferable job, so he wanted his family to be with him. If his wife was employed, she would stay back, he would have to shift and he would miss out on family life because the children would be with her. It never struck him that she could always resign her job and joins some concern in the city where he shifted. But he wants to educate his daughter and wants her to join IIM at Ahmedabad. This is his goal in life. When asked if he would allow her to work, he said when she is so qualified, why should he deny her a career? His wife is a rank holder and a qualified person, but he wants her home. He was asked if in the future a groom wanted his daughter to stay at home, would he agree to this alliance. He said he would refuse. Another gentleman said he did not want his wife to undergo the hassles of managing home and job. The daily hazards of bus/train journey, stress of a workaholic boss, stress of meeting deadlines, could all be avoided if she stays at home. Also the children, his parents, relatives could all be taken care of by her. Even if she was willing to shoulder the burden of work and home, and was confident of doing justice to both, he was not convinced. Another lady accused her husband of having got used to having her wait on him; give him his coffee when he comes home, etc. That is the reason why he was loathes seeing her take up a job. Another gentleman said when a woman is confident of handling both a home and a career, and then she must be encouraged. His wife was completing her higher education and was planning to take up a job. He was very supportive, and felt all husbands must emulate him. According to him, women are a capable lot; they can take any amount of changes and tensions and come out smiling. He said they are a lot stronger than men and they are capable of more. So the debate raged and husbands and wives were throwing questions at each other. One lady said she was upset having to leave her child at the crà ¨che while she attended office. And any calls from there, she had to seek permission from her boss and leave. She felt she was being put in a delicate situation. Her husband asked her if he had ever pushed her to work. She declined. He too shared in all the chores, and he too went to the crà ¨che whenever he received a call. And he asked her whether she was capable of staying at home at a stretch. She agreed it was not possible. So why was she complaining? All the ladies who wanted to work and were working were vociferously advocating that women should work. All those who were qualified and who wanted to work should be encouraged. This was their viewpoint. They could not understand why the men folk objected. All those women who felt women should not work said women should learn to manage the family within what their husbands earned. Also it was very stressful to manage both home and career. They felt when they are at home; they can take good care of their children, in-laws, parents, and all the guests who arrived. They can concentrate on everyone’s health, and also take active participation in their children’s education. This was their argument. The rebuttal to this was when you have family support, and then a woman can achieve a lot. And there is the concept of quality time. Also those children, whose mothers were working, turned out to be more independent and also aware of their responsibilities. They learned to participate in all the household chores and were proud of their working mothers. The debate rages on. There was even one guy who said 40% of workingwomen were going astray. He was right royally condemned. Even his own group people were against his remark and he had to apologize. He was ripped apart by the anchor. So, you get all kinds in a debate. This debate is to be continued. Hope to catch it. But seriously, what do you think? Is a woman capable of managing a home and her career? Those men, who feel they are doing a favor to their wives by asking them to be housewives, are they doing it out of selfish reasons or do they feel threatened? Going out to work gives anyone, not only women, a sense of confidence. There are women who have no choice but work. But many ladies also work because they are qualified and have a passion for it. And they do bring in useful money, one must admit. Who does not like money? Women are good at multi-tasking. And they can handle wolves, eve teasers, and grouchy bosses. They may be physically weaker, but are emotionally stronger. They will always find a way of handling any crisis. Like a lady on the show said, if necessary they will get up an hour early to accomplish everything. I feel the choice should be given to the lady. If she wishes to work, if she is confident of handling both and if her spouse and family are willing to support her, then she can have a career. It does lead to fulfillment. And with changing times, a lady can also work from home, part time, or flexible hours. So let her choose. Whether she wants to have a career or wants to be a housewife.

A comparison between cardiac CT scanning and cardiac digital subtraction angiography (DSA)

Abstract Coronary artery disease affects nearly one tenth of the UK population and remains the leading cause of death in the western world. To investigate and provide interventions for coronary artery disease, imaging of the coronary arteries to enable visualisation of atheromatous plaque is required. This review looked at the techniques of cardiac computed tomography scanning and cardiac digital subtraction angiography, and their contribution to the investigation of coronary artery disease. Comparison of the procedures considered technique, radiation exposure, contrast agent, clinical indications and efficacy in diagnosis of coronary artery stenosis. On comparison of the effectiveness of the techniques, both were shown to have been effective non-invasive procedures that may be used to rule out diagnoses and avoid inappropriate use of invasive angiography. The research shows mixed evidence for cardiac computed tomography angiography as a test of high specificity, however sensitivity and speci ficity of cardiac digital subtraction angiography is high, and therefore suggest that the techniques may be useful in low risk patients. Introduction Coronary artery disease remains the main cause of death in the UK and western world (Hacker, 2013; Liu et al., 2002) and contributes a substantial disease burden, affecting 7% of men and 5% of women in the UK in 1999 (Liu et al., 2002). Coronary artery disease results from the build up of atherosclerotic plaque within the arteries supplying the myocardium. This plaque limits the flow of blood through the arteries, and can cause ischaemia of the heart muscle. If the plaque becomes unstable and ruptures, this may lead to thrombus formation and the complete occlusion of an artery, resulting in a myocardial infarction (McClure et al., 2009). Acute coronary syndrome (ACS) is a sub-classification of coronary artery disease and encompasses unstable angina, non-ST elevation myocardial infarction and ST elevation myocardial infarction. ACS represents a range of conditions that result from thrombus formation in coronary arteries, and if untreated has poor prognosis and high mortality (NICE, 2010). To investigate and provide information for interventions for coronary artery disease and ACS, visualization of the coronary arteries and any lesions caused by atherosclerotic plaque is required. Advances in technology have given rise to several sophisticated perfusion analysis techniques, which provide greater prognostic value than morphological imaging (Hacker, 2013). Perfusion analysis allows the blood flow through the coronary vessels to be observed and any abnormalities in the perfusion can be interpreted as a functional consequence of atherosclerotic changes within the vessels (Hacker, 2013). Currently, UK guidelines (NICE, 2010a) recommend coronary angiogram as first line management for patients presenting with ACS. This enables imaging of the coronary arteries to assess perfusion. It is important to assess the circulation as arteries can be affected from the earliest stages of endothelial dysfunction to high-grade coronary artery stenoses (Hacker et al., 2010; Bugiardini et al. 2004; Kaufmann et al., 2000), and this provides the information necessary for prognosis and intervention. With the advances in technology, there are now various diagnostic tests available to assess coronary artery disease, including coronary angiography and computed tomography (CT) scanning (Gorenoi, Schonermark & Hagen, 2012). This review aims to review the literature on coronary CT scanning and digital subtraction angiography, their clinical applications, techniques and comparative value in coronary artery assessment and diagnosis. Cardiac Digital subtraction angiography Coronary angiography is the conventional diagnostic procedure used in coronary artery disease. It is a minimally invasive technique, whereby a catheter is placed into the radial or femoral artery and is advanced through the arterial system to the coronary arteries. A contrast agent is then injected at the aortic root and allows visualization of the arteries using x-ray in real time at up to 30 frames per second. This allows a view of the extent, location and severity of coronary obstructive lesions such as atherosclerosis and enables prognostic indication (Miller et al., 2008). Coronary angiography also enables catheter placement either side of the lesion to assess pressure changes and determines the degree of flow obstruction (Miller et al., 2008). . Digital subtraction angiography (DSA) again works by introducing a contrast agent into the coronary arteries and taking x-rays in real time, however a pre image is taken by x-ray. This allows for the post images to be subtracted from the original mask image, eliminating bone and soft tissue images, which would otherwise overlie the artery under study (Hasegawa, 1987). Unlike conventional angiography, it is possible to conduct DSA via the venous system, through accessing the superior vena cava via the basillic vein (Myerowitz, 1982). This removes the risks associated with arterial cannulation (Mancini & Higgins, 1985). The procedure can also be performed with a lower dose of contrast agent and be done more quickly therefore eliminating constraints of using too much contrast during a procedure (Myerowitz, 1982). Whilst DSA is the gold standard in arterial imaging of carotid artery stenosis (Herzig et al., 2004), the application of DSA to the coronary arteries is limited due to motion artefacts associated with each heartbeat and respiration (Yamamoto et al., 2009). There are numerous cardiac clinical applications of DSA, it can be used to assess coronary blood flow (Molloi et al., 1996), valvular regurgitation (Booth, Nissen & DeMaria, 1985), cardiac phase (Katritsis et al., 1988), congenital heart shunts (Myerowitz, Swanson, & Turnipseed, 1985), coronary bypass grafts and percutaneous coronary intervention outcomes (Katritsis et al, 1988; Guthaner, Wexler & Bradley, 1985). However, others have suggested that the coronary arteries are not visualized well due to their small size, movement, their position overlying the opacified aorta and left ventricle, and confusion with other structures such as the pulmonary veins (Myerowitz, 1982). Cardiac CT Scanning Development of CT scanning in the 1990s enabled an increase in temporal resolution that was sufficient to view the beating heart, and they now provide a non-invasive technique for diagnostic and prognostic purposes. Cardiac CT scans have clinical applications that go beyond perfusion investigation, and can be used to assess structure and function of the heart (for example in electrophysiology disorders or congenital heart disease) due to its ability to provide anatomical detail (Achenbach & Raggi, 2010). CT scans can be used to assess coronary artery disease with and without injection of contrast agent (Achenbach & Raggi, 2010) by calcium scan or CT angiography. Coronary calcium CT scanning uses the evidence base that coronary artery calcium is a correlate of atherosclerosis (Burke et al., 2003) and is a strong prognostic predictor of the future development of coronary artery disease and cardiac events (Arad et al., 2000; Budoff et al., 2009; Achenbach & Raggi, 2010). Calcium is easily depicted on CT scan due to its high CT attenuation, and is classified according to the Agatson score, which considers the density and area of the calcification (Hoffman, Brady & Muller, 2003). Coronary CT angiography (CTA) allows visualization of the coronary artery lumen to identify any atherosclerosis or stenosis within the vessels. Patients are injected intravenously with a contrast agent and then undergo a CT scan. There are limitations regarding the suitability of patients for coronary CTA due to prerequisites of sinus rhythm, low heart rate and ability to follow breath-holding commands. Additionally, obesity presents a problem for patients that cannot fit into the scanner and affects the accuracy of the procedure. (Achenbach & Raggi, 2010). Comparison of cardiac DSA and cardiac CT scanning The technical differences between cardiac DSA and cardiac CT scanning give rise to differences in the clinical indications for the procedures, their diagnostic efficacy and also different risks or relative benefits to the patients. Due to the nature of the images produced by coronary CTA and DSA, each lends itself to different indications for use. Whilst coronary DSA provides imaging of all aspects of perfusion, CTA used with contrast agent also provides this however has the additional advantage of being able to assess structure and function of the heart. Coronary CTA has been shown to have a high accuracy at detection and exclusion of coronary artery stenoses (Achenbach & Raggi, 2010). In a multicentre trial conducted by Miller et al. (2008), patients underwent coronary calcium scoring and CT angiography prior to conventional invasive coronary angiography. The diagnostic accuracy of coronary CTA at ruling out or detecting coronary stenoses of 50% was shown to have a sensitivity of 85% and a specificity of 90%. This showed that coronary CTA was particularly effective at ruling out non-significant stenoses. Additionally, coronary CTA was shown to be of equal efficacy as conventional coronary angiography at identifying the patients that subsequently went on to have revascularisation via percutaneous intervention. This was shown by an area under the curve (AUC), a measure of accuracy of 0.84 for coronary CTA and 0.82 for coronary angiography. Miller et al.’s (2008) study included a large number of patients at different study sites , and additionally represented a large variety of clinical patient characteristics. The author’s claim that these factors contribute to the strength and validity of the study findings, and suggest that in addition to using patients with clinical indications for anatomical coronary imaging, should be used as evidence that coronary CTA is accurate at identifying disease severity in coronary artery disease. Miller et al. (2008) did however,, find that positive predictive and negative predictive values of coronary CTA were 91% and 83% respectively and therefore suggested that coronary CTA should not be used in place of the more accurate conventional coronary angiography. A low positive predictive value (in relation to the prevalence of disease) was proposed to be due to a tendency to overestimate stenosis degree as well as the presence of artefacts leading to false positive interpretation (Achenbach & Raggi, 2010). Other research providing comparison between coronary CTA and conventional coronary angiogram has highlighted variability in results. A meta-analysis conducted by Gorenoi, Schonermark and Hagen (2012) investigated the diagnostic capabilities of coronary CTA and invasive coronary angiography using intracoronary pressure measurement as the reference standard. The authors found that CT coronary angiography had a greater sensitivity than invasive coronary angiography (80% vs 67%), meaning that coronary CTA was more likely to identify functionally relevant coronary artery stenoses in patients. Despite this,, specificity of coronary CTA was 67%, compared to 75% in invasive coronary angiography, meaning that the technique was less effective at correctly excluding non-diagnoses than invasive coronary angiogram. This research appears to contradict the power of cardiac CTA at excluding diagnoses of coronary artery stenosis as suggested by Miller et al. (2008), he study did combine evidence from over 44 studies to provide their results and therefore had a large statistical power. The authors interpret the results in light of the clinical relevance of cardiac imaging, suggesting that patients with a higher pretest possibility of coronary heart disease will likely require invasive coronary angiography for revascularisation indicating that coronary CTA may be a helpful technique in those patients with an intermediate pre-test probability of coronary heart disease that will therefore not require invasive angiography. Goldberg et al. (1986) investigated the efficacy of DSA in comparison to conventional coronary angiography in 77 patients. They found that the two angiograms agreed within one grade of severity in 84% of single cases and 90% of multiple cases, identifying both patent and lesioned arteries. The results led the authors to conclude that there was no significant difference between the two methods and that DSA could be used in selective coronary angiography to find results comparable to that of conventional angiography. In addition to being a small study into the efficacy of DSA, the study also had several sources of inherent variability that should be considered when interpreting the results. These included differing sizes of digital imaging screen and non-use of calipers, meaning that the interpretation of the images could vary throughout the study. The authors also suggest that whilst showing strong support for the use of DSA in coronary artery disease, the technique may not actually p ermit better prognostic determinations or clinical judgements that are better than conventional angiography, and therefore the further implementation of the techniques may not be founded or necessitated. More recently, there has been further research looking at the effectiveness of DSA as a way of measuring coronary blood flow. Whilst motion artefacts have proven a problem in lots of past research (Marinus, Buis & Benthem, 1990; Hangiandreou, 1990), recent research has developed methods to minimise these. Moilloi and colleaues (1996) showed that using a motion-immune dual-energy digital subtraction angiography, absolute volumetric coronary blood flow could be measured accurately and thus provide an indication of the severity of any arterial stenosis.This may provide further suggestion for clinical implementation of DSA. Although these studies provide evidence for the efficacy of cardiac DSA and CTA, they often make comparisons to conventional angiography. This is useful as a baseline comparison, however it is difficult to make comparisons between the two procedures directly due to less available evidence making direct comparisons. Lupon-Roses et al. (1985) conducted a study investigating both coronary CTA and venous DSA. The study looked at the efficacy of both techniques at diagnosing patency of coronary artery grafts compared to the control conventional angiography. CT was shown to diagnose 93% of the patent grafts and 67% of the occluded grafts whereas DSA correctly diagnosed 98% and 100% of patent and occluded grafts respectively. Interestingly, the DSA picked up the 11 grafts that were misdiagnosed by CTA and the CTA picked up the 2 grafts misdiagnosed by the DSA. This data may suggest that individually, DSA has a better profile for diagnosis of coronary artery occlusion, however if the two procedures are used in combination exclusion of patent arteries and diagnosis of occluded arteries would be effective (Lupon-Roses et al., 1985). Coronary DSA and CTA are both non-invasive procedures (unlike the conventional coronary angiography where a wire is placed in the coronary vasculature). With the only invasive part of the procedure being the injection of the contrast material into a vein. This presents a significant advantage to both procedures over that of conventional angiography, and may even permit investigation on an outpatient basis (Meaney et al., 1980). Similarly, both DSA and coronary CTA are favoured because of their intravenous approach, eliminating the risks of bleeding or arterial injury from an intra-arterial catheterization and being able to be used in those with limited arterial access. However, although the intravenous approach used in cardiac DSA makes it favourable, it does lead to difficulty with visualisation of the coronary arteries due to the overlying iodinated pulmonary and cardiac structures (Mancini & Higgins, 1985). Therefore,, intra-arterial DSA is also sometimes used (Yamamoto et al., 20 09). As with all CT scanning, coronary CTA carries with it a dose of ionizing radiation (Brenner & Hall, 2007). Studies have estimated that for diagnostic CT scanning, patients are on average exposed to 12mSv of radiation during the procedure, the equivalent of 600 x-rays (Hausleiter et al., 2009). Estimates of radiation doses associated with conventional coronary angiography are lower than that of coronary CTA at 7mSv (Einstein et al., 2007). Additionally, DSA technique reduces the radiation dose from that of conventional coronary angiography as the vessels are visualised more clearly (Yamamoto et al., 2008). The dangers of radiation exposure are increased risk of developing cancer, skin injuries and cateracts (Einstein et al., 2007). It is therefore important that the benefits of conducting the procedure greatly outweigh the risk of radiation exposure. CT calcium scanning provides a low radiation dose at around 1mSv (Hunold et al., 2003). Cardiac CT calcium scanning does not require administration of a contrast agent, unlike in coronary CTA and DSA that use iodine based contrast agents. The risks associated with contrast agent include nephrotoxicity and risks of hives, allergic reactions and anaphylaxis (Maddox, 2002). The amount of contrast agent used is partly dependent on the length of the procedure and how clearly the arteries can be visualised. For this reason, both cardiac CTA and DSA use less contrast agent that conventional coronary angiography (Brant-Zawadzki, et al., 1983). CT calcium scanning of the coronary arteries is therefore recommended in those with less likelihood of coronary artery disease (NICE, 2010). Both coronary CTA and DSA require interpretation by trained physicians, and the importance of training and achieving intra-rater reliability should not be underestimated (Pugliese et al., 2009). Conclusion Overall, both coronary CT and DSA have been demonstrated as effective procedures for the imaging of the coronary arteries in CAD (Achenbach & Raggi, 2010; Miller et al., 2008; Moilloi et al., 1996; Goldberg et al., 1986). Whilst cardiac CT scanning does provide a wider range of clinical applications, allowing assessment of perfusion as well as cardiac structure and function (Achenbach & Raggi, 2010), coronary DSA has many applications that allow assessment of coronary blood flow (Molloi et al., 1996; Katritsis et al, 1988; Booth, Nissen & DeMaria, 1985; Guthaner, Wexler & Bradley, 1985; Myerowitz, Swanson, & Turnipseed, 198). Both cardiac DSA and CTA procedures have their advantages. As non-invasive procedures, these techniques pose less risk to patients, and enable the possibility of outpatient investigation, to be used to rule out diagnoses and to avoid inappropriate invasive coronary angiogram (Gorenori et al., 2012). Additionally, intravenous access is preferential to arterial cannulation for the contrast infusion, removing the risks associated with bleeding or intra-arterial injury. Cardiac DSA exposes the patient to a lower dose of radiation that coronary CTA (Hausleiter et al., 2009; Yamamoto et al., 2008; Einstein et al., 2007), which is beneficial at reducing the risk of genetic mutations and cancer. Cardiac CTA and DSA also have their common disadvantages. The use of contrast agent may present side effects for the patient including kidney damage and risk of allergic reactions and anaphylaxis (Maddox, 2002). For this reason, calcium CT scanning can be useful in patients that are not at high likelihood of coronary artery disease (NICE, 2010b). Additionally, both cardiac DSA and CTA are subject to motion artefacts from respiration and heart beats, which can cause difficulties with interpretation (Achenbach & Raggi, 2010; Yamamoto et al., 2009). In the case of cardiac CTA, this excludes a subset of patients that are unable to follow commands and those who have high heart rates. Overall, cardiac CTA and cardiac DSA are effective, non-invasive imaging techniques for assessment of coronary artery disease. Whilst they are not the gold standards in cardiac monitoring, they can provide important diagnostic information without exposing patients to the risks of invasive angiography. Due to this, their use should be weighted against clinical need, the risks of the procedures, and the suitability of the patient. Interpretation of cardiac CTA and DSA imaging should be by trained individuals. 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